1
|
Cottrell MA, Raymer ME, Maclachlan LR, Vuvan V, Smith MD, O'Leary SP, Vicenzino B, Comans T, Kemp JL, Barton CJ, Collins NJ. Implementing good life with osteoArthritis from Denmark (GLA:D®) in Australian public hospitals. Part 2: Service providers' perceptions. Musculoskelet Sci Pract 2024; 71:102961. [PMID: 38664192 DOI: 10.1016/j.msksp.2024.102961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Previous literature has reported the successful implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program into predominantly private practice settings. There may be unique challenges present within the public hospital setting that influence GLA:D® implementation in public health. OBJECTIVE Explore the attitudes and experiences of service providers directly involved in implementing GLA:D® in Australian public tertiary hospitals. DESIGN Qualitative descriptive study design. METHOD Service providers (n = 14) from three participating hospitals took part in semi-structured focus groups at the completion of the 6-month implementation period. Inductive thematic analysis was employed to identify primary domains across all facilities. RESULTS Four broad domains were identified. Factors that influenced uptake included GLA:D® being a recognisable, evidence-based product requiring minimal development or adaptation. The fidelity of the GLA:D® Australia program was challenged by referral of patients with multiple/complex medical comorbidities, and patient preference to complete registry data via paper rather than online. Several operational considerations are required when delivering GLA:D® in a public hospital setting, including adequate numbers of GLA:D®-trained staff, additional screening requirements, obtaining appropriate clinical space, and persisting patient barriers to attending the service. GLA:D® provided benefits beyond improvement in pain and function, including social interactivity, high attendance and promotion of long-term self-management, while also maximising service efficiencies. CONCLUSIONS Implementing GLA:D® in Australian public hospitals was supported by service providers. Specific operational and administrative factors, including staff training, patient complexity, and registry requirements should be considered when attempting to embed and sustain GLA:D® in large Australian public tertiary hospitals.
Collapse
Affiliation(s)
- Michelle A Cottrell
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Maree E Raymer
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Liam R Maclachlan
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
| | - Viana Vuvan
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Shaun P O'Leary
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia; School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Tracy Comans
- Centre for Health Services Research, The University of Queensland, Herston, Queensland, Australia.
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Natalie J Collins
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| |
Collapse
|
2
|
Alyousef YS, Johnston V, Smith MD. Work-related interventions are not commonly included in physiotherapy management of lower limb osteoarthritis: A cross-sectional survey of Australian Physiotherapists. Musculoskelet Sci Pract 2024; 71:102942. [PMID: 38507868 DOI: 10.1016/j.msksp.2024.102942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Lower limb osteoarthritis (OA) is a leading cause of disability and can affect an individual's ability to work. OBJECTIVES To explore Australian physiotherapists' use of work-related interventions in managing patients with lower limb OA, and identify current management practices. METHODS Physiotherapists with at least two years of experience treating patients with lower limb OA were invited to complete an online survey to understand how physiotherapists manage patients with lower limb OA, specifically regarding interventions related to work. RESULTS A total of 132 physiotherapists completed the survey. In free text responses, only 1.5% and 2.3% of physiotherapists nominated work-related items in their key components of treatment or educational topics discussed with patients with lower limb OA, respectively. From a range of work-related activities presented, over half of physiotherapists indicated they regularly/always provided education about the benefits of remaining in work (63.5%) and advice on managing symptoms at work (57.4%). Less than 10% of physiotherapists regularly/always used a validated scale to identify barriers for work (9.6%), discussed absences from work (9.6%), conducted a workplace assessment (4.4%), and discussed submitting workers' compensation claims (2.6%). Exercise and patient education were the most frequently nominated physiotherapy treatments in free text (96.2% and 86.3%, respectively) and fixed response (99.2% and 93.9%, respectively) questions. CONCLUSION Many physiotherapists do not address work-related activities in their management of patients with lower limb OA. In light of work-related challenges commonly experienced by individuals with lower limb OA, this is an important aspect of management of this condition.
Collapse
Affiliation(s)
- Yousef S Alyousef
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, Australia; Majmaah University, College of Applied Medical Sciences, Al Majma'ah, Saudi Arabia
| | - Venerina Johnston
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, Australia; University of Southern Queensland, School of Health and Medical Sciences, Ipswich, QLD, Australia
| | - Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, Australia.
| |
Collapse
|
3
|
Collins NJ, Smith MD, O'Leary SP, Maclachlan LR, Cottrell MA, Vicenzino B, Vuvan V, Comans T, Kemp JL, Barton CJ, Lee D, McCaskill S, Cush A, Hislop AC, Raymer ME. Implementing good life with osteoArthritis from Denmark (GLA:D®) in australian public hospitals. Part 1: Feasibility. Musculoskelet Sci Pract 2024; 71:102960. [PMID: 38670811 DOI: 10.1016/j.msksp.2024.102960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Literature reporting positive outcomes from the Good Life with osteoArthritis in Denmark (GLA:D®) program in Australia mainly involves patients attending private physiotherapy services. OBJECTIVE Evaluate the feasibility of implementing GLA:D® in Australian public hospitals. DESIGN Implementation study in three metropolitan tertiary public hospitals over six months. METHOD Patients aged ≥18 years with knee or hip joint-related problems deemed appropriate for non-surgical care were invited to participate in GLA:D®. Feasibility was evaluated using RE-AIM framework components (Implementation, Effectiveness, Maintenance) using service-level metrics, patient-level data, and program fidelity assessment. Findings of qualitative interviews with service providers are presented in Part 2. RESULTS Implementation: 70 patients (69 with knee osteoarthritis) participated (13 cohorts). 55 (79%) patients attended both education sessions, and 49 patients (70%) attended 10-12 exercises sessions. Fidelity was met based on environmental, therapist, participant- and program-related criteria. EFFECTIVENESS At 3 months, patients reported lower average pain (visual analogue scale [0-100 mm]: effect size -0.56, 95% CI -0.88 to -0.23) and disability (HOOS/KOOS-12 [100-0]: 0.67, 0.28 to 1.05), and improved quality of life (EQ-5D overall score: 0.46, 0.11 to 0.80). No adverse events were reported. All patients who completed 3-month assessment (n = 52) would recommend GLA:D®. Maintenance: All participating services elected to continue delivering GLA:D® beyond the study. CONCLUSIONS Implementing GLA:D® in Australian public hospitals is feasible, safe, and acceptable to patients with knee osteoarthritis. Public hospital patients with knee osteoarthritis reported improvements in pain, disability, and quality of life similar to previous GLA:D® cohorts.
Collapse
Affiliation(s)
- Natalie J Collins
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Shaun P O'Leary
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Liam R Maclachlan
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
| | - Michelle A Cottrell
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Viana Vuvan
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Tracy Comans
- Centre for Health Services Research, The University of Queensland, Herston, Queensland, Australia.
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia.
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Darryl Lee
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Stuart McCaskill
- Physiotherapy Department, Queen Elizabeth II Hospital, Coopers Plains, Queensland, Australia.
| | - Adrian Cush
- Physiotherapy Department, Queen Elizabeth II Hospital, Coopers Plains, Queensland, Australia.
| | - Andrew C Hislop
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Physiotherapy Department, The Prince Charles Hospital, Chermside, Queensland, Australia.
| | - Maree E Raymer
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| |
Collapse
|
4
|
Smith MD, McKendry R, Shah S, Desai V, Abouzed A, Byrnes B, Farmer S, Glyde C, Lawrenson PR, Ross MH, Collins NJ. An exploration of footwear preferences, attitudes and beliefs in people with knee osteoarthritis: A qualitative study. Musculoskelet Sci Pract 2024; 72:102948. [PMID: 38588610 DOI: 10.1016/j.msksp.2024.102948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/24/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Although footwear can improve pain and function in individuals with knee osteoarthritis (OA), perspectives about footwear in this population have not been explored. OBJECTIVES This qualitative study explored preferences, attitudes and beliefs about footwear in adults with knee OA. METHODS Twenty individuals with a clinical diagnosis of knee OA (aged 45-79 years, 65% women) participated in semi-structured interviews about factors which influence footwear selection, the effect of footwear on knee symptoms, and footwear modifications. Data were analysed thematically. RESULTS Four themes, with sub-themes, were identified: i) there are specific footwear characteristics people look for, with comfort as their top priority; ii) shoe appearance is important; iii) footwear can aggravate or ease symptoms; and iv) people with knee OA find footwear in a variety of ways. Participants related built-in arch support, a cushioned insole and low/no heel, without addition of foot orthoses, to comfort, and were willing to pay more for comfort and quality. Appearance was also a consideration, and participants indicated they would tolerate short periods of symptom aggravation for aesthetic shoes. Participants felt that footwear choice affected their knee symptoms and risk of slipping/twisting. Participants reported that their footwear choices were determined through trial-and-error, and sometimes on advice from health professionals or shoe store salespersons. CONCLUSIONS There are specific footwear features important to individuals with knee OA. Knowledge of these features can be used by health professionals to inform footwear discussions with knee OA patients and serve as considerations when developing footwear targeted for this population.
Collapse
Affiliation(s)
- Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| | - Ruth McKendry
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Simran Shah
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Vaibhavi Desai
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - AbdelRahman Abouzed
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Blake Byrnes
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Stacey Farmer
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Carl Glyde
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Peter R Lawrenson
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia; Queensland Health, Metro North Health, Community and Oral Health Innovation and Research Centre, Brighton, QLD, 4017, Australia
| | - Megan H Ross
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Natalie J Collins
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| |
Collapse
|
5
|
Alanazi SA, Vicenzino B, Smith MD. Concerns beyond ankle symptoms predominate healthcare professionals' views of patients with ankle osteoarthritis: A qualitative study. Musculoskelet Sci Pract 2024; 72:102946. [PMID: 38574428 DOI: 10.1016/j.msksp.2024.102946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES Explore healthcare professionals' perspectives on the main problems that their patients with ankle osteoarthritis experience and to propose health-related domains. METHODS A qualitative study using semi-structured interviews was conducted with an international multidisciplinary group of healthcare professionals identified as ankle experts. Eligibility criteria were aged ≥18 years, and a certified healthcare professional with ≥ 5-year experience post-qualification in working with ankle osteoarthritis and/or chronic ankle pain. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS Twenty-one healthcare professionals (20 males; mean (range) age 49 (34-72) years) from four professions (orthopaedic surgeons (n = 9), athletic trainers (n = 5), physiotherapists (n = 4) and podiatrists (n = 3)) were interviewed. Four main themes were identified: 1) people with ankle osteoarthritis have difficulty with weight-bearing activities; 2) symptoms of pain and stiffness predominate, alongside swelling, instability, weakness and poor balance; 3) chronic pain in ankle osteoarthritis has psychosocial consequences; and 4) the loss of activities of daily living and independence compromises quality of life. We proposed 15 health-related domains that emerge from the interview data. CONCLUSION Healthcare professionals recognise that ankle osteoarthritis patients have difficulty in physical, sporting, and occupational weight-bearing activities, and they live with persistent ankle pain, stiffness and other symptoms that have physical and psychosocial consequences. The health-related domains derived from interviews with expert healthcare professionals will contribute to the development of a core domain set for ankle osteoarthritis.
Collapse
Affiliation(s)
- Sultan Ayyadah Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia; The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia. https://twitter.com/Bill_Vicenzino
| | - Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| |
Collapse
|
6
|
Smith MD, Wee NSH. Coach perspectives on factors that influence the implementation of injury prevention programs in community netball: A qualitative study. Phys Ther Sport 2024; 66:37-42. [PMID: 38281361 DOI: 10.1016/j.ptsp.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE The Netball KNEE Program is an injury prevention program (IPP) developed by Netball Australia. It is promoted to coaches, but implementation is limited. This study explored community netball coaches' perspectives on factors that influence IPP implementation, and ideas on how it could be improved. METHODS Twenty-four coaches from 16 netball clubs participated in semi-structured interviews that asked about their beliefs about injury prevention, use of and confidence in delivering IPP, barriers and facilitators to implementation, and suggestions to ease IPP implementation. Interviews were analysed using inductive thematic analysis. RESULTS Two themes were identified - Factors that influence IPP implementation (4 sub-themes), and Suggestions to improve IPP implementation (2 sub-themes). Coaches thought early development of injury prevention habits was important. Life roles, coaching experience and engagement with development courses influenced IPP delivery. Coaches expressed concerns about Netball KNEE program length and complexity and lack of implementation support. They suggested the need for a short simple IPP and engagement with health/exercise professionals for implementation. CONCLUSIONS This study engaged with stakeholders to identify barriers that need to be addressed to improve IPP implementation in netball. Coaches desired a short simple standardised IPP, and training from physiotherapists or exercise professionals on implementation.
Collapse
Affiliation(s)
- Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| | - Natasha Shi Hui Wee
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| |
Collapse
|
7
|
Alyousef YS, Ross MH, Johnston V, Smith MD. Experiences of Working with Lower Limb Osteoarthritis: A Qualitative Study. J Occup Rehabil 2023:10.1007/s10926-023-10158-8. [PMID: 37995059 DOI: 10.1007/s10926-023-10158-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 11/24/2023]
Abstract
PURPOSE Pain and disability associated with lower limb osteoarthritis (OA) may contribute to difficulties at work. This study aimed to understand the perspectives of workers with lower limb OA on difficulties, concerns, and coping strategies used at work. METHODS Twenty-two individuals with lower limb OA who were working in paid employment participated in semi-structured interviews. Data were qualitatively analyzed using an inductive thematic approach. Codes were identified and refined through review of interview transcripts and discussion with the research team. RESULTS Six themes were identified in relation to experiences working with lower limb OA. Themes were as follows: weight-bearing physical demands are challenging; lower limb OA can affect work performance; emotional consequences of pain; concerns about work in the future; positive experiences of supportive colleagues and managers; and minimal effects on sedentary work. Three themes were identified relating to strategies to manage at work: adjustments at work help manage pain and avoid exacerbations; regular strategies to manage pain; and healthcare professionals are consulted, but usually not specifically for work. CONCLUSIONS Workers with lower limb OA experience physical and emotional difficulties at work that can impact work performance. Workers are concerned about longevity and job security and use a range of strategies to manage symptoms and remain at work. Employers, employees, and healthcare professionals may need to work together to create workplace accommodations to help workers with lower limb OA confidently remain in work.
Collapse
Affiliation(s)
- Yousef S Alyousef
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
- College of Applied Medical Sciences, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Megan H Ross
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia.
| |
Collapse
|
8
|
Smith MD, Vuvan V, Collins NJ, Hunter DJ, Costa N, Smith MMF, Vicenzino B. Protocol for a randomised feasibility trial comparing a combined program of education and exercise versus general advice for ankle osteoarthritis. J Foot Ankle Res 2023; 16:72. [PMID: 37858226 PMCID: PMC10588035 DOI: 10.1186/s13047-023-00669-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Ankle osteoarthritis (OA) is a serious problem with high associated pain and disability. While education and exercise are recommended for the initial management of OA, this has not been investigated in ankle OA. The primary aim of this study is to establish the feasibility of running a full-scale randomised controlled trial (RCT) investigating a combined education and exercise program compared to a general advice program for people with ankle OA. The secondary aims are to collect preliminary data which will inform sample size calculations, and understand the perspectives of people with ankle OA on their participation in the trial. METHODS Thirty individuals aged 35 years or older with symptomatic radiographic ankle OA will be recruited from the community and randomised to receive either a combined education and exercise program or a general advice program, both of which will be delivered by a physiotherapist in a group setting. Primary outcomes of feasibility include responses to study advertisements, number of eligible participants, recruitment rate, adherence with the intervention, fidelity of the intervention, adverse events, drop-out rate, and credibility and expectancy of the intervention. Secondary participant-reported outcomes will include global rating of change, patient acceptable symptom state, severity of ankle pain and stiffness, self-reported function, quality of life, satisfaction with treatment, and use of co-interventions. Follow up will be at 8 weeks and 3 months. Physical measures of 40 m walking speed, timed stairs descent, heel raise endurance and ankle dorsiflexion range of motion will be collected at baseline and 8 weeks. Primary feasibility outcomes will be reported descriptively, and estimates of the variability of secondary participant-reported and physical outcomes will be calculated. Semi-structured interviews will be conducted with participants to understand perspectives about the intervention and participation in the trial, with data analyzed thematically. DISCUSSION Study findings will establish the feasibility of running a full-scale RCT to investigate a combined education and exercise program compared to a general advice program for people with ankle OA. This study is a necessary first step to advance the international research agenda of evaluating the efficacy of exercise in the management of ankle OA. TRIAL REGISTRATION ACTRN12623000017628. Registered 10 January 2023, https://www.anzctr.org.au/ACTRN12623000017628.aspx .
Collapse
Affiliation(s)
- Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| | - Viana Vuvan
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Natalie J Collins
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - David J Hunter
- Sydney Musculoskeletal Health, Kolling Institute, Rheumatology Department, The University of Sydney, Royal North Shore Hospital, Sydney, Australia
| | - Nathalia Costa
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- Sydney School of Health Sciences, The University of Sydney, Physiotherapy, Sydney, NSW, Australia
| | - Melinda M Franettovich Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| |
Collapse
|
9
|
Alyousef YS, Johnston V, Smith MD. Work-related outcomes in individuals with and without lower limb osteoarthritis: an online survey. BMC Public Health 2023; 23:1885. [PMID: 37773119 PMCID: PMC10540324 DOI: 10.1186/s12889-023-16723-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE While osteoarthritis (OA) affects people who are still participating in the workforce, there is limited data about the impact of OA on work. The aim of this study was to compare work participation in individuals with and without lower limb OA. METHODS This cross-sectional study included workers with (n = 124) and without (n = 106) lower limb OA. Work participation was assessed as work status (full/part time work), work ability (Work Ability Index (WAI)), absenteeism and presenteeism (World Health Organization's Health and Work Performance Questionnaire (WHO-HPQ)), and perceived difficulties meeting work demands (Work Role Functioning Questionnaire (WRFQ)). The data were analyzed using an analysis of covariance with age, body mass index and physical job demands included as covariates. RESULTS Work ability was poorer (p < 0.001) and loss of work performance (p < 0.001) was higher among workers with OA than healthy controls. There was no statistical difference in absenteeism or overall ability to meet work demands between participants with and without lower limb OA. However, workers with lower limb OA had more difficulty with work scheduling demands (p = 0.05) and physical demands (p = 0.003) than healthy workers. CONCLUSION Lower limb OA was associated with poorer work ability, loss of work performance and difficulty in meeting physical and work scheduling demands. Health professionals and employers should consider these challenges when managing individuals with lower limb OA and supporting them to remain in the workforce.
Collapse
Affiliation(s)
- Yousef S Alyousef
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, Australia
- College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Venerina Johnston
- College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
| | - Michelle D Smith
- College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia.
| |
Collapse
|
10
|
Alyousef YS, Johnston V, Mellor R, Plinsinga ML, Zerguine H, Smith MD. The effect of lower limb osteoarthritis on work-related outcomes: a systematic review and meta-analysis. Disabil Rehabil 2023:1-10. [PMID: 37740531 DOI: 10.1080/09638288.2023.2259304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
PURPOSE Lower limb osteoarthritis (OA) is a prevalent condition that has a profound impact on an individual's life in several domains, including occupational activities. The objective of this study was to systematically describe and compare work-related outcomes (e.g., employment status, absenteeism, and productivity loss) in individuals with and without lower limb OA. MATERIALS AND METHODS Five databases were searched until 17 June 2023. Studies were eligible for inclusion if they compared work-related outcomes between individuals with lower limb OA and healthy controls (e.g., people without OA or the general population). RESULTS Seven studies met the inclusion criteria of which two were included in a meta-analysis. Meta-analysis revealed that individuals with OA were less frequently in paid employment than control individuals (odds ratio: 0.25; 95% confidence intervals: 0.12, 0.53). Evidence from single studies indicated greater absenteeism and presenteeism and poorer functional capacity in people with lower limb OA compared to controls. CONCLUSIONS This systematic review suggests that individuals with lower limb OA have poorer work-related outcomes than those without OA. Low study numbers and lack of consistency in the way work outcomes are defined and measured make accurate quantification of the impact of OA on work challenging.Prospero: registration number: CRD42020178820.
Collapse
Affiliation(s)
- Yousef S Alyousef
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
- College of Applied Medical Sciences, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
| | - Rebecca Mellor
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD, Australia
| | - Melanie L Plinsinga
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia
| | - Haroun Zerguine
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
11
|
Al Mahrouqi MM, Vicenzino B, MacDonald DA, Smith MD. Falls and falls-related injuries in individuals with chronic ankle symptoms: a cross-sectional study. J Foot Ankle Res 2023; 16:49. [PMID: 37587537 PMCID: PMC10428594 DOI: 10.1186/s13047-023-00649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Falls are a major public health concern globally. While falls are associated with osteoarthritis and persistent pain at the hip and knee, falls have not been investigated in people with chronic ankle symptoms. This study aimed to compare self-reported history of falls between adults with and without chronic ankle symptoms. Secondary aims were to compare concern about falling and balance confidence between groups, and to identify factors associated with falling. METHODS A total of 226 participants (134 with chronic ankle pain and/or stiffness and 92 controls) participated in this cross-sectional case-control study. Participants completed an online questionnaire about falls in the past 12 months, injuries associated with falling, concern about falling, balance confidence, function, pain and multimorbidity. RESULTS Eighty-six (64%) participants with chronic ankle symptoms and 24 (26%) controls reported at least one fall in the last 12 months (p < 0.001). Participants with chronic ankle symptoms reported more falls, more injurious falls, and more hospitalisations because of a fall than controls (p > 0.002). There was a small effect for lower balance confidence and higher concern about falling in symptomatic participants (standardised mean difference: 0.39-0.49; p > 0.017). Logistic regression analysis identified that falling was associated with the presence of ankle symptoms (3.08 (1.20, 7.92); p = 0.02) and concern about falling (odds ratio (95% confidence intervals): 1.13 (1.05, 1.23); p = 0.002). CONCLUSIONS Falls and falls-related injuries are a problem in individuals with chronic ankle symptoms. The high falls occurrence and concern about falling in individuals with chronic ankle symptoms suggest the need for clinicians to assess these factors in this population.
Collapse
Affiliation(s)
- Munira M Al Mahrouqi
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- Division of Physiotherapy, Oman College of Health Sciences, Ministry of Health, P.O. Box 3720, Muscat, PC, 112, Sultanate of Oman
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
| | - David A MacDonald
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia
- Physiotherapy, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| |
Collapse
|
12
|
Alanazi SA, Vicenzino B, Maclachlan LR, Smith MD. "It's like a nail being driven in the ankle": A qualitative study of individuals' lived experiences to inform a core domain set for ankle osteoarthritis. Musculoskelet Sci Pract 2023; 66:102813. [PMID: 37421757 DOI: 10.1016/j.msksp.2023.102813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/29/2023] [Accepted: 06/19/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVES Explore individuals' lived experience with ankle osteoarthritis and to identify health-related domains for ankle osteoarthritis based on the perspectives of people living with the condition, as an initial step to address the International Foot and Ankle Osteoarthritis Consortium's recommendation to develop a core domain set for ankle osteoarthritis. METHODS A qualitative study using semi-structured interviews was conducted. Interviews were undertaken with individuals with symptomatic ankle osteoarthritis who were aged ≥35 years. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS Twenty-three individuals (16 females; mean (range) age 62 (42-80) years) were interviewed. Five themes were identified: pain, often severe, is a central feature of living with ankle osteoarthritis; stiffness and swelling are key symptoms; ankle osteoarthritis induced mobility impairments compromise enjoyment in life; ankle osteoarthritis instability and balance impairments lead to concerns about falling; there are financial implications of living with ankle osteoarthritis. We propose 17 domains based on individuals' experiences. CONCLUSION Study findings indicate that individuals with ankle osteoarthritis live with chronic ankle pain, stiffness and swelling which affect their ability to participate in physical, and social activities, maintain an active lifestyle, and work in physical occupations. From the data, we propose 17 domains that are important to people with ankle osteoarthritis. These domains require further evaluation to ascertain their inclusion in a core domain set for ankle osteoarthritis.
Collapse
Affiliation(s)
- Sultan Ayyadah Alanazi
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia; Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Kingdom of Saudi Arabia. https://twitter.com/PTsultan_
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia. https://twitter.com/Bill_Vicenzino
| | - Liam R Maclachlan
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia. https://twitter.com/LiamRobMac
| | - Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, 4072, Australia.
| |
Collapse
|
13
|
Ross MH, Smith MD, Vicenzino B. Characterising tibialis posterior tendinopathy using the International Classification of Functioning, Disability and Health: a cross sectional study. Braz J Phys Ther 2023; 27:100498. [PMID: 36966686 PMCID: PMC10064434 DOI: 10.1016/j.bjpt.2023.100498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/25/2022] [Accepted: 03/08/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Tibialis posterior tendinopathy (TPT) is characterised by pain around the medial foot/ankle and difficulties weightbearing. OBJECTIVE Compare individuals who have TPT with asymptomatic controls across the International Classification of Functioning, Disability and Health (ICF) domains of body structure and function, activity, participation and personal factors. METHODS Twenty-two individuals meeting the selection criteria for TPT (86% female, mean ± SD age:43 ± 13 years; body mass index [BMI]:28 ± 7 kg/m2) were compared to 27 controls (93% female, age:44 ± 16 years, BMI:23 ± 5 kg/m2). Standardised differences (and 95% confidence intervals [CIs]) between groups were estimated for outcomes under each ICF domain using Cliff's delta to allow for comparison of the magnitude of deficits across outcomes (>0.47 considered large). RESULTS Impairments in body structure and function in individuals with TPT were accompanied by activity limitations including difficulties due to foot problems (-1.0 (-1.0, -1.0)) and with independent living (-0.8 (-1.0, -0.3)) and greater time to complete stair descent/ascent (-0.6 (-0.8, -0.3)). Considering participation, overall foot-related function (-1.0 (-1.0, -1.0)), ability to participate in activities (-0.7 (-0.08, -0.3)), social restrictions (-0.8 (-1.0, -0.4)) and quality of life (-0.7 (-0.9, -0.5)) were poorer in individuals with TPT. CONCLUSION Individuals with TPT have large impairments in body structure and function, activity limitations and participation restrictions, particularly relating to independent living, mental health and pain. Personal factors appear to contribute to a lesser extent to the TPT presentation. Treatment plans should consider activity and participation limitations in addition to body structure and function.
Collapse
Affiliation(s)
- Megan H Ross
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia.
| |
Collapse
|
14
|
Smith MD, Manning J, Nielsen M, Hayes SC, Plinsinga ML, Coppieters MW. Exploring women's experiences with persistent pain and pain management following breast cancer treatment: A qualitative study. Front Pain Res (Lausanne) 2023; 4:1095377. [PMID: 36860333 PMCID: PMC9968918 DOI: 10.3389/fpain.2023.1095377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023] Open
Abstract
This qualitative study aimed to explore experiences of women with persistent pain following breast cancer treatment, including their perceptions about the cause of their pain, how they manage their pain and their interactions with healthcare providers related to their pain during and following breast cancer treatment. Fourteen women who experienced pain for more than 3 months following breast cancer treatment were recruited from the general breast cancer survivorship community. Focus groups and in-depth, semi-structured interviews were conducted by one interviewer, audio-recorded, and transcribed verbatim. Transcripts were coded and analysed using Framework Analysis. Three main descriptive themes emerged from the interview transcripts: (1) characteristics of pain, (2) interactions with healthcare providers and (3) pain management. Women had various types and degrees of persistent pain, all of which they believed were related to breast cancer treatment. Most felt like they were not given enough information pre- or post-treatment and believed their experience and ability to cope with pain would have been better if they were given accurate information and advice about (the possibility of) experiencing persistent pain. Pain management strategies ranged from trial and error approaches, to pharmacotherapy, and to 'just coping with the pain". These findings highlight the importance of the provision of empathetic supportive care before, during and after cancer treatment that can facilitate access to relevant information, multidisciplinary care teams (including allied health professionals) and consumer support.
Collapse
Affiliation(s)
- Michelle D. Smith
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia,Correspondence: Michelle D. Smith
| | - Joanne Manning
- School of Health and Rehabilitation Sciences, Physiotherapy, The University of Queensland, Brisbane, QLD, Australia
| | - Mandy Nielsen
- AcquiredBrain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, QLD, Australia,Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia
| | - Sandra C. Hayes
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia
| | - Melanie L. Plinsinga
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia
| | - Michel W. Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, QLD, Australia,Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
15
|
Tenison E, Cullen A, Pendry-Brazier D, Smith MD, Ben-Shlomo Y, Henderson EJ. 1219 INFORMAL CAREGIVERS OF PEOPLE WITH PARKINSONISM IN THE PRIME-UK CROSS-SECTIONAL STUDY. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Many people with parkinsonism require care as the disease progresses with much provided unpaid by family and friends. Caring for someone can have a negative impact on physical and psychosocial wellbeing. Caregiver burden can impact ability to continue this role, which can precipitate hospitalisation or institutionalisation of the recipient.
Methods
In this single-site study, primary, informal caregivers, defined as those providing any care or support, were enrolled alongside the person with parkinsonism or individually. Self-reported questionnaires included the 22-item Zarit Burden Interview (ZBI), which can range from 0-88, with higher scores representing greater burden. Linear regression was used to explore the association between recipient characteristics/need and caregiver burden.
Results
Of 1,032 eligible patients approached, 813 participants indicated whether they had an informal caregiver (708) or not (105). 376 caregivers consented (53.1%), of whom 321 have returned questionnaires, with patient data available for 296. The median age of caregivers was 73.0 (range 27.0- 91.1 years), 237 (73.8%) female. 274 (85.4%) were the spouse/partner of the patient. 215 (67.0%) were the sole caregiver. The median time per week spent caring was 21 hours (interquartile range 7, 41 hours). 18 (5.6%) of caregivers provided 24-hour care daily and 113 (35.2%) had provided support for over 5 years. Median ZBI score was 17, (interquartile range 7-29). The care recipient’s duration of parkinsonism was associated with higher burden score (0.38 increase per year of parkinsonism; 95% CI 0.07, 0.69; p value 0.015), as was the time per week spent caring (0.16 increase for each additional hour; 95% CI 0.11, 0.20; p value <0.0001).
Conclusions
Many informal caregivers in this study were the sole caregiver and many were themselves older adults. Burden increased with increasing duration of parkinsonism and as time spent caring increased. This highlights the ongoing need to improve support for this group.
Collapse
Affiliation(s)
- E Tenison
- University of Bristol Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 1NU, UK
| | - A Cullen
- University of Bristol Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 1NU, UK
| | - D Pendry-Brazier
- University of Bristol Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 1NU, UK
| | - M D Smith
- University of Bristol Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 1NU, UK
| | - Y Ben-Shlomo
- University of Bristol Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 1NU, UK
| | - E J Henderson
- University of Bristol Department of Population Health Sciences, Bristol Medical School, , Bristol, BS8 1NU, UK
- Royal United Hospitals Bath NHS Foundation Trust Older People’s Unit, , Combe Park, Bath, UK
| |
Collapse
|
16
|
Alanazi SA, Vicenzino B, van Bergen CJA, Hunter DJ, Wikstrom EA, Menz HB, Golightly YM, Smith MD. Protocol for the development of a core domain set for individuals with ankle osteoarthritis. Trials 2022; 23:748. [PMID: 36064628 PMCID: PMC9446870 DOI: 10.1186/s13063-022-06692-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Ankle osteoarthritis (OA) is a debilitating health condition that is increasing in prevalence. Currently, there are no evidence-based guidelines for managing ankle OA. One of the current challenges to establishing guidelines is the lack of a widely agreed-upon set of outcome measures that are consistently used in ankle OA research. Without a set of agreed-upon outcome measures, it is difficult to synthesise clinical trial outcomes through meta-analysis—an essential element of evidence-informed practice. In order to develop an appropriate set of outcome measures for ankle OA, it is important first to develop a core domain set. In this protocol, we describe the methodological approach that we will use to develop such a core domain set for ankle OA. Methods We established an international steering committee to guide the development of a core domain set for ankle OA. The core domain set development will follow a multi-staged approach consisting of three phases, involving participation by patients and clinicians/healthcare professionals. In phase 1, a list of candidate domains will be gleaned from (a) a scoping review of outcome measures used in ankle OA research, (b) qualitative interviews with individuals with ankle OA, and (c) qualitative interviews with healthcare professionals with expertise in ankle OA. In phase 2, the steering committee will review and generate a list of candidate domains from those gleaned in phase 1. In phase 3, this list of candidate domains will be considered in a Delphi process to reach a consensus on a core domain set. We anticipated this will involve 3 rounds of surveys. Conclusion This protocol describes the methods that will be used to develop a core domain set of health-related aspects for ankle OA. Importantly, it will include both healthcare professional and patient involvement. This is a prerequisite step to developing a core outcome set for ankle OA that should be reported in all clinical trials for ankle OA. The findings will be widely disseminated across peer-refereed publication(s) and national and international conferences, as well as via relevant professional societies, patient support group organisations, and social media platforms. Project registration This project is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database on 17 March 2021. https://www.comet-initiative.org/Studies/Details/1837. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06692-0.
Collapse
Affiliation(s)
- Sultan Ayyadah Alanazi
- The University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Australia.,Department of Physical Therapy, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Saudi Arabia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Australia
| | - Christiaan J A van Bergen
- Department of Orthopedic Surgery, Amphia, Breda, the Netherlands.,Department of Orthopedic Surgery and Sports Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - David J Hunter
- Sydney Musculoskeletal Health, Kolling Institute, The University of Sydney, Sydney, Australia.,Rheumatology Department, Royal North Shore Hospital, Sydney, Australia
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Yvonne M Golightly
- College of Allied Health Professionals, University of Nebraska Medical Center, Omaha, NE, USA.,Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Australia.
| |
Collapse
|
17
|
Nicol JL, Woodrow C, Cunningham BJ, Mollee P, Weber N, Smith MD, Nicol AJ, Gordon LG, Hill MM, Skinner TL. An Individualized Exercise Intervention for People with Multiple Myeloma—Study Protocol of a Randomized Waitlist-Controlled Trial. Curr Oncol 2022; 29:901-923. [PMID: 35200576 PMCID: PMC8870457 DOI: 10.3390/curroncol29020077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (n = 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12–52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12–24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.
Collapse
Affiliation(s)
- Jennifer L. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Correspondence:
| | - Carmel Woodrow
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
| | - Brent J. Cunningham
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
| | - Peter Mollee
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Nicholas Weber
- Haematology, Cancer Care Services, Royal Brisbane and Women’s Hospital, Brisbane 4006, Australia;
| | - Michelle D. Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
| | - Andrew J. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- Brisbane Clinic for Lymphoma, Myeloma and Leukaemia, Greenslopes Private Hospital, Brisbane 4120, Australia
| | - Louisa G. Gordon
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
- Palliative Care Outcomes Centre, School of Nursing and Cancer, Queensland University of Technology, Brisbane 4059, Australia
| | - Michelle M. Hill
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
| |
Collapse
|
18
|
Khalaj N, Vicenzino B, Smith MD. Hip and knee muscle torque is not impaired in the first three months of a first-time lateral ankle sprain. Phys Ther Sport 2021; 53:1-6. [PMID: 34763241 DOI: 10.1016/j.ptsp.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The primary objective was to compare hip and knee isometric muscle strength between individuals with a first-time acute lateral ankle sprain and controls. A secondary objective was to investigate hip and knee isometric muscle strength three months post-injury. DESIGN Cross-sectional and prospective follow-up components. SETTING Laboratory environment. PARTICIPANTS Forty-two participants (21 acute lateral ankle sprain and 21 controls) matched for age, sex, physical activity and leg dominance participated. MAIN OUTCOME MEASURES Hip and knee isometric muscle torque was assessed using a rigidly fixated hand-held dynamometer. Testing in acute lateral ankle sprain participants was performed within four weeks of injury and three months post-injury. Controls were tested at one timepoint. RESULTS There were no differences in hip or knee isometric muscle torque between acute lateral ankle sprain and control participants (mean differences <0.08). Hip and knee isometric muscle torque in acute ankle sprain participants did not differ between baseline and three months post-injury testing (mean difference <0.06). CONCLUSIONS Proximal lower limb isometric strength is not impaired within the first three months of sustaining a first-time lateral ankle sprain injury. This implies that hip and knee isometric strength deficits in individuals with CAI may occur at some later stage.
Collapse
Affiliation(s)
- Nafiseh Khalaj
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia.
| |
Collapse
|
19
|
Smith MD, Rhodes J, Al Mahrouqi M, MacDonald DA, Vicenzino B. Balance is impaired in symptomatic ankle osteoarthritis: A cross-sectional study. Gait Posture 2021; 90:61-66. [PMID: 34399156 DOI: 10.1016/j.gaitpost.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Ankle osteoarthritis (OA) is associated with several physical impairments but investigations into balance impairments in this population are limited. Understanding balance impairments in ankle OA may help inform the management of this condition. RESEARCH QUESTION Does balance overall performance differ between individuals with symptomatic radiographic ankle OA, asymptomatic radiographic ankle OA and healthy controls? Are there any differences in mediolateral or anteroposterior balance, or confidence to perform balance tasks between these groups? METHODS Ninety-six volunteers (31 symptomatic radiographic ankle OA, 41 asymptomatic radiographic ankle OA and 24 healthy controls) completed six static balance tasks: bilateral stance on a firm surface, bilateral stance on foam, and tandem stance, all performed with eyes open and closed. Centre of pressure (COP) data were collected using force plates. Confidence to perform each balance task was collected using an 11-point numerical rating scale. RESULTS Compared to controls, participants with symptomatic radiographic ankle OA had greater COP area when standing on a firm surface, foam and in tandem with eyes closed (all p < 0.05) and greater total COP sway in both firm surface and tandem stance conditions (p < 0.04). Participants with symptomatic ankle OA had greater COP area (p < 0.04) and total COP sway (p = 0.01) than those with asymptomatic ankle OA during tandem stance. Total COP sway and area were similar between asymptomatic ankle OA and control participants. Some differences in mediolateral and anteroposterior balance were identified between groups. Individuals with symptomatic ankle OA had lower confidence to perform the tandem stance eyes closed task compared to controls. SIGNIFICANCE Balance impairments and decreased balance confidence were identified in those with symptomatic radiographic ankle OA compared to asymptomatic individuals with and without radiographic ankle OA. This suggests that balance deficits in ankle OA may be related to symptoms, rather than radiographic evidence of disease.
Collapse
Affiliation(s)
- Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia.
| | - Jonah Rhodes
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Munira Al Mahrouqi
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia; Oman College of Health Sciences, Division of Physiotherapy, Ministry of Health, Muscat, P.O. Box 3720, PC 112, Oman
| | - David A MacDonald
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia; Griffith University, School of Allied Health Sciences, Gold Coast, QLD, 4222, Australia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia
| |
Collapse
|
20
|
Smith MD, Vicenzino B, Bahr R, Bandholm T, Cooke R, Mendonça LDM, Fourchet F, Glasgow P, Gribble PA, Herrington L, Hiller CE, Lee SY, Macaluso A, Meeusen R, Owoeye OBA, Reid D, Tassignon B, Terada M, Thorborg K, Verhagen E, Verschueren J, Wang D, Whiteley R, Wikstrom EA, Delahunt E. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus. Br J Sports Med 2021; 55:1270-1276. [PMID: 34158354 DOI: 10.1136/bjsports-2021-104087] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap. METHODS We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses. RESULTS Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement-PAASS: Pain (during sport participation and over the last 24 hours), Ankle impairments (range of motion; muscle strength, endurance and power), Athlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), Sensorimotor control (proprioception; dynamic postural control/balance), Sport/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session). CONCLUSION Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury. TRIAL REGISTRATION NUMBER ACTRN12619000522112.
Collapse
Affiliation(s)
- Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Roald Bahr
- Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway.,Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy and Department of Clinical Research, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rosalyn Cooke
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK
| | - Luciana De Michelis Mendonça
- Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.,Graduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - François Fourchet
- Physiotherapy Department, Hôpital de La Tour, Meyrin, Switzerland.,Laboratoire Interuniversitaire de Biologie de la Motricité, UJM-Saint-Etienne, University of Lyon, Lyon, France
| | - Philip Glasgow
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,School of Sport, Ulster University, Jordanstown, UK
| | - Phillip A Gribble
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Lee Herrington
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK.,Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Claire E Hiller
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Seoul, South Korea
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Roma, Italy.,Villa Stuart Sport Clinic, FIFA Medical Centre of Excellence, Roma, Italy
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Saint Louis, Missouri, USA.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Duncan Reid
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, AUT University, Auckland, New Zealand
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre University Hospital, Copenhagen, Denmark.,Physical Medicine Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre University Hospital, Copenhagen, Denmark
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VUmc site, Amsterdam, Netherlands
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Rod Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,School of Human Movement & Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| |
Collapse
|
21
|
Amer MA, Herbison GP, Grainger SH, Khoo CH, Smith MD, McCall JL. A meta-epidemiological study of bias in randomized clinical trials of open and laparoscopic surgery. Br J Surg 2021; 108:477-483. [PMID: 33778858 DOI: 10.1093/bjs/znab035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/15/2020] [Accepted: 01/17/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Blinding, random sequence generation, and allocation concealment are established strategies to minimize bias in RCTs. Meta-epidemiological studies of drug trials have demonstrated exaggerated treatment effects in RCTs where such methods were not employed. As blinding is more difficult in surgical trials it is important to determine whether this applies to them. The study aimed to investigate this using systematic meta-epidemiological methods. METHOD The Cochrane Database of Systematic Reviews was searched for systematic reviews of RCTs that compared laparoscopic and open abdominal surgical procedures. Each review was then scrutinized to determine whether at least one of the included trials was blinded. Eligible reviews were updated and individual RCTs retrieved. Extracted data included the primary outcomes of interest (length of stay and complications), secondary outcomes and a risk of bias assessment. A multistep meta-regression analysis was then performed to obtain an overall difference in the reported outcome differences between trials that employed each bias-minimization strategy, and those that did not. RESULTS Some 316 RCTs were included, reporting on eight different procedures. Patient-blinded RCTs reported a smaller difference in length of stay between laparoscopic and open groups (difference of standardized mean differences -0·36 (95 per cent c.i. -0·73 to 0·00)) and complications (ratio of odds ratios 0·76 (95 per cent c.i. 0·61 to 0·93)). Blinding of postoperative carers and outcome assessors had similar effects. CONCLUSION Lack of blinding significantly altered the treatment effect estimates of RCTs comparing laparoscopic and open surgery. Blinding should be implemented in surgical RCTs where possible to avoid systematic bias.
Collapse
Affiliation(s)
- M A Amer
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - G P Herbison
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - S H Grainger
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - C H Khoo
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - M D Smith
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand
| | - J L McCall
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand.,Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand.,New Zealand Liver Transplant Unit, Auckland, New Zealand
| |
Collapse
|
22
|
Smith MD, Vitharana TN, Wallis GM, Vicenzino B. Response profile of fibular repositioning tape on ankle osteokinematics, arthrokinematics, perceived stability and confidence in chronic ankle instability. Musculoskelet Sci Pract 2020; 50:102272. [PMID: 33096505 DOI: 10.1016/j.msksp.2020.102272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/14/2020] [Accepted: 10/06/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Preliminary evidence suggests that fibular repositioning tape reduces risk of recurrent ankle injuries, but the underlying mechanism has not been investigated. OBJECTIVE To investigate the effects of fibular repositioning tape on ankle osteokinematics, arthrokinematics and perceived stability and confidence in individuals with chronic ankle instability immediately post-tape and following exercise. DESIGN Cross-sectional repeated measures study. METHOD Passive ankle plantarflexion-inversion range of motion, weight-bearing dorsiflexion range of motion, anteroposterior translation, inversion-eversion tilt, and perceived ankle stability and confidence during hopping were assessed before and immediately after the application of fibular repositioning tape and after 15 min of exercise in 14 individuals with chronic ankle instability. RESULTS Ankle plantarflexion-inversion range of motion, inversion-eversion tilt and anteroposterior translation were reduced immediately after the application of tape compared to pre-tape (p < 0.01). After exercise, total inversion-eversion tilt was significantly lower than pre-tape (p = 0.01), but there were no differences for any of the other mechanical outcomes. Dorsiflexion range of motion did not differ between conditions (p > 0.11). Perceived ankle stability, ankle and task confidence were greater immediately post-tape and post-exercise compared to pre-tape (p < 0.01). CONCLUSIONS Fibular repositioning tape was associated with a restriction of ankle total inversion-eversion tilt and improved perceived ankle stability and confidence both immediately after application of tape and after participating in exercise. This data provides grounds for exploring mechanical and psychological mechanisms underpinning any clinical efficacy of fibular repositioning tape.
Collapse
Affiliation(s)
- Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia.
| | - Thilina N Vitharana
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Gena M Wallis
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia
| |
Collapse
|
23
|
Rodríguez-Romero B, Smith MD, Quintela-del-Rio A, Johnston V. What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study. Int J Environ Res Public Health 2020; 17:ijerph17197104. [PMID: 32998273 PMCID: PMC7579504 DOI: 10.3390/ijerph17197104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/19/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022]
Abstract
This study examines demographic, physical and psychosocial factors associated with an increase in low back pain (LBP) during a one-hour standing task. A cross-sectional survey with 40 office workers was conducted. The primary outcome was pain severity during a one-hour standing task recorded every 15 min using a 100 mm Visual Analogue Scale (VAS). Participants were defined as pain developers (PD), if they reported a change in pain of ≥10 mm from baseline, or non-pain developers (NPD). Physical outcomes included participant-rated and examiner-rated trunk and hip motor control and endurance. Self-report history of LBP, physical activity, psychosocial job characteristics, general health and pain catastrophising were collected. Fourteen participants were PD. Hip abduction, abdominal and spinal muscle endurance was lower for PD (p ≤ 0.05). PD had greater self-reported difficulty performing active hip abduction and active straight leg raise tests (p ≤ 0.04). Those reporting a lifetime, 12 month or 7-day history of LBP (p < 0.05) and lower self-reported physical function (p = 0.01) were more likely to develop LBP during the standing task. In conclusion, a history of LBP, reduced trunk and hip muscle endurance and deficits in lumbopelvic/hip motor control may be important to consider in office workers experiencing standing-induced LBP.
Collapse
Affiliation(s)
- Beatriz Rodríguez-Romero
- Psychosocial Intervention and Functional Rehabilitation Research Group, Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, Universidade da Coruña, Campus de A Coruña, 15071 A Coruna, Spain
- Correspondence: ; Tel.: +34-981-167000 (ext. 5841)
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (M.D.S.); (V.J.)
| | - Alejandro Quintela-del-Rio
- Psychosocial Intervention and Functional Rehabilitation Research Group, Department of Mathematics, Faculty of Physiotherapy, Universidade de A Coruna, 15071 A Coruna, Spain;
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (M.D.S.); (V.J.)
- Recover Injury Research Centre, The University of Queensland, Brisbane 4006, Australia
| |
Collapse
|
24
|
Ferri A, Gane EM, Smith MD, Pinkham EP, Gomersall SR, Johnston V. Experiences of people with cancer who have participated in a hospital-based exercise program: a qualitative study. Support Care Cancer 2020; 29:1575-1583. [PMID: 32740895 DOI: 10.1007/s00520-020-05647-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/22/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Exercise interventions for people with cancer and cancer survivors improve physical health, fatigue, and quality of life. Despite these benefits, poor adherence to exercise is an ongoing challenge among this population. In order to improve adherence in clinical services, this study aims to explore the benefits, challenges, barriers, and facilitators experienced by people with cancer and cancer survivors who participated in a hospital-based exercise program, specifically those who completed or did not complete the full program. METHODS This study involved a qualitative approach. People with a cancer diagnosis who did complete (completers, n = 11) and did not complete (non-completers, n = 4) a 12-session exercise program at a tertiary hospital were recruited. Semi-structured interviews were conducted and thematic analysis was employed to identify emergent themes. RESULTS Perceived benefits of exercise was the most prominent theme to emerge, with most participants recognizing improvements in physical, mental, and/or social well-being. Non-completers focused on treatment-related side effects, whereas completers saw an opportunity to return to a healthy lifestyle. The transition from a supervised environment to everyday life presented as the most significant barrier to exercise beyond the program among both program completers and non-completers. CONCLUSIONS Most people with cancer identified physical, mental, and social benefits from exercising. However, people with cancer and cancer survivors had difficulty maintaining exercise participation beyond completion of a supervised hospital-based program. IMPLICATIONS Improving exercise participation in people with cancer and cancer survivors may require supervised exercise interventions plus the implementation of strategies to manage side effects and to facilitate the transition of exercise into everyday life to enhance long-term adherence.
Collapse
Affiliation(s)
- Alessia Ferri
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Elise M Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD, 4006, Australia
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane, QLD, 4102, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD, 4102, Australia
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Elizabeth P Pinkham
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane, QLD, 4102, Australia
| | - Sjaan R Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD, 4006, Australia
| |
Collapse
|
25
|
Acharya A, Agarwal R, Baker M, Baudry J, Bhowmik D, Boehm S, Byler KG, Coates L, Chen SY, Cooper CJ, Demerdash O, Daidone I, Eblen JD, Ellingson S, Forli S, Glaser J, Gumbart JC, Gunnels J, Hernandez O, Irle S, Larkin J, Lawrence TJ, LeGrand S, Liu SH, Mitchell JC, Park G, Parks JM, Pavlova A, Petridis L, Poole D, Pouchard L, Ramanathan A, Rogers D, Santos-Martins D, Scheinberg A, Sedova A, Shen S, Smith JC, Smith MD, Soto C, Tsaris A, Thavappiragasam M, Tillack AF, Vermaas JV, Vuong VQ, Yin J, Yoo S, Zahran M, Zanetti-Polzi L. Supercomputer-Based Ensemble Docking Drug Discovery Pipeline with Application to Covid-19. ChemRxiv 2020:12725465. [PMID: 33200117 PMCID: PMC7668744 DOI: 10.26434/chemrxiv.12725465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 07/29/2020] [Indexed: 01/18/2023]
Abstract
We present a supercomputer-driven pipeline for in-silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. We also describe preliminary results obtained for 23 systems involving eight protein targets of the proteome of SARS CoV-2. THe MD performed is temperature replica-exchange enhanced sampling, making use of the massively parallel supercomputing on the SUMMIT supercomputer at Oak Ridge National Laboratory, with which more than 1ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to ten configurations of each of the 23 SARS CoV-2 systems using AutoDock Vina. We also demonstrate that using Autodock-GPU on SUMMIT, it is possible to perform exhaustive docking of one billion compounds in under 24 hours. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and AI methods to cluster MD trajectories and rescore docking poses.
Collapse
Affiliation(s)
- A Acharya
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332
| | - R Agarwal
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - M Baker
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - J Baudry
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899
| | - D Bhowmik
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
| | - S Boehm
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - K G Byler
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899
| | - L Coates
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
| | - S Y Chen
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - C J Cooper
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - O Demerdash
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - I Daidone
- Department of Physical and Chemical Sciences, University of L'Aquila, I-67010 L'Aquila, Italy
| | - J D Eblen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - S Ellingson
- University of Kentucky, Division of Biomedical Informatics, College of Medicine, UK Medical Center MN 150, Lexington KY, 40536
| | - S Forli
- Scripps Research, La Jolla, CA, 92037
| | - J Glaser
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | - J C Gumbart
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332
| | - J Gunnels
- HPC Engineering, Amazon Web Services, Seattle, WA 98121
| | - O Hernandez
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - S Irle
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996
| | - J Larkin
- NVIDIA Corporation, Santa Clara, CA 95051
| | - T J Lawrence
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - S LeGrand
- NVIDIA Corporation, Santa Clara, CA 95051
| | - S-H Liu
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - J C Mitchell
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - G Park
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - J M Parks
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - A Pavlova
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332
| | - L Petridis
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - D Poole
- NVIDIA Corporation, Santa Clara, CA 95051
| | - L Pouchard
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - A Ramanathan
- Data Science and Learning Division, Argonne National Lab, Lemont, IL 60439
| | - D Rogers
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | | | | | - A Sedova
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - S Shen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - J C Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - M D Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - C Soto
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - A Tsaris
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | | | | | - J V Vermaas
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | - V Q Vuong
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996
| | - J Yin
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | - S Yoo
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - M Zahran
- Department of Biological Sciences, New York City College of Technology, The City University of New York (CUNY), Brooklyn, NY 11201
| | | |
Collapse
|
26
|
Tong L, Li W, Lo MMC, Gao X, Wai JMC, Rudd M, Tellers D, Joshi A, Zeng Z, Miller P, Salinas C, Riffel K, Haley H, Purcell M, Holahan M, Gantert L, Schubert JW, Jones K, Mulhearn J, Egbertson M, Meng Z, Hanney B, Gomez R, Harrison ST, McQuade P, Bueters T, Uslaner J, Morrow J, Thomson F, Kong J, Liao J, Selyutin O, Bao J, Hastings NB, Agrawal S, Magliaro BC, Monsma FJ, Smith MD, Risso S, Hesk D, Hostetler E, Mazzola R. Discovery of [ 11C]MK-6884: A Positron Emission Tomography (PET) Imaging Agent for the Study of M4Muscarinic Receptor Positive Allosteric Modulators (PAMs) in Neurodegenerative Diseases. J Med Chem 2020; 63:2411-2425. [PMID: 32101422 DOI: 10.1021/acs.jmedchem.9b01406] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The measurement of receptor occupancy (RO) using positron emission tomography (PET) has been instrumental in guiding discovery and development of CNS directed therapeutics. We and others have investigated muscarinic acetylcholine receptor 4 (M4) positive allosteric modulators (PAMs) for the treatment of symptoms associated with neuropsychiatric disorders. In this article, we describe the synthesis, in vitro, and in vivo characterization of a series of central pyridine-related M4 PAMs that can be conveniently radiolabeled with carbon-11 as PET tracers for the in vivo imaging of an allosteric binding site of the M4 receptor. We first demonstrated its feasibility by mapping the receptor distribution in mouse brain and confirming that a lead molecule 1 binds selectively to the receptor only in the presence of the orthosteric agonist carbachol. Through a competitive binding affinity assay and a number of physiochemical properties filters, several related compounds were identified as candidates for in vivo evaluation. These candidates were then radiolabeled with 11C and studied in vivo in rhesus monkeys. This research eventually led to the discovery of the clinical radiotracer candidate [11C]MK-6884.
Collapse
Affiliation(s)
- Ling Tong
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Wenping Li
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Michael Man-Chu Lo
- Discovery Chemistry, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, New Jersey 07033, United States
| | - Xiaolei Gao
- Discovery Chemistry, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, New Jersey 07033, United States
| | - Jenny Miu-Chen Wai
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Michael Rudd
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - David Tellers
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Aniket Joshi
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Zhizhen Zeng
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Patricia Miller
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Cristian Salinas
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Kerry Riffel
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Hyking Haley
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Mona Purcell
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Marie Holahan
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Liza Gantert
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Jeffrey W Schubert
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Kristen Jones
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - James Mulhearn
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Melissa Egbertson
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Zhaoyang Meng
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Barbara Hanney
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Robert Gomez
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Scott T Harrison
- Discovery Chemistry, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Paul McQuade
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Tjerk Bueters
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Jason Uslaner
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - John Morrow
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Fiona Thomson
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Jongrock Kong
- Department of Process Research and Development, Merck & Co., Inc., 126 East Lincoln Avenue Rahway, New Jersey 07065, United States
| | - Jing Liao
- Department of Process Research and Development, Merck & Co., Inc., 126 East Lincoln Avenue Rahway, New Jersey 07065, United States
| | - Oleg Selyutin
- Discovery Chemistry, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, New Jersey 07033, United States
| | - Jianming Bao
- Discovery Chemistry, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, New Jersey 07033, United States
| | - Nicholas B Hastings
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Sony Agrawal
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Brian C Magliaro
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Frederick J Monsma
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Michelle D Smith
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Stefania Risso
- Discovery Biology, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - David Hesk
- Department of Process Research and Development, Merck & Co., Inc., 126 East Lincoln Avenue Rahway, New Jersey 07065, United States
| | - Eric Hostetler
- Translational Biomarkers, Merck & Co., Inc., 770 Sumneytown Pike, West Point, Pennsylvania 19486, United States
| | - Robert Mazzola
- Discovery Chemistry, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, New Jersey 07033, United States
| |
Collapse
|
27
|
Khalaj N, Vicenzino B, Heales LJ, Smith MD. Is chronic ankle instability associated with impaired muscle strength? Ankle, knee and hip muscle strength in individuals with chronic ankle instability: a systematic review with meta-analysis. Br J Sports Med 2020; 54:839-847. [PMID: 31937576 DOI: 10.1136/bjsports-2018-100070] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Determine whether impairments in lower limb muscle strength exist in individuals with chronic ankle instability (CAI) compared with uninjured controls. DESIGN Systematic review with meta-analysis. DATA SOURCE A comprehensive search of PubMed, Cochrane, CINAHL, Web of Science and EMBASE electronic databases from inception to 10 February 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Cross-sectional and case-control studies were included if they objectively measured lower limb muscle strength in individuals with CAI compared with controls. Risk of bias and quality of included studies were assessed. Data of included studies were extracted, and meta-analysis was conducted where appropriate. RESULTS 12 397 unique studies were identified, of which 20 were included and 16 were eligible for meta-analysis. Reviewed studies clearly described the aim/hypothesis and main outcome measure, but most lacked sample size calculation and assessor blinding. Meta-analyses showed individuals with CAI had lower eccentric and concentric evertor strength (30 and 120°/s; Nm; standardised mean difference (SMD) between -0.73 and -0.95), eccentric invertor strength (60 and 120°/s; both Nm and Nm/kg; SMD between -0.61 and -1.37), concentric invertor strength (60 and 120°/s; Nm; SMD=-0.7) and concentric knee extensor strength (SMD=-0.64) compared with control participants. Ankle eccentric dorsiflexor strength was not different between groups. Although pooling was not possible, data from three separate studies indicated that hip flexor, abductor and external rotator strength, but not hip adductor and extensor strength, was lower in individuals with CAI than in control participants. CONCLUSION Individuals with CAI have ankle inversion and eversion strength deficits. Our data also point to differences between individuals with CAI and controls in hip and knee strength. These elements of the kinetic chain should be evaluated by clinicians who rehabilitate individuals with CAI. PROSPERO REGISTRATION NUMBER CRD42016037759.
Collapse
Affiliation(s)
- Nafiseh Khalaj
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Luke James Heales
- Health and Exercise Science, Central Queensland University, Rockhampton, Queensland, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
28
|
Forner LB, Beckman EM, Smith MD. Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey. Int Urogynecol J 2019; 31:1551-1558. [DOI: 10.1007/s00192-019-04163-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/20/2019] [Indexed: 12/13/2022]
|
29
|
Viúdez-Moreiras D, Newman CE, de la Torre M, Martínez G, Guzewich S, Lemmon M, Pla-García J, Smith MD, Harri AM, Genzer M, Vicente-Retortillo A, Lepinette A, Rodriguez-Manfredi JA, Vasavada AR, Gómez-Elvira J. Effects of the MY34/2018 Global Dust Storm as Measured by MSL REMS in Gale Crater. J Geophys Res Planets 2019; 124:1899-1912. [PMID: 31534881 PMCID: PMC6750032 DOI: 10.1029/2019je005985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/19/2019] [Indexed: 05/28/2023]
Abstract
The Rover Environmental Monitoring Station (REMS) instrument that is onboard NASA's Mars Science Laboratory (MSL) Curiosity rover. REMS has been measuring surface pressure, air and ground brightness temperature, relative humidity, and UV irradiance since MSL's landing in 2012. In Mars Year (MY) 34 (2018) a global dust storm reached Gale Crater at Ls ~190°. REMS offers a unique opportunity to better understand the impact of a global dust storm on local environmental conditions, which complements previous observations by the Viking landers and Mars Exploration Rovers. All atmospheric variables measured by REMS are strongly affected albeit at different times. During the onset phase, the daily maximum UV radiation decreased by 90% between sols 2075 (opacity ~1) and 2085 (opacity ~8.5). The diurnal range in ground and air temperatures decreased by 35K and 56K, respectively, with also a diurnal-average decrease of ~2K and 4K respectively. The maximum relative humidity, which occurs right before sunrise, decreased to below 5%, compared with pre-storm values of up to 29%, due to the warmer air temperatures at night while the inferred water vapor abundance suggests an increase during the storm. Between sols 2085 and 2130, the typical nighttime stable inversion layer was absent near the surface as ground temperatures remained warmer than near-surface air temperatures. Finally, the frequency-domain behavior of the diurnal pressure cycle shows a strong increase in the strength of the semidiurnal and terdiurnal modes peaking after the local opacity maximum, also suggesting differences in the dust abundance inside and outside Gale.
Collapse
Affiliation(s)
- D Viúdez-Moreiras
- Centro de Astrobiología (CSIC-INTA) & Spanish National Institute for Aerospace Technology (INTA), Torrejón de Ardoz, Madrid, Spain
| | - C E Newman
- Aeolis Research, 600 N. Rosemead Ave., Suite 205, Pasadena, CA 91106, USA
| | - M de la Torre
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109, USA
| | - G Martínez
- University of Michigan, Ann Arbor, Michigan, USA
| | - S Guzewich
- NASA Goddard Spaceflight Center, Greenbelt, MD, USA
| | - M Lemmon
- Space Science Institute, College Station, TX 77843 USA
| | - J Pla-García
- Centro de Astrobiología (CSIC-INTA) & Spanish National Institute for Aerospace Technology (INTA), Torrejón de Ardoz, Madrid, Spain
| | - M D Smith
- NASA Goddard Spaceflight Center, Greenbelt, MD, USA
| | - A-M Harri
- Earth Observation, Finnish Meteorological Institute, Erik Palménin aukio, Helsinki, Finland
| | - M Genzer
- Earth Observation, Finnish Meteorological Institute, Erik Palménin aukio, Helsinki, Finland
| | | | - A Lepinette
- Centro de Astrobiología (CSIC-INTA) & Spanish National Institute for Aerospace Technology (INTA), Torrejón de Ardoz, Madrid, Spain
| | - J A Rodriguez-Manfredi
- Centro de Astrobiología (CSIC-INTA) & Spanish National Institute for Aerospace Technology (INTA), Torrejón de Ardoz, Madrid, Spain
| | - A R Vasavada
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109, USA
| | - J Gómez-Elvira
- Centro de Astrobiología (CSIC-INTA) & Spanish National Institute for Aerospace Technology (INTA), Torrejón de Ardoz, Madrid, Spain
| |
Collapse
|
30
|
Johnston V, Gane EM, Brown W, Vicenzino B, Healy GN, Gilson N, Smith MD. Feasibility and impact of sit-stand workstations with and without exercise in office workers at risk of low back pain: A pilot comparative effectiveness trial. Appl Ergon 2019; 76:82-89. [PMID: 30642528 DOI: 10.1016/j.apergo.2018.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/06/2018] [Accepted: 12/08/2018] [Indexed: 06/09/2023]
Abstract
The aim of this study was to compare the feasibility and impact of sit-stand workstations plus advice, with or without exercise, on back pain and sitting time in office workers at risk of low back pain (LBP). Eligible participants (n = 29/169; 17% overall) were randomized to receive a sit-stand workstation and advice with (n = 16) or without (n = 13) progressive resistance exercise training for 4-weeks. Feasibility (recruitment, acceptability, adherence) and impact (LBP severity during a standardized standing task, workplace-sitting time) were assessed. Intervention acceptability (87.5% very satisfied) was good and adherence (60% completed all 12 exercise sessions) was satisfactory. Maximum LBP severity (mean difference of -1.3 (-2.0, -0.6) and workplace sitting time (82.7-99.3 min/8-hr workday reduction) were similarly reduced in both groups. The introduction of a sit-stand workstation with advice was feasible and achieved similar outcomes for LBP and workplace sitting time when administered with or without exercise.
Collapse
Affiliation(s)
- Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia; Division of Physiotherapy, School of Health and Rehabilitation Sciences, Therapies Building, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
| | - Elise M Gane
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, Therapies Building, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia; Centre for Functioning and Health Research, Metro South Health Hospital and Health Service, P.O. Box 6053, Buranda, Brisbane, QLD, 4102, Australia
| | - Wendy Brown
- School of Human Movement and Nutrition Sciences, Human Movement Studies Building, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Bill Vicenzino
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, Therapies Building, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Genevieve N Healy
- School of Public Health, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia; School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia
| | - Nicholas Gilson
- School of Human Movement and Nutrition Sciences, Human Movement Studies Building, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Michelle D Smith
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, Therapies Building, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| |
Collapse
|
31
|
Ross MH, Smith MD, Mellor R, Vicenzino B. Exercise for posterior tibial tendon dysfunction: a systematic review of randomised clinical trials and clinical guidelines. BMJ Open Sport Exerc Med 2018; 4:e000430. [PMID: 30271611 PMCID: PMC6157513 DOI: 10.1136/bmjsem-2018-000430] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2018] [Indexed: 12/25/2022] Open
Abstract
Objective To systematically review all randomised clinical trials to determine the efficacy of local strengthening exercises compared with other forms of conservative management for adults with posterior tibial tendon dysfunction. Design Systematic review. Data sources Four electronic databases (Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase and PubMed) were searched up to June 2018. Eligibility criteria for selecting studies The study included randomised clinical trials investigating individuals with posterior tibial tendon dysfunction where local strengthening was compared with other forms of conservative management with respect to pain, function and/or physical impairment outcome measures. Standardised mean differences (SMDs) were used to compare change scores between groups and descriptors of exercise prescription assessed according to the Template for Intervention Description and Replication and the Toigo and Boutellier recommendations. Results 3 studies (n=93) were eligible for inclusion in the review. Varying strengthening exercises were compared with stretching and foot orthoses (n=2) or no intervention (n=1). Moderate effects (SMD 0.6-1.2) were found for reducing pain and disability with eccentric strengthening in conjunction with stretching and orthoses compared with concentric exercises, stretching and orthoses combined, and stretching and orthoses alone. Evaluation of exercise prescription parameters demonstrated minimal reporting, with the only consistent parameters being the number of sets and repetitions of the exercises, and the duration of the experimental period. Conclusion This review demonstrates the paucity of high-quality research for the conservative management of posterior tibial tendon dysfunction, and highlights the lack of exercise prescription parameters reported in clinical trials. Trial registration number CRD42017076156.
Collapse
Affiliation(s)
- Megan H Ross
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Michelle D Smith
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Rebecca Mellor
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Bill Vicenzino
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
32
|
Picorelli AMA, Hatton AL, Gane EM, Smith MD. Balance performance in older adults with hip osteoarthritis: A systematic review. Gait Posture 2018; 65:89-99. [PMID: 30558954 DOI: 10.1016/j.gaitpost.2018.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/04/2018] [Accepted: 07/01/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The hip is one of the most common joints affected by osteoarthritis (OA) and it has been identified as a key risk factors for falls. Physical impairments associated with OA, such as joint pain, muscle weakness, joint stiffness and sensory dysfunction, can all negatively affect balance and increase risk of falling. QUESTION Is balance performance altered in older adults with hip osteoarthritis? To determine whether static, dynamic, reactive or functional balance performance is altered in older people with hip osteoarthritis. METHODS Quantitative measures of postural control, including clinical and lab-based assessment of static, dynamic, reactive and/or functional balance performance, compared with a healthy control group or to the asymptomatic limb. RESULTS A total of 5407 articles were identified and 14 papers were included (10 with standardised mean different (SMD) data, four without SMD data). Based on data from single studies, there were medium/large effects for increased medio-lateral displacement when standing with eyes open, increased anterior-posterior and total sway path length when standing with eyes closed, greater overall instability when standing on an unstable surface, and increased displacement toward the stance leg in a lateral step in hip OA compared with controls. CONCLUSION Balance impairments were identified in some measures, limiting the conclusions as to whether balance deficits are a problem in hip OA. Inconsistent findings suggest that balance may not be a primary contributor to increased falls risk in older adults with hip OA. Other factors, such as musculoskeletal deficits, may contribute to higher falls rate in this population.
Collapse
Affiliation(s)
| | - Anna L Hatton
- School of Health and Rehabilitation Sciences, University of Queensland, Australia.
| | - Elise M Gane
- School of Health and Rehabilitation Sciences, University of Queensland, Australia; Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Australia.
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, University of Queensland, Australia.
| |
Collapse
|
33
|
Smith MD, Meredith PJ, Chua SY. The experience of persistent pain and quality of life among women following treatment for breast cancer: An attachment perspective. Psychooncology 2018; 27:2442-2449. [PMID: 30067313 DOI: 10.1002/pon.4848] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/29/2018] [Accepted: 07/23/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aims of this study were to investigate associations between attachment and the presence of persistent pain in women following treatment for breast cancer and to investigate the relationship between attachment, pain, and quality of life (QOL) in women with persistent pain. METHODS Women (N = 335) previously diagnosed with primary non-metastatic breast cancer completed an online survey with measures of attachment, pain, QOL, demographics, and medical history. Variables were compared between women with (N = 128) and without (N = 207) persistent pain. For those reporting pain, regression analyses were conducted to investigate relationships between attachment, pain, and QOL. RESULTS Higher attachment anxiety, but not attachment avoidance, was related to the presence of persistent pain. Among women with persistent pain, associations between attachment anxiety and avoidance and greater pain intensity were lost when pain catastrophizing was considered in analysis. Significant associations between attachment and diminished QOL and perceived effectiveness of pain management were identified in multivariate analysis. CONCLUSIONS These findings extend the available literature regarding associations between pain and attachment insecurity. In women with pain after breast cancer treatment, attachment anxiety and avoidance were associated with negative pain and QOL outcomes. Further attention regarding the use of attachment-informed approaches in supporting women following breast cancer treatment is indicated.
Collapse
Affiliation(s)
- Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Pamela J Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Siong Yin Chua
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
34
|
Amer MA, Smith MD, Khoo CH, Herbison GP, McCall JL. Network meta-analysis of surgical management of gastro-oesophageal reflux disease in adults. Br J Surg 2018; 105:1398-1407. [PMID: 30004114 DOI: 10.1002/bjs.10924] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/20/2018] [Accepted: 05/29/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Proton pump inhibitors are the mainstay of treatment for gastro-oesophageal reflux disease, but are associated with ongoing costs and side-effects. Antireflux surgery is cost-effective and is preferred by many patients. A total (360o or Nissen) fundoplication is the traditional procedure, but other variations including partial fundoplications are also commonly performed, with the aim of achieving durable reflux control with minimal dysphagia. Many RCTs and some pairwise meta-analyses have compared some of these procedures but there is still uncertainty about which, if any, is superior. Network meta-analysis allows multiple simultaneous comparisons and robust synthesis of the available evidence in these situations. A network meta-analysis comparing all antireflux procedures was performed to identify which has the most favourable outcomes at short-term (3-12 months), medium-term (1-5 years) and long-term (10 years and more than 10 years) follow-up. METHODS Article databases were searched systematically for all eligible RCTs. Primary outcomes were quality-of-life measures and dysphagia. Secondary outcomes included reflux symptoms, pH studies and complications. RESULTS Fifty-one RCTs were included, involving 5357 patients and 14 different treatments. Posterior partial fundoplication ranked best in terms of reflux symptoms, and caused less dysphagia than most other interventions including Nissen fundoplication. This was consistent across all time points and outcome measures. CONCLUSION Posterior partial fundoplication provides the best balance of long-term, durable reflux control with less dysphagia, compared with other treatments.
Collapse
Affiliation(s)
- M A Amer
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - M D Smith
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand
| | - C H Khoo
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - G P Herbison
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - J L McCall
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand.,Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand.,New Zealand Liver Transplant Unit, Auckland, New Zealand
| |
Collapse
|
35
|
Wilson RS, David GK, Murphy SC, Angilletta MJ, Niehaus AC, Hunter AH, Smith MD. Skill not athleticism predicts individual variation in match performance of soccer players. Proc Biol Sci 2017; 284:20170953. [PMID: 29187623 PMCID: PMC5740267 DOI: 10.1098/rspb.2017.0953] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/27/2017] [Indexed: 01/14/2023] Open
Abstract
Just as evolutionary biologists endeavour to link phenotypes to fitness, sport scientists try to identify traits that determine athlete success. Both disciplines would benefit from collaboration, and to illustrate this, we used an analytical approach common to evolutionary biology to isolate the phenotypes that promote success in soccer, a complex activity of humans played in nearly every modern society. Using path analysis, we quantified the relationships among morphology, balance, skill, athleticism and performance of soccer players. We focused on performance in two complex motor activities: a simple game of soccer tennis (1 on 1), and a standard soccer match (11 on 11). In both contests, players with greater skill and balance were more likely to perform better. However, maximal athletic ability was not associated with success in a game. A social network analysis revealed that skill also predicted movement. The relationships between phenotypes and success during individual and team sports have potential implications for how selection acts on these phenotypes, in humans and other species, and thus should ultimately interest evolutionary biologists. Hence, we propose a field of evolutionary sports science that lies at the nexus of evolutionary biology and sports science. This would allow biologists to take advantage of the staggering quantity of data on performance in sporting events to answer evolutionary questions that are more difficult to answer for other species. In return, sports scientists could benefit from the theoretical framework developed to study natural selection in non-human species.
Collapse
Affiliation(s)
- Robbie S Wilson
- School of Biological Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Gwendolyn K David
- School of Biological Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Sean C Murphy
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | | | - Amanda C Niehaus
- School of Biological Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Andrew H Hunter
- School of Biological Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| |
Collapse
|
36
|
Guzewich SD, Newman CE, Smith MD, Moores JE, Smith CL, Moore C, Richardson MI, Kass D, Kleinböhl A, Mischna M, Martín-Torres FJ, Zorzano-Mier MP, Battalio M. The Vertical Dust Profile over Gale Crater, Mars. J Geophys Res Planets 2017; 122:2779-2792. [PMID: 32523861 PMCID: PMC7285022 DOI: 10.1002/2017je005420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We create a vertically coarse, but complete, vertical profile of dust mixing ratio from the surface to the upper atmosphere over Gale Crater, Mars, using the frequent joint atmospheric observations of the orbiting Mars Climate Sounder (MCS) and the Mars Science Laboratory (MSL) Curiosity rover. Using these data and an estimate of planetary boundary layer (PBL) depth from the MarsWRF general circulation model, we divide the vertical column into three regions. The first region is the Gale Crater PBL, the second is the MCS-sampled region, and the third is between these first two. We solve for a well-mixed dust mixing ratio within this third (middle) layer of atmosphere to complete the profile. We identify a unique seasonal cycle of dust within each atmospheric layer. Within the Gale PBL, dust mixing ratio maximizes near southern hemisphere summer solstice (Ls = 270°) and minimizes near winter solstice (Ls = 90-100°) with a smooth sinusoidal transition between them. However, the layer above Gale Crater and below the MCS-sampled region more closely follows the global opacity cycle and has a maximum in opacity near Ls = 240° and exhibits a local minimum (associated with the "solsticial pause" in dust storm activity) near Ls = 270°. With knowledge of the complete vertical dust profile, we can also assess the frequency of high-altitude dust layers over Gale. We determine that 36% of MCS profiles near Gale Crater contain an "absolute" high-altitude dust layer wherein the dust mixing ratio is the maximum in the entire vertical column.
Collapse
Affiliation(s)
- Scott D Guzewich
- NASA Goddard Spaceflight Center, 8800 Greenbelt Road, Code 693, Greenbelt, MD 20771
| | | | - M D Smith
- NASA Goddard Spaceflight Center, 8800 Greenbelt Road, Code 693, Greenbelt, MD 20771
| | - J E Moores
- York University, Department of Earth and Space Science and Engineering, Toronto, ON, Canada M3J 1P3
| | - C L Smith
- York University, Department of Earth and Space Science and Engineering, Toronto, ON, Canada M3J 1P3
| | - C Moore
- York University, Department of Earth and Space Science and Engineering, Toronto, ON, Canada M3J 1P3
| | | | - D Kass
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109
| | - A Kleinböhl
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109
| | - M Mischna
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109
| | - F J Martín-Torres
- Division of Space Technology, Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Kiruna, Sweden; Instituto Andaluz de Ciencias de la Tierra (CSIC-UGR), 18100 Granada, Spain
| | - M-P Zorzano-Mier
- Division of Space Technology, Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Kiruna, Sweden; Centro de Astrobiología (INTA-CSIC), Torrejón de Ardoz, 28850 Madrid, Spain
| | - M Battalio
- Texas A&M University, Department of Atmospheric Sciences, College Station, TX 77843
| |
Collapse
|
37
|
Ross MH, Smith MD, Vicenzino B. Reported selection criteria for adult acquired flatfoot deformity and posterior tibial tendon dysfunction: Are they one and the same? A systematic review. PLoS One 2017; 12:e0187201. [PMID: 29194449 PMCID: PMC5711021 DOI: 10.1371/journal.pone.0187201] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/16/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Posterior tibial tendon dysfunction (PTTD) and adult acquired flatfoot deformity (AAFD) are used interchangeably, although both suggest quite different pathological processes. OBJECTIVE To investigate key differences in selection criteria used for inclusion into research studies. METHODS An electronic database search was performed from inception to June 2016. All primary research articles with clear inclusion/diagnostic criteria for PTTD or AAFD were included in the review. All criteria were extracted and synthesised into one aggregate list. Frequencies of recurring criteria were calculated and reported for each stage of the conditions. RESULTS Of the potentially eligible papers, 148 (65%) did not specify inclusion/selection criteria for PTTD or AAFD and were excluded. Eligibility criteria were reported 82 times in the 80 included papers, with 69 descriptions for PTTD and 13 for AAFD. After synthesis of criteria from all papers, there were 18 key signs and symptoms. Signs and symptoms were considered to be those relating to tendon pathology and those relating to structural deformity. The total number of individual inclusion/diagnostic criteria ranged from 2 to 9. The majority of articles required signs of both tendon dysfunction and structural deformity (84% for AAFD and 81% for PTTD). Across both groups, the most frequently reported criteria were abduction of the forefoot (11.5% of total criteria used), the presence of a flexible deformity (10.2%) and difficulty performing a single leg heel raise (10.0%). This was largely the case for the PTTD articles, whereas the AAFD articles were more focused on postural issues such as forefoot abduction, medial arch collapse, and hindfoot valgus (each 16.7%). CONCLUSION As well as synthesising the available literature and providing reporting recommendations, this review has identified that many papers investigating PTTD/AAFD do not state condition-specific selection criteria and that this limits their clinical applicability. Key signs and symptoms of PTTD and AAFD appear similar, except in early PTTD where no structural deformity is present. We recommend that PTTD is the preferred terminology for the condition associated with signs of local tendon dysfunction with pain and/or swelling along the tendon and difficulty with inversion and/or single leg heel raise characterising stage I and difficulty with single leg heel raise and a flexible flatfoot deformity characterizing stage II PTTD. While AAFD may be useful as an umbrella term for acquired flatfoot deformities, the specific associated aetiology should be reported in studies to aid consolidation and implementation of research into practice. TRIAL REGISTRATION Prospero ID: 42016046943.
Collapse
Affiliation(s)
- Megan H. Ross
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Michelle D. Smith
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| |
Collapse
|
38
|
Jennings DE, Flasar FM, Kunde VG, Nixon CA, Segura ME, Romani PN, Gorius N, Albright S, Brasunas JC, Carlson RC, Mamoutkine AA, Guandique E, Kaelberer MS, Aslam S, Achterberg RK, Bjoraker GL, Anderson CM, Cottini V, Pearl JC, Smith MD, Hesman BE, Barney RD, Calcutt S, Vellacott TJ, Spilker LJ, Edgington SG, Brooks SM, Ade P, Schinder PJ, Coustenis A, Courtin R, Michel G, Fettig R, Pilorz S, Ferrari C. Composite infrared spectrometer (CIRS) on Cassini: publisher's note. Appl Opt 2017; 56:5897. [PMID: 29047908 DOI: 10.1364/ao.56.005897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Indexed: 06/07/2023]
Abstract
This publisher's note renumbers the reference list in Appl. Opt.56, 5274 (2017)APOPAI0003-693510.1364/AO.56.005274.
Collapse
|
39
|
Jennings DE, Flasar FM, Kunde VG, Nixon CA, Segura ME, Romani PN, Gorius N, Albright S, Brasunas JC, Carlson RC, Mamoutkine AA, Guandique E, Kaelberer MS, Aslam S, Achterberg RK, Bjoraker GL, Anderson CM, Cottini V, Pearl JC, Smith MD, Hesman BE, Barney RD, Calcutt S, Vellacott TJ, Spilker LJ, Edgington SG, Brooks SM, Ade P, Schinder PJ, Coustenis A, Courtin R, Michel G, Fettig R, Pilorz S, Ferrari C. Composite infrared spectrometer (CIRS) on Cassini. Appl Opt 2017; 56:5274-5294. [PMID: 29047582 DOI: 10.1364/ao.56.005274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
The Cassini spacecraft orbiting Saturn carries the composite infrared spectrometer (CIRS) designed to study thermal emission from Saturn and its rings and moons. CIRS, a Fourier transform spectrometer, is an indispensable part of the payload providing unique measurements and important synergies with the other instruments. It takes full advantage of Cassini's 13-year-long mission and surpasses the capabilities of previous spectrometers on Voyager 1 and 2. The instrument, consisting of two interferometers sharing a telescope and a scan mechanism, covers over a factor of 100 in wavelength in the mid and far infrared. It is used to study temperature, composition, structure, and dynamics of the atmospheres of Jupiter, Saturn, and Titan, the rings of Saturn, and surfaces of the icy moons. CIRS has returned a large volume of scientific results, the culmination of over 30 years of instrument development, operation, data calibration, and analysis. As Cassini and CIRS reach the end of their mission in 2017, we expect that archived spectra will be used by scientists for many years to come.
Collapse
|
40
|
Homsher MF, Beshore DC, Cassaday J, Squadroni B, Mohammed E, Hartnett M, Day S, Ma L, Pechter D, Smith MD, Monsma F, Zuck P, Finley MF, Uebele VN, Hermes JD. High-Throughput Agonist Shift Assay Development for the Analysis of M 1-Positive Allosteric Modulators. SLAS Discov 2017; 22:1060-1066. [PMID: 28426939 DOI: 10.1177/2472555217705373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Agonist shift assays feature cross-titrations of allosteric modulators and orthosteric ligands. Information generated in agonist shift assays can include a modulator's effect on the orthosteric agonist's potency (alpha) and efficacy (beta), as well as direct agonist activity of the allosteric ligand (tauB) and the intrinsic binding affinity of the modulator to the unoccupied receptor (KB). Because of the heavy resource demand and complex data handling, these allosteric parameters are determined infrequently during the course of a drug discovery program and on a relatively small subset of compounds. Automation of agonist shift assays enables this data-rich analysis to evaluate a larger number of compounds, offering the potential to differentiate compound classes earlier and prospectively prioritize based on desired molecular pharmacology. A high-throughput calcium-imaging agonist shift assay was pursued to determine the allosteric parameters of over 1000 positive allosteric modulator (PAM) molecules for the human muscarinic acetylcholine receptor 1 (M1). Control compounds were run repeatedly to demonstrate internal consistency. Comparisons between potency measurements and the allosteric parameter results demonstrate that these different types of measurements do not necessarily correlate, highlighting the importance of fully characterizing and understanding the allosteric properties of leads.
Collapse
Affiliation(s)
| | | | - Jason Cassaday
- 1 Screening and Protein Sciences, Merck and Co, North Wales, PA, USA
| | - Brian Squadroni
- 1 Screening and Protein Sciences, Merck and Co, North Wales, PA, USA
| | | | - Michelle Hartnett
- 1 Screening and Protein Sciences, Merck and Co, North Wales, PA, USA
| | - Stephen Day
- 3 MRL Pipeline Support, Merck and Co, Montreal, Canada
| | - Lei Ma
- 4 Neuroscience, Merck Research Labs, West Point, PA, USA
| | - David Pechter
- 5 Assay Operations, Merck Research Labs, Kenilworth, NJ, USA
| | | | | | - Paul Zuck
- 1 Screening and Protein Sciences, Merck and Co, North Wales, PA, USA
| | - Michael F Finley
- 1 Screening and Protein Sciences, Merck and Co, North Wales, PA, USA
| | - Victor N Uebele
- 1 Screening and Protein Sciences, Merck and Co, North Wales, PA, USA
| | - Jeffrey D Hermes
- 1 Screening and Protein Sciences, Merck and Co, North Wales, PA, USA
| |
Collapse
|
41
|
Amer MA, Smith MD, Herbison GP, Plank LD, McCall JL. Network meta-analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery. Br J Surg 2016; 104:187-197. [PMID: 28000931 DOI: 10.1002/bjs.10408] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/08/2016] [Accepted: 09/21/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Three meta-analyses have summarized the effects of preoperative carbohydrate administration on postoperative outcomes in adult patients undergoing elective surgery. However, these studies could not account for the different doses of carbohydrate administered and the different controls used. Multiple-treatments meta-analysis allows robust synthesis of all available evidence in these situations. METHODS Article databases were searched systematically for RCTs comparing preoperative carbohydrate administration with water, a placebo drink, or fasting. A four-treatment multiple-treatments meta-analysis was performed comparing two carbohydrate dose groups (low, 10-44 g; high, 45 g or more) with two control groups (fasting; water or placebo). Primary outcomes were length of hospital stay and postoperative complication rate. Secondary outcomes included postoperative insulin resistance, vomiting and fatigue. RESULTS Some 43 trials involving 3110 participants were included. Compared with fasting, preoperative low-dose and high-dose carbohydrate administration decreased postoperative length of stay by 0·4 (95 per cent c.i. 0·03 to 0·7) and 0·2 (0·04 to 0·4) days respectively. There was no significant decrease in length of stay compared with water or placebo. There was no statistically significant difference in the postoperative complication rate, or in most of the secondary outcomes, between carbohydrate and control groups. CONCLUSION Carbohydrate loading before elective surgery conferred a small reduction in length of postoperative hospital stay compared with fasting, and no benefit in comparison with water or placebo.
Collapse
Affiliation(s)
- M A Amer
- Departments of Surgical Sciences, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand
| | - M D Smith
- Departments of Surgical Sciences, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Southland Hospital, Invercargill, New Zealand
| | - G P Herbison
- Departments of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - L D Plank
- Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand
| | - J L McCall
- Departments of Surgical Sciences, University of Otago, Dunedin, New Zealand.,Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand.,Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand.,New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand
| |
Collapse
|
42
|
Hoover DL, Knapp AK, Smith MD. Photosynthetic responses of a dominant C 4 grass to an experimental heat wave are mediated by soil moisture. Oecologia 2016; 183:303-313. [PMID: 27757543 DOI: 10.1007/s00442-016-3755-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 10/07/2016] [Indexed: 11/30/2022]
Abstract
Extreme heat waves and drought are predicted to increase in frequency and magnitude with climate change. These extreme events often co-occur, making it difficult to separate their direct and indirect effects on important ecophysiological and carbon cycling processes such as photosynthesis. Here, we assessed the independent and interactive effects of experimental heat waves and drought on photosynthesis in Andropogon gerardii, a dominant C4 grass in a native mesic grassland. We experimentally imposed a two-week heat wave at four intensity levels under two contrasting soil moisture regimes: a well-watered control and an extreme drought. There were three main findings from this study. First, the soil moisture regimes had large effects on canopy temperature, leading to extremely high temperatures under drought and low temperatures under well-watered conditions. Second, soil moisture mediated the photosynthetic response to heat; heat reduced photosynthesis under the well-watered control, but not under the extreme drought treatment. Third, the effects of heat on photosynthesis appeared to be driven by a direct thermal effect, not indirectly through other environmental or ecophysiological variables. These results suggest that while photosynthesis in this dominant C4 grass is sensitive to heat stress, this sensitivity can be overwhelmed by extreme drought stress.
Collapse
Affiliation(s)
- D L Hoover
- Graduate Degree Program in Ecology and Department of Biology, Colorado State University, Fort Collins, CO, 80526, USA.
| | - A K Knapp
- Graduate Degree Program in Ecology and Department of Biology, Colorado State University, Fort Collins, CO, 80526, USA
| | - M D Smith
- Graduate Degree Program in Ecology and Department of Biology, Colorado State University, Fort Collins, CO, 80526, USA
| |
Collapse
|
43
|
Affiliation(s)
- D Doll
- Trauma Directorate Chris Hani Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, South Africa
| | - F Bonanno
- Trauma Directorate Chris Hani Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, South Africa
| | - MD Smith
- Trauma Directorate Chris Hani Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, South Africa
| | - E Degiannis
- Trauma Directorate Chris Hani Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, South Africa,
| |
Collapse
|
44
|
Hurn SE, Vicenzino BT, Smith MD. Non-surgical treatment of hallux valgus: a current practice survey of Australian podiatrists. J Foot Ankle Res 2016; 9:16. [PMID: 27148407 PMCID: PMC4855349 DOI: 10.1186/s13047-016-0146-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/26/2016] [Indexed: 12/03/2022] Open
Abstract
Background Patients with hallux valgus (HV) frequently present to podiatrists for non-surgical management, with a wide range of concerns including pain, footwear difficulty and quality of life impacts. There is little research evidence guiding podiatrists’ clinical decisions surrounding non-surgical management of HV. Thus practitioners rely largely upon clinical experience and expert opinion. This survey was conducted to determine whether a consensus exists among Australian podiatrists regarding non-surgical treatment of HV, and secondly to explore common presenting concerns and physical examination findings associated with HV. Methods An online survey was distributed to Australian podiatrists in mid-2013 via the professional association in each state (approximately 1900 members). Podiatrists indicated common treatments recommended, presenting problems and physical examination findings associated with HV in juveniles, adults and older adults. Proportions were calculated to determine the most common responses, and Chi-squared tests were used to examine differences in treatment recommendations according to HV patient age group and podiatrist demographics. Results Of 210 survey respondents, 65 % (136) were female and 80 % (168) were private practitioners. Complete survey responses were received from 159 podiatrists for juvenile HV, 146 for adults and 141 for older adults. Seven different non-surgical treatment options were commonly recommended (by >50 % podiatrists), although recommendations differed between adult, older adult and juvenile HV. Common treatments included footwear advice or modification, custom and prefabricated orthotic devices, addition of padding, and muscle strengthening/retraining exercises. Padding was more likely to be utilised in older adults, while exercises were more likely to be prescribed for juveniles. A diverse range of presenting problems and physical examination findings were reported to be associated with HV. Conclusions Despite the lack of empirical evidence in this area, there appears to be a consensus among Australian podiatrists regarding non-surgical management of HV, and these recommendations are largely aligned with available clinical consensus documents. Presenting concerns and physical examination findings associated with HV are diverse and have implications for treatment decisions. Management strategies differ across patient age groups, thus any updated clinical guidelines should differentiate between adult and juvenile HV. This study provides useful data to inform clinical practice, education, policy and future research. Electronic supplementary material The online version of this article (doi:10.1186/s13047-016-0146-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sheree E Hurn
- Queensland University of Technology, School of Clinical Sciences, Kelvin Grove, QLD 4059 Australia ; Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD 4059 Australia
| | - Bill T Vicenzino
- Division of Physiotherapy, University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, QLD 4072 Australia
| | - Michelle D Smith
- Division of Physiotherapy, University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, QLD 4072 Australia
| |
Collapse
|
45
|
Leung J, Smith MD, McLaughlin D. Inequalities in long term health-related quality of life between partnered and not partnered breast cancer survivors through the mediation effect of social support. Psychooncology 2016; 25:1222-1228. [PMID: 27062092 DOI: 10.1002/pon.4131] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 01/20/2016] [Accepted: 03/08/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare long-term quality of life outcomes by marital status among women living with breast cancer, and to test the mediation effects of social support as an underlying factor. METHODS Data are drawn from 1996 to 2010 of the Australian Longitudinal Study on Women's Health. The sample included 505 women with breast cancer with six years of follow-up data. Social support was measured by the Medical Outcomes Study Social Support Survey (MOS-SSS). Physical and mental health-related quality of life (HRQOL) was measured using the Short-Form Health Survey (SF-36). RESULTS Breast cancer survivors who did not have a partner, compared to those who had a partner, had significantly lower levels of social support, which was associated with poorer HRQOL. Social support mediated the relationship between not having a partner and poorer HRQOL. Results were consistent after taken into consideration socio-demographic characteristics, which included age, highest level of education, country of birth, and area of residence. CONCLUSIONS Women recovering from breast cancer who do not have partners have poorer physical and mental HRQOL, than those with partners, with a lack of social support as an underlying inequality. Partners of breast cancer survivors are importance sources in the provision of social support to help them maintain well-being and quality of life. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Janni Leung
- School of Public Health, The University of Queensland, Australia. .,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia.
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | | |
Collapse
|
46
|
Wilson RS, James RS, David G, Hermann E, Morgan OJ, Niehaus AC, Hunter A, Thake D, Smith MD. Multivariate analyses of individual variation in soccer skill as a tool for talent identification and development: utilising evolutionary theory in sports science. J Sports Sci 2016; 34:2074-86. [DOI: 10.1080/02640414.2016.1151544] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
47
|
Smith MD, Harvey EH, van den Hoorn W, Shay BL, Pereira GM, Hodges PW. Out-Patient Pulmonary Rehabilitation Improves Medial-Lateral Balance in Subjects With Chronic Respiratory Disease: Proof-of-Concept Study. Respir Care 2016; 61:510-20. [PMID: 26814219 DOI: 10.4187/respcare.04109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Recent studies show balance impairment in subjects with chronic respiratory disease. The aim of this proof-of-concept study was to investigate clinical and quantitative measures of balance in people with chronic respiratory disease following participation in an out-patient pulmonary rehabilitation (PR) program to better understand features of balance improvement. A secondary aim was to probe possible mechanisms for balance improvement to provide the foundation for optimal design of future studies. METHODS Eleven individuals with chronic respiratory disease enrolled in an 8-week out-patient PR program participated. Standing balance, measured with a force plate, in the medial-lateral and anterior-posterior directions with eyes open and closed was assessed with linear (SD and sway path length) and non-linear (diffusion analysis) center-of-pressure measures. Balance was evaluated clinically with the Timed Up and Go and Four Square Step Test. Fear of falling and balance confidence were assessed with questionnaires. RESULTS After participation in PR, medial-lateral sway path length decreased (P = .031), and center-of-pressure diffusion in the medial-lateral direction was slower (P = .02) and traveled over less distance (P = .03) with eyes closed. This suggests greater control of medial-lateral sway. There was no change in anterior-posterior balance (P > .067). Performance improved on the Timed Up and Go (median [interquartile range] pre-PR = 9.4 [7.9-12.8] vs. post-PR = 8.1 [7.3-12.2] s, P = .003) and Four Square Step Test (median [interquartile range] pre-PR = 9.3 [7.2-14.2] vs. post-PR = 8.7 [7.4-10.2] s, P = .050). There were no changes in balance confidence (P = .72) or fear of falling (P = .57). CONCLUSIONS Participation in an 8-week out-patient PR program improved balance, as assessed by clinical and laboratory measures. Detailed analysis of force plate measures demonstrated improvements primarily with respect to medial-lateral balance control. These data provide a basis for the development of larger scale studies to investigate the mechanisms for medial-lateral balance improvements following PR and to determine how PR may be refined to enhance balance outcomes in this population. (ClinicalTrials.gov registration NCT00864084.).
Collapse
Affiliation(s)
- Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia.
| | - Elizabeth H Harvey
- School of Medical Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Wolbert van den Hoorn
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Barbara L Shay
- School of Medical Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gisèle M Pereira
- School of Medical Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| |
Collapse
|
48
|
Smith MD, Chang AT, Hodges PW. Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease. Gait Posture 2016; 43:101-7. [PMID: 26471324 DOI: 10.1016/j.gaitpost.2015.09.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 08/27/2015] [Accepted: 09/04/2015] [Indexed: 02/02/2023]
Abstract
Increased respiration in chronic obstructive pulmonary disease (COPD) requires greater abdominal muscle activation, which may impact on contribution of the trunk to postural control. This study aimed to determine whether recovery of balance from postural perturbations and trunk muscle activity differs in people with and without COPD before and/or after exercise. Electromyography (EMG) of the obliquus internus (OI) and externus (OE) abdominis, rectus abdominis (RA), erector spinae (ES) and deltoid muscles was recorded with surface electrodes during rapid shoulder flexion and extension. Time taken to regain baseline centre of pressure velocity (vCOP) and the number of postural adjustments following arm movement was calculated from force plate data. Time to recover balance in the direction of postural disturbance (anteroposterior vCOP) was longer in COPD, particularly more severe COPD, than controls. Mediolateral vCOP (perpendicular to the perturbation) and the number of postural adjustments did not differ between groups, but people with more severe COPD were less successful at returning their mediolateral vCOP to baseline. Abdominal muscle EMG was similar between groups, but controls had greater ES EMG during arm movements. Individuals with more severe COPD had greater OE and RA EMG both before and during arm movement compared to those with less severe COPD and controls. Following exercise, OE and ES EMG increased in people with less severe COPD. This study shows that severe COPD is associated with impaired ability to recover balance and greater trunk muscle activity during postural challenges. Augmented trunk muscle activity may limit the contribution of trunk movements to balance recovery and could contribute to increased falls risk.
Collapse
Affiliation(s)
- Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, St. Lucia 4072, QLD, Australia.
| | - Angela T Chang
- The University of Queensland, School of Health and Rehabilitation Sciences, St. Lucia 4072, QLD, Australia
| | - Paul W Hodges
- The University of Queensland, School of Health and Rehabilitation Sciences, St. Lucia 4072, QLD, Australia
| |
Collapse
|
49
|
Smith MD, Russell T, Thomson A, MacIntyre E, Devane H, Howe E, Tucker K. 43 Frontal plane knee and pelvis angles during single leg squat and step down tasks do not differ between people with and without chronic ankle instability. Br J Sports Med 2015. [DOI: 10.1136/bjsports-2015-095573.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
50
|
Fell MJ, Mirescu C, Basu K, Cheewatrakoolpong B, DeMong DE, Ellis JM, Hyde LA, Lin Y, Markgraf CG, Mei H, Miller M, Poulet FM, Scott JD, Smith MD, Yin Z, Zhou X, Parker EM, Kennedy ME, Morrow JA. MLi-2, a Potent, Selective, and Centrally Active Compound for Exploring the Therapeutic Potential and Safety of LRRK2 Kinase Inhibition. J Pharmacol Exp Ther 2015; 355:397-409. [DOI: 10.1124/jpet.115.227587] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 09/24/2015] [Indexed: 11/22/2022] Open
|