Professor Lisa Harvey
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1 The JWCRR research, education and resource development programs: Physiotherapy management of spinal cord injuries Professor Lisa Harvey John Walsh Centre for Rehabilitation Research School of Medicine University of, Australia
2 One of our key missions Research Education Resources Promote evidence-based practice
3 One of our key missions Research Education Resources Promote evidence-based practice
4 One of our key missions The structure of our research program The type of research we do Promote evidence-based practice
5 Structure of our research program 2 SCI units for NSW (~ 8 million)
6 Acknowledgements University of A de Wolf C Fornusek C Lin G Davis J Bowden JChu J Crosbie J Glinsky M Stadler N Lannin O Katalinic R Adams R Quirk S Chee J Diong K Kwah Swiss Paraplegic Centre, Nottwil A Raab Indian Spinal Injury Center M Arora H Harvinder Centre for Rehabilitation of the Paralyzed, Bangladesh S Hossain A Rahman Stoke Mandeville, UK D Tussler M Coggrave The George Institute A Moseley C Sherrington Hampstead SCI Unit C Drury Maastricht University, Netherlands M Korten P van Es NeuroScience Australia R Herbert S Gandevia J Diong K Lihim S Lord Prince of Wales Hospital J Batty S Denis C Boswell-Ruys S Engel K Ralston EBye Royal Rehabilitation Centre A Byak B Armstrong S McClean H Folpp M Ben S Kwok D Pironello D Ristev G Weber J Middleton L Katte Royal North Shore Hospital D Simpson J Barker D Barrett LChen * Bold = student
7 Structure of our research program Benefits: 1. Build clinicians skills in reading and interpreting evidence 2. Generate evidence in SCI physiotherapy 3. Creates an intellectuallysimulating work environment Promote evidence-based practice
8 Types of studies Types of studies: 1. Clinical trials 2. Systematic reviews 3. Prognostic cohort studies 4. Psychometric studies
9 Training hand function Comparison: 1. Rejoyce + ES + usual care 2. usual care Primary outcome hand Fx
10 Standing for bowel function Comparison: 1. standing 2. no standing Primary outcome bowel Fx
11 ES cycling for bladder function Comparison: 1. ES cycling 2. no ES cycling Primary outcome bladder Fx
12 Ventolin in acute SCI Comparison: 1. Real ventolin 2. Sham ventolin Primary outcome FEV1
13 Passive movements for joint mobility Comparison: min daily PM 2. No treatment Primary outcome - ROM
14 Stretch for contracture Mx Comparison: 1. Stretch 2. No stretch Primary outcome - ROM
15 Training for sitting Comparison: 1. usual care 2. intensive training + usual care Primary outcome - ability to sit
16 Weight training for strength Comparison: 1. Strength training +/- ES 2. No training Primary outcome - strength
17 Repetitious contractions for recovery Comparison: repetitious contractions per day 2. Usual care Primary outcome - strength
18 Managing shoulder problems Comparison: 1. Shoulder exercise program delivered through mobile device 2. Usual care Primary outcome - pain
19 Challenges Funding Complex interventions Recruitment
20 Around Asia: Bangladesh India Nepal Sri Lanka Further afield: UK Denmark Canada Switzerland
21 Types of studies Types of studies: 1. Clinical trials 2. Systematic reviews 3. Prognostic cohort studies 4. Psychometric studies
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23 Stretch for the treatment and prevention of contractures (Review)
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26 Treadmill training Treadmill gait training with body weight support vs over-ground gait training
27 CONSORT Quality of trials reported 2003 to 2013 (n=53) No. items fully reported Max score (37) 11 items (7 to 20) median (IQR) Year of publication
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29 Types of studies Types of studies: 1. Clinical trials 2. Systematic reviews 3. Prognostic cohort studies 4. Psychometric studies
30 Incidence of contractures
31 Survival following SCI in Bangladesh Source: Spinal Cord (2016) Advance online
32 Types of studies Types of studies: 1. Clinical trials 2. Systematic reviews 3. Prognostic cohort studies 4. Psychometric studies
33 AIS self-report
34 Other outcomes Including: 1. AuSpinal 2. 5-AML 3. CMC joint mobility 4. Complications Scale 5. Wound undermining
35 One of our key missions Research Education Resources Promote evidence-based practice
36 REHABILITATION Studies Unit
37 REHABILITATION Studies Unit
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41 Look Think Do Revise
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49 By professions 30,000 registered users Doctors PTs are biggest users Physiotherapists
50 By country (140+ countries) Canada Australia Australians are biggest users
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53 Registrants = 10,000 from 150 countries India 1,824 Australia 977 USA 930 Egypt 900 UK 555 Pakistan 512 Saudi Arabia 250 Nigeria 207 Canada 153 China 106 Vietnam 97 Source: Spinal Cord (2014) 52:911-8 & J Physiotherapy (2015) 61: 21-27
54 Acknowledgement: Dr Joanne Glinsky
55 Acknowledgement: Dr Joanne Glinsky
56 Acknowledgement: Dr Joanne Glinsky
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59 Current projects elearnsci.org Adding evidence tips Adding a consumers module Translating into different languages
60 enables physiotherapists to use their PCs or any mobile device to prescribe exercises for people with injuries and disabilities
61 What is it? 15 years work FREE for everyone to use video
62 Current projects Physiotherapyexercises.com Adding exercises for PD, amputees and burns Adding more exercise programs Getting the patients App to work offline
63 Acknowledgements University of A de Wolf C Fornusek C Lin G Davis J Bowden JChu J Crosbie J Glinsky M Stadler N Lannin O Katalinic R Adams R Quirk S Chee J Diong K Kwah Swiss Paraplegic Centre, Nottwil A Raab Indian Spinal Injury Center M Arora H Harvinder Centre for Rehabilitation of the Paralyzed, Bangladesh S Hossain A Rahman Stoke Mandeville, UK D Tussler M Coggrave The George Institute A Moseley C Sherrington Hampstead SCI Unit C Drury Maastricht University, Netherlands M Korten P van Es NeuroScience Australia R Herbert S Gandevia J Diong K Lihim S Lord Prince of Wales Hospital J Batty S Denis C Boswell-Ruys S Engel K Ralston EBye Royal Rehabilitation Centre A Byak B Armstrong S McClean H Folpp M Ben S Kwok D Pironello D Ristev G Weber J Middleton L Katte Royal North Shore Hospital D Simpson J Barker D Barrett LChen * Bold = student
Contractures. Stretch for the treatment and prevention of contractures: what does the evidence say? Stretch for management of contractures
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enables physiotherapists to use their PCs or any mobile device to prescribe exercises
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FOCUSSED CLINICAL QUESTION:
Treatment Critically Appraised Topic: Is daily passive muscle stretching effective at preventing losses of range of motion in adult spinal cord injured patients within a rehabilitation environment? Prepared
Training unsupported sitting does not improve ability to sit in people with recently acquired paraplegia: a randomised trial
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Does 12 weeks of regular standing prevent loss of ankle mobility and bone mineral density in people with recent spinal cord injuries?
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CURRICULUM VITAE. 1984: Bachelor of Applied Science (Physiotherapy), The University of Sydney.
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NEWSLETTER Issue
Dear Members, Greetings to everyone and I hope that 2012 is going well for everyone it seems to be racing along, end of April already. It has been good to receive news from a number of countries regarding