University of The JWCRR research, education and …sydney.edu.au/medicine/rehab/education/Lisa...
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University of Sydney Professor Lisa Harvey The JWCRR research, education and resource development programs: Physiotherapy management of spinal cord injuries John Walsh Centre for Rehabilitation Research Sydney School of Medicine University of Sydney, Australia
Transcript of University of The JWCRR research, education and …sydney.edu.au/medicine/rehab/education/Lisa...
University ofSydney
Professor Lisa Harvey
The JWCRR research, education and resource development programs: Physiotherapy
management of spinal cord injuries
John Walsh Centre for Rehabilitation ResearchSydney School of MedicineUniversity of Sydney, Australia
University ofSydney
One of our key missions
• Research• Education• Resources
Promote evidence-based practice
University ofSydney
One of our key missions
• Research• Education• Resources
Promote evidence-based practice
University ofSydney
One of our key missions
• The structure of our research program
• The type of researchwe do
Promote evidence-based practice
University ofSydney
Structure of our research program
2 SCI units for NSW(~ 8 million)
University ofSydney
Acknowledgements
University of SydneyA de WolfC FornusekC LinG DavisJ BowdenJ ChuJ CrosbieJ GlinskyM StadlerN LanninO KatalinicR AdamsR QuirkS CheeJ DiongK Kwah
Swiss ParaplegicCentre, NottwilA Raab
* Bold = student
Indian Spinal Injury CenterM AroraH Harvinder
Centre for Rehabilitation ofthe Paralyzed, BangladeshS HossainA Rahman
Stoke Mandeville, UKD TusslerM Coggrave
The George InstituteA MoseleyC Sherrington
Hampstead SCI UnitC Drury
Maastricht University, NetherlandsM KortenP van Es
NeuroScience AustraliaR HerbertS GandeviaJ DiongK LihimS Lord
Prince of Wales HospitalJ BattyS DenisC Boswell-RuysS EngelK RalstonE Bye
Royal Rehabilitation Centre SydneyA ByakB ArmstrongS McCleanH FolppM BenS KwokD PironelloD RistevG WeberJ MiddletonL Katte
Royal North Shore HospitalD SimpsonJ BarkerD BarrettL Chen
University ofSydney
Structure of our research program
Promote evidence-based practice
Benefits:1. Build clinicians’ skills in
reading and interpreting evidence
2. Generate evidence in SCI physiotherapy
3. Creates an intellectually-simulating work environment
University ofSydney
Types of studies
Types of studies:1. Clinical trials2. Systematic reviews3. Prognostic cohort studies4. Psychometric studies
University ofSydney
Comparison:1. Rejoyce + ES + usual care2. usual care
Primary outcome – hand Fx
Training hand function
University ofSydney
Comparison:1. standing2. no standing
Primary outcome – bowel Fx
Standing for bowel function
University ofSydney
ES cycling for bladder function
Comparison:1. ES cycling2. no ES cycling
Primary outcome – bladder Fx
University ofSydney
Comparison:1. Real ventolin2. Sham ventolin
Primary outcome – FEV1
Ventolin in acute SCI
University ofSydney
Passive movements for joint mobility
Comparison:1. 20 min daily PM2. No treatment
Primary outcome - ROM
University ofSydney
Stretch for contracture Mx
Comparison:1. Stretch2. No stretch
Primary outcome - ROM
University ofSydney
Comparison:1. usual care2. intensive training
+ usual care
Primary outcome - ability to sit
Training for sitting
University ofSydney
Comparison:1. Strength training +/- ES2. No training
Primary outcome - strength
Weight training for strength
University ofSydney
Repetitious contractions for recovery
Comparison:1. 200 repetitious contractions
per day2. Usual care
Primary outcome - strength
University ofSydney
Managing shoulder problems
Comparison:1. Shoulder exercise program
delivered through mobile device
2. Usual care
Primary outcome - pain
University ofSydney
• Funding• Complex interventions• Recruitment
Challenges
Around Asia:• Bangladesh• India• Nepal• Sri Lanka
Further afield:• UK• Denmark• Canada• Switzerland
University ofSydney
Types of studies
Types of studies:1. Clinical trials2. Systematic reviews3. Prognostic cohort studies4. Psychometric studies
Stretch for the treatment and prevention of contractures
(Review)
University ofSydney
University ofSydney
Treadmill gait training with body weight support vsover-ground gait training
Treadmill training
University ofSydney
No.
item
s fu
lly re
port
ed
Year of publication03 05 07 09 11 13
Max score (37)
10
20
30
40
CONSORT
Quality of trials reported 2003 to 2013 (n=53)
11 items (7 to 20)median (IQR)
University ofSydney
Types of studies
Types of studies:1. Clinical trials2. Systematic reviews3. Prognostic cohort studies4. Psychometric studies
University ofSydney
Incidence of contractures
University ofSydney
Source: Spinal Cord (2016) Advance online
Survival following SCI in Bangladesh
University ofSydney
Types of studies
Types of studies:1. Clinical trials2. Systematic reviews3. Prognostic cohort studies4. Psychometric studies
University ofSydney
AIS self-report
University ofSydney
Other outcomes
Including:1. AuSpinal2. 5-AML3. CMC joint mobility4. Complications Scale5. Wound undermining
University ofSydney
One of our key missions
• Research• Education• Resources
Promote evidence-based practice
REHABILITATIONStudies Unit
www.elearnSCI.org
REHABILITATIONStudies Unit
University ofSydney
University ofSydney
University ofSydney
University ofSydney
LookThink
Do Revise
University ofSydney
University ofSydney
University ofSydney
University ofSydney
University ofSydney
University ofSydney
University ofSydney
University ofSydney
30,000 registered users
PTs are biggest users
By professions
Physiotherapists
Doctors
University ofSydney
Australians are biggest users
By country (140+ countries)
AustraliaCanada
University ofSydney
University ofSydney
University ofSydney
Registrants = 10,000 from 150 countries
India 1,824Australia 977USA 930Egypt 900UK 555Pakistan 512Saudi Arabia 250Nigeria 207Canada 153China 106Vietnam 97
Source: Spinal Cord (2014) 52:911-8 & J Physiotherapy (2015) 61: 21-27
University ofSydney
www.SCIMOOC.org
Acknowledgement: Dr Joanne Glinsky
University ofSydney
www.SCIMOOC.org
Acknowledgement: Dr Joanne Glinsky
University ofSydney
www.SCIMOOC.org
Acknowledgement: Dr Joanne Glinsky
University ofSydney
University ofSydney
University ofSydney
elearnSCI.org
• Adding evidence tips
• Adding a consumers’ module
• Translating into different languages
Current projects
www.physiotherapyexercises.comenables physiotherapists to use their PCs or any mobile
device to prescribe exercises for people with injuries and disabilities
What is it?15 years work
FREE for everyone to use
video
University ofSydney
Physiotherapyexercises.com
• Adding exercises for PD, amputees and burns
• Adding more exercise programs
• Getting the patients’ App to work offline
Current projects
University ofSydney
Acknowledgements
University of SydneyA de WolfC FornusekC LinG DavisJ BowdenJ ChuJ CrosbieJ GlinskyM StadlerN LanninO KatalinicR AdamsR QuirkS CheeJ DiongK Kwah
Swiss ParaplegicCentre, NottwilA Raab
* Bold = student
Indian Spinal Injury CenterM AroraH Harvinder
Centre for Rehabilitation ofthe Paralyzed, BangladeshS HossainA Rahman
Stoke Mandeville, UKD TusslerM Coggrave
The George InstituteA MoseleyC Sherrington
Hampstead SCI UnitC Drury
Maastricht University, NetherlandsM KortenP van Es
NeuroScience AustraliaR HerbertS GandeviaJ DiongK LihimS Lord
Prince of Wales HospitalJ BattyS DenisC Boswell-RuysS EngelK RalstonE Bye
Royal Rehabilitation Centre SydneyA ByakB ArmstrongS McCleanH FolppM BenS KwokD PironelloD RistevG WeberJ MiddletonL Katte
Royal North Shore HospitalD SimpsonJ BarkerD BarrettL Chen
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