Health Sciences

Ageing and Neurological Disorders Research Group

The goal of our research group is to contribute to the evidence base for physiotherapists working with   aged and neurological disorders by maximizing rehabilitation outcomes for participation in home and community based activities. Members of our group are currently undertaking research with stroke survivors and other Acquired Brain Injuries (ABI), people with vestibular disorders, and older adults after falls / fracture falls.  

Staff Members of our Research Team

Professor Nancy Low Choy (View Staff Profile)
Mary Lynch (View Staff Profile)
Emma Taylor (View Staff Profile)
Dr Simone Dorsch (View Staff Profile)

Higher Degree Research Students
Phil Abery
Troy Ditton
Rebecca Ferrier
Sarah Mattin
Ian Parker
Vicky Stewart

Specific research interests include:
1. Predicting the context of falls for stroke survivors, fracture fallers, people with vestibular disorders to enable targeted interventions to maximise outcomes from rehabilitation
2. Use of technologies / biofeedback and intensity of task oriented practice to optimise outcomes with people following stroke / other ABI
3. Factors associated with longer term stroke survivorship
-    Health and well-being of stroke survivors  
-    The relationship between physical activity, balance and gait after stroke
4. The relationship between sensori-motor impairments and disability after stroke
-    Strength / weakness, balance and gait following Stroke / ABI
-    Sensory impairments, balance and gait following Stroke / ABI
-    Unilateral spatial neglect, balance and gait following stroke 

Current projects

1.    Predicting the context of falls for targeted interventions to maximise outcomes from rehabilitation and optimal participation within home/community.

a) Selecting gait measures to predict falls and their context when stroke survivors, ortho-geriatric / frail older adults and / or those with vestibular disorders  are discharged to home from rehabilitation

  • Concurrent validity of the Functional Gait Assessment with the TUG, 10MWT and 6MWT and predictive capacity for falls within 1-month of discharge to home from rehabilitation.
  • Concurrent validity of the HABAM, COVS, PMS and DEMMI at discharge to home from rehabilitation and sensitivity to change at 1-month  follow-up
Collaborators
-    Dr Ann Rahmann, Senior Physiotherapist, Brighton Sub-acute Rehabilitation Unit / ACU
-    Mr Paul Bew, Senior Physiotherapist, Brighton Sub-acute Rehabilitation Unit   

b) Addressing the context of falls following fractures, vestibular deficits and neuro-motor disorders to maximise outcomes and prevent falls / re-presentation to Emergency Department and / or re-admission to hospital.

This collaborative study will be undertaken across 2013-2016 with clinicians based in the ACU Health Clinic and the Rehabilitation Unit (TPCH).

Collaborators  

Australian Catholic University Limited (ACU)
-    Ms Susan Lewandowski, Physiotherapist / Research Assistant, School of Physiotherapy
-    Ms Gail Wickham, Senior Clinician & Clinical Educator, School of Physiotherapy

Clinical Colleagues Metro-North Health Service & District
-    Dr Eamon Eeles, Geriatrician, Internal Medicine, The Prince Charles Hospital (TPCH)
-    Dr Chrys Poole, Geriatrician, Orthopaedics, TPCH
-    Dr Shaun Pandy, Geriatrician, IMS, TPCH
-    Ms Rebecca Ferrier, Senior Physiotherapist Orthopaedics, TPCH
-    Mr Aaron Lamont, Senior Physiotherapist, Orthopaedics and Musculo-skeletal Physiotherapy, TPCH  
-    Mr Greg Morrison, Senior Physiotherapist, Rehabilitation Unit, TPCH
-    Ms Vicky Stewart, Senior Vestibular Rehabilitation Physiotherapist, TPCH

2. Using Technology to increase Intensity of Practice during Rehabilitation after Acquired Brain Injury (ABI):

a) Exergames trial: A multi-centre clinical trial investigating the effectiveness of technology to assist rehabilitation in stroke and orthopedic rehabilitation has been funded by a NHMRC grant ($1.4M).

Does technology increase intensity of practice in rehabilitation?
A randomised trial will be conducted comparing the number of repetitions people with stroke complete in technology assisted rehabilitation for improving balance compared with standard rehabilitation.

Collaborators:
-    A/Prof Cathie Sherrington, The George Institute, The University of Sydney
-    Prof Maria Crotty, Director of Rehabilitation and Ageing, Repatriation General Hospital and Flinders University
-    Prof Richard Lindley, Professor of Medicine, The George Institute, The University of Sydney
-    Dr Annie McCluskey, The Faculty of Health Sciences, The University of Sydney
-    Karl Schurr, Stroke Rehabilitation,  Bankstown Hospital
-    Dr Kate Scrivener, Lecturer, Macquarie University

b) An investigation of the effect of single and multiple dose interventions of insole auditory biofeedback on balance and gait of chronic stroke survivors.  Funding from the National Stroke Foundation ($6,000) has been used to support two preliminary studies:

  • Immediate effects of a single-dose in-sole auditory biofeedback intervention on the spatiotemporal characteristics of gait in chronic stroke survivors: Pilot data.
  • Effect of augmenting a home exercise program with insole biofeedback on balance and gait parameters of stroke survivors

c) The effectiveness of positional biofeedback training combined with task oriented training to improve recovery of balance and gait in people with Unilateral Neglect following stroke:  a pilot study 

3. Factor associated with Stroke Survivorship

a) A survey-based approach to the assessment of health, physical function, self-efficacy and falls risk in stroke survivors and their care-givers. The study is funded by Faculty Health Sciences Research Grant ($17,995.76)

Collaborators

Australian Catholic University Limited (ACU)
-    Schools of Physiotherapy (Low Choy, Dorsch,  Lynch)
-    Nursing, Midwifery and Paramedicine (Professor Mary Courtney, Professor Sandy Middleton, Simeon Dale,        Asmara Jammall-Blasi)
-    Allied / Pubic Health: Professor Janet Hiller and
-    Exercise Science (Dr Michael Cole)

University of Melbourne
-    Dr Kade Paterson School of Exercise Science
 
b) A study of the association between physical activity, balance and gait parameters of chronic stroke survivors.

This study is being undertaken by physiotherapy colleagues across both McAuley and North Sydney Campuses (Taylor, Lynch, Dorsch, Low Choy). A Research Support Team Grant awarded by ACU is being used to fund this study ($15,000).

4. The Contribution of Impairments to Disability after Stroke:

a) Does cycling with electrical stimulation (ES) improve strength and walking ability in stroke survivors?

This randomised controlled trial is investigating the effect of cycling with electrical stimulation on lower limb strength and walking ability compared to usual therapy alone. This study has received funding from the National Stroke Foundation Grant ($11,450)

b) A Longitudinal study of strength and activity limitations after stroke:

This longitudinal study will measure changes in lower limb strength after stroke and the associations between these changes in strength and improvement in activity in the first year after stroke.

Collaborators
-    Prof Louise Ada, The Faculty of Health Sciences, The University of Sydney
-    A/Prof Colleen Canning, The Faculty of Health Sciences, The University of Sydney
-    A/Prof Lisa Harvey, The Rehabilitation Studies Unit, The University of Sydney
-    Mr Davide Desousa, Graythwaite Rehabilitation Hospital, Ryde

c) The relationship between sensory impairment in the lower limb and motor and functional recovery in people with acquired brain injury.

  • Clinical assessment procedures for lower limb sensory function for people with acquired brain injury.
  • The development of a sensory training program for the lower limb for people with acquired brain injury.

d) Physiotherapy Management Practices for Unilateral Neglect following Stroke

The effectiveness of phasic alert training combined with task oriented training to improve recovery of balance and gait function in people with Unilateral Neglect following stroke.

e) Research Higher Degree Projects

  • P Abery:  Investigating the translation of the clinical guidelines for stroke into practice 
  • T Ditton: An investigation into the long term efficacy of four wheel walker use and presentation of back pain: implications for prescription and  management of those using walking aids (Survey & laboratory study)
  • R Ferrier: Maximising Recovery after Surgery for a Fractured Neck of Femur: a prospective cohort study.
  • S Mattin: Readiness for discharge from rehabilitation: Physiotherapist, family/carer and perspectives.  
  • I Parker: Prevalence, profile and efficacy of conservative management for patients on ENT wait-list (RBWH) who present with vestibular dysfunction. 
  • V Stewart: Validity, specificity and sensitivity of the short-form dizziness questionnaire when used in the acute hospital setting to refer older fallers to physiotherapy for assessment and management?