Health Sciences

Paediatric Research Group

The ACU School of Physiotherapy Paediatric Research Group is a collaborative research group from the Brisbane and Sydney campuses. The aim of this research group is to develop, conduct and publish research to support better outcomes in child health and fitness. In addition, the group works with industry partners in health and education to address key areas of need in growth and development throughout childhood.

Researchers:
Dr Jane Butler (View Staff Profile)
Dr Marcella Danks (View Staff Profile)
Dr Judith Hough (View Staff Profile)

Higher Degree Research Students:
Bronagh McAlinden

Area of Research

  • Physical activity in childhood
  • Developmental outcomes for at risk children
  • Physiotherapy support of the infant in neonatal intensive care
  • Sports related injuries in adolescence

 

Physical Activity in Childhood

Collaborations:

  • Mater Health Services Health and Wellness Clinic, Brisbane, Australia.
  • The Cerebral Palsy Alliance of NSW


Physical activity and walking parameters in childhood project
Decreased levels of physical activity have been widely reported across childhood into adolescence amongst typically-developing children.  These decreased levels of physical activity have also been seen in populations of children with emerging chronic health conditions and physical disability.  Decreased physical activity may be related to poorer health outcomes. Therefore, promoting physical activity in all childhood populations is a health priority.  To support healthy lifestyles in childhood, physiotherapists are increasingly being called on to promote physical activity in children.  A closer examination of measurement tools for physical activity and the association between physical activity and quality of walking (temporal-spatial parameters of gait) and walking capacity (distance walked) may help clinicians inform community-based physical activity programs.

Physical activity and cardiorespiratory fitness in children with cerebral palsy
It is known that children with cerebral palsy have decreased levels of cardiorespiratory fitness compared to their typically-developing peers. It is also known that decreased cardiorespiratory fitness in these children contributes to ongoing physical inactivity due to reduced stamina and aerobic capacity.  Of concern, is the knowledge that these factors are likely to be discouraging, or limiting, participation in community activities.  This is an ongoing study to investigate physical activity, cardiorespiratory fitness and walking capacity in independently walking children with cerebral palsy.

 

Developmental Outcomes for At Risk Children 

Collaborations:
Growth and Development Clinic, Mater Mothers’ Hospital, Brisbane Australia.

  • Dr Peter Gray
  • Dr Yvonne Burns
  • Dr Monica Cuskelly
  • Leith Poulsen

Vision Australia, Brisbane, Australia

  • Amanda Bacon

Trish Wisbey-Roth and Tahnee Westbury, Bounce Back 4 Kids, Oatley NSW.

Current research projects in Developmental Outcomes for At Risk Children:

Motor ability and behaviour outcomes in children born extremely preterm
Children born extremely preterm have a high prevalence of developmental delay including poorer motor, learning and behavioural outcomes. As these children have poorer outcomes than term born children and need more support, there is a need to better understand constraints on the developmental outcomes of these children. Recent research has found that chronic mild motor impairments can predict decreased behavioural outcomes in term born children. However, while mild motor impairment in children born preterm has been shown to be predictive of other developmental outcomes such as learning, the relationship between mild motor impairments and behavioural outcomes in the children born extremely preterm has yet to be investigated.  Investigating the relationship between mild motor impairments and behaviour may benefit theses children by identifying possible opportunities to support better function.

Neurodevelopmental outcomes of infants following gastroschisis repair
The number of infants requiring major surgery in the immediate period following their birth is increasing. This is particularly so for children who are born with a defect in their abdominal wall (Gastroschisis). This condition must be repaired surgically as soon as possible after birth. Although this abdominal defect can be successfully corrected with surgery, it is not known whether these children go on to fully recover form the surgery and to grow and develop as  well as children who did not need surgery in infancy. This needs to be investigated to identify if these children are experienceing ongoing difficulties in their gowth and development and if they would benefit from early intervention services.

Physiotherapy intervention for children with developmental coordination disorder
Developmental Coordination Disorder (DCD) is a universal term used to describe children who present with impairment in their gross motor, postural and/or fine motor performance which affects their ability to perform skilled movements essential for daily living. Approximately 6-8% of school-age children in Australia have movement difficulties which could be categorised as DCD. Physiiotherapy for these children differs throughout Australia and has varaiability in effectiveness of intervention. The aim of this study is to investigate the effectiveness of an 8 week group-based task orientated therapy approach for children who have been identified as having DCD. It is anticipated that the information gained from this study will lead to a better understanding of the effect a task oriented exercise program has on the fine and gross motor skills, balance, awareness, posture, core strength and motor planning abilities in these children. Consequently, this knowledge could be used to inform the efficacy of using such a program for professionals working with children identified with DCD.

Physiotherapy support of the infants in Neonatal Intensive Care

Collaborations:
Mater Research Institute – University of Queensland

- Critical Care of the Newborn Program

  • Dr Luke Jardine
  • Andrew Shearman

- Paediatric Critical Care Research Group

  • Dr Andreas Schibler
  • Dr Luregn Schlapbach


Current research projects in Physiotherapy support of the infants in Neonatal Intensive Care:

HiSigh. Does the addition of intermittent sigh breaths when compared to standard high frequency ventilation improve end expiratory lung volume measured by electrical impedance tomography?
Ventilator induced lung injury (VILI) remains a problem in neonatology. High frequency oscillatory ventilation (HFOV) provides effective gas exchange with minimal pressure fluctuation around a continuous distending pressure and small tidal volume. Animal studies showed that recruitment and maintenance of functional residual capacity (FRC) during HFOV could reduce lung injury. Some neonatologists suggest combining HFOV with recurrent sigh-breaths (HFOV-sigh) delivered as modified conventional ventilator-breaths at a rate of 3/min. The clinical observation is that HFOV-sigh leads to more stable oxygenation, quicker weaning and shorter ventilation. This may be related to improved lung recruitment. Electric Impedance Tomography (EIT) enables measurement and mapping of regional ventilation distribution and end-expiratory lung volume (EELV) and has been shown to be a valid and safe tool in neonates. The purpose of this study is to compare HFOV-sigh with HFOV-only and determine if there is a difference in global and regional EELV and spatial distribution of ventilation measured by EIT and to provide information on feasibility and treatment effect of HFOV-sigh to assist planning larger studies.

Humidified nasal high flow for infants with respiratory dysfunction  
Respiratory therapy using humidified high flow nasal cannula (HHFNC) has gained acceptance in many neonatal units. A number of studies have investigated the effect of HHFNC and HFNC in treating apnoea of prematurity, on continuous distending pressure (CDP) in neonates, pharyngeal pressure and its role in the post extubation period. Despite its acceptance, the use of HHFNC is still controversial and not recommended by some outside of a research protocol.. Of primary concern is the paucity of available evidence on the effect of HHFNC on CDP and end expiratory lung volume (EELV), and the perceived associated risks. The purpose of this study is to investigate one specific commercially available HHFNC and measure its effect on CDP, EELV and regional ventilation distribution and other respiratory physiological parameters such as heart rate, respiratory rate and work or breathing.  CDP will be a direct measurement of oesophageal pressure and is equivalent to alveolar pressure, while EELV is a calculated measure of relative volume at end expiration.

The effect of chest physiotherapy on regional lung volume changes in ventilated children using Electrical Impedance Tomography.
Children who require mechanical ventilation are at risk of lung collapse from increased airway secretions and ineffective clearance of these secretions. Chest physiotherapy, which involves a combination of patting and shaking the chest, positioning, assisted breathing techniques and airway suctioning, is often used to enhance the removal of these secretions that can cause lung collapse. Previous studies have used indirect measures of examining the effect of chest physiotherapy techniques on oxygen requirements but none have looked at its effect on distribution of air within the lung. Electrical Impedance Tomography (EIT) has the potential to non-invasively examine the effect of chest physiotherapy on air distribution within the lung. This study will describe these changes in a group of ventilated infants and children. We aim to demonstrate the positive effect of physiotherapy intervention on regional lung ventilation and determine the potential of EIT as a clinical assessment tool.

Sports related injuries in adolescence

Collaborations:

  • NSW Academy of Sport, Narrabeen, NSW.


Current research projects in Sports related injuries in adolescence:

Screening assessment for shoulder stability in adolescent male rugby players
Rugby union, as a contact sport, is inherently associated with a high risk of injury with adolescents representing a large proportion of the rugby-playing population. The implementation of injury-prevention strategies for adolescent rugby players is an area that has received very little attention. While a large number of studies have collected epidemiological data on adolescent rugby injuries there are few that have tested predictive injury risk factors in this population. Specifically, there is little evidence-based information on risk factors for shoulder injury. Therefore, this project will investigate shoulder strength, shoulder range of movement and joint hypermobility in adolescent rugby union players in order to determine the relationship between these variables and shoulder stability.