ANZCTR search results

Ageing is associated with a range of anatomical and physiological changes that include the respiratory system. These changes begin as early as 40 years of age and include stiffening of the spine and chest wall. This stiffening has an impact on breathing mechanics and is a cause of the progressive decline in lung function typically associated with ageing. The aim of this trial is to investigate whether reducing stiffness in the spine and chest wall improves lung function in people over 50 years of age. The trial is designed as a randomised controlled trial with 306 healthy people between the ages of 50 and 65 years randomly allocated to one of three equal groups. Group 1 (Control) will receive a standardised exercise program performed on a treadmill. Group 2 will receive a mobilisation protocol designed to increase joint mobility in the thoracic spine and ribs followed by the same exercise program. Group 3 will receive a manipulation protocol designed to increase joint mobility in the thoracic spine and ribs followed by the same exercise program. Each participant will receive six intervention sessions over a period of three weeks. Outcome measurements will be taken by assessors who are unaware of the group a participant has been allocated to. They include non-invasive lung function measurements, chest expansion and a respiratory function questionnaire. These measurements will be taken on four occasions: before the first intervention (baseline), at the end of the intervention period (3 weeks), and then at 3 and 6 weeks post-intervention (i.e. in the 6th and 9th weeks of the trial). The last two measuring points are designed to assess whether the effects of intervention are ongoing. Lung function will be measured using spirometry (exhaling into a tube) and chest expansion measured using a tape measure. It is expected that manual therapy plus exercise will improve lung function more than exercise alone. It is also expected that improvements in lung function will be different for the two manual therapy interventions.

An audit of all consultations for patients 50 years and over spanning 2005-2010 was undertaken. Management of patients was categorised according to treatment delivery (yes/no); treatment type (passive care with/without SMT); spinal region (cervical/thoracic/lumbo-pelvic); whether imaging was obtained (yes/no); image timing (prior to care yes/no); and imaging centre (MUCC/external). This study aims to quantify the imaging patterns and practices at a chiropractic teaching clinic and its significance with respect to spinal manipulation. The use of imaging within the chiropractic profession is the subject of significant debate, and especially the question of whether spinal manipulation should be performed in the absence of spinal imaging of the relevant spinal region. There has been, to date little data on the actual frequency of the use of imaging for patients undergoing chiropractic care. Whilst there is not universal agreement as to the significance of age, it does constitute an ideal starting point, a baseline to quantitatively measure imaging behaviour in a clinical setting. This study sets out with the primary clinical question; "How often do students at a chiropractic teaching clinic view images of the region being treated with high velocity low amplitude (HVLA) manipulation of the spine if the patient is age 50 or greater?" A second question is; "If images were viewed, were they obtained prior to HVLA treatment?" Finally "If images were obtained, were they performed on campus or externally, or both

The primary purpose of this trial is to investigate whether the use microporous polysaccharide hemosphere (MPH) reduces the rate of seroma formation in breast cancer patients following mastectomy. Who is it for? You may be eligible to enrol in this trial if you are aged over 18 and have been diagnosed with breast cancer for which you are scheduled to undergo a mastectomy with or without sentinel lymph node biopsy, and with or without axillary lymph node dissection. Study details All participants enrolled in this trial will be randomly allocated (by chance) to receive either MPH or no MPH applied to the wound prior to wound closure. All participants will be followed up at 2 weeks following surgery to assess the wound site for seroma (fluid pockets). It is hoped that this trial will provide information on whether MPH is effective in the prevention of seroma in breast cancer patients following mastectomy.

Specialised Hand Therapy Services is conducting research in conjunction with Edith Cowan University into outcomes following treatment of tendinous Mallet finger injuries. The aim is to determine whether long term outcomes can be improved by providing an additional splint to the usual standard splint protocol that is currently used. The project is being conducted by Taryn Post, Jessica Mirabile, Cathy Thomas and staff at Specialised Hand Therapy Services and also with Dr. Janet Richmond from Edith Cowan University. This project will help us find out if positioning the finger differently (i.e. with the PIP joint in flexion as well as the DIP joint in extension/hyperextension) improves results/ outcomes for our clients. We are currently evaluating the protocol and splint type that we use for the treatment of acute tendinous mallet injuries. We are collecting data and evaluating the outcomes to better aid in the protocol that we use in the treatment for these diagnoses. We wish to study whether an additional splint that keeps the PIP (middle) joint of the injured finger in a slightly flexed (bent) position while wearing the splint for the injured DIP (end) joint improves long term outcomes and results with conservative/nonsurgical management of Mallet finger injuries.

In this prospective observational study, we are investigating the association between blood proteins (beta-2-glycoprotein I, Apo B100 and HDL) and coronary artery disease as well as complications after percutaneous coronary intervention (stenting or ballooning) and late graft failure after coronary artery bypass grafting.

The primary purpose of this trial is to investigate the efficacy of progressive resistance training for reducing the side effects of loss of muscle and increase in fat associated with androgen deprivation therapy (ADT) for men with prostate cancer. Who is it for? You may be eligible to enroll in this trial if you are aged 50-80 years and have been diagnosed with prostate cancer for which you are scheduled to receive ADT by a GnRH agonist. Study details All participants enrolled in this trial will be randomly allocated (by chance) to either the progressive resistance training group or the control group, who receive no training. Participants in the progressive resistance group will receive self-managed structured 40 minute resistance exercise regimen using dumbbells 3 times a week for 12 months. It is hoped that this trial will provide information on the efficacy of progressive resistance training for reducing the loss of protein, muscle mass and function associated with ADT in prostate cancer patients.

This study aims to determine whether the infiltration of local anaesthetic following transperineal prostate biopsy significantly reduces pain scores as determined by VAS and short McGill pain questionnaire. Who is it for? You may be eligible to join this study if you are a male aged 50 years or above and are undergoing transperineal prostate biopsy. Study details Men will be allocated into 2 groups by chance, a treatment group and a control group. Men in the treatment group will receive infiltration of local anaesthetic (20mls of 0.5% bupivacaine) into the perineal skin after prostate biopsy. Men in the control group will receive no intervention. Data to be collected will be VAS and short McGill pain questionnaire forms 30 minutes following the procedure (to be filled out by the patient). The design of this study (RCT) will enable data collection and analysis to determine whether or not infiltration of local anaesthetic at the time of transperineal prostate biopsy is effective. That is, does it reliably reduce pain scores (VAS and short McGill pain questionnaire) and are the results statistically significant.

The aim of this randomised controlled trial is to evaluate the preliminary efficacy and feasibility of implementing: 1. Three qualified Exercise Specialist sessions and two sessions with a qualified Psychologist OR two qualified Exercise Specialist sessions and three sessions with a qualified Psychologist (based on individual participant choice); and 2. Three qualified Exercise Specialist sessions and two sessions with a qualified Psychologist OR two qualified Exercise Specialist sessions and three sessions with a qualified psychologist (based on individual participant choice) plus a behaviour change support package (e-health, m-health and help-line) on physical activity levels of school teachers who have type 2 diabetes or are at ‘intermediate/high risk’ of developing type 2 diabetes. Physical activity, HbA1C, fasting blood sugar, blood lipids, Body Mass Index, waist circumference, blood pressure, diet, depression, anxiety, quality of life, social cognitive constructs related to physical activity, teaching self-efficacy related to general teaching and sport/physical activity will be assessed. Assessments will be conducted at baseline, 3-months, 9-months and 18-months post baseline.

Non-contact knee injuries (especially those involving the ligaments of the knee) are prevalent in the female athlete population. The risk of knee injury has been largely correlated with several specific biomechanical patterns including knee valgus and lateral trunk flexion during dynamic tasks, as well as measures of postural control. The research team is interested in whether novel injury prevention strategies could help to reduce these risk factors during dynamic tasks (single leg squat and single leg landing). Specifically, we are interested to see if risk factors for knee injury can be reduced following one of the following three interventions. 1. contracting specific muscles of the trunk, known as trunk motor control retraining, for a few moments at a time over a 5 minute period prior to performing a single leg squat and single leg jump task that will be captured using a force plate and motion analysis software for examination of joint angles. 2. contracting specific muscles of the hip, known as hip motor control retraining, for a few moments at a time over a 5 minute period prior to performing a single leg squat and single leg jump task that will be captured using a force plate and motion analysis software for examination of joint angles. 3. application of a soft, flexible sports tape, called kinesio tape applied to joints of the lower limb prior to performing a single leg squat and single leg jump task that will be captured using a force plate and motion analysis software for examination of joint angles. The research team is also interested in relationships between participant height, body composition, leg dominance, and biomechanics, which will be measured using image capture technology and a force plate. The intervention groups will consist of females aged between 18-35 because this is the population most considered 'high risk' for serious knee injury. The aim of the study is to investigate the effects of trunk motor control retraining, hip motor control retraining and application of kinesio tape on biomechanical risk factors for non-contact knee injury during a single leg squat and a single leg landing in female athletes. Participants will be asked to attend three data collection sessions, spread out over a minimum period of three weeks (in order to include for a washout period). The first session will include completion of a health and activity questionnaire and gathering of participant details, such as height and weight. In each of the three visits, participants will either undergo a control session OR trunk muscle retraining OR hip muscle retraining OR application of sports tape to the lower limb, with analysis of a single leg squat and a single leg landing via motion capture ( the sequence will be randomly allocated)

Global demand for plasma-derived products including intravenous immunoglobulin (IVIg) continues to grow steadily. In contrast, medical advances and improvements in patient blood management have decreased requirements for red cell products. With less collections required to meet red cell inventory, the amount of fractionated plasma available from whole blood donations has been reduced. These factors have shifted donor centre operations from a primary focus on whole blood collections to an increased effort to recruit and retain plasmapheresis donors to meet future demand. Australian Blood Service policy currently requires that blood donors give at least one whole blood donation before entering the plasmapheresis programme. The rationale behind this policy has been to determine donor suitability for apheresis donation (e.g. blood type, vein suitability) and to minimise vasovagal reactions and resulting donor drop-outs and deferrals. Similar policies for recruitment to plasmapheresis donation panels exist overseas with only the United States and the United Kingdom Blood Services permitting first-appointment apheresis donation. Consequently, little data exists regarding tolerability and donor acceptance of first-attendance plasma donation – particularly for voluntary non-remunerated blood donors. With improvements in plasmapheresis safety (e.g. saline compensation), and concern over iron depletion among whole blood donors, a review of Australian plasmapheresis donation policy is warranted. Importantly, there is no regulatory barrier to implementing first appointment plasmapheresis donation. If tolerable and acceptable to donors, first-attendance plasmapheresis donation could help to: 1. Increase the plasmapheresis panel and overall collections of plasma for fractionation 2. Reduce the number of first attendance red cell deferrals 3. Reduce reliance on fractionated whole blood donations for collection of plasma