ANZCTR search results

This study is a stepped wedge randomised controlled trial aimed at investigating the implementation and clinical effectiveness of multidisciplinary post-discharge bundles on preventing readmission for older people transitioning from hospital to residential aged care for the first time. This will be carried out at multiple hospital sites in three local health networks in South Australia. Eligible patients will be stratified according to their risk of readmission and will receive a customized post-discharge bundle of interventions based on their assessed risk. The outcomes are 30- and 90- day readmissions after the index discharge and length of stay out of hospital. Process evaluation will include the acceptability, adoption, feasibility and fidelity of implementation.

The aim of this feasibility study is to compare the effects of dance therapy in addition to usual care with conventional group-based physiotherapy in addition to usual care, on physical function in recently hospitalised adults with acquired brain injuries. Specifically the researchers of this study will examine the effect of dance compared with conventional physiotherapy therapy on physical function, mobility, self-efficacy, quality of life and satisfaction; understand patients’ preferences for dance therapy; and assess the acceptability, adherence and adverse events associated with a dance therapy program. A steering committee of consumers, dancers and the health service will co-design the dance therapy program and will meet bimonthly either face to face or online platform (given general health recommendations during the global pandemic) to discuss about the program. Adding dance to rehabilitation may have the potential to reduce hospital lengths of stay and return people to their homes earlier by enhancing motivation, providing additional opportunities for movement.

Optimal nutrition is critical in protecting against frailty in later life. A Mediterranean diet has been shown in international trials to reduce frailty in elderly individuals living independently. This benefit is related in part to the impact of diet on gut microbiology. Our study focuses on extending this highly successful nutritional strategy to those living in residential aged care facilities.

Residential aged care facilities (RACF) have experienced catastrophic outbreaks of the COVID-19 respiratory virus, yet the development of RACF-specific protective measures have been largely neglected. Commercially available upper-room germicidal ultra-violet (GUV) devices (with effective air-mixing) have been shown to be highly effective against airborne viruses, including influenza and SARS-CoV-1. Similarly, when GUV has been deployed in “in-duct” or standalone systems (wall-mounted or portable), it has been shown to result in significant reductions in both viral viability and rates of symptomatic respiratory infections. These GUV modalities might therefore be combined to achieve effective air disinfection in accordance with RACF layout, occupancy, and air ventilation setups. Our study expects to find that facility-tailored GUV strategies, as an adjunct to existing infection control measures, can substantially reduce rates of symptomatic respiratory viral infection in residents of residential aged care facilities.

The aim of this study is to evaluate the efficacy and efficiency of two telerehabilitation interventions: 1) traditional model which is predominantly focuses on improving physical function and is currently offered as usual care by the home rehabilitation service: 2) a rehabilitation intervention which focuses more on participation in usual activities and is offered via a coaching model to a virtual group of people. Both interventions are provided in a telehealth format as a response to the global pandemic, COVID-19. The purpose is to determine whether the novel intervention is more effective as well as if it is more efficient (as it is offered in a virtual group format). We plan to recruit 58 participants who have been confirmed with COVID-19 and referred to home rehabilitation services at Flinders Medical Centre Division of Rehabilitation Aged and Palliative care. At the completion of the study, we expect to be able to describe the functional and social impacts of a telerehabilitation interventions for individuals confirmed with COVID-19 receiving home rehabilitation services.

Impaired arm and hand function is a common and often devastating problem for stroke survivors. Regaining lost movement in the arm/hand is more difficult to achieve than walking, with only 5% of people with hemiplegia regaining functional use of their hand. This devastating outcome could potentially be addressed, however we do not yet know how to best increase movement in the arm and hand after stroke for patients with spasticity. There is a lack of randomized controlled trials of botulinum toxin A (BoNT-A) with a group who does not receive therapy in some dose, and so whether gains were achieved through BoNT-A or a combination of the BoNT-A and therapy cannot be determined from the studies to date.The research project is testing whether intense therapy given after botulinum toxin injections into the arm is more helpful than just the injections alone.

Mobility limitation is common in rehabilitation patients and can be improved by well-designed exercise programs. Exercise in people with mobility limitation is associated with better functional outcomes if the exercises relate closely to functional movements required for daily task independence. The broad aim of this project is to enhance mobility outcomes for people undergoing aged care and neurological rehabilitation. The specific hypothesis of this trial is that the addition of technology-based interactive exercises involving feedback to usual care will lead to better mobility outcomes than usual care alone for people admitted to aged care and neurological rehabilitation wards with mobility limitations. This study also aims to assess the cost-effectiveness of the intervention compared with usual care, establish predictors of greater use of the technologies and enhance understanding of participant experiences of technology use with qualitative methods. Participants will be randomised into a control and intervention group (n=300). Both groups will include hospital patients undertaking a usual rehabilitation program and the intervention group will receive one extra 30 to 60-minute session per day of video and computer or tablet-based interactive exercises. After discharge from the inpatient stay, participants in the intervention group will be encouraged to continue using the technologies at home. The total duration of the intervention will be six months after randomisation. Participants will be loaned necessary technology and trained in the safe use and progression of the games/exercises during a home visit by therapy staff. Weekly support via telephone, email of videoconference will also be provided during this phase of the study. This support will aim to assist study participants to maintain motivation and will identify and address any barriers to technology use at home. A baseline assessment will be conducted and follow-up assessments will occur at 3 and 12 weeks and 6 months after randomisation.

Several systematic reviews have indicated that additional exercise therapy and repetitive task training have a significant effect on functional outcome after stroke. Guidelines therefore conclude that patients in a rehabilitation setting should have the opportunity to get an increase of intensity of therapy. A new method to meet these recommendations could be to involve caregivers (partner, family, friends) in exercise training. Previous studies suggest that this form of exercises done with a caregiver can lead to a better functional outcome for the patient and less strain for the caregiver. This feasibility study will test the proof of concept of caregiver mediated exercises when combined with innovative ICT techniques (CARE4STROKE package) aimed at improving gait, ADL independency and allowing early discharge to patients own home setting after stroke. We hypothesize that patients allocated to the CARE4STROKE programme will show better outcomes in terms of gait, gait-related activities and ADL with a reduced length of stay (LOS) when compared to usual care alone. In addition we hypothesize that this programme leads to increased levels of self-efficacy for patient and caregiver and a reduced caregiver burden. This study is related to the CARE4STROKE trial registered on NTR with ID: NTR3739.

This project aims to see if a 4 week rehabilitation program will improve the health of older people living in an aged care facility who have recently had a hip fracture.

This project will evaluate a client-centred motor-training intervention to improve functional outcome after botulinum toxin injection (BoNT-A) for people with a neurological injury (stroke or brain injury). Spasticity is common following stroke and those with greater spasticity typically experience less recovery. Current treatment for spasticity is to provide BoNT-A, an antispasticity drug. Some evidence exists to support the use of BoNT-A, but all studies recommend that BoNT-A be provided in conjunction with physical therapy. However, little direct evidence exists for optimum type, dosage and timing of therapy. Participants will be recruited on a consecutive admission basis from hospital outpatient spasticity clinic and receive an 8-week intervention which will include intensive one-on-one physiotherapy, behavioural strategies to increase patient motivation, and a task-specific home exercise program. A distinguishing feature of the program is that it is tailored to the specific needs of each participant, patients are extended to receive intensive physiotherapy practice, and the content is driven by the Clinical Guidelines for Stroke Management (National Stroke Foundation, 2010). Outcomes will be assessed at baseline, post-intervention, and at 3 months following the conclusion of intervention and will include assessment of functional movement, quality of life, and cost.