ANZCTR search results

For many years the phenomenon of involuntary movements provoked by yawning, has been observed in stroke patients with paralysed limbs, particularly the arm. More than a hundred years ago, an analysis suggested that removal of inhibitory pathways, unmasked the associated movements of yawning and limb movements, which had an evolutionary link related back to the swim bladder and pectoral fins of fish. In healthy individuals, yawning is often accompanied by generalised stretching, which may include elevation of the arms, known as pandiculation. The paralysed arm of stroke patients can be seen to move during a yawn, often bringing the hand towards the mouth, before suddenly dropping again at the end of the yawn. Walusinski coined this, “parakinesia brachialis oscitans”. The observation appears to have been regarded as a curiosity, with some texts almost derisively regarding it as something that could potentially give false hope to stroke patients. There has been some investigation into the neural basis of yawning in healthy subjects, with interest in the possible involvement of the mirror neurone pathways, and other regions distant to the motor cortex, including the ventromedial posterior prefrontal cortex. Movement of the paralysed limb during yawning in patients with pyramidal tract lesions, has been suggested to provide evidence for an independent “emotional motor” system, separate to the corticospinal motor tracts. Recruitment of these areas and pathways might provide a potential mechanism for recovery of motor function after stroke, particularly in the arm. There may thus be some potential for somehow utilising arm movements associated with yawning to stimulate upper limb recovery. Another fascinating aspect of yawning, is the common observation that witnessing yawning in others may result in another individual yawning; so called “contagious” yawning. This does not appear to be related to hypoxia or hypercarbia8. Some 42-55% of humans witnessing images of subjects yawning, will yawn themselves and the act of thinking of yawning may provoke yawning. 33% of adult chimpanzees yawned in response to seeing videos of other chimps yawning, possibly inferring advanced self awareness and empathy in this species. It is possible, therefore that yawning could be “evoked”, and thus used as a potential means for stimulating upper limb movements in paralysed patients. The exciting potential could be that yawning could thus be utilised as a neurorehabilitation therapy The primary purpose of the study is determine the incidence of Yawning Induced Movements in stroke survivors. We hope to use this data to guide the development of future studies with the aim of determining if these movements can have an application in the rehabilitation of stroke survivors

AIM: The aim of this randomised controlled study is to investigate the impact, in older adults, of a novel aquatic exercise intervention which optimises the haemodynamic stimulus responsible for improvement in brain blood flow and function. HYPOTHESES: 1. A land-based walking program will improve brain blood flow and function in elderly subjects (>50yrs), relative to a matched but non-trained control group. 2. Water-based walking, involving elevated responses to the circulation when training in water will improve brain blood flow and function to a greater degree than land-walking. 3. Improvement in brain blood flow measures will be significantly related to changes in cognition, memory and clinical measures. RESEARCH DESIGN: The study is a randomised, single-blind controlled trial. METHODS: One hundred fifty healthy, insufficiently active individuals, aged 50 years and older, with subjective memory complaints will be recruited from the community. Participants will be randomised to either a land-based, water-based or non-exercise training group. The exercise groups will attend centre-based exercise sessions 3 times a week for 6 months. The control group will maintain their usual lifestyle and attend 4, one hour centre-based healthy ageing education sessions over the 6 months. Primary and secondary outcome measures will be assessed at baseline, 6 and 12 months. In addition the primary outcomes brain blood flow and peripheral vascular function will be assessed at week 12 during the 6-month exercise training period.

This trial aims to establish the impact of a physical activity and fall prevention intervention compared to an advice brochure on physical activity levels, mobility goal attainment, fall rates, mobility disability, quality of life, fear of falling, mood and community participation in community-dwelling older people. We hypothesise that at the end of the 12 month follow-up period, intervention participants will be more physically active, have fewer falls and improve on measures of mobility goal attainment, mobility disability, quality of life, fear of falling, mood and community participation compared to control group participants.

This project aims to estimate the incidence of preoperative frailty in patients undergoing minor surgery at Peter MacCallum Cancer Centre, and to explore the correlation between preoperative frailty and recovery from surgery. It will also explore the practicality of assessing frailty using the Edmonton Frail Scale in a preanaesthetic environment.

Obstructive Sleep Apnoea (OSA) is a common respiratory disease, caused by collapse of the airway during sleep, which produces oxygen desaturations and sleep disruption. OSA is associated with cognitive deficits, reduced quality of life, and depressed mood. The prevalence of both depressive symptoms and major depressive disorder (MDD) are significantly higher in OSA patients compared to the general community. Currently there is little clinical evidence to support whether treatment of OSA improves depressive symptoms in OSA patients with comorbid depressive symptoms or MDD. The aim of this study is to determine whether CPAP treatment improves depressive symptoms and cognitive functioning over the short and long term. This project is a prospective, randomised controlled trial of an enhanced CPAP treatment program for OSA patients with comorbid MDD and depressive symptoms, compared to a wait list control group, and treatment as usual. This study will provide much-needed clinical evidence of the efficacy of CPAP therapy for improving both depression and cognitive functioning in OSA.

This study aims to investigate if, following anaesthesia-related healthcare interventions, individuals with Mild Cognitive Impairment (MCI) or dementia will suffer cognitive decline at an increased frequency or severity, when compared with a comparable group who do not undergo such interventions. Participants will complete cognitive and memory testing at five time points - once prior to surgery, then 7 days, 3, 12 and 24 months following surgery. Participants in the control group who are not having surgery will complete tests at comparable time points.

To assess visual performance of prototype soft contact lens designs compared to commercially available contact lenses.

The proposed study is a single-blind, randomised controlled trial (RCT) comparing two forms of early intervention for psychosis. The proposed interventions are the current model of early intervention for psychosis (i.e., 18 months to 2 years of specialised treatment followed by discharge to standard treatment; FU-ST), and FU-ST in conjunction with a world-first online psychosocial intervention (Horyzons). Patients with first episode psychosis (FEP) will be randomised from between 3 months prior to discharge and discharge from specialised treatment to receive either i) FU-ST, or ii) FU-ST+ Horyzons, for 18 months. The primary hypothesis is that FU-ST+Horyzons participants will show better outcomes than FU-ST participants on social functioning at 18 months follow-up. The secondary hypotheses are that FU-ST+Horyzons participants will show improved outcomes compared with FU-ST on the secondary outcomes of: i) relapse rates; ii) depression; iii) psychological wellbeing, iii) anxiety, iv) social support and social isolation; v) quality of life; vi) satisfaction with life; vii) self-esteem; viii) empowerment; ix) physical health; xi) vocational status; and xii) substance use, over 18 months follow-up. Finally, FU-ST+Horyzons will be more cost-effective than FU-ST at 18 months follow-up. This will be the first study to examine whether an innovative online intervention is an effective strategy for maintaining the clinical benefits beyond discharge of early intervention in first episode psychosis.

This is a single-site, double-blind, randomised, clinical trial of 16 weeks duration and utilising active and placebo arms with baseline data collection. The study aims to: Assess the effectiveness of orally dosed supplement Skin Accumax on treatment of persistent acne grade II and lll in men and women aged 16 to 35, over 16 weeks. Assess quality of life and self-esteem before and after treatment. Evaluate dietary influences on acne through dietary survey. Evaluate safety and tolerability over 16 weeks. Provide information that will be required by Therapeutic Goods Administration (TGA) and international regulatory bodies to support product tolerability and therapeutic claims.

Narrowing or occlusion of the arteries of the lower limb, caused by atherosclerotic lesions, can lead to leg pain, ulceration and ultimately amputation. Endovascular revascularisation is a procedure in which the artery opened through the use of balloons or stents inserted under the guidance of a special x-ray technique called angiography. These procedures have a high rate of failure with about half developing a >/=50% narrowing (or restenosis) within a year. Much of this failure rate is attributed to technical factors such as incorrect size of catheter or incorrect positioning and in part may relate to the limited view provided by angiography. Intravascular ultrasound (IVUS) is an alternative imaging method that provides a more complete view of the artery. It has been shown that IVUS adds more information when combined with angiography but it is unclear whether this results in changes to treatment and whether this then results in better outcomes for patients. This aim of this study is to investigate whether the addition of IVUS improves the outcomes for endovascular revascularisation. This is a randomised control trial comparing endovascular revascularisation procedures guided by angiography with procedures guided by both angiography and IVUS. The study sample of 150 patients will be recruited from patients requiring treatment of lesions in the superficial femoral or popliteal arteries. Patients will be randomised into two groups of equal size; a control group having angiography guidance only and a second group having both angiography and IVUS guidance. All patients will have non-invasive tests of endothelial function (tests of the functioning the inner surface of the artery – an essential component in maintaining vascular wellbeing) before their and after the procedure as well as the standard blood tests and regular surveillance imaging that is normally scheduled for patients after these procedures. The primary outcome measure will be >/=50% restenosis of the treated artery. This degree of restenosis requires re-intervention to reopen the artery. At this point the original procedure will be deemed to have failed for the purposes of analysis. The restenosis rate will be compared for each group.