ANZCTR search results

Alignment of total knee replacement is of importance with regards to the length of survivorship. Currently a rod is passed down the centre of both the tibia and the femur so as that the correct bone cuts are made in order the prosthesis fits the bone in the correct alignment. New technology now exists that enables custom cutting blocks to be manufactured specifically for that individuals patients knee so as the bone cuts made are as accurate as possible. This involves undergoing an MRI scan of the knee and from this the cutting blocks specific for the patients knee are made. This new technology is used to aid in establishing the correct bone cuts in the tibia and femur and hence ultimately the overall alignment of the knee replacement. The knee replacement used will be the same type in each group and the method of insertion will be the same. Post-operatively both groups will undergo a CT scan of the knee in order to establish the precise alignment of the knee replacement in relation to bony landmarks. From this we can establish whether or not there is any difference between the two different methods of bone preparation in the overall alignment of the knee replacement.

The study aims to determine if a group exercise and educational program provides benefit after hip or knee joint replacement surgery. Previous research has indicated that these programs do not provide much benenfit post-operatively, especially post knee replacement. We will evaluate if patients who receive the intervention reach functional milestones during hospital stay more quickly after surgery than patients who do not complete the program. It will also provide data that could be used to design a larger study in the future.

Mouth (oral) route breathing during sleep may be a risk factor for obstructive sleep apnoea (OSA) leading to increased disease severity related to a more collapsible upper airway. CPAP (continuous positive airway pressure) is the current gold standard treatment of choice for severe OSA for mild to moderate OSA CPAP is less convincing and often less well tolerated. Hence a range of alternative treatment options have been utilised with varying degres of success. Because of the lack of effective and iniversally acceptable therapies for OSA there remains a need to develop alternative approaches. One such approach maybe to prevent oral route breathing during sleep which maybe an important contributor to worsening uppder airway obstruction in subjects who breathing oronasally during sleep.

For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning. This study builds on our earlier research which demonstrated significantly improved blood glucose levels from a strength training program for older adults with T2DM. The strength training program is to be administered nationally in a research to practice trial (Lift for Life); however, the original research found that those who did not complete the program as it was intended (ie, poor adherence) did not show significant improvements in blood glucose levels. Furthermore, maintenance of strength training exercises after completion of the program was poor and resulted in return of blood glucose levels back to pre-starting levels. In people without diabetes, we have collected pilot data that shows that the use of behavioural strategies based on behavioural theories whereby each person’s motivations and barriers are taken into consideration is more effective than the traditional one-treatment-fits-all approach. This study will evaluate the effectiveness of using behavioural strategies for improving adherence and maintenance to the Lift for Life strength training program (Enhanced L4L) for older adults with T2DM compared with the Standard L4L program. It will also follow-up participants 6 months later to determine the extent to which the changes in behaviour can be maintained. The study will provide information that will assist in the design, delivery and uptake of programs to improve treatment strategies in older adults with T2DM through the maintenance of healthier behaviours and lifestyles.

The study aims to determine if exercise during significant weight loss as a result of a very low calorie diet influences cardio-metabolic risk factors to a greater extent than current standard practice and in doing so enhances patient adherence to a healthier lifestyle. Design and Methods 120 pre menopausal females, aged 18 and 50 years will be recruited for this study. Participants will be randomly allocated into either a 12 month exercise intervention (EXER) group or control (standard care ER) group. People will be excluded from the study if they have: (i) muscle or joint problems that limit physical activity, (ii) have type 1 diabetes, (iii) are pregnant or planning to become pregnant in the next 12 months, or are breast feeding, (iv) Unstable cardiac condition. The exercise group will train with an accredited exercise physiologist (AEP) and/or Masters of clinical exercise physiology student three days per week for 6 weeks and slowly reduce in face to face contact over the 12-month period. During the 12-month period participants will increase home based exercise developed in conjunction with the AEP and/or Masters student. The AEP will remain in regular contact with the participants through the use of telecommunication, email and social networking in addition to the supervised training that progressively reduces to fortnightly consultations in the second 6 month period. The intention of this model is to help the participant move from high reliance and contact with the AEP to self-management of their own exercise program, while still receiving ongoing support of the AEP. Training will consist of a variety of aerobic and resistance exercise with a 5 minute warm up followed by 50 minutes of exercise and 5 minutes of cool down at either: Deakin University Burwood campus, BakerIDI, or community based facility. At baseline and at 3, 6 and 12 months, after recruitment participants will undergo the following assessments at Deakin University Burwood and Baker IDI: Dual-energy X-ray absorptiometry (DXA) body composition; fasting blood collection to measure cholesterol, glucose, insulin, markers of bone formation and breakdown; muscle strength tests, aerobic capacity (fitness) test; sit to stand out of a chair, blood pressure over 24 hours, physical activity recordings using an accelerometor, recordings of nerve activity of the leg and testing of the elasticity of the blood vessels using non-invasive methods; and questionnaires to assess quality of life, exercise self efficacy, and rating of musculoskeletal pain.

Providing Mobile Mentor will increase weight loss and improve retention on a meal replacement program.

The aim of this project is to examine whether impaired bronchodilator recovery in asthma is due to: 1. reduced bronchodilation and/or 2. reduced bronchoprotection. This will be explored in 2 studies. Participants can participate in 1 or both of these studies. Study 1 is described below. Study 1. Effects of macronutrients on bronchodilation At baseline, participants will consume the study meal (fat, carbohydrate or water), then their lung function will be assessed. They then will be administered with a short acting B2-agonist (salbutamol 400ug). Lung function measurements will then be repeated hourly, for the next 6 hours.

This study will investigate whether nerve and tendon gliding exercises are capable of reducing carpal tunnel pressure in patients with carpal tunnel syndrome

This study will investigate whether nerve and tendon gliding exercises or splinting are capable of reducing swelling intra- as well as extraneurally in patients with carpal tunnel syndrome.

1. Patients with a unilateral vocal fold palsy (UVFP) who are randomized to undertake Expiratory Muscle Strength Training (EMST) will demonstrate greater improvement in measures of voice quality and airway protection over a six-week period than patients who are randomized to undertake ‘Usual’ voice therapy. 2. Both the EMST and Usual groups will show improvement in their measures of voice quality compared to patients who elect not to undertake therapy. 3. Patients who undergo EMST and Usual therapy will maintain improvements to their vocal quality when followed up one month post completion of treatment. 4. Patients with UVFP in the EMST group will show greater adherence to treatment techniques than patients in the Usual group.