ANZCTR search results

Distress with breathing or shortness of breath can be a debilitating experience for people suffering from lung diseases. The severity of this sensation often precludes individuals from maintaining a normal active lifestyle. As the severity of the shortness of breath increases, so the activity performed decreases, often to the point where moving from one’s bed or chair can be exhausting. The general physical and mental health consequences of this are such that these individuals and those who care for them have a significantly lower social and mental health well being. The severity of breathlessness and impairment of activity have been shown to correlate strongly with increased hospitalizations and a longer time to recovery once their condition has worsened, as in the case of exacerbations. It is hoped that a low density gas mix, such as Heliox (21 % oxygen in balance Helium), can reduce the magnitude of muscular effort associated with breathing in patients with chronic obstructive pulmonary diseases (COPD) and allow for an alteration in both the sensation and magnitude of dyspnoea allowing patients to exercise longer and at greater intensities., thus facilitating a training effect. This would allow these individuals to improve their social activity, mental health and their quality of life whilst reducing the recovery time resultant from a transient worsening of their conditions (infective exacerbations of COPD) which may have otherwise predisposed hospitalization.

Critically ill patients often have signs of inadequate oxygen delivery. We know this adversely impacts on survival. The hypothesis is that the introduction of non invasive cardiac output monitoring will allow us to improve or correct oxygen delivery, thus possibly improving survival

Cystic Fibrosis (CF) is a commonly inherited genetic disorder affecting numerous bodily systems, with great impact on the respiratory system including thoracic muscles. Although musculoskeletal problems such as back pain appear to be common in CF patients, there has been little research conducted to investigate the efficacy of musculoskeletal techniques such as stretching in this population. Cystic fibrosis patients are invited to take part in a study to investigate the effects of stretching exercises on quality of life. Background You will be invited to attend one session, lasting 60 minutes at the Department of Physiotherapy, Prince Charles Hospital, where a physiotherapist will assess the following: 1.How much air you can breathe out in 1 second, repeated up to 6 times 2.Amount of movement you have in your arms, using a device to measure angles 3.How much you move your upper, middle and lower chest during breathing, by placing a tape measure around your chest and asking you to breathe in and out 3 times. 4.Measuring the curve of your thoracic spine by placing a soft mouldable ruler over your spine while standing 5.Fill out a questionnaire containing questions regarding your quality of life. 6.Fill out a questionnaire containing questions how your pain affects your daily tasks After the 1st session, you will be randomly allocated to one of the following groups. Arm stretches group: This involves completing a series of stretches for your arms and trunk over the 6 week period. Your physiotherapist will show you these exercises. You will be asked to do these once a day over the study period and complete a diary of how many exercises you performed each day. Leg stretches group: This involves completing a series of stretches for your legs over the 6 week period. Your physiotherapist will show you these exercises. You will be asked to do these once a day over the study period and complete a diary of how many exercises you performed each day. At the end of the 6 week period, you will be asked to attend another visit to repeat the above measures. Benefits Your participation in the study is not likely to benefit you directly but may assist in the development of future rehabilitation programs for patients with cystic fibrosis.

By the year 2031 women (and men) who are currently 40 years of age and over will comprise the 25% of the Australian population aged over 65. The projected fall related health costs will have escalated to over $1000 million annually (Moller 2003) and the current rate of falls (1 in 3 older persons falling annually) will continue for those over 65 (Morris et al 2004) unless new initiatives are implemented. Moller (2003) identified a need for more effective prevention of falls and we believe this intervention must start before decline in balance and bone density become established. Current initiatives that aim to reduce falls and fall related injury and are available in the community presently target adults 65 years and over. Over the last eight years our research team has undertaken a number of projects that helped to inform the evidence base regarding the decline in the sensory-motor contribution to balance and the efficacy of specific balance strategy training in counteracting this decline. Our research team has demonstrated that postural stability and functional balance capacity are significantly reduced in women across the menopause transition period (40 to 60 years) and further reduced in the older person (Isles et al 2004, Low Choy et al 2003, Nitz et al 2003). We have found reduced strength and flexibility, reduced sensory acuity, and increased joint position error and higher thresholds of vibration sensitivity negatively contributing to this early change period in balance ability (Low Choy et al 2008; Low Choy et al 2007; Nitz & Low Choy 2004). Similar findings were reported by Lord & Ward (1994) although there was less data for women under 65 with only 20 to 30 subjects in the 40s and 50s decade groups compared to 118 and 116 for our study. A contributing factor associated with reduced strength and flexibility and reduced ability to balance in women, (Nitz & Low Choy 2007) is a lower self-reported activity level where habitual patterns of activity range from sedentary through to walking several times a week at a comfortable pace. Another most important aspect revealed by our studies of women aged 40 to 80 years has been the identification of the prevalence of falls across these decades and the major physiological factors that might have contributed to the falls in these women. Of particular interest are the findings over the 5 year longitudinal assessment study of balance and postural stability in women aged 40-80. Falls were recorded in 8.5% of women in their 40s in the year 1 audit and this rose to 15% in year 5. For those in their 50s, 13.5% had fallen at year 1 audit. This prevalence remained stable over 5 years. 24.5% of women in their 60s had fallen at year 1 audit but this prevalence dropped slightly to 21% by year 5 and 43% in their 70s had fallen at year 1 audit and this prevalence dropped to 31% by year 5. Of interest is the rise in multiple fall episodes in some women in their 40s through to 70s in the 5 year data collection period (Nitz et al, in review). This provides compelling evidence for the need to target women prior to age 64 for pre-emptive balance preserving intervention. Of particular interest for these younger women is what type of exercise might be adopted to address these declines and potential to fall. We propose to investigate three different exercise approaches that theoretically might reduce or delay the decline in balance and sensorimotor function in younger women. The effect of three approaches to slowing the balance, sensorimotor and fitness decline problem through three different exercise programs will be compared. Previously, balance strategy training has been shown and to improve balance (Hourigan et al 2008) as has aerobic exercises (Lui-Ambrose et al 2007). The effect achieve through exercise using a Wii.Fit™ will be evaluated. Then the three exercise approaches will be compared for effect. Primary aims are to: 1. demonstrate the effect of a training program using the Wii.Fit trademarkon balance, sensorimotor function and fitness in women aged 20-70years. 2. compare the effect in women aged 20-70year of Wii.Fit trademark training with balance strategy training (BST) and aerobic training (AT). Secondary aims are to identify whether one training method is better than another in this cohort of women

Aim is to determine the overall level of activity generated in everyday living by patients with COPD and co-morbidities compared to a COPD population without co-morbidities. The hypothesis is that people with COPD and co-morbid conditions generate less physical activity in every day living compared to people living with COPD with no co-morbid conditions.

This is a clincial trial running within Shenton Park Rehabilitation Hospital. Recruitment is from the outpatient rehabilitation list.

Aggressive behaviours are common issues in young people accessing mental health services. Fish oils are popular treatments and are sometimes marketed for behavioural problems. However, no research has specifically examined fish oils for aggressive behaviour in young people. This study will examine whether fish oil is able to reduce the frequency and severity of aggressive behaviour in children and adolescents.

In recent years, researchers of psychotic disorders, a group of mental disorders that involve a loss of contact with reality and symptoms such as hallucinations and delusions, have focused their attention on studying the early phase of psychotic disorders, referred to as the prodromal phase. The prodromal phase is the period of a psychotic disorder where individuals experience the types of symptoms that are indicative of a psychotic disorder but are not yet of the severity or frequency that constitute a psychotic disorder. Much of the disability associated with psychotic disorders can develop during this phase, and such disability is difficult to reverse once a full psychotic disorder has developed. Hence, researchers are keen to learn more about the prodromal phase of psychotic disorders and investigate treatment strategies that can be applied during this phase with the hope of preventing, delaying or reducing the severity of psychotic disorders. As yet, a clear treatment strategy for this phase of disease has not been established. Researchers have established criteria to define individuals who are 'at risk' of developing a psychotic disorder. These are referred to as the 'ultra high risk' (UHR) criteria. Not all patients who are 'at risk' go on to develop a psychotic disorder; however, the use of such criteria allows researchers to further define the prodromal phase and investigate strategies that may prevent the development of a psychotic disorder. In this study, 320 patients who are 'at risk' of developing a psychotic disorder will be treated with omega-3 fatty acids, naturally occurring molecules found in fish oil, or receive a placebo. In addition to receiving one of these two treatments, all patients will receive a psychological treatment known as cognitive behavioural case management, which is based around standard case management and cognitive behavioural therapy that is routinely delivered by doctors and psychologists. The primary aim of the study is to determine whether omega-3 fatty acids, provided on a background of cognitive behavioural case management, can reduce the incidence of the development of a psychotic disorder in patients who are 'at risk' of developing such a disorder.

Phase 1 and 2 This study looks at the effectiveness and side effects of different dose strengths of the drug sunitinib used in combination with standard pre-operative radiotherapy for soft-tissue sarcoma. Who is it for? You can join this study if you have soft-tissue sarcoma that has been confirmed by microscopic analysis, and is suitable for preventative radiotherapy and surgery and you are aged 16 years or older. Trial details Location: Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Victoria, Australia. Participants will receive treatment over seven and a half weeks’ treatment. This involves 14 days of orally administered sunitinib followed by 5 weeks of combination treatment comprising standard pre-operative radiotherapy and oral administered sunitinib, at varying dosage levels. This research is being carried out with the aim of developing a more effective treatment than standard radiotherapy and surgery alone. Although standard treatment is frequently successful, some patients do not respond well to this treatment. Low oxygen levels in tumours, which may be a particular problem with sarcomas, are thought to be one factor that contributes to failure of radiotherapy. Sunitinib is a new drug that is active against cells with low oxygen levels. The combination of sunitinib and radiotherapy has shown promising results in other cancers. The purpose of this study is to find out whether treatment with a new drug, sunitinib, can increase the effectiveness of radiotherapy at killing cancer cells, and to test the safety of the combination of sunitinib and radiotherapy.