ANZCTR search results

We aim to assess whether undertaking a structured, non-weightbearing exercise program over 20 weeks will accelerate healing in people with chronic diabetic foot ulcers. We also aim to assess whether this program improves glycaemic control, body mass index, wound bed substrate and quality of life.

The study aims to measure skin oxygen tension of skin adjacent to chronic wounds and assess whether low oxygen tension occurs in wounds that have delayed healing. If there is a relationship, this measurement device may be used as a screening tool to identify those people who require additional therapies in order to improve healing rates.

This study will evaluate the safety of a new anti-infective gel, and will also measure how well it is tolerated when applied two times a day to the forehead for 28 days.

This project includes researching the benefits of applying a chronic disease management model to veterans with alcohol use issues. It will assess the effects of increasing self management (the Flinders model of chronic condition self management) for veterans who have alcohol related conditions compared to usual care. Alcohol use has been identified as a significant issue for the veteran community. It is reported that alcohol dependence is one of the four most common mental health disorders among veterans who have an accepted mental health disability. In addition, the level of co-morbidity between alcohol and other health problems among veterans, particularly mental health problems, is high. Methods for increasing self management and positive behaviour change in veterans with alcohol related conditions are needed. This will be a randomised control trial (50:50 randomisation) with measurement of repeated measures of quality of life in 160 patients. VV will be randomized either to Group A (Flinders group) or Group B (usual care group with a waiting list option to have the FM after nine months). a fifteen-month recruitment and intervention phase with a thirteen month follow up phase for between-group comparisons. Recruitment will be through the RGH, general practitioners in the Southern area, community health care centres, Vietnam Veterans Counselling Service (VVCS) and advertised through VV groups. Veterans will either be approached by their health professional or will volunteer themselves after hearing of the study.

We think that the bandaging people put in place when someone is bitten by a snake is not stopping that person getting sick. We want to test if this is because of the bandages we use not being very good, or if the first aid is just difficult to put in place correctly. We will test different materials and a different way of bandaging. We know that the bandages need to be tight, but not too tight and we can measure the pressure inside the bandage to see if they are likely to help someone who has been bitten. We can use the measurments we get to judge which method and/or material is easiest to use. Experimentally first aid has been recommended with certain pressures corresponding to the different techniques. For the pressure immobilization method this corresponds to 40-70 mmHg in the upper limb and 55-70mmHg in the lower limb. In the Monash method, pressures greater than 70mmHg were found to be neccessary on all limbs. We believe that if these pressures cannot be achieved then neither can effective bandaging. 1/ We will first do a pilot study on mannequin's and ourselves to work out the standard deviation and spread of the variance between typical bandage applications. This initial study will also allow us to decide what material we would like to compare to crepe (eg. thicker crepe, elastic compression bandage, pantihose). 2/ We will then conduct a study to find out the spread of pressures generated by five separate subpopulations. a. Emergency nursing staff (4 to 6 people) putting a bandage on 6 times each on a leg and arm. b. Ambulance officers (4 to 6 people) putting a bandage on 6 times each on a leg and arm. c. Doctors (4 to 6 people) putting a bandage on 6 times each on a leg and arm. d. Snake handlers (4 to 6 people) putting a bandage on 6 times each on a leg and arm. e. General public (4 to 6 people) putting a bandage on 6 times each on a leg and arm. This group to have never put on a bandage before. 3/ Then once we have calculated the variance within an individual, within groups and between groups and can calculate a sample size we will compare materials in a randomised study. We will test our preferred material against crepe with the help of volunteers who will bandage alternate lower limbs on the same subject with each material, eg. left crepe and right gold standard. 4/ The other trial will compare pressure immobilization to the new Monash method. We will ask health professionals to perform the first aid in the same way as we compared materials. We will measure all pressures to ascertain which is more often correctly applied. 5/ In a small subset of volunteers we will ask them to keep the bandages on for longer while stationary or travelling and will compare the changes in pressure between these two groups. We aim to find out if a better material could be used, or if there is a technique that is easier to put in place, or if extra training improves the application of the current first aid technique.

Nausea and vomiting are symptoms frequently reported by patients attending Emergency Departments (EDs).We aim to determine if Acupressure is useful for reducing nausea and vomiting experienced by patients presenting to the Emergency Department. Acupressure is a non-invasive variation of the traditional Chinese Medicine Modality of Acupuncture. To date no studies have been performed in an Emergency Department. Conclusions from previous studies of acupressure in other settings have had mixed results. These studies all suggest that acupressure wristbands are safe and easy to apply. Our hypothesis is that the use of Acupressure bracelets will lead to a clinically significant reduction in nausea experienced by Emergency Department patients. Our secondary hypothesis is that Sham acupressure (placebo) may provide a similar clinically significant benefit.

Manipulation is a common treatment for non-specific neck pain. Neck manipulation, unlike gentler forms of manual therapy such as mobilisation, is associated with a small risk of serious neurovascular injury and can result in stroke or death. There is long standing and vigorous debate both within and between the professions that practice neck manipulation and the wider scientific community as to whether neck manipulation potentially does more harm than good. Both manipulation and mobilisation, when used in combination with exercise are more effective than placebo or other treatments for subacute and chronic neck pain. It is not known however, if manipulation leads to more rapid or more complete recovery than safer manual therapy techniques for neck pain of recent onset. This randomised controlled trial will compare the effectiveness of manipulation and mobilisation for an episode of recent onset neck pain.

Injury to the Infrapatellar branch of the saphenous nerve (IPBSN) may result uncomfortable or even painful sensory changes to the skin over the front of the knee. Anterior cruciate ligament (ACL) reconstruction in an established effective procedure in symptomatic instability. There are two main techniques for the surgery. A 4 strand hamstring graft is commonly performed in Australia. The nerve or its branches run very closely to or through the site of incision for hamstring harvest or the main alternative procedure harvesting patellar ligament and bone. Injury to the IPBSN or its branches is common in ACL surgery. Anatomical dissection studies have recommended that oblique or horizontal incisons may result in a lower rate of nerve injury. The current standard technique is a vertical incision. There has been a clinical outcome study investigating obliquity of incision in patellar ligament grafts which demonstrated a relationship with nerve injury. There has not been an clinical outcome study investigating obliquity of incision and nerve injury in hamstring grafts.

The primary purpose of this study is to determine the most effective way of improving the ability of people with spinal cord injuries to balance and sit unsupported. We hope to learn whether an intensive 6-week balance-training program improves the ability of people with established spinal cord injuries to balance and perform functional tasks.