ANZCTR search results

The reported incidence of painful Achilles tendinosis is 6-17% amongst adult athletes. This condition results in considerable impairment of training and performance in athletes. To date, evidence suggests that of the treatment strategies investigated, exercise programs that involve mildly painful eccentric contractions of the muscles of the calf are the most effective at reducing pain and improving function for people suffering from this condition. Although the underlying mechanism conferring improvement is unknown, there is now some evidence suggesting a link between the presence of newly formed blood vessels (neovascularisation) and painful tendinosis. With a program of mildly painful eccentric loading exercises, there is a sustained reduction in pain with disappearance of these new vessels. Similar sustained reductions in pain have been shown with prolotherapy injections of hypertonic glucose and local anaesthetic. Prolotherapy involves the repeated injections of an irritant solution with the intention of sclerosing neovessels and stimulating inflammation and subsequently new collagen formation. With respect to Achilles tendinosis, the relative efficacy of these two approaches, individually and in combination, has not been tested. This project aims to conduct a pilot randomised clinical trial comparing prolotherapy injections eccentric loading exercises singly and in combination. It will be conducted in research clinics to be set up at Logan and in Christchurch, New Zealand. It will be a single blinded trial with the assessor being the blinded person. Experience and information from this pilot trial will be used to inform an adequately powered randomised clinical trial of prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis.

The purpose of this project is to test a new way of providing patients with information about chemotherapy. Previous experience has shown that many patients feel anxious before starting chemotherapy treatment, and would like the opportunity to discuss their concerns about treatment, treatment related side effects and ask questions. Patients will be randomly allocated to receive either the usual chemotherapy education program or the new chemotherapy education program we are testing. The two groups will be compared on measures of psychological distress, symptoms/side effects of chemotherapy, confidence in dealing with side effects of chemotherapy and unmet needs.

40 patients with COPD are randomly allocated to either receive a four session preventative CBT intervention, or not receive this intervention in addition to usual treatment. Subjects are then followed up every six months for 18 months to investigate the efficacy of the intervention in preventing the development/worsening of panic anxiety symptoms.

The aim of this project is to evaluate the effectiveness of reducing painful callus (hard skin) on the bottom of the feet (using scalpel debridement) versus no reduction (using a sham debridement technique). This study is double-blind: both the participants and the assessors will be blinded.

The aim of this study is to determine the effect of extended therapeutic contact over a 2 year period on a community-based weight management group program in overweight and obese young people aged 13-16 years. The additional therapeutic contact, via phone coaching, e-mail and SMS messages, is designed to give each young person the extra support and guidance to empower them to make and maintain healthy lifestyle changes. 168 young people will be randomised into either the group program, or the group program plus extended therapeutic contact. They will be followed up for 2 years to assess the effect of the program on a variety of health outcomes including weight, self-esteem and metabolic health. Adolescents’ height, weight and waist circumference will be measured at baseline, 12 months and 24 months by contract staff who are blinded to treatment allocation. In addition, adolescents will be asked not to reveal their treatment allocation to staff who perform the measurements. Of course, it will not be possible for the adolescents to be blinded to treatment allocation. If effective, we expect the following outcomes: 1) A reduction in levels of overweight and obesity in young people aged 13-16 years 2) The adoption and maintenance of healthy lifestyle behaviours in that segment of the population which has most to gain over a lifetime - overweight and obese young people 3) A novel, replicable, feasible, cost-effective community-based approach to overweight and obesity in young people tailored to the Australian health care system

The purpose of this study is to investigate the effect of a 6-week patient education program, the Arthritis Self-Management Program, for people with hip or knee osteoarthritis. This study will find out whether the Program improves people’s wellbeing and whether it is good value for money.

Many people who acquire a brain impairment (e.g. through stroke or traumatic injury) suffer significant paralysis and loss of function in their arms and hands. This loss of function is extremely disabling and effects many aspects of their daily lives. Therapists frequently provide motor retraining programs to try and help them regain functional use of their limbs. Unfortunately, there is considerable variation in the type and amount of therapy given. Current evidence also suggests that many of these patients do not regain their function despite participating in therapy. This randomised controlled trial will attempt to determine if an intensive daily program of specific functionally based hand exercises is able to improve the hand function of people with acquired brain impairment. It is hoped that its results will help to guide the current and future practice of Occupational and Physiotherapists working in rehabilitation. Final measured outcome assessor of the study is blinded.

Health professionals working with people with haemophilia and other bleeding disorders (PWH) report a concern that patients appear to be at increased risk of falls and serious injuries from falls. However, to date there is no published research about falls risk in samples of adult haemophilia patients or any research quantifying the extent of balance dysfunction in PWH. Therefore this project aims to: - Determine which measures of balance performance are most useful in identifying balance impairment in PWH in comparison to healthy age and gender matched controls; - Evaluate the association between balance performance and falls risk; - Evaluate the association between balance performance and falls efficacy (confidence in mobility); and - Evaluate the feasibility and effectiveness of a tailored home exercise program in improving balance and related outcomes for PWH. Thirty adults with haemophilia or other bleeding disorders and 30 age and gender matched healthy adults will be recruited. All participants will undergo a baseline assessment of laboratory measures of balance, clinical measures of balance, falls risk, falls efficacy, activity level, pain, disease severity and health related quality of life. Following the initial assessment the participants from the haemophilia group will be provided with an individually tailored balance and strengthening home exercise program from a physiotherapist, based on the results of the initial assessment. The participants will be required to undertake the home exercise program for four months, during which time they will receive two visits from the physiotherapist, who will review them and provide any support required. At the end of the four month program the participants from the haemophilia group will undergo the baseline assessment again in order to evaluate their progress. This pilot work will be useful to inform health care providers, and PWH, about the magnitude of the problem of balance dysfunction, what methods are most appropriate to identify this risk, and whether standard balance training exercises will be useful in this group. If successful, further studies will be required with a large sample to evaluate whether this approach can reduce falls in this group.

To trial the clinical effectiveness of manual therapy in the treatment of temporomandibular disorder. Applicants are screened over the telephone, and if they meet exclusion/inclusion criteria are asked to complete application forms and undergo an assessment. Acceptable participants are numbered, then randomly assigned to thier respective groups by a blinded off-site person holding the randomization schedule. Control patients are blinded as to thier current status within the trial. Due to ethical considerations they will be offered free treatment at the conclusion of the trial observation period (1yr). Assessments are further carried out following intervention (week5), 6months post, and 1 yr post. Assessor is blinded as to which group the participant belongs, and the clinician is blinded to the results of assessments.

This project aims to establish the feasibility and acceptability of implementing Question Prompt Lists (QPLs) to cancer patients in order to improve doctor-patient communication and encourage greater patient involvement in decision-making during oncology consultations. The QPL is a structured list of questions relating to illness and treatment that a patient may ask of their oncologist or surgeon. Previous research evaluating their effectiveness has consistently shown increased question asking during consultation and increased patient satisfaction post-consultation. As few evidence-based interventions are integrated into clinical practice, this project will examine the practical effects of, and attitudes to, the implementation of QPLs in four major hospitals across NSW.