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Spasticity is a common sequelae following stroke with prevalence rates of 30-80%. Patients experiencing upper limb spasticity report reduced quality of life secondary to difficulties using their arm for daily tasks and pain. Valid and reliable assessments for spasticity are critical for the selection and evaluation of treatments. Clinical scales are the most common method for assessing upper limb spasticity following a stroke, and include the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS). More recently, robotic devices and information technology have been found to be safe and effective in increasing the efficiency of care, including objectively measuring impairments. We hypothesise that a robotic device will provide a more accurate and reliable measure of spasticity than existing clinical scales. This study aims to compare reliability between the robotic device and the two clinical measures, the MAS and MTS, in assessing spasticity in the elbow flexors of stroke survivors. Participants’ affected upper limb will be passively moved from flexion to extension using different speeds. This study will take place at the Royal Melbourne Hospital, in Australia.

After a period of hospitalisation, pulmonary rehabilitation can improve symptoms and function and reduce healthcare costs in people with chronic obstructive pulmonary disease (COPD). Yet less than 10% of people with COPD access pulmonary rehabilitation after a hospital stay. This multi-site randomised controlled trial will examine the benefits and costs of home-based pulmonary rehabilitation undertaken immediately following hospitalisation, compared to usual care, for people with COPD. It is hypothesised that Early HomeBase pulmonary rehabilitation will reduce hospital readmissions, and provide clinically significant improvements in exercise capacity and health-related quality of life, which are greater than those seen in the usual care group.

The aim of this project is to assess the reflux and retention of a therapeutic substance delivered into the sub-retinal space via two different techniques. We hypothesise that defining the space to be injected using an inert fluid (balanced salt solution) first (so-called 2-step injection) results in less drug wastage than attempting to inject directly under the retina with a drug-containing solution (so-called 1-step injection).

Cannabidiol has shown much promise for its immunomodulation and anti-inflammatory properties. The purpose of this trial is to investigate the effects of short-term oral supplementation of cannabidiol (CBD) prior to and following downhill running on serum markers of inflammation and muscle damage, functional recovery and perceived muscle soreness in untrained individuals. This will be a double blind, randomised, placebo-controlled study comprising two experimental conditions (CBD versus placebo). It is hypothesised that CBD will elicit reduced pro-inflammatory blood markers, reduced recovery time, and reduced subjective muscle soreness compared to placebo.

Ventilator hyperinflation (VHI) is used by physiotherapists in patients who are in intensive care and are receiving mechanical ventilation. VHI aims to move secretions out of the lungs towards the larger airways of the lung where they can be suctioned. This is achieved by giving a larger, slow breath via the ventilator and creating a fast expiration. Currently, little is reported on the actual ability to bias the flow inspiratory and expiratory flow rates during VHI. The primary aim of the study is to measure the characteristics of inspiratory and expiratory flows generated using different methods of VHI in patients receiving mechanical ventilation.

Repetitive Transcranial Magnetic Stimulation (rTMS) uses changing magnetic fields that alter activity in a part of the brain. This randomized control trial will assess 2 weeks of rTMS treatment in children with persistent post-concussions syndrome (PPCS) compared to sham treatment, and if a subsequent 2 week rTMS treatment leads to further PPCS improvement.

This study aims to find out whether treatment with alpelisib plus fulvestrant increases progression-free survival compared to capecitabine in women and men with eostrogen receptor positive (ER+), HER2-negative advanced breast cancer who have a PIKC3A mutation identified in circulating tumour DNA (ctDNA). Who is it for? This study may be suitable for you if you are 18 years or older, have advanced ER+, HER2-negative breast cancer, and have already had treatment with a CDK4/6 inhibitor and an aromatase inhibitor. Potential participants will consent to a blood test to find out if the cancer has a PIK3CA mutation. This mutation occur in 35-40% of ER+ breast cancers and may make tumours more sensitive to treatments, such as alpelisib, that target the PI3K pathway (which is important for cell growth and survival). The PIKC3A gene mutation can be detected through a blood test for circulating tumour DNA. As a cancer grows, cancer cells die and are replaced by new ones. The dead cells get broken down and their contents, including DNA, go into the bloodstream. These very small pieces of DNA are called circulating tumour DNA (ctDNA). Trial Details If a PIK3CA mutation is identified, before being randomised, participants will have their health checked, medical history recorded, standard blood tests, and provide a tumour biopsy (either a new biopsy or provide material collected earlier). Participants will be randomised 1:1 to either: Arm A: alpelisib plus fulvestrant (clinic visits every 28 days) Arm B: capecitabine (clinic visits every 21 days) Participants on Arm A will take 1 alpelisib tablet per day with fulvestrant injected intramuscularly once every 28 days. Women who are pre- or perimenopausal will also have a goserelin implant inserted under their skin to stop their ovaries producing oestrogen. Participants on Arm B will take 1 capecitabine tablet twice per day on Days 1 to 14 of a 21 day cycle. All participants will be regularly monitored throughout treatment to evaluate their health. Tumours will be assessed by imaging (CT scan, Bone Scan, MRI or PET scan if clinically indicated) and as per RECIST 1.1 every 8 weeks during treatment. Treatment will continue until documented disease progression . The following biological samples will be collected: * Tumour samples of archived tissue or a new biopsy at screening (before first dose of study treatment); * Blood samples for ctDNA testing at pre-screening (to confirm eligibility), Cycle 1 Day 1, Cycle 1 Day 15 (Arm A only), at every cycle during treatment and the End of Treatment Visit. In the event of DNA extraction failure, a replacement blood sample may be requested from the participant. * Tissue collection at disease progression is suggested (optional). Participants will have their final visit 28 days after their last dose of study treatment. It is hoped this research will provide a new treatment option for people with incurable breast cancer.

Collective evidence supports the salutary benefits of exercise training for health and fitness among healthy adults, working populations, and adults with cardiovascular diseases (Andrews et al., 2019). However, there are several limitations of previous research into training health evaluations of firefighters including pooled measurement and lack of objective precision, lack of applicability to firefighter performance outcomes and limited holistic evaluation of the perceptions of key stakeholders within the process (Andrews et al., 2019). Thus, the aim of this research is to evaluate the effectiveness of the Fire and Rescue NSW (FRNSW) Tactical Athlete Resilience Program (TARP). The TARP is a holistic training intervention for metropolitan firefighters conducted on site with South Sydney Football Club (SSFC) with SSFC performance staff. Effectiveness outcomes include cost effectiveness, program adherence and satisfaction, objective health, physiological and psychosocial outcomes,

This study seeks to investigate the efficacy and mechanisms of change of group behavioral activation therapy (BA) for depression in adults in comparison with standard group cognitive behavior therapy (CBT). It is hypothesized that severely depressed adults receiving group BA will show a significantly greater reduction in self-reported depression scores over 10 weeks of therapy than severely depressed adults receiving group CBT over the same period, and that improvement in depression scores in the BA group will be mediated by changes in participants use of behavioural coping skills, while improvement in the CBT group will be mediated by changes in participants use of cognitive coping skills.

Stroke survivors fall often with fall rates of more than twice that of the general older population, placing an enormous economic burden on the national health system and society in general. The aim of Falls After Stroke Trial (FAST) is to test the effect of home-based, tailored intervention to reduce falls. A sample of community-dwelling stroke (n=370) survivors who have completed formal rehabilitation will be randomly assigned to an experimental group (habit-forming exercise and safety training), or a control group (usual care). The primary outcome measures will be falls recorded daily by the participants and monitored monthly by a researcher blinded to group allocation. Secondary outcomes will be community participation, balance, self-efficacy, mobility, physical activity, health-related quality of life healthcare utilisation and costs.