Research into the benefits of Physiotherapy for the elderly

Investigators:

Significance:

1. Progressive Resistance Training for the Elderly (2002)

In conjunction with the Aged Care Department with funding from the DVA, the Physiotherapy Department researched the efficacy and cost-effectiveness of conducting Progressive Resistance (strength) Training Programmes in community settings (RSL clubs, church halls etc) using simple weights (eg dumbbells and ankle weights). The research showed the programme produced strength, balance and gait improvements; supporting the idea that relatively high intensity strength training should be included in exercise programs for older adults.

2. Hydrotherapy or Tai Chi for People with Osteoarthritis of the Knee (2006-07)

The combined Physiotherapy and Rheumatology Departments’ completed research, an RCT on physical activity for osteoarthritis management has provided evidence that hydrotherapy or Tai Chi can provide significant and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA.

3. Stroke Contracture Prevention (2006 –07)

The Physiotherapy Department participated in the multi-centre trial “Efficacy of Prolonged Stretching in Preventing Ankle Contracture After Stroke”. This provided evidence that either providing night splints or tilt-tabling patients prevent development of contractures in early stroke patients.

Most important aspects of current work

1. Recovery of Walking Following Stroke:

The Physiotherapy Department is currently involved in a multi-centre randomised controlled trial “Recovery of Walking Following Stroke” using the Lite-Gait. The Lite-Gait is a supportive harness system over a treadmill, allowing patients to practise walking with physiotherapists specifically training movement in the stroke-affected leg.

This study will evaluate the quality and speed of stroke patients’ walking who have been trained with the Lite-Gait system compared to traditional physiotherapy practice methods.

2. Inhaled Dry Powder Mannitol (IDPM) for treatment of patients with COPD:

The Physiotherapy Department is participating in a pilot study with the Department of Respiratory Medicine to determine the safety of 400 mg twice-daily administration of inhaled Dry Powder Mannitol as determined by respiratory function (FEV1) in patients hospitalised with acute exacerbations of COPD.

3. Incontinence Treatment:

In the near future the Physiotherapy Department we will be participating in a randomised controlled study comparing standard physiotherapy treatment for incontinence with treatment with an electro-magnetic current delivered by the Neotonis Chair. An ethics application is being prepared. There has not been any RCT’s comparing the 2 treatment regimens despite the chair’s popularity amongst the medical profession.

4. Pelvic Organ Prolapse:

The Physiotherapy Department is participating in the international multi-centre trial “Pelvic Organ Prolapse Physiotherapy” (POPPY Australia). Problems related to prolapse include bladder, bowel and sexual dysfunction. Surgery may not be appropriate for all women with prolapses and other treatment methods need to be found. The study aims to determine the effectiveness and cost-effectiveness of physiotherapy-delivered pelvic floor muscle training in the management of pelvic organ prolapse in women, in terms of reducing prolapse symptoms, severity and the need for further treatment.

5. The Development of an Incontinence Treatment Motivation Questionnaire for patients undergoing Pelvic Floor Physiotherapy in the treatment of Stress Incontinence

It has been previously shown that motivation to comply with pelvic floor muscle training is an important predictor of success for preventing stress incontinence and leakage, but there was nothing validated to be able to determine the patients’ motivation level. In conjunction with the departments of Uro-gynaecology and Psychiatry, a Motivation Questionnaire has been developed to be validated which can then be used to assess the level of patients’ motivation which impacts on their management.

Recent publications