Assessing communication using functional approaches for adults with traumatic brain injury

This systematic review aims to identify functional assessments used to evaluate communication impairments following a traumatic brain injury, and to critically evaluate the psychometric properties of these tools. This review will contribute to the development of better functional assessments of communication impairment following traumatic brain injury by identifying those that are currently available and determining their validity. Where there are obvious gaps identified in the area of functional communication assessments, directions for future research will be provided.

Acceptance of rehabilitation technology in adults with moderate to severe traumatic brain injury, their caregivers, and healthcare professionals: A systematic review

Authors: Dr Atiyeh Vaezipour, Dr Brooke-Mai Whelan, Dr Kylie Wall, Professor Deborah Theodoros.

This systematic review explored technology acceptance/usability of telerehabilitation platforms used to manage adults injured in motor vehicle accidents from both the perspective of the injured person and the health service provider. The review explored:

  1. The measures/theoretical frameworks used to assess technology acceptance in telerehabilitation in adults with traumatic brain injury;
  2. Factors that predict technology acceptance;
  3. Barriers to technology adoption; and,
  4. Directions for future research.

The review revealed limited research that formally evaluated user acceptance in relation to rehabilitation technologies designed for adults with TBI. Furthermore, where such evaluations were conducted, comprehensive research designs incorporating theoretical frameworks of technology acceptance were sparse. Importantly, a range of technologies and recommendations that positively influenced user acceptance were identified. Future directions for research in this area include the use of theory-driven research designs to enhance our understanding of technology acceptance, to support the development of rehabilitation technologies that maximize functional outcomes for individuals with TBI.

Read the publication.

The impact of musculoskeletal injuries sustained in road traffic accidents on work-related outcomes

Authors: Dr Elise Gane, Dr Charlotte Brakenridge, Dr Esther Smits, Dr Tammy Aplin and Associate Professor Venerina Johnston. 

The aim of this systematic review is to determine the impact of sustaining a musculoskeletal injury during a road traffic accident on an individual’s ability to work. The concept of work encompasses the rate of return to work following injury, the utilisation of sick leave, work capacity, work ability, and health-related work productivity loss. The existing evidence considering the impact to work and work-related outcomes arising from musculoskeletal injuries and road traffic accidents has not yet been synthesised with a systematic review. This synthesis is required to inform future studies to promote timely and sustained return to work after these injuries, to inform policy and legislation, and to raise awareness of the long term consequences of injuries that can be minor in nature, but significant in their effect on the lives of individuals in the community.

Read the published protocol.

Dissemination

An oral presentation of this paper will be conducted at the Australian Physiotherapy Association's annual conference, 17 - 19 October 2019, at the Adelaide Convention Centre.

Impact of interventions on work-related outcomes for individuals with musculoskeletal injuries after road traffic crash: A systematic review

Authors: Dr Charlotte Brakenridge, Dr Elise Gane, Dr Esther SmitsDr Nicole AndrewsAssociate Professor Venerina Johnston.

Background

Musculoskeletal injuries are the most common non-fatal injuries that result from road traffic crashes and can affect one’s work capacity or ability to return to work post-crash. This review will explore whether there are effective interventions that can improve work-related outcomes after musculoskeletal road traffic injuries, and whether there are participant, intervention or external factors that are associated with improvement.  The findings from this review may be useful in identifying individuals needing more intensive intervention, and may contribute to the planning of future interventions and policy.

Objectives

  1. To evaluate the impact of interventions (medical, therapeutic, work-based, multicomponent, or other) on work-related outcomes in individuals who have sustained a traffic crash-related musculoskeletal injury.
  2. To understand the intervention components, external factors (e.g., compensation schemes) and participant characteristics (sociodemographic, health, injury and work-related) that may be associated with improvement in work-related outcomes.

 

Single case experimental designs (SCEDs) in physiotherapy for musculoskeletal injuries

Single case experimental designs (SCEDs) are studies conducted in a single person, using the individual as their own control. SCEDs allow individual responses to interventions to be measured.

This review aims to:

  1. Assess the extent of use, purpose, and treatment outcome of SCEDs in the field of physiotherapy for musculoskeletal injury;
  2. Determine the clinical utility of SCEDs in the field of physiotherapy for musculoskeletal injuries;
  3. Determine the extent to which treatment decisions in physiotherapy are influenced by SCED results; and,
  4. Assess the quality of SCEDs in physiotherapy for musculoskeletal injuries.

 

Single case experimental designs (SCEDs) in chronic pain

We are conducting a systematic review of the use of Single Case and N-of-1 methods to study pain-related outcomes and to evaluate interventions for chronic pain. In particular, we are examining:

  1. Which populations/conditions have been studied;
  2. Which types of pain interventions have been evaluated;
  3. Which research designs have been used;
  4. Which pain-related variables have been studied as outcome variables and how frequently have they been measured and how; and,
  5. How data has been evaluated.

Relationships between improvement in patient-reported outcomes and physical function after specific exercise interventions for chronic neck pain: A systematic review

Authors: Mr Kenneth Chen, Dr Rutger de Zoete, Professor Michele Sterling.

Background

Numerous movement and muscle related deficits have been identified in patients with neck pain. Subsequently specific neck exercises have been advocated to address these impairments and improve pain and disability.

Aim

To evaluate the relationship between changes in patient-reported outcomes (e.g., pain and disability) and changes in physical function (e.g., muscle strength and function) as a result of specific exercise interventions for chronic neck pain.

Results

Of the 977 studies retrieved, 47 studies were included. From these studies, 61 exercise interventions were identified. Only 3 out of 47 studies reported any correlation analyses between patient-reported outcomes and physical function measures. Two of these found no correlation between physical measures (improved neck strength, balance) and improved pain and disability. One study found a moderate correlation between improved isometric neck strength and reduced pain.

Conclusion

We did not find sufficient evidence to support the proposal that treatment effects of specific neck exercise are attributable to improved performance on relevant tests of physical function. Future research could undertake mediational analyses to investigate relationships between self-reported outcomes and physical function with specific neck exercise as well as explore alternative explanations for the effects of neck specific exercise.

So, although some might assume that improvements in patient-reported outcomes are associated with improvements in physical function, this review demonstrates that only a few studies have looked at this. And two out of three studies that did investigate the association found no correlation. This highlights that we need to investigate how the effects of exercise on symptoms such as pain and disability are modulated.

Dissemination

A manuscript describing the results of this systematic review is currently under review for publication with Musculoskeletal Science & Practice, an international journal of musculoskeletal physiotherapy.

Barriers and facilitators associated with returning to work following road traffic injuries: A systematic review

Authors: Ms Zohre Abedi, Dr Elise Gane, Mr Haroun Zerguine, Associate Professor Venerina Johnston.

Returning to work after an injury is considered important for physical, mental and social well-being. It also reduces the financial burden on individuals and society. This systematic review will identify the modifiable factors that can affect the success of return to work for those with crash-related injuries. Qualitative and quantitative studies will be reviewed to investigate these factors from the perspectives of key stakeholders, including injured individuals, treating health professionals, workplace and legal representatives. ). The findings will guide injury management efforts and help survivors return to function and independence through implementation of appropriate strategies.

Objectives

  • Investigating barriers and facilitators associated with returning to work for those with minor to severe injuries after a road traffic crash.