Boosting the careers of new researchers

 

The 2018 Seeding Grants have been awarded to three APA members. Kate Cameron, Gabrielle Street and Robyn Brennen discuss their research projects.

Kate Cameron has been awarded just over $7000 for a feasibility trial looking at a dance participation intervention for preterm children with motor impairment at preschool age.

Overview

There is considerable evidence showing that children born preterm have significantly higher rates of motor impairment (including cerebral palsy and developmental coordination disorder) compared with children born at term. By school age, children with motor impairment participate in less physical activity (PA) than their typically developing peers, negatively impacting cardiovascular fitness and strength.

Furthermore, reduced PA participation results in decreased opportunity for learning fundamental motor skills, which are so important for physical literacy and lifelong PA.

Importantly, participation provides opportunity for children to develop and perform motor skills in a real-world context, rather than simply the capacity to complete a skill in a clinical environment. There is limited research, however, into the best way to facilitate participation for preschool age children. Dance PREEMIE is a feasibility trial exploring the role physiotherapy can play in promoting and facilitating PA participation for preschool age children who were born extremely preterm (<28 weeks’ gestation) and have motor impairment.

In essence, the study involves upskilling community-based dance teachers through physiotherapy-led training, and then enrolling preterm children into these classes. We hope that the extra training and support will better equip dance teachers to promote participation for children who may face greater challenges in engaging in PA than their typically developing peers.

Importance of the funds

The PRF seeding grant is going to be an incredible help for Dance PREEMIE. Socioeconomic status plays a huge role in a family’s ability to involve their child in structured physical activity. Through the PRF funding, we will be able to remove the financial barrier of participating in a preschool dance class for children at risk of motor impairment, which is really exciting. The PRF funding will also enable us to gain rich qualitative data through one on one interviews with parents and teachers.

As this is a feasibility study, by definition we face the exhilarating challenge of trying something new for the first time. Dance PREEMIE is exploring the important role physiotherapists can play as educators, except rather than educating our clients or patients, we are educating community providers of physical activity; this will be an exciting challenge.

The future

There is a substantial body of evidence supporting early intervention for children born preterm. Research shows, however, that motor difficulties experienced by children born preterm persist throughout childhood and into adolescence, and there is little evidence of interventions to improve outcomes at preschool and school age. It would be great to see more of these trials, and in particular, trials considering meaningful, family-centred, participation- focused outcomes.

Kate Cameron is a PhD student at University of Melbourne and Murdoch Children’s Research Institute, where she is part of the Victorian infant brain study group. She is supervised by associate professors Alicia Spittle, Jennifer McGinley, Jeanie Cheong and Dr Kim Allison.

Gabrielle Street has been awarded almost $12,000 for a pilot and feasibility randomised controlled trial exploring internet-based management of rotator cuff tendinopathy with remote physiotherapist-led support.

Overview

Our trials will show us the completeness of reporting particular parameters required to replicate study interventions. It will demonstrate whether exercise is effective in treating rotator cuff tendinopathy and exactly which exercises are the best. Currently we have little to no solid evidence for how dose or type of exercise effects outcome, and also if rehab and education for this cohort can be delivered online with and without telerehabilitation support. Two reviews I highlight in my research by Chalmers (2009) and Glaziou (2014) identified major reporting deficiencies in health research rendering most of the trials unusable, amounting to billions of dollars in research funding being wasted.

We need to find out how to adequately describe exercise interventions, which exercises should be prescribed, and how we can deliver them to this population.

I have always been curious and passionate about learning. Studying at Monash University just enhanced my excitement into always asking questions and never settling.

Physiotherapy is about asking questions over and over to understand people’s movement, behaviour and overall function. Without asking why, we would never be able to restore, improve or enhance optimal movement. One of my frustrations is the lack of high-quality rehabilitation evidence for people with shoulder pain and this is something I am motivated to study and change. I am hoping that via my research I will be able to further enhance my knowledge but also change clinical practice in shoulder pain and improve translation of knowledge into practice.

Importance of the funds

The funding will allow us to undertake a high- quality trial to test the feasibility of delivering shoulder pain and education intervention online and via telerehabilitation. The funding made this study possible and will allowed us to fund recruitment and development of a website.

The future

If feasibility of the study is successful, it will allow us to focus on developing a full-scale trial. This would also demonstrate a better understanding of not only whether exercise is beneficial in treating rotator cuff tendinopathy, but which exercises are better. If it is successful it will not just change research, but also clinical practice.

Gabrielle Street is currently working and operating her private practice, Better Moves Physiotherapy, and she has a huge drive for success and promoting physiotherapy in the health and fitness industry. Gabrielle has been working in the allied health and fitness industry since 2011, and worked with various sporting teams across Melbourne and Tasmania.

Robyn Brennen has been awarded $12,000 for a pilot randomised controlled trial investigating if pre- and postoperative pelvic floor muscle training can reduce pelvic floor dysfunction in patients undergoing gynaecological cancer treatment.

Overview

I have been working in pelvic floor and continence physiotherapy for 12 years, including multiple public health services in Australia. The provision of continence and pelvic floor physiotherapy services to men before and after prostate cancer has improved quite a lot in this time, but there simply has not been enough research evidence to develop similar services for women before and after gynaecological cancer. The published prevalence data shows that pelvic floor dysfunction after gynaecological cancer treatment is high but we do not yet have a strong evidence-base for interventions. With public health services already working at maximum capacity, we need a strong evidence- base to justify expanding pelvic floor physiotherapy services to these women and to evaluate the best parameters for interventions in this population.

Importance of the funds

The PRF Seeding Grant will support our pilot intervention study, which is crucial to establishing the feasibility of an intervention protocol for women who are undergoing treatment for gynaecological cancer. Our pilot study should then justify and form the basis of a large-scale randomised controlled trial to thoroughly assess the effectiveness of the intervention.

Our team is studying the prevalence, experience and physiotherapy treatment of pelvic floor dysfunction in women with gynaecological cancer; therefore, going through the diagnosis of, and treatment for cancer is a very harrowing process for many people and poses many challenges on an individual level. We are well aware that this may limit potential participants’ capacity or desire to participate in the intervention study. For this reason, we will be monitoring recruitment and adherence very closely, and have already planned some back-up strategies in case there are any challenges with these.

The future

Once we have established the feasibility of the intervention, we would love to see this developed into a large-scale randomised controlled trial because this is the best way to provide the evidence-base that we need to plan and implement continence and pelvic floor physiotherapy services for gynaecological cancer survivors.

Robyn Brennen is a qualified physiotherapist and midwife with a passion for the provision of high-quality, low-cost women’s healthcare services. She recently finished working as the Grade 4 clinical lead physiotherapist in women’s and men’s health physiotherapy and community continence clinic lead at Monash Health to take up her PhD in ‘Pelvic floor dysfunction after gynaecological cancer’, under the supervision of Associate Professor Helena Frawley and Dr Kuan-Yin Lin.

2019 SEEDING GRANTS

Seeding Grants are designed to support new researchers establish their career. Details for next year’s program will be announced in February. If you would like to register your interest, email jenine.fleming@australian.physio

 

 

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