John Gormley

Trinity College, Hartford, Connecticut, United States

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Publications (51)92.03 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Reduced participation in physical activity and increased time in sedentary behavior is associated with overweight, chronic disease and disability. In order to optimize recommendations and interventions to increase physical activity and reduce sedentary behavior in children with cerebral palsy (CP) knowledge of their physical activity and sedentary behavior is required. The aim of this study was to describe light, moderate, and vigorous physical activity and sedentary behaviour in pre-adolescent children with and without CP, and to compare physical activity and sedentary behavior between the two groups. This was a cross-sectional study of 33 children, aged 6 to 10 years, with CP [Gross Motor Function Classification System (GMFCS) levels I-III] and 33 age- and sex-matched children with typical development. Physical activity was measured using the RT3 accelerometer over 7 days. Children with CP spent more time in sedentary behavior (p<0.001) and accumulated less total activity (p<0.01), moderate activity (p<0.05), vigorous activity (p<0.05) and sustained bouts of moderate-to-vigorous activity (MVPA) (p<0.01). They also accumulated a fewer number of bouts of MVPA and vigorous activity (p<0.05 and p<0.01, respectively), despite spending a similar amount of time in each bout. The small number of children in GMFCS levels II and III did not allow us to adjust for GMFCS level when comparing physical activity between children with and without CP. Pre-adolescent children with CP spent less time in moderate and vigorous activity, and more time in sedentary behaviour than children with typical development. Children with CP also accumulated less continuous MVPA and vigorous activity as a result of achieving fewer sustained bouts of MVPA and vigorous activity throughout the day. © 2015 American Physical Therapy Association.
    Physical Therapy 05/2015; DOI:10.2522/ptj.20140337 · 3.25 Impact Factor
  • PLoS ONE 04/2015; 10(4). DOI:10.1371/journal.pone.0123267 · 3.23 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the potential use of "Wii™ Fit Free Jogging" (Nintendo(®), Kyoto, Japan) as a tool to estimate aerobic fitness in healthy young adults. It was hypothesized that virtual distance achieved, an outcome reported by the "Wii Fit Free Jogging" game, may be used to estimate aerobic fitness. Two exercise tests using "Wii Fit Free Jogging" were developed: the Wii Jogging Test and the Wii Step Test. For the Wii Jogging Test participants were required to jog on the spot with the aim of achieving the highest virtual distance possible in a given time. For the Wii Step Test participants had the same aim but were required to step up and down a 30-cm step. The construct and criterion validities of these tests were examined in two separate studies. Results were compared with maximal oxygen consumption (VO2max), which was established using the Bruce treadmill protocol. Oxygen consumption and heart rate were measured using an Oxycon™ Mobile indirect calorimeter (Jaeger™; Viasys Healthcare, Hoechberg, Germany) and a Polar heart rate monitor (Polar Electro Oy, Kempele, Finland). There was no difference between the highest oxygen consumption reached during the Wii Step Test and VO2max (P=0.101). In regression analysis virtual distance results from neither the Wii Jogging Test nor the Wii Step Test contributed to the prediction of VO2max (P=0.235 and P=0.396, respectively). In its current form, "Wii Fit Free Jogging" is not suitable for use as an exercise test. Although it elicited near-maximal exertion, there was no valid method of estimating aerobic fitness from virtual distance results.
    10/2014; 3(5):296-302. DOI:10.1089/g4h.2013.0089
  • Jennifer Ryan · Michael Walsh · John Gormley
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    ABSTRACT: This study investigated the ability of published cut points for the RT3 accelerometer to differentiate between levels of physical activity intensity in children with cerebral palsy (CP). Oxygen consumption (metabolic equivalents; METs) and RT3 data (counts/min) were measured during rest and 5 walking trials. METs and corresponding counts/min were classified as sedentary, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) according to MET thresholds. Counts were also classified according to published cut points. A published cut point exhibited an excellent ability to classify sedentary activity (sensitivity = 89.5%, specificity = 100.0%). Classification accuracy decreased when published cut points were used to classify LPA (sensitivity = 88.9%, specificity = 79.6%) and MVPA (sensitivity = 70%, specificity = 95-97%). Derivation of a new cut point improved classification of both LPA and MVPA. Applying published cut points to RT3 accelerometer data collected in children with CP may result in misclassification of LPA and MVPA.
    Adapted physical activity quarterly: APAQ 10/2014; 31(4):310-324. DOI:10.1123/apaq.2013-0088 · 1.08 Impact Factor
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    ABSTRACT: Adults with cerebral palsy (CP) are known to participate in reduced levels of total physical activity. There is no information available however, regarding levels of moderate-to-vigorous physical activity (MVPA) in this population. Reduced participation in MVPA is associated with several cardiometabolic risk factors. The purpose of this study was firstly to compare levels of sedentary, light, MVPA and total activity in adults with CP to adults without CP. Secondly, the objective was to investigate the association between physical activity components, sedentary behavior and cardiometabolic risk factors in adults with CP. Adults with CP (n = 41) age 18–62 yr (mean ± SD = 36.5 ± 12.5 yr), classified in Gross Motor Function Classification System level I (n = 13), II (n = 18) and III (n = 10) participated in this study. Physical activity was measured by accelerometry in adults with CP and in age- and sex-matched adults without CP over 7 days. Anthropometric indicators of obesity, blood pressure and several biomarkers of cardiometabolic disease were also measured in adults with CP. Adults with CP spent less time in light, moderate, vigorous and total activity, and more time in sedentary activity than adults without CP (p < 0.01 for all). Moderate physical activity was associated with waist-height ratio when adjusted for age and sex (β = −0.314, p < 0.05). When further adjustment was made for total activity, moderate activity was associated with waist-height ratio (β = −0.538, p < 0.05), waist circumference (β = −0.518, p < 0.05), systolic blood pressure (β = −0.592, p < 0.05) and diastolic blood pressure (β = −0.636, p < 0.05). Sedentary activity was not associated with any risk factor. The findings provide evidence that relatively young adults with CP participate in reduced levels of MVPA and spend increased time in sedentary behavior, potentially increasing their risk of developing cardiometabolic disease.
    Research in developmental disabilities 09/2014; 35(9):1995–2002. DOI:10.1016/j.ridd.2014.03.051 · 4.41 Impact Factor
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    Jennifer M Ryan · Michael Walsh · John Gormley
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    ABSTRACT: Background Advanced accelerometry-based devices have the potential to improve the measurement of everyday energy expenditure (EE) in people with cerebral palsy (CP). The aim of this study was to investigate the ability of two such devices (the Sensewear ProArmband and the Intelligent Device for Energy Expenditure and Activity) and the ability of a traditional accelerometer (the RT3) to estimate EE in adults and children with CP. Methods Adults (n = 18; age 31.9 ± 9.5 yr) and children (n = 18; age 11.4 ± 3.2 yr) with CP (GMFCS levels I-III) participated in this study. Oxygen uptake, measured by the Oxycon Mobile portable indirect calorimeter, was converted into EE using Weir’s equation and used as the criterion measure. Participants’ EE was measured simultaneously with the indirect calorimeter and three accelerometers while they rested for 10 minutes in a supine position, walked overground at a maximal effort for 6 minutes, and completed four treadmill activities for 5 minutes each at speeds of 1.0 km.h−1, 1.0 km.h−1 at 5% incline, 2.0 km.h−1, and 4.0 km.h−1. Results In adults the mean absolute percentage error was smallest for the IDEEA, ranging from 8.4% to 24.5% for individual activities (mean 16.3%). In children the mean absolute percentage error was smallest for the SWA, ranging from 0.9% to 23.0% for individual activities (mean 12.4%). Limits of agreement revealed that the RT3 provided the best agreement with the indirect calorimeter for adults and children. The upper and lower limits of agreement for adults were 3.18 kcal.min−1 (95% CI = 2.66 to 3.70 kcal.min−1) and -2.47 kcal.min−1 (95% CI = -1.95 to -3.00 kcal.min−1), respectively. For children, the upper and lower limits of agreement were 1.91 kcal.min−1 (1.64 to 2.19 kcal.min−1) and -0.92 kcal.min−1 (95% CI = -1.20 to -0.64 kcal.min−1) respectively. These limits of agreement represent -67.2% to 86.3% of mean EE for adults and -36.5% to 76.3% of mean EE for children, respectively. Conclusions Although the RT3 provided the best agreement with the indirect calorimeter the RT3 could significantly overestimate or underestimate individual estimates of EE. The development of CP-specific algorithms may improve the ability of these devices to estimate EE in this population.
    Journal of NeuroEngineering and Rehabilitation 08/2014; 11(1):116. DOI:10.1186/1743-0003-11-116 · 2.62 Impact Factor
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    ABSTRACT: To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors. Cross-sectional study SETTING: Testing took place in a laboratory setting PARTICIPANTS: Fifty-five adults with CP (mean±SD age 37.5±13.3 yr; Gross Motor Function Classification System levels I-V) participated in this study. Not applicable MAIN OUTCOME MEASURES: Total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glucose, insulin and C-reactive protein were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment Index (HOMA-IR). The metabolic syndrome was defined according to the 2009 Joint Interim Statement. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio and waist-height ratio were also measured. The prevalence of the metabolic syndrome was 20.5% in ambulatory adults and 28.6% in non-ambulatory adults. BMI was associated with HOMA-IR only (β=0.451, p<0.01). WC was associated with HOMA-IR (β=0.480, p<0.01), triglycerides (β=0.450, p<0.01) and systolic blood pressure (β=0.352, p<0.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidaemia, HOMA-IR, and the presence of multiple risk factors (area under the curve values of 0.713-0.763). A high prevalence of the metabolic syndrome was observed in this relatively young sample of adults. WC was a better indicator of a number of risk factors compared to BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP.
    Archives of physical medicine and rehabilitation 04/2014; DOI:10.1016/j.apmr.2014.03.029 · 2.44 Impact Factor
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    ABSTRACT: Background Children with cerebral palsy (CP) participate in reduced levels of physical activity and spend increased time in sedentary behavior. The effect of this on their cardiometabolic health has not been investigated.Objectives The purpose of this study was to investigate the prevalence of overweight/obesity and elevated blood pressure (BP) among a cohort of ambulatory children with CP. Secondly, the aim was to investigate the association between physical activity, sedentary behavior, overweight/obesity and BP in children with CP.Study designThis was a cross-sectional study of 90 ambulatory children, age 6 to 17 years, with CP.Methods Body mass index (BMI), waist circumference, waist-height ratio and BP were measured on one occasion. Habitual physical activity was measured by accelerometry over 7 days.ResultsThe prevalence of overweight/obesity in the cohort was 18.9%. Twenty-two percent of children had BP values within the hypertensive or pre-hypertensive range. Systolic BP was positively associated with waist circumference (β = 0.324, p <0.05) and BMI (β = 0.249, p<0.05). Elevated BP values were associated with reduced time in moderate-to-vigorous activity, vigorous activity and total activity, and increased time in sedentary behavior. The strongest association was observed between elevated BP and vigorous activity alone (odds ratio, 0.61; 95% confidence interval, 0.37-0.99; p <0.05).LimitationsA convenience sample was recruited for this study and it is possible that this resulted in selection bias.Conclusions Despite the relatively low prevalence of overweight/obesity, a relatively high proportion of children with CP had elevated BP values. Reducing sedentary behavior and increasing habitual physical activity, particularly vigorous activity, should be a primary aim of rehabilitation in order to reduce cardiometabolic disease risk in this population.
    Physical Therapy 04/2014; 94(8). DOI:10.2522/ptj.20130499 · 3.25 Impact Factor
  • Jennifer Ryan · John Gormley
    Physical Therapy Reviews 04/2014; 19(2):154-155. DOI:10.1179/1743288X13Y.0000000115
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    ABSTRACT: Objective To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors. Design Cross-sectional study Setting Testing took place in a laboratory setting Participants Fifty-five adults with CP (mean±SD age 37.5±13.3 yr; Gross Motor Function Classification System levels I-V) participated in this study. Interventions Not applicable Main Outcome Measures Total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glucose, insulin and C-reactive protein were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment Index (HOMA-IR). The metabolic syndrome was defined according to the 2009 Joint Interim Statement. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio and waist-height ratio were also measured. Results The prevalence of the metabolic syndrome was 20.5% in ambulatory adults and 28.6% in non-ambulatory adults. BMI was associated with HOMA-IR only (β=0.451, p<0.01). WC was associated with HOMA-IR (β=0.480, p<0.01), triglycerides (β=0.450, p<0.01) and systolic blood pressure (β=0.352, p<0.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidaemia, HOMA-IR, and the presence of multiple risk factors (area under the curve values of 0.713-0.763). Conclusion A high prevalence of the metabolic syndrome was observed in this relatively young sample of adults. WC was a better indicator of a number of risk factors compared to BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP.
    Archives of Physical Medicine and Rehabilitation 01/2014; · 2.44 Impact Factor
  • Jennifer Ryan · John Gormley
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    ABSTRACT: Abstract A comparative evaluation of the ability of activity monitors to predict energy expenditure (EE) is necessary to aid in the investigation of the effect of EE on health. The purpose of this study was to validate and compare the RT3, the SWA and the IDEEA at measuring EE in adults and children. Twenty-six adults and 22 children completed a resting metabolic rate (RMR) test and performed four treadmill activities at 3 km.h(-1), 6 km.h(-1), 6 km.h(-1) at a 10% incline, 9 km.h(-1). EE was assessed throughout the protocol by the RT3, the SWA and the IDEEA. Indirect calorimetry (IC) was used as a criterion measure of EE against which each monitor was compared. Mean bias was assessed by subtracting EE from IC from EE from each monitor for each activity. Limit of agreement plots were used to assess the agreement between each monitor and IC. Limits of agreement for resting EE were narrowest for the RT3 for adults and children. Although the IDEEA displayed the smallest mean bias between measures at 3 km.h(-1), 6 km.h(-1) and 9 km.h(-1) in adults and children, the SWA agreed closest with IC at 6 km.h(-1), 6 km.h(-1) at a 10% incline and 9 km.h(-1). Limits of agreement were closest for the SWA at 9 km.h(-1) in adults representing 42% of the overall mean EE. Although the RT3 provided the best estimate of resting EE in adults and children, the SWA provided the most accurate estimate of EE across a range of physical activity intensities.
    European Journal of Sport Science 11/2013; 13(6):681-688. DOI:10.1080/17461391.2013.776639 · 1.31 Impact Factor
  • Jennifer Ryan · John Gormley
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    ABSTRACT: Background: Recent research has indicated that energy expenditure (EE) is predictive of health related outcomes. Valid, reliable and feasible measures of EE are required to further investigate this relationship and to monitor adherence to activity guidelines. Objective: To assess the ability of activity monitors to measure EE in apparently healthy adults and children. Major findings: Three monitors met the inclusion criteria for this review: the RT3, the IDEEA, and the Sensewear Pro Armband (SWA). Thirty-three studies reported on the validity and reliability of these monitors. Fifteen studies reported on the feasibility of the monitors. The ability of the monitors to assess EE varied across activity types. All monitors underestimated the energy cost of free-living activities. The estimation of total energy expenditure from all three monitors disagreed considerably with a criterion measure of EE. Conclusion: Of these monitors, the SWA is the most studied activity monitor in adults and children. However, until a standardized methodology is used in validation studies, it is difficult to recommend the use of one monitor above others. Further research is required into the comparative validity, the reliability and the feasibility of these monitors to aid monitor selection.
    Physical Therapy Reviews 08/2013; 18(4):239-262. DOI:10.1179/1743288X13Y.0000000063
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    Fiona Wilson · Conor Gissane · John Gormley · Ciaran Simms
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    ABSTRACT: Lumbar spine injury in rowers is common and ergometer rowing has been cited as a risk factor for this injury. The purpose of this study is to compare lumbar kinematics between ergometer and single scull rowing and to examine the effect of fatigue on kinematics. The sagittal lumbar spine motion of 19 elite male rowers (lumbar spine injury free in the previous six months) was measured with an electrogoniometer during a 'step test' on an ergometer and in a single sculling boat. Maximum range of lumbar flexion was recorded in standing for reference. Power output and heart rate were recorded during the ergometer tests. Heart rate was used as a surrogate for power output in the sculling test. Maximum lumbar flexion increased during the step test and was significantly greater on the ergometer (4.4 degrees +/- 0.9 degrees change), compared with the boat (+1.3 degrees +/- 1.1 degrees change), (3.1 degrees difference, p = 0.035). Compared to the voluntary range of motion, there is an increase of 11.3% (ergometer) and 4.1% (boat). Lumbar spine flexion increases significantly during the course of an ergometer trial while changes in a sculling boat were minimal. Such differences may contribute to the recent findings linking ergometer use to lower-back injury.
    Sports Biomechanics 06/2013; 12(2):132-42. DOI:10.1080/14763141.2012.726640 · 0.87 Impact Factor
  • Katie Jane Sheehan · John Gormley
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    ABSTRACT: BACKGROUND: This study aimed to assess the presentation of gait for adults who are overweight, independent of the confounding influence of velocity. METHODS: Cross sectional study design. Twenty-five adults of a healthy weight were matched by age, gender, height and velocity to twenty-five adults who were overweight. Participants traversed a 10m walkway embedded with 2 AMTI force platforms (AMTI BP400600 Force Platforms: Advanced Mechanical Technologies, Inc., Watertown, MA, USA) and running between 2 CODA Dual CX1 sensors (CODA CX1: Charnwood Dynamics, Barrow on Soar, Leicestershire, England). Temporal-spatial parameters, maximum ground reaction forces, maximum joint powers, and three dimensional kinematic and kinetic parameters at the 7 events of the gait cycle were assessed. FINDINGS: With velocity accounted for, relatively few changes in the presentation of gait were seen for adults who were overweight. Alterations included increased stance phase duration, hip flexion, knee flexion, hip abduction, and knee varus for overweight adults. A reduction in hip abductor moment normalised for body mass was noted for overweight adults. Absolute maximum ground reaction forces were increased while maximum hip power absorption was reduced for overweight adults. INTERPRETATION: Changes were seen at the hip and knee during the swing phase of gait. During swing there is a stronger association with soft tissue injury as compared to joint injury. Overweight individuals were seen to adopt few alterations during the stance phase to accommodate for the increased absolute ground reaction forces. As a result the joint surfaces of overweight adults are exposed to increased loading.
    Clinical biomechanics (Bristol, Avon) 02/2013; 28. DOI:10.1016/j.clinbiomech.2013.01.007 · 1.88 Impact Factor
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    ABSTRACT: BACKGROUND: Physical activity has beneficial effects on arterial stiffness among healthy adults. There is a lack of data on this relationship in adults with hypertension. The majority of studies which have examined physical activity and arterial stiffness have used subjective measures of activity. The aim of this study was to investigate the relationship between objectively measured habitual physical activity and arterial stiffness in individuals with newly diagnosed essential hypertension. METHODS: Adults attending an outpatient hypertension clinic were recruited into this cross sectional study. Physical activity was measured using a triaxial accelerometer. Pulse wave velocity (PWV) and augmentation index (AIx) were measured using applanation tonometry. Participant's full lipid profile and glucose were determined through the collection of a fasting blood sample. RESULTS: Fifty three adults (51(14) years, 26 male) participated, 16 of whom had the metabolic syndrome. Inactivity was positively correlated with PWV (r=0.53, p<0.001) and AIx (r=0.48, p<0.001). There were significant inverse associations between habitual physical activity of all intensities and both AIx and PWV. In stepwise regression, after adjusting for potential confounders, physical activity was a significant predictor of AIx and PWV. CONCLUSION: Habitual physical activity of all intensities is associated with reduced arterial stiffness among adults with hypertension.
    Journal of Physical Activity and Health 01/2013; 11(2). DOI:10.1123/jpah.2012-0075 · 1.95 Impact Factor
  • Jennifer Ryan · John Gormley
    Physical Therapy Reviews 01/2013; 18(4):239-262.
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    Fiona Wilson · John Gormley · Conor Gissane · Ciaran Simms
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    ABSTRACT: Abstract Lumbar spine injury is common in rowers and examination of spinal kinematics may improve the understanding of this injury's prevalence. This study aimed to examine the range of frontal plane angular displacement (AD) in the lumbar spine at L3 during ergometer rowing and to investigate the effect of exhaustion on lumbar kinematics. Twelve elite male rowers completed an incremental test on a Concept 2 ergometer. Lumbar AD at L3 was measured continually throughout the rowing trial using a Spectrotilt Inclinometer and blood lactate was sampled at 3-minute intervals. AD of between 4.7° and 8.8° was recorded at L3. There was a significant increase in AD between the first and last stage of the test (mean increase = 4.1 ± 1.94°, 95% Confidence Interval [CI], 2.9 to 5.3°, t = 7.36, P = 0.000014). Incremental rise in AD was associated with an incremental rise in blood lactate but regression confirmed that only stroke rate was a significant predictor for increasing angle. Thus there is a statistically significant increase in frontal plane AD at L3 over the course of an incremental exercise test although it cannot be confirmed if this is as a result of exhaustion. The values of AD confirm that there is motion in the frontal plane in ergometer rowing.
    Journal of Sports Sciences 08/2012; 30(14):1481-9. DOI:10.1080/02640414.2012.711486 · 2.10 Impact Factor
  • K. Sheehan · J. Gormley
    Gait & Posture 06/2012; 36:S23. DOI:10.1016/j.gaitpost.2011.10.219 · 2.30 Impact Factor
  • K Sheehan · J Gormley
    Physical Therapy Reviews 04/2012; 17(2):91-98. DOI:10.1179/1743288X11Y.0000000057
  • Fiona Wilson · Ciaran Simms · John Gormley · Conor Gissane
    IOC Conference on Prevention of Injury and Illness in Sport, Monaco; 04/2011

Publication Stats

342 Citations
92.03 Total Impact Points

Institutions

  • 1999–2015
    • Trinity College
      Hartford, Connecticut, United States
  • 2002–2014
    • Trinity College Dublin
      • • School of Medicine
      • • Department of Physiotherapy
      Dublin, Leinster, Ireland
  • 2009
    • Department of Health, Ireland
      Dublin, Leinster, Ireland
  • 1999–2008
    • St. James's Hospital
      • Department of Physiotherapy
      Dublin, Leinster, Ireland