Bernard Liew

Bernard Liew
University of Essex · School of Physiotherapy and Exercise Science

Doctor of Philosophy

About

76
Publications
12,061
Reads
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368
Citations
Introduction
I am trained as a clinical physiotherapist. Prior to starting my academic journey, I worked as a clinician in Singapore largely within the areas of musculoskeletal, sports, and orthopaedics. I developed an expertise in Biomechanics and a growing experience through my collaborations in advance Machine Learning. I am currently a Lecturer in Biomechanics at the University of Essex. Broadly, I am interested in synergising Biomechanics, Rehabilitation, and Machine Learning to develop tools that will help clinicians make faster and more accurate decisions, and develop biologically driven interventions to prolong the longevity of healthy movement behaviors.
Additional affiliations
May 2019 - present
University of Essex
Position
  • Lecturer
Description
  • Module coordinator for Applied Biomechanics & Professional skills for Sports Science, Sports Coaching, and Sports Therapy students. Co-module coordinator for Research Methods for Postgraduate Health Sciences students.
May 2019 - present
University of Essex
Position
  • Lecturer
Description
  • Module coordinator for Applied Biomechanics & Professional skills for Sports Science, Sports Coaching, and Sports Therapy students. Co-module coordinator for Research Methods for Postgraduate Health Sciences students.
October 2017 - May 2019
University of Birmingham
Position
  • Research Associate
Description
  • Investigating the influence of low back pain on muscle synergies. Understanding causal mediators of symptom and functional recovery in chronic musculoskeletal pain disorders
Education
April 2014 - October 2017
Curtin University
Field of study
  • Physiotherapy
February 2010 - November 2011
Curtin University
Field of study
  • Physiotherapy
April 2006 - May 2009
Nanyang Polytechnic
Field of study
  • Physiotherapy

Publications

Publications (76)
Article
Full-text available
Purpose Prognostic models play an important clinical role in the clinical management of neck pain disorders. No study has compared the performance of modern machine learning (ML) techniques, against more traditional regression techniques, when developing prognostic models in individuals with neck pain. Methods A total of 3001 participants sufferin...
Article
Full-text available
Purpose To systematically review and analyse whether musculoskeletal conditions affect peripheral joint muscle force control (i.e. magnitude and/or complexity of force fluctuations). Methods A literature search was conducted using MEDLINE, CINAHL and SPORTDiscus databases (from inception-8th April 2021) for studies involving: 1) participants with...
Article
Full-text available
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is associated with psychological/emotional disturbances. This study aimed to assess internal consistency, reliability, and construct validity of the Hospital Anxiety and Depressive Scale (HADS), as a patient-reported outcome measure (PROM) for evaluating emotional consequences of SA...
Article
Full-text available
Although neck pain is known to be a complex and multifactorial condition characterised by the interplay between physical and psychological domains, a comprehensive investigation examining the interactions across multiple features is still lacking. In this study, we aimed to unravel the structure of associations between physical measures of neuromus...
Article
Full-text available
We aimed to explore a path model identified using a structural equation model (SEM) which best explains the multivariate contributions of sensitization, sensitivity, and emotional variables to clinical severity in women with FMS. Pain features, the Central Sensitization Inventory (CSI), painDETECT, S-LANSS, the Hospital Anxiety and Depression Scale...
Article
Full-text available
Knee joint moments are commonly calculated to provide an indirect measure of knee joint loads. A shortcoming of inverse dynamics approaches is that the process of collecting and processing human motion data can be time-consuming. This study aimed to benchmark five different deep learning methods in using walking segment kinematics for predicting in...
Article
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Purpose The psychological response to an Anterior Cruciate Ligament (ACL) injury is significant and can negatively impact return to sports outcomes. This study aimed to quantify the association between factors associated with return to sport using network analysis. Methods 441 participants who underwent primary ACL reconstruction. The 12-item ACL...
Article
Objective The purpose of this study was to develop a data-driven Bayesian network approach to understand the potential multivariate pathways of the effect of manual physical therapy in women with carpal tunnel syndrome (CTS). Methods Data from a randomized clinical trial (n = 104) were analyzed, comparing manual therapy including desensitization m...
Article
Full-text available
Purpose The Oswestry Disability Index (ODI) is a common aggregate measure of disability for people with Low Back Pain (LBP). Scores on individual items and the relationship between items of the ODI may help understand the complexity of low back disorders and their response to treatment. In this study, we present a network analysis to explore how in...
Article
Full-text available
This study investigates whether baseline pain extent, extracted from an electronic pain drawing, is an independent predictive factor of pain and disability measured 1 year and 2 years later in people with chronic WAD. Participants completed questionnaires assessing neck pain intensity, disability via the Neck Disability Index (NDI), psychological f...
Article
Full-text available
Purpose Understanding what constitutes normal walking mechanics across the adult lifespan is crucial to the identification and intervention of early decline in walking function. Existing research has assumed a simple linear alteration in peak joint powers between young and older adults. The aim of the present study was to quantify the potential (no...
Article
Joint moments are commonly calculated in biomechanics research and provide an indirect measure of muscular behaviors and joint loads. However, joint moments cannot be easily quantified clinically or in the field, primarily due to challenges measuring ground reaction forces outside the laboratory. The present study aimed to compare the accuracy of t...
Article
Full-text available
Purpose Individualised physiotherapy is an effective treatment for low back pain. We sought to determine how this treatment works by using randomised controlled trial data to develop a Bayesian Network model. Methods 300 randomised controlled trial participants (153 male, 147 female, mean age 44.1) with low back pain (of duration 6–26 weeks) recei...
Article
The purpose of this narrative review is to provide a critical reflection of how analytical machine learning approaches could provide the platform to harness variability of patient presentation to enhance clinical prediction. The review includes a summary of current knowledge on the physiological adaptations present in people with spinal pain. We di...
Article
Objective Current evidence suggests that carpal tunnel syndrome (CTS) involves widespread pressure pain sensitivity as manifestion of central sensitization. This study aimed to quantify mechanisms driving widespread pressure pain hyperalgesia in CTS by using network analysis. Design Cross-sectional. Setting Urban hospital. Subjects 120 women wit...
Article
Full-text available
PurposeTo evaluate whether a set of pre-accident demographic, accident-related, post-accident treatment and psychosocial factors assessed in people with acute/subacute whiplash-associated disorders (WAD) mediate the association between pain intensity and: (1) pain interference and (2) expectations of recovery, using Bayesian networks (BNs) analyses...
Article
Full-text available
Background and Objective Numerous studies have examined the influence of pain on spinal reflex excitability, motor unit behaviour and corticospinal excitability. Nevertheless, there are inconsistencies in the conclusions made. This systematic review sought to understand the effect of pain on spinal and supraspinal projections to motoneurons and mot...
Article
Full-text available
The inter-session Intraclass Correlation Coefficient (ICC) is a commonly investigated and clinically important metric of reliability for pressure pain threshold (PPT) measurement. However, current investigations do not account for inter-repetition variability when calculating inter-session ICC, even though a PPT measurement taken at different sessi...
Article
Full-text available
Hamstring muscle function during knee flexion has been linked to hamstring injury and performance. However, it is unclear whether knee flexion alone (KF) requires similar hamstring electromyography (EMG) activity pattern to simultaneous hip extension and knee flexion (HE-KF), a combination that occurs in the late swing phase of sprinting. This stud...
Article
Objectives: To examine the effects of plyometric jump training (PJT) on lower limb stiffness. Methods: Systematic searches were conducted in PubMed, Web of Science, and SCOPUS. Studies included healthy males and females who undertook a plyometric jump training programme, isolated from any other training type. Results: There was a small effect size...
Article
Full-text available
Background: The mechanisms of action that facilitate improved outcomes after conservative rehabilitation are unclear in individuals with cervical radiculopathy (CR). This study aims to determine the pathways of recovery of disability with different exercise programs in individuals with CR. Methods: We analysed a dataset of 144 individuals with C...
Article
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Background: Both bilateral (BLE) and unilateral resistance exercise (ULE) methods can confer benefit to an athlete but it remains to be established which has a greater effect on movement speed. Objectives: To evaluate the effects of BLE and ULE on horizontal movement performance. Data sources: Google Scholar, CrossRef and PubMed. Study eligibility...
Article
Full-text available
Background: In accordance with the principle of training specificity, adaptations to vertically- or horizontally-orientated plyometric training (VPT, HPT) directly transfer to athletic tasks that are carried out in the same direction as they are performed. Objectives: The objective of this systematic review and meta-analysis was to determine the re...
Article
An inability to pre-plan a side-step cutting maneuver results in a greater reduction in speed and shallower cut angle. Although leg stiffness has not been directly quantified in cutting, indirect evidence suggest that greater stiffness may benefit cutting speed, but lower stiffness may benefit cut angle. No studies have investigated if stiffness ca...
Article
Full-text available
Having an abundance of motor solutions during movement may be advantageous for the health of musculoskeletal tissues, given greater load distribution between tissues. The aim of the present study was to understand whether motor abundance differs between people with and without low back pain (LBP) during a low-load lifting task. Motion capture with...
Article
Full-text available
Prognostic models play an important role in the clinical management of cervical radiculopathy (CR). No study has compared the performance of modern machine learning techniques, against more traditional stepwise regression techniques, when developing prognostic models in individuals with CR. We analysed a prospective cohort dataset of 201 individual...
Article
Full-text available
PurposeTo evaluate the predictive performance of statistical models which distinguishes different low back pain (LBP) sub-types and healthy controls, using as input predictors the time-varying signals of electromyographic and kinematic variables, collected during low-load lifting. Methods Motion capture with electromyography (EMG) assessment was pe...
Article
Understanding the influence of load carriage on trunk-pelvis coordination and its variability has important functional implications for athletes who need to run with load. The aim of this study was to examine the influence of load carriage on trunk-pelvis coordination in running. Thirty healthy adults performed running while wearing a 20% bodyweigh...
Article
Full-text available
Background: Predictors of recovery in patellofemoral pain syndrome (PFPS) currently used in prognostic models are scalar in nature, despite many physiological measures originally lying on the functional scale. Traditional modelling techniques cannot harness the potential predictive value of functional physiological variables. Research question:...
Article
Full-text available
Side-step cutting is a common evasive maneuver which is typically performed without prior anticipation. Studies quantifying joint work and its inter-joint proportions in cutting have not accounted for work done by the foot, even though this segment has been shown to be an important source of mechanical work in walking, running, and landing. The aim...
Article
Full-text available
Background Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders. Pain may be further exacerbated by atypical motor coordination strategies. It has been thought that low coordination variability may concentrate loads onto painful knee tissues. Research question To investigate if inter-limb force coordination is al...
Article
Full-text available
Background: Rehabilitation approaches should be based on an understanding of the mechanisms underpinning functional recovery. Yet, the mediators that drive an improvement in post-surgical pain-related disability in individuals with cervical radiculopathy (CR) is unknown. The aim of the present study is to use Bayesian Networks (BN) to learn the pr...
Article
Background Individuals with neck pain have different movement and muscular activation (collectively termed as biomechanical variables) patterns compared to healthy individuals. Incorporating biomechanical variables as covariates into prognostic models is challenging due to the high dimensionality of the data. Research question What is the classifi...
Article
Full-text available
Recent research using high-density electromyography (HDEMG) has provided a more precise understanding of the behaviour of the paraspinal muscles in people with low back pain (LBP); but so far, HDEMG has not been used to investigate the flexion relaxation phenomenon (FRP). To evaluate this, HDEMG signals were detected with grids of electrodes (13 ×...
Article
Full-text available
Background: A patient-centred approach to care is increasingly the mandate for healthcare delivery. There is a need to explore how health professional students develop patient-centred attributes. This study aims to understand the extent of patient-centred orientations of health professional students, their perceptions and factors influencing their...
Article
Full-text available
Objectives: The present study's objective is to understand the causal mechanisms underpinning the recovery of individuals with whiplash-associated disorders (WAD). We applied Bayesian Networks (BN) to answer two study aims: (1) to identify the causal mechanism(s) of recovery underpinning neck-specific exercise, and (2) quantify if the cyclical pat...
Article
Full-text available
Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and...
Article
Three-dimensional gait analysis (3D–GA) is commonly used to answer clinical questions of the form “which joints and what variables are most affected during when”. When studying high-dimensional datasets, traditional dimension reduction methods (e.g. principal components analysis) require “data flattening”, which may make the ensuing solutions diffi...
Article
High-density surface electromyography (HDsEMG) provides a detailed analysis of a muscle's spatial distribution of activity. We applied a Bayesian spatio-temporal statistical method to quantify how acute nociception and task repetition alters the upper trapezius instantaneous spatial distribution of activity during dynamic muscular contractions. Ten...
Article
Background: Biomechanical data in cerebral palsy are inherently variable but no optimal model of translational joint constraint has been identified. The primary aim of this study was to determine which model of translational joint constraint resulted in the lowest within-participant variability of lower limb joint angles and moments. The secondary...
Article
Full-text available
Background The effects of resistance training on a muscle’s neural, architectural, and mechanical properties are well established. However, whether resistance training can positively change the coordination of multiple motor elements in the control of a well-defined lower limb motor performance objective remains unclear. Such knowledge is critical...
Article
Greater functional knee valgus (FKV) is thought to contribute to a greater risk of sustaining overuse running injuries. The hip is commonly implicated in greater functional knee valgus, but no studies have investigated the effects of hip taping on running kinematics. The present study investigated whether or not hip taping altered hip and knee kine...
Article
Full-text available
Background: Musculoskeletal (MSK) pain disorders represent a group of highly prevalent and often disabling conditions. Investigating the structure of motor variability in response to pain may reveal novel motor impairment mechanisms that may lead to enhanced management of motor dysfunction associated with MSK pain disorders. This review aims to sy...
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Article
Vertical jumping involves coordinating the temporal sequencing of angular motion, moment, and power across multiple joints. Studying the biomechanical coordination strategies that differentiates loaded from unloaded vertical jumping may better inform training prescription for athletes needing to jump with load. Common multivariate methods (e.g. Pri...
Article
Full-text available
Background There is convincing evidence for the benefits of resistance training on vertical jump improvements, but little evidence to guide optimal training prescription. The inability to detect small between modality effects may partially reflect the use of ANOVA statistics. This study represents the results of a sub-study from a larger project in...