Christine T Shiner

Christine T Shiner
St. Vincent's Hospital Sydney · Department of Rehabilitation and Pain Medicine

BMedSci (Hons I), PhD

About

45
Publications
5,568
Reads
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476
Citations
Citations since 2016
31 Research Items
444 Citations
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2016201720182019202020212022020406080100
2016201720182019202020212022020406080100
Additional affiliations
February 2016 - present
St. Vincent's Hospital Sydney
Position
  • Research Officer
April 2014 - April 2015
UNSW Sydney
Position
  • Lad demonstrator
February 2012 - August 2015
Neuroscience Research Australia
Position
  • PhD Student
Education
February 2012 - August 2015
UNSW Sydney
Field of study
  • PhD in Neurophysiology
January 2008 - December 2011
UNSW Sydney
Field of study
  • BMedSci Hons I

Publications

Publications (45)
Article
Purpose Professional interpreters can improve healthcare quality and outcomes when there is language discordance between patients and health care providers. Multidisciplinary rehabilitation relies on nuanced communication; however, the use of interpreters in rehabilitation is underexplored. This study aimed to examine patterns of health care interp...
Article
Full-text available
Background: Commercial delivery cyclists represent a uniquely vulnerable and poorly understood road user. The primary aim of this study was to pilot whether cycling injuries could be categorised as either commercial or non-commercial using documentation entered into routine hospital medical records, in order to determine the feasibility of conduct...
Article
Full-text available
Objectives Societal and health system pressures associated with the COVID-19 pandemic exacerbated the burden of chronic pain and limited access to pain management services for many. Online multidisciplinary pain programs offer an effective and scalable treatment option, but have not been evaluated within the context of COVID-19. This study aimed to...
Article
Pulmonary hypertension (PH) is characterized by progressive dyspnea, fatigue and reduced exercise capacity. Despite medical treatment, outcomes remain poor. Whilst exercise training is a well established in patients with heart failure, it is less established in patients with PH. This single blind, randomised controlled pilot study examined the feas...
Article
Objective: To describe the rehabilitation services available for people with stroke and hip fracture across New South Wales/Australian Capital Territory metropolitan and rural/regional public hospitals in Australia. Design: A cross-sectional study design was used. Setting: New South Wales/Australian Capital Territory public hospital providing...
Article
Objectives It is unclear how acute care influences patient outcomes in those who receive rehabilitation. We aimed to determine the associations between acute stroke therapies, outcomes during inpatient rehabilitation and self-reported outcomes at 90-180 days after stroke. Materials and Methods Patient-level data from adults with acute stroke regis...
Preprint
Full-text available
Background: Commercial delivery cyclists represent a uniquely vulnerable and poorly understood road user. The aim of this study was to determine whether cyclists could be categorised as commercial or non-commercial from routine medical records and which key demographic, incident and injury characteristics could be identified and attributed to each...
Preprint
BACKGROUND Internet-based treatment programs present a solution for providing access to pain management for those unable to access clinic-based multidisciplinary pain programs. Attrition from internet interventions is a common issue. Clinician supported guidance can be an important feature in online interventions however the optimal level of therap...
Article
Background: Internet-based treatment programs present a solution for providing access to pain management for those unable to access clinic-based multidisciplinary pain programs. Attrition from internet interventions is a common issue. Clinician-supported guidance can be an important feature in web-based interventions; however, the optimal level of...
Article
Objective Chronic pain is a prevalent and disabling condition. Reboot Online was developed as a multidisciplinary and widely accessible online treatment program for chronic pain. It has been shown to be effective in clinical trials, but the effectiveness of this program in routine care settings remains unknown. This study aimed to examine program a...
Article
Full-text available
Rehabilitation programmes can be delivered to patients receiving acute care (‘in-reach rehabilitation’) and/or those who have completed acute care but experience ongoing functional impairments (‘subacute rehabilitation’). Access to these programmes depends on a rehabilitation assessment, but there are concerns that referrals for this assessment are...
Article
Purpose: Persistent activity limitations are common among road trauma survivors, yet access to rehabilitation in hospital and in the community remains variable. This study aimed to identify unmet rehabilitation needs following road trauma and assess the feasibility of a novel rehabilitation consultation service delivered via telehealth following h...
Article
Background Upper limb (UL) impairment in stroke survivors is both multifactorial and heterogeneous. Stratification of motor function helps identify the most sensitive and appropriate assessments, which in turn aids the design of effective and individualized rehabilitation strategies. We previously developed a stratification method combining the Gro...
Article
Full-text available
Patients with pulmonary hypertension are more sedentary than the general population, but attitudes and experiences that may influence their exercise behaviour remain poorly understood. This study identified patterns of behaviour, attitudes towards exercise, barriers and enablers of exercise for people living with pulmonary hypertension. Accessibili...
Article
Full-text available
Exercise training was not traditionally recommended for patients with pulmonary hypertension. However, recent work has demonstrated that exercise improves endurance and quality-of-life in patients with pulmonary hypertension. Unfortunately, patients with pulmonary hypertension are often sedentary. While some studies have examined patient attitudes...
Article
Full-text available
Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty st...
Article
Objective: Chronic pain is a prevalent and burdensome condition. Reboot Online was developed to address treatment barriers traditionally associated with accessing face-to-face chronic pain management programs. It is a comprehensive multidisciplinary online treatment program, based on an existing and effective face-to-face multidisciplinary pain pr...
Article
Purpose: Post-stroke spasticity can impair motor function and may cause pain, limb deformity, contracture, and difficulties with limb care. This study aimed to assess the prevalence and burden of post-stroke upper-limb spasticity among nursing home residents. Materials and methods: A multisite, cross-sectional study was conducted across three nursi...
Article
Background Cardiopulmonary transplantation is becoming a more common treatment option for advanced heart and/or lung disease. Specialist rehabilitation programs may assist recovery and enhance functional independence following transplantation. Objective To quantify the outcomes of multidisciplinary inpatient rehabilitation following cardiopulmonar...
Article
Full-text available
Impaired motor control post-stroke is typically measured using clinical assessments employing categorical and subjective scoring. We investigated quantitative kinematic parameters of a complex movement with therapy in chronic stroke. Tri-axial accelerometry of the more-affected arm of 24 patients was recorded during early- (day 2-3) and late- (days...
Article
Background: Education is essential to promote prevention of recurrent stroke and maximize rehabilitation; however, current techniques are limited and many patients remain dissatisfied. Virtual reality (VR) may provide an alternative way of conveying complex information through a more universal language. Aim: To develop and conduct preliminary asses...
Article
Full-text available
Objectives Chronic pain causes significant disability and psychological distress, but barriers often prevent people with pain from engaging in traditional face-to-face pain management programs. Accessible, feasible, and effective alternative treatment options are needed. Methods A prospective, feasibility pilot study was conducted to trial a novel...
Article
Full-text available
Fine motor control is achieved through the coordinated activation of groups of muscles, or “muscle synergies.” Muscle synergies change after stroke as a consequence of the motor deficit. We investigated the pattern and longitudinal changes in upper limb muscle synergies during therapy in a largely unconstrained movement in patients with a broad spe...
Article
Full-text available
Poststroke weakness on the more-affected side may arise from reduced corticospinal drive, disuse muscle atrophy, spasticity, and abnormal coordination. This study investigated changes in muscle activation patterns to understand therapy-induced improvements in motor-function in chronic stroke compared to clinical assessments and to identify the effe...
Article
Purpose: Transient ischemic attack (TIA) and mild stroke represent a large proportion of cerebrovascular events, at high risk of being followed by recurrent, serious events. The importance of early education addressing risk management, secondary prevention and lifestyle modifications is the centerpiece of further stroke prevention. However, deliver...
Article
Purpose: Post-stroke hemiparesis may manifest as asymmetric gait, poor balance, and inefficient movement patterns. We investigated improvements in lower-limb muscle activation and function during Wii-based Movement Therapy (WMT), a rehabilitation program specifically targeting upper-limb motor-function. Methods: Electromyography (EMG) was record...
Article
Full-text available
Background: Persistent motor impairment is common but highly heterogeneous poststroke. Genetic polymorphisms, including those identified on the brain-derived neurotrophic factor (BDNF) and apolipoprotein E (APOE) genes, may contribute to this variability by limiting the capacity for use-dependent neuroplasticity, and hence rehabilitation responsiv...
Article
Introduction: Post-stroke cardiovascular fitness is typically half that of healthy age-matched people. Cardiovascular deconditioning is a risk factor for recurrent stroke that may be overlooked during routine rehabilitation. This study investigated the cardiovascular responses of two upper limb rehabilitation protocols. Methods: Forty-six stroke...
Article
Full-text available
More effective and efficient rehabilitation is urgently needed to address the prevalence of unmet rehabilitation needs after stroke. This study compared the efficacy of two poststroke upper limb therapy protocols. We tested the hypothesis that Wii-based movement therapy would be as effective as modified constraint-induced movement therapy for post-...
Article
Full-text available
Background: Functional ability is regularly monitored poststroke to assess improvement and the efficacy of clinical trials. The balance between implementation times and sensitivity has led to multidomain tools that aim to assess upper-limb function comprehensively. Objective: This study implemented 3 common multidomain tools to investigate their...
Article
Full-text available
Motor deficits after a stroke are thought to be compounded by the development of asymmetric interhemispheric inhibition. Bilateral priming was developed to rebalance this asymmetry and thus improve therapy efficacy. This study investigated the effect of bilateral priming before Wii-based Movement Therapy to improve rehabilitation after stroke. Ten...
Article
Full-text available
. Neurological deficits after a stroke are commonly classified according to motor function for clinical decision making regarding discharge and rehabilitation. Participants in clinical stroke studies are also stratified by motor function to avoid a sampling bias. . This post hoc analysis examined a suite of upper limb functional assessment tools to...
Article
Full-text available
Purpose – Stroke patients with low and very low functional movement are not usually considered suitable for rehabilitation. Without therapy the more-affected side will not improve and may lose any residual function. Poor movement ability reduces independence and limits the social engagement of such patients. The purpose of this paper was to investi...
Article
The stability of the maximal muscle response (M(max)) is critical to H reflex methodology. It has previously been reported that the amplitude of M(max) declines over time. If reproducible, this finding would have implications for all experimental studies that normalise the output of the motoneurone pool against the M wave. We investigated the effec...
Article
Persistent motor disability limits the capacity of stroke patients to retain or regain physical fitness. Increased metabolic demands of hemiparetic gait, physical deconditioning, and secondary muscle changes including atrophy and a shift in muscle fibre phenotype, combine to reduce post-stroke aerobic capacity by ∼50%. Fitness may be overlooked in...

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