Helen Dawes

University of Exeter | UoE · College of Medicine and Health

Objectives: The purpose of this study was to evaluate the feasibility and potential effect of a physical exercise package on the motor proficiency of children and adolescents with Down syndrome. Methods: In this research, an experimental design was conducted in two special schools to evaluate the effectiveness of this package and identify its stren...

This study examined the potential for effect of a six-week gait aid training program for people with dementia on spatiotemporal gait outcomes, perception of use, and falls with gait aid use. The program utilised four 30-min physiotherapy home visits, scheduled at weeks 1/2/3/6, and was enhanced by carer-supervised practice. Falls and the physiother...

Introduction Survivors of critical illness frequently experience long-term physical impairment, decreased health-related quality of life and low rates of return to employment. There has been limited investigation of the underlying problems affecting physical function post-intensive care unit (ICU) admission. Musculoskeletal (MSK) conditions may be...

Background: Developmental coordination disorder affects approximately 6% of children, interfering with participation in physical activity and can persist through adulthood. However, no studies have investigated the neuromotor mechanisms of learning of a novel task with rhythmic cueing. Methods: Movement Assessment Battery for Children-2nd editio...

Objective: It is generally believed that gait characteristics of diabetic neuropathic patients differ from those of non-diabetic ones. However, it is still unclear how the abnormal foot sensation influences the gait during walking in type 2 diabetes mellitus (T2DM). For the purpose of gaining a better insight into the alterations of detailed gait...

Importance: Cerebrovascular changes are already evident in young adults with hypertension and exercise is recommended to reduce cardiovascular risk. To what extent exercise benefits the cerebrovasculature at an early stage of the disease remains unclear. Objective: To investigate whether structured aerobic exercise increases brain vessel lumen d...

Background People with Long Covid (Post Covid-19 Condition) describe multiple symptoms which vary between and within individuals over relatively short time intervals. We aimed to describe the real-time associations between different symptoms and between symptoms and physical activity at the individual patient level. Methods and findings Intensive...

Objective Advances in computer vision make it possible to combine low-cost cameras with algorithms, enabling biomechanical measures of body function and rehabilitation programs to be performed anywhere. We evaluated a computer vision system's accuracy and concurrent validity for estimating clinically relevant biomechanical measures. Design Cross-s...

Background: The association between diet, symptoms and health related quality of life in children and young people with Juvenile idiopathic arthritis (JIA) is not clearly understood. The objectives of this systematic review and meta-analysis were to explore the evidence for a relationship between nutritional status, dietary intake, arthritis sympt...

Background Despite existing guidelines for managing mild traumatic brain injury (mTBI), evidence-based treatments are still scarce and large-scale studies on the provision and impact of specific rehabilitation services are needed. This study aimed to describe the provision of rehabilitation to patients after complicated and uncomplicated mTBI and i...

Purpose: Fatigue is a major symptom of ABI. Greater fatigue is associated with cognitive impairment. Our aim was to systematically review, describe and analyse the literature on the extent of this relationship. Methods: Five databases were searched from inception. Studies were included where: participants had a defined clinical diagnosis of ABI...

Introduction: This study aimed to estimate the criterion validity of functional movement and posture measurement using remote technology systems in people with and without Axial spondylarthritis (axSpA). Methods: Validity and agreement of the remote-technology measurement of functional movement and posture were tested cross-sectionally and compa...

Purpose To determine gait aid use and decision-making related to usage in people with dementia, and examine factors influencing (1) gait aid use or not; and (2) falls in past year. Materials and methods A survey of informal carers of older people with dementia in the community. Closed questions on gait aid use, falls, timing and sources of gait ai...

(1) Background: People with ASD commonly present difficulty performing motor skills and a decline in physical activity (PA) level and low enjoyment of PA. We aimed to evaluate whether longitudinal practice of an activity in virtual and real environments improves motor performance and whether this improvement is transferred to a subsequent practice...

Background/Aims: The relationship between physical activity (PA) and left ventricular diastolic function (LVDF) has not been well studied in adolescents. We assessed the associations of different PA intensities with LVDF, accounting for the well-known effect of adiposity. Methods: Wrist-worn accelerometery was used in 12-17-year-olds with (n=33; bo...

Traumatic brain injury (TBI) is frequently associated with neuropsychiatric impairments such as symptoms of post-traumatic stress disorder (PTSD), which can be screened using self-report instruments such as the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). The current study aims to inspect the factorial validity and cross-linguistic e...

Fatigue is one of the most debilitating symptoms for people with multiple sclerosis (PwMS). By consolidating a diverse and conflicting evidence-base, this systematic review and meta-analysis aimed to gain new insights into the neurobiology of MS fatigue. MEDLINE, ProQuest, CINAHL, Web of Science databases and grey literature were searched using Med...

The application of machine learning (ML) has made an unprecedented change in the field of medicine, showing a significant potential to automate tasks and to achieve objectives that are closer to human cognitive capabilities. Human gait, in particular, is a series of continuous metabolic interactions specific for humans. The need for an intelligent...

Motor competence (MC) is a key component reflecting one’s ability to execute motor tasks and is an important predictor of physical fitness. For adolescents experiencing rapid growth changes, understanding the factors affecting MC is pertinent to the development of more sophisticated sporting skills. Previous studies considered the influence of poor...

Purpose: To systematically review studies assessing (1) psychometric properties of the maximal oxygen uptake (VO2max) test in PD, (2) VO2max levels in persons with PD (pwPD) compared to healthy controls (HCs), and (3) reported VO2max associations in PD. Materials and methods: Six databases were searched. Descriptive data synthesis was used to su...

Purpose To estimate the criterion validity of sagittal thoracolumbar spine measurement using a surface topography method in a clinical population against the gold standard and to estimate concurrent validity against two non-radiographic clinical tools. Methods In this cross-sectional validity study, thoracolumbar curvature was measured in adults w...

Aim: To develop a core set of outcome domains to be measured in clinical studies on lower limb orthopaedic surgery for ambulant children with cerebral palsy (CP) that represents the priorities of an international multi-stakeholder group (children, parent/carers, and health professionals). Method: Potential outcome domains were identified through...

Introduction Occupation-based interventions could help to address a growing mental health crisis among young people and adolescents. To develop new interventions and avoid research waste, a review of the academic literature is needed that systematically identifies and describes interventions designed to improve the mental health and wellbeing of 11...

Introduction Axial spondylarthritis (axSpA) is a chronic inflammatory disease and commonly results in pain and joint stiffness. Using remote technology, such as a computer vision-aided system, has the potential to monitor functional movement and posture. Methods The validity of the remote technology measurement of functional movement and posture we...

Until recently, neural assessments of gross motor coordination could not reliably handle active tasks, particularly in realistic environments, and offered a narrow understanding of motor-cognition. By applying a comprehensive neuroergonomic approach using optical mobile neuroimaging, we probed the neural correlates of motor functioning in young peo...

OBJECTIVES There is no clear guidance on the intensity and duration of physical activity (PA) that adolescents require to maximise cardiorespiratory fitness (CRF). We aimed to determine the strength of associations between each PA intensity and CRF, independently of other intensities, and the PA duration at each intensity associated with maximal CR...

Computed tomography (CT) brain imaging is routinely used to support clinical decision-making in patients with traumatic brain injury (TBI). Only 7% of scans, however, demonstrate evidence of TBI. The other 93% of scans contribute a significant cost to the healthcare system and a radiation risk to patients. There may be better strategies to identify...

Background Exercise is advised for young adults with elevated blood pressure, but no trials have investigated efficacy at this age. We aimed to determine whether aerobic exercise, self-monitoring and motivational coaching lowers blood pressure in this group. Methods The study was a single-centre, open, two-arm, parallel superiority randomized clin...

Background People with Long Covid (Post-Acute Sequelae of Covid-19) describe multiple symptoms which vary between and within individuals over relatively short time intervals. We aimed to describe the real-time associations between different symptoms and between symptoms and physical activity at the individual patient level. Methods and Findings In...

Complex metabolic disruption is a crucial aspect of the pathophysiology of traumatic brain injury (TBI). Associations between this and systemic metabolism and their potential prognostic value are poorly understood. Here, we aimed to describe the serum metabolome (including lipidome) associated with acute TBI within 24 h post-injury, and its relatio...

Background Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma. Methods We did a prospective, observational, comparat...

Introduction The incidence of traumatic brain injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in ol...

Introduction: Long COVID, a new condition whose origins and natural history are not yet fully established, currently affects 1.5 million people in the UK. Most do not have access to specialist long COVID services. We seek to optimise long COVID care both within and outside specialist clinics, including improving access, reducing inequalities, help...

Desaturation on exercise has been suggested as a predictive feature for deterioration in COVID-19. The objective of this paper was to determine the feasibility and validity for the 40-steps desaturation test.A prospective observational cohort study was undertaken in patients assessed in hospital prior to discharge. One-hundred and fifty-two partici...

Introduction Long COVID, a new condition whose origins and natural history are not yet fully established, currently affects 1.5 million people in the UK. Most do not have access to specialist long COVID services. We seek to optimise long COVID care both within and outside specialist clinics, including improving access, reducing inequalities, helpin...

Objective: Evidence-based treatment for nonmotor symptoms in Parkinson's disease (PD) is limited. Lifestyle-based improvements including dietary changes may be a potential management strategy. The intent of this research was to investigate the extent to which 3 dietary indices (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay [MIND...

This study aimed to explore factors associated with Physical Activity (PA) in Jordanian older people. Global Physical Activity Questionnaire was used to measure PA in 120 adults aged ≥ 60 years. Physical and psychosocial factors related to PA were measured including gait and balance, cognition, health-related quality of life, self-reported health,...

Purpose: To explore, in a European cohort of people living with Parkinson's (PD), issues affecting employment and economic consequences, considering age at diagnosis. Materials and methods: A cross-sectional survey (European convenience sample). Inclusion criteria were ≥18 years, a PD diagnosis and in work when diagnosed. Data were collected onl...

Background. In China, swinging the leg backwards and forwards is a commonly used therapy for people with osteoarthritis of the knee. One rationale is that movement without weightbearing may increase the range of movement by allowing a greater range of pian-free movement at the knee. There have been no studies evaluating its effectiveness. Before un...

Repair of critical-size bone defects in patients with diabetes mellitus (DM) has always been a challenge in clinical treatment. The process of bone defect regeneration can be impaired by underlying diseases including DM, but the mechanism remains unclear. In bone tissue engineering, the integration of bionic coatings and bioactive components into b...

Background: The association between diet, symptoms and health related quality of life in children and young people with Juvenile idiopathic arthritis (JIA) is not clearly understood. The objectives of this systematic review and meta-analysis were to explore the evidence for a relationship of dietary intakes and arthritis symptoms such as pain and i...

Background Frailty is known to be associated with poorer outcomes in individuals admitted to hospital for medical conditions requiring intensive care. However, little evidence is available for the effect of frailty on patients’ outcomes after traumatic brain injury. Many frailty indices have been validated for clinical practice and show good perfor...

Flavonoids, plant compounds found in certain foods, may have the ability to improve fatigue and fatigability. However, to date, no well-designed intervention studies assessing the role of flavonoid consumption for fatigue management in people with Parkinson’s (pwP) have been performed. Objectives To determine the feasibility and estimate potential...

Introduction: Although several outcomes are commonly measured to assess the effect of surgery for young people with cerebral palsy (CP), these are selected mainly by health professionals and researchers. Including the perspectives of a broader range of stakeholders is an essential step towards determining important outcomes for assessment. This qu...

Objectives The objective was to determine recent cross-sectional trends in health-related fitness (HRF) in secondary school students by studying the 13–14 years old age group repeatedly over 6 years, considering parallel national trends in physical education (PE). Methods Height, weight, broad jump, grip strength, 20 m shuttle run and throwing and...

Objectives: Physical activity declines during adolescence. The Theory of Planned Behaviour (TPB) is a useful framework for investigating activity but leaves variance unexplained. We explored the utility of a dual-process approach using the TPB and the Prototype Willingness Model (PWM) to investigate correlates of physical activity, and 1-year chan...

Purpose To explore the perspectives of children with CP, their parents or carers, and health professionals on factors affecting expectations and perceptions of surgical outcomes for lower limb orthopaedic surgery. Materials and methods Semi-structured interviews were conducted with 10 healthcare professionals, 10 children and young people with CP,...

Background Trauma-induced coagulopathy in traumatic brain injury (TBI) remains associated with high rates of complications, unfavorable outcomes, and mortality. The underlying mechanisms are largely unknown. Embedded in the prospective multinational Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) stu...

Background In traumatic brain injury (TBI), large between-center differences in treatment and outcome for patients managed in the intensive care unit (ICU) have been shown. The aim of this study is to explore if European neurotrauma centers can be clustered, based on their treatment preference in different domains of TBI care in the ICU. Methods P...

Osteoarthritis (OA), characterized by chondrocyte apoptosis and disturbance of the balance between catabolism and anabolism of the extracellular matrix (ECM), is the most common age-related degenerative joint disease worldwide. As sleep has been found to be beneficial for cartilage repair, and circular RNAs (circRNAs) have been demonstrated to be i...

Background Prehospital care for patients with traumatic brain injury (TBI) varies with some emergency medical systems recommending direct transport of patients with moderate to severe TBI to hospitals with specialist neurotrauma care (SNCs). The aim of this study is to assess variation in levels of early secondary referral within European SNCs and...

Purpose To explore the extent to which musculoskeletal (MSK) complications have been reported following critical illness, identifying evidence gaps and providing recommendations for future research. Materials and methods We searched five databases from January 1st 2000 to March 31st 2021. We included published original research reporting MSK compl...

Introduction Neurocognitive problems associated with posttraumatic stress disorder (PTSD) can interact with impairment resulting from traumatic brain injury (TBI). Research question We aimed to identify neurocognitive problems associated with probable PTSD following TBI in a civilian sample. Material and methods The study is part of the CENTER-TB...

Back pain is a common form of disability worldwide, and one condition that causes chronic back pain is axial spondyloarthritis (axSpA) which primarily affects spinal joints resulting in pain and joint stiffness. Markerless human motion analysis uses a computer-vision (CV) aided system to automate human movement from videos. In this protocol, the st...

Importance An interview is considered the gold standard method of assessing global functional outcomes in clinical trials among patients with acute traumatic brain injury (TBI). However, several multicenter clinical trials have used questionnaires completed by a patient or caregiver to assess the primary end point. Objective To examine agreement b...

Background People with progressive Multiple Sclerosis often struggle to access appropriate and inclusive support for regular physical activity. The Lifestyle, Exercise and Activity Package (LEAP-MS) intervention, is a co-designed web-based physical activity intervention for people with progressive Multiple Sclerosis (MS). It consists of two key com...

Background The long-term psychological consequences of stroke and how cognitive problems change over time after the first-year following stroke remain unclear. Particularly, trajectories of domain-specific and domain-general cognitive functions and how cognition interacts with mood, fatigue and quality of life are not well described. Aims To deter...

Rare neurological conditions (RNCs) encompass a variety of diseases that differ in progression and symptoms but typically include muscle weakness, sensory and balance impairment and difficulty with coordinating voluntary movement. This can limit overall physical activity, so interventions to address this are recommended. The aim of this study was t...

Background In patients with severe brain injury, withdrawal of life-sustaining measures (WLSM) is common in intensive care units (ICU). WLSM constitutes a dilemma: instituting WLSM too early could result in death despite the possibility of an acceptable functional outcome, whereas delaying WLSM could unnecessarily burden patients, families, clinici...

CARDIGAN project aims to use criticality analysis of gait to identify individuals at risk of developing diabetes among overweight teenagers in Mexico. This project aims to draw together computer scientists, life scientists and clinicians from Mexico and UK.

Purpose To integrate the evidence of gait aid prescription for improving spatiotemporal gait parameters, balance, safety, adherence to gait aid use, and reducing falls in community-dwelling older people. Methods Seven health databases were searched to June 2021. Experimental studies investigating gait aid prescription (provision and instruction fo...

Until recently, neural assessments of gross motor coordination could not reliably handle active tasks, particularly in realistic environments, and offered a narrow understanding of motor-cognition. By applying a comprehensive neuroergonomic approach using optical mobile neuroimaging, we demonstrated the broader capability for ecologically relevant...

Background In patients with severe brain injury, withdrawal of life-sustaining measures (WLSM) is common in intensive care units (ICU). WLSM constitutes a dilemma: instituting WLSM too early could result in death despite the possibility of an acceptable functional outcome, whereas delaying WLSM could unnecessarily burden patients, families, clinici...