Meg E Morris

University of Melbourne | MSD · Department of Physiotherapy

Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are to increase access to best...

Retention of care support workers in residential aged care facilities and home-based, domiciliary aged care is a global challenge, with rapid turnover, low job satisfaction, and poorly defined career pathways. A mixed-methods systematic review of the workforce literature was conducted to understand the factors that attract and retain care staff acr...

Introduction While individualised falls preventive education has been effective in reducing hospital falls among older patients, there is a dearth of research exploring consumers' perspectives on hospital falls prevention education. Objective This study aimed to explore the knowledge of older consumers regarding preventing falls in hospital and the...

Background Hospital falls are a major global problem responsible for considerable morbidity, mortality, and healthcare costs. Clinical practice guidelines for hospital falls prevention, facilitate the implementation of falls prevention research into practice, through the provision of evidence-based recommendations to mitigate the risk of falls. The...

Background: Self-directed therapy activities are not currently part of routine care during inpatient rehabilitation. Understanding patient and clinician perspectives on self-directed therapy is key to increasing implementation. The aim of this study was to investigate barriers and facilitators to implementing a self-directed therapy programme ("My...

Low back pain is prevalent in the community and associated with deficits in core muscle strength and activation. Pilates is argued to improve movement and reduce pain, yet there is a limited understanding of the specific effects of Pilates training on core muscle strength or activity. A systematic search of databases (CINAHL, Embase, Ovid MEDLINE)...

There is a need to ensure that healthcare organisations enable their workforces to use digital methods in service delivery. This study aimed to evaluate the current level of digital understanding and ability in nursing, midwifery, and allied health workforces and identify some of the training requirements to improve digital literacy in these health...

Background: Dancing is an engaging physical activity for people living with Parkinson’s disease (PD). We conducted a process evaluation for a PD trial on online dancing. Methods: “ParkinDANCE Online” was co-produced by people with PD, healthcare professionals, dance instructors, and a PD organisation. The evaluation mapped the following inputs: (i)...

Background Patient reported outcome measures (PROMs) engage patients in co-evaluation of their health and wellbeing outcomes. This study aimed to determine the feasibility, response rate, degree of recovery and patient acceptability of a PROM survey for elective surgery. Methods We sampled patients with a broad range of elective surgeries from fou...

Background Codesign strengthens partnerships between healthcare workers and patients. It also facilitates collaborations supporting the development, design and delivery of healthcare services. Prior rehabilitation reviews have focused mainly on the clinical and organisational outcomes of codesign with less focus on the lived experience of rehabilit...

Background Private hospitals in Australia manage 11% of acute and 48% of rehabilitation stroke admissions, yet little is known about implementation of stroke clinical guidelines in this setting. Clinical guidelines recommend that acute stroke patients be co-located in a stroke unit in a geographically defined area, rather than dispersed across the...

Questions: In people recovering from traumatic brain injury, is a 3-month ballistic resistance training program targeting three lower limb muscle groups more effective than non-ballistic exercise rehabilitation for improving mobility, strength and balance? Does improved mobility translate to better health-related quality of life? Design: A prosp...

Background and purpose: Exercise interventions can improve physical recovery and reduce falls in older adults following hospitalization. The aim of the study was to identify factors associated with exercise engagement after hospital discharge. Methods: This study was a secondary analysis of data collected as part of a randomized controlled trial...

Objective Implementing the routine collection of patient reported outcome measures (PROMs) is key to improving healthcare quality and patient satisfaction. The implementation process can be strengthened through staff and patient co-design. The aim of this project was to develop a set of Australian PROM implementation recommendations ('AusPROM') to...

Patient education is key to preventing hospital falls yet is inconsistently implemented by health professionals. A mixed methods study was conducted involving a ward-based evaluation of patients receiving education from health professionals using a scripted conversation guide with a falls prevention brochure, followed by semi-structured qualitative...

Virtual communities of practice consist of individuals who use a common online platform to share professional expertise and experiences. In healthcare settings a virtual community of practice (VCoP) can optimise knowledge, skills, and the implementation of evidence-based practice. To ensure effective knowledge synthesis and translation into practic...

Aim: The aim of this study was to design, deliver and evaluate an interprofessional education programme for healthcare professionals on how to implement a modified version of the safe recovery programme to prevent falls in hospitalized patients. Design: Mixed methods design incorporating pre- and post education surveys and individual semi-struct...

Obtaining pre-surgery PROM measures is not always feasible. The aim of this study was to examine if self-reports of change following elective surgery correlate with change scores from a validated PROM (15-item Quality of Recovery (QoR-15)). This cross-sectional study across 29 hospitals enrolled elective surgery patients. PROMs were collected one-w...

Background Falls remain a common and debilitating problem in hospitals worldwide. The aim of this study was to investigate the effects of falls prevention interventions on falls rates and the risk of falling in hospital. Design Systematic review and meta-analysis. Participants Hospitalised adults. Intervention Prevention methods included staff a...

Objective To investigate the feasibility and preliminary effects of Pilates exercises in primigravida women. Design Single-blind randomized controlled feasibility trial. Setting Community Pilates classes. Participants Low-risk pregnant women. Interventions Pregnant women were randomly assigned to Pilates® exercises (experimental) group for 6 co...

In hospitals, patient falls prevention education is frequently delivered by nurses and allied health professionals. Hospital falls rates remain high globally, despite the many systems and approaches that attempt to mitigate falling. The aim of this study was to investigate health professional views on the enablers and barriers to providing patient...

Introduction: Patient-centred care can be facilitated by co-design, which refers to collaboration between healthcare professionals and consumers in producing and implementing healthcare. Systematic reviews on co-design have mainly focused on the effectiveness of co-produced healthcare interventions. Less attention has been directed towards the exp...

Objective: To test the feasibility, safety and effectiveness of the My Therapy programme for inpatients with mild-moderate cognitive impairment. Design: Observational pilot study. Patients: Rehabilitation inpatients with mild-moderate cognitive impairment. Methods: During their inpatient admission, participants received My Therapy, a program...

Background: While the challenges for psychological well-being for Australian healthcare workers have been documented, there has been a dearth of qualitative research on the sources of resilience that sustained workers during the COVID-19 pandemic. This study identified sources of resilience that clinicians used to cope with frontline challenges du...

Introduction Parkinson’s disease can be associated with speech deterioration and low communication confidence which in turn compromises social interaction. Therapeutic singing is an engaging method for combatting speech decline; however, face-to-face delivery can limit access to group singing. The aim of this study is to test the feasibility and ac...

Background: Aquatic therapy is one therapy option for people living with Parkinson's disease (PD). However, the optimal prescription, dosage, and delivery remain unclear. Objective: i) To generate consensus statements, ii) to establish evidence-based clinical practice aquatic therapy guidelines for PD. Methods: Seventy-three international expe...

Objective: To evaluate the outcomes of face-to-face, digital, and virtual modes of dancing for people living with Parkinson's disease (PD). Design: Systematic review informed by Cochrane and PRIMSA guidelines. Data Sources. Seven electronic databases were searched: AMED, Cochrane, PEDro, CINHAL, PsycINFO, EMBASE, and MEDLINE. Methods: Eligible...

Background Implementing evidence into clinical practice is a key focus of healthcare improvements to reduce unwarranted variation. Dissemination of evidence-based recommendations and knowledge brokering have emerged as potential strategies to achieve evidence implementation by influencing resource allocation decisions. The aim of this study was to...

Background Therapeutic dancing can be beneficial for people living with Parkinson’s disease (PD), yet community-based classes can be difficult to access. Objective To evaluate the feasibility and impact of online therapeutic dancing classes for people in the early to mid-stages of PD. Methods Co-produced with people living with PD, physiotherapis...

Introduction Incorporating patient-reported outcome measures (PROMs) into usual care in hospitals can improve safety and quality. Gaps exist in electronic PROM (ePROM) implementation recommendations, including for elective surgery. The aims are to: (1) understand barriers and enablers to ePROM implementation in hospitals and develop Australian ePRO...

Background Ensuring patients receive an effective dose of therapeutic exercises and activities is a significant challenge for inpatient rehabilitation. My Therapy is a self-management program which encourages independent practice of occupational therapy and physiotherapy exercises and activities, outside of supervised therapy sessions. Methods Thi...

Recently hospitalized older people are at risk of falls and face barriers to undertaking fall prevention strategies after they return home from hospital. The authors examined the effects of tailored education delivered by physiotherapists on the knowledge (capability) and the motivation of older people to engage in fall prevention after hospital di...

Objective Falls are a significant problem for many older patients after hospital discharge. The purpose of this study was to evaluate the fidelity and impact of a tailored patient fall prevention education programme from the perspective of the educators who delivered the programme. Design Qualitative sequential design. Setting Three rehabilitatio...

Introduction Virtual communities of practice (VCoPs) use a common online platform to provide healthcare professionals with the opportunity to access highly specialised knowledge, build a professional support network and promote the translation of research evidence into practice. There is limited reporting of how best to design and administer VCoPs...

Background/objectives: We investigated the impact of ceasing routine falls risk assessment tool (FRAT) completion and instead used clinical reasoning to select fall mitigation strategies. Design: Two-group, multi-site cluster-randomized active-control non-inferiority trial. Setting: Hospital wards. Participants: Adult inpatients admitted to...

Background Non-slip socks are sometimes used in an attempt to prevent falls in hospitals despite limited evidence of benefit. We critique the current literature on their risks, benefits and effects. Methods A rapid review was conducted following the Cochrane Rapid Review Methods Group Guidelines. To be included, studies needed to have data on sing...

Aim To produce a pelvic floor muscle training variation of the Consensus on Exercise Reporting Template (CERT-PFMT). Methods Qualitative methods were used to explore the perspectives of physiotherapists who have post-graduate continence and pelvic floor rehabilitation qualifications on using research evidence to implement pelvic floor muscle train...

Hospital falls remain an intractable problem worldwide and patient education is one approach to falls mitigation. Although educating patients can help their understanding of risks and empower them with prevention strategies, patient experiences of hospital falls education are poorly understood. This study aimed to understand the perspectives and pr...

Background: People living with progressive supranuclear palsy (PSP) can experience considerable difficulties with movement, walking, balance, and oculomotor control. The role of exercises and physical activities in mitigating the motor and non-motor symptoms of PSP remains uncertain. Aims: The aim of this study was to identify the perspectives and...

Background Older people are often admitted for rehabilitation to improve walking, yet not everyone improves. The aim of this study was to determine key factors associated with a positive response to hospital-based rehabilitation in older people. Methods This was a secondary data analysis from a multisite randomized controlled trial. Older people (...

Background The adoption of research evidence to improve client outcomes may be enhanced using the principles of implementation science. This systematic review aimed to understand the effect of involving consumers to change health professional behaviours and practice. The barriers and enablers to consumer engagement will also be examined. Methods W...

Objective Although health professional education has the potential to mitigate hospital falls risk, the best methods to develop, deliver and evaluate health professional education remain unclear. This study applied evidence-based approaches to education design to improve falls risk mitigation. Design Mixed methods using questionnaires to evaluate...

Aim: The current study aimed to identify and understand the reasons why allied health professionals think certain areas of healthcare service provision are a high priority for implementation of evidence into practice. Methods: A cross-sectional online survey using open-ended questions was conducted between April and May 2018 to identify potentia...

Introduction Progressive Supranuclear Palsy (PSP) is a debilitating form of atypical Parkinsonism. People living with PSP experience movement disorders affecting walking, balance and eye movements. The role of exercise in optimising movement remains unclear. Aims To identify beliefs about exercise and structured physical activity through the exper...

Background: Parkinson's disease (PD) frequently causes progressive deterioration in speech, voice and cognitive aspects of communication. These affect wellbeing and quality of life and are associated with caregiver strain and burden. Therapeutic singing groups can ameliorate PD-related communication disorders and increase social interaction and we...

Purpose: There is limited understanding of the characteristics and evaluation of more affected hand dexterity loss in Parkinson's disease. We described 9-Hole Peg Test performance for the more affected hand and examined the construct validity of these pegboard scores in mild to severe Parkinson's disease. Methods: This observational study analysed...

Older adults recently discharged from hospital are at high risk of functional decline and falls. A tailored fall prevention education provided at hospital discharge aimed to improve the capacity of older adults to engage in falls prevention activities. What remains unknown are the factors affecting behaviour change after hospital discharge. This st...

Background: Hospital falls remain a frequent and debilitating problem worldwide. Most hospital falls prevention strategies have targeted clinician education, environmental modifications, assistive devices, hospital systems and medication reviews. The role that patients can play in preventing falls whilst in hospital has received less attention. Th...

Background/Purpose: Although gait disorders occur early in the course of Alzheimer's disease (AD) and increase the risk of falling, methods to improve walking in the home setting are poorly understood. This study aimed to determine the feasibility of a home-based gait training program using rhythmic auditory cues for individuals living with mild to...

Objectives: To evaluate the construct validity of two dexterity measures, the 9-Hole Peg Test (9HPT) and Purdue Pegboard Test (PPT) in people with Parkinson's disease (PD). Design: Cross-sectional observational study. Setting: Testing was conducted at the university or in participants' homes. Participants: Thirty community dwelling people wi...

Background The role of the clinical prosthetist in healthcare has evolved substantially, and it is likely that expectations of the role have changed in recent times. Organisational Role Theory provides a framework for considering the expectations and behaviours of health professionals regarding their functions and roles. Objectives The main object...

Background: Exercise and physical activity are argued to promote neural plasticity in Parkinson's disease (PD), with potential to slow disease progression. Boxing for PD is rapidly growing in popularity. Objectives: (i) To evaluate evidence on benefits and risks of boxing exercises for people living with PD and (ii) to appraise websites for evidenc...

Background: Progressive Supranuclear Palsy (PSP) is the most frequent form of atypical Parkinsonism. Although there is preliminary evidence for the benefits of gait rehabilitation, balance training and oculomotor exercises in PSP, the quality of reporting of exercise therapies appears mixed. The current investigation aims to evaluate the comprehen...

Objective To conduct a systematic review to evaluate exercise and structured physical activity for people living with Progressive Supranuclear Palsy. Data sources AMED, CINAHL, Cochrane, EMBASE, Informit, MEDLINE, PEDro, PsycINFO, PubMed and SportDiscus were searched until 18 August 2019. Reference lists of included studies were hand-searched. Me...

Introduction Falls prevention in hospitals is an ongoing challenge worldwide. Despite a wide variety of recommended falls mitigation strategies, few have strong evidence for effectiveness in reducing falls and accompanying injuries. Patient education programmes that promote engagement and enable people to understand their heightened falls risk whil...

Aim: To examine the extent to which level of clinical experience of orthoptists influences eye movements, gaze behaviour and diagnostic accuracy when examining optic disc images for glaucoma. Methods: Eye movements and gaze behaviour of participating orthoptists were recorded whilst examining 20 optic disc images for signs of glaucoma. A maximum of...

Background: Older adults recently discharged from the hospital are known to be at risk of functional decline and falls. This study evaluated the effect of a tailored education program provided in the hospital on older adult engagement in fall prevention strategies within 6 months after hospital discharge. Methods: A process evaluation of a rando...

Introduction: The aim of this study was to determine the accuracy of orthoptists when examining the optic disc for signs of glaucoma, and to explore the impact of targeted clinical education on accuracy. Methods: In this randomized controlled trial, 42 monoscopic color optic disc images were presented to 46 orthoptists who assessed the likelihoo...

Importance: Knowledge regarding the reliability of pegboard tests when used to measure dexterity in people with Parkinson's disease (PD) is currently limited. Objective: To examine the test-retest and interrater reliability of the 9-Hole Peg Test (9HPT) and Purdue Pegboard Test (PPT) in people with PD. Design: Cross-sectional observational stu...

Background: Adults who live in residential aged care can have reduced participation in physical activities and sit for prolonged periods. Therapeutic dancing aims to optimize movement, creative expression, well-being, and social interaction. Objectives: To investigate the benefits, challenges, and facilitators to implementing therapeutic dancing...

The purpose of this paper is to discuss how knowledge of the biomechanics of walking can be used to inform the prescription of resistance exercises for people with mobility limitations. Muscle weakness is a key physical impairment that limits walking in commonly occurring neurologic conditions such as cerebral palsy, traumatic brain injury, and str...

Background Implementation research is increasingly being recognised for optimising the outcomes of clinical practice. Frequently, the benefits of new evidence are not implemented due to the difficulties applying traditional research methodologies to implementation settings. Randomised controlled trials are not always practical for the implementatio...

Objectives: To understand the benefits and feasibility of using supervised, home-based, music-cued training to improve gait speed and stability in community-dwelling people with Progressive Supranuclear Palsy. Design: Feasibility trial incorporating a single group repeated-measures design. Setting: Human movement laboratory and participants' homes....

Background Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. Methods A randomized clini...

Questions: Among older people receiving inpatient rehabilitation, does additional supervised physical activity lead to faster self-selected gait speed at discharge? Does additional supervised physical activity lead to better mobility, function and quality of life at discharge and 6 months following discharge? Design: Multi-centre, parallel-group...

Background: It is widely acknowledged that health policy and practice do not always reflect current research evidence. Whether knowledge transfer from research to practice is more successful when specific implementation approaches are used remains unclear. A model to assist engagement of allied health managers and clinicians with research implemen...