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836
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Citations since 2017
Publications
Publications (134)
Objective:
Epilepsy is associated with an increased risk of cardiovascular disease and mortality. Whether cardiac structure and function are altered in epilepsy remains unclear. To address this, we conducted a systematic review and meta-analysis of studies evaluating cardiac structure and function in patients with epilepsy.
Methods:
We searched...
Purpose:
The aim of this study was to explore the experience of people with non-traumatic spinal cord injuries who have recently returned home from inpatient rehabilitation.
Methods:
Semi-structured interviews were conducted with seven adults with non-traumatic spinal cord injuries who had been discharged from inpatient rehabilitation from an Au...
Purpose
The delivery of healthcare services in rural locations can be challenging. From the perspectives of rural rehabilitation practitioners and compensation claims managers, this study explored the experience of providing and coordinating rehabilitation services for rural major traumatic injury survivors.
Materials and Methods
Semi-structured i...
The effect of treatment dose on recovery of post-stroke aphasia is not well understood. Inconsistent conceptualisation, measurement, and reporting of the multiple dimensions of dose hinders efforts to evaluate dose-response relationships in aphasia rehabilitation research. We review the state of dose conceptualisation in aphasia rehabilitation and...
Background: Difficulty using the upper extremity in everyday activities is common after stroke. Constraint-induced movement therapy (CIMT) has been shown to be effective in both sub-acute and chronic phases of stroke recovery and is recommended in clinical practice guidelines for stroke internationally. Despite reports of equivalence of outcome whe...
Objectives
: To determine the outcomes and outcome-measurement tools currently used during the prescription of new wheelchairs and/ or seating systems. A systematic review of studies was performed to identify outcome-measurement tools
Data sources
: MEDLINE, CINAHL, EMBASE, and PsycINFO were searched from earliest available to March 2022. Study
S...
Introduction: Broadening eligibility criteria has been a focus to increase the generalisability of trial findings. Using upper limb motor trials conducted early post-stroke as the illustrative domain, we sought to (a) investigate whether the published aim and conclusion statements adequately reflect the generalisability of findings and, (b) explore...
Background: Discharge planning is recommended to optimise the transition from acute care to home for patients admitted with stroke. Despite this guideline recommendation, many patients do not receive a discharge care plan. Also, there is limited evidence on factors influencing the provision of discharge care plan post-stroke. We evaluated patient,...
Introduction
Due to the increase in participation and risk of anterior cruciate ligament (ACL) injuries and concussion in women’s Australian Football, an injury prevention programme (Prep-to-Play) was codesigned with consumers (eg, coaches, players) and stakeholders (eg, the Australian Football League). The impact of supported and unsupported inter...
Background: Australian Primary Care Practitioners are incentivised through Medicare funded policies to provide chronic disease management and facilitate multidisciplinary care. Little is known about how these policies are claimed in the long-term management of stroke. The objective of this study was to describe the use of funded primary care polici...
Background
There is limited evidence regarding the optimal design and composition of multifaceted quality improvement programs to improve acute stroke care. The researchers aimed to test the effectiveness of a co-designed multifaceted intervention (STELAR: Shared Team Efforts Leading to Adherence Results) directed at hospital clinicians for improvi...
Background: Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e., IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of...
Introduction:
Despite digital health tools being popular for supporting self-management of chronic diseases, little research has been undertaken on stroke. We developed and pilot tested, using a randomized controlled design, a multicomponent digital health programme, known as Inspiring Virtual Enabled Resources following Vascular Events (iVERVE),...
Background: Evidence for digital health programs to support people living with stroke is limited. We assessed the feasibility of a protocol and procedures for the Re covery-focused C ommunity support to A void readmissions and improve P articipation after S troke (ReCAPS) intervention. Method: We conducted a mixed-method feasibility study. Particip...
Background:
People with communication disabilities post-stroke have poor quality-of-life.
Objectives:
We aimed to explore the association of self-reported communication disabilities with different dimensions of quality-of-life between 90 and 180 days post-stroke.
Methods:
Cross-sectional survey data were obtained between 90 and 180 days post-s...
BACKGROUND
Resuming work after stroke is a common goal of working-age adults, yet there are few vocational rehabilitation programs designed to address the unique challenges faced following stroke. The WORK intervention was developed to address these gaps.
OBJECTIVE
This study aims to test the WORK intervention, by piloting the intervention and tri...
Background
Resuming work after stroke is a common goal of working-age adults, yet there are few vocational rehabilitation programs designed to address the unique challenges faced following stroke. The Work intervention was developed to address these gaps.
Objective
This paper presents a protocol that outlines the steps that will be undertaken to p...
Background
Several active ingredients contribute to the purposes and mechanisms of goal-setting in rehabilitation. Active ingredients in the goal-setting process include, interdisciplinary teamworking, shared decision-making, having meaningful and specific goals, and including action planning, coping planning, feedback, and review. Clinicians have...
Background and Objectives
To examine the preferences and user experiences of people with epilepsy and caregivers regarding automated wearable seizure detection devices.
Methods
We performed a mixed-methods systematic review. We searched electronic databases for original peer-reviewed publications between January 1, 2000, and May 26, 2021. Key sear...
Background
Stroke is a high-cost condition. Detailed patient-level assessments of the costs of care received and outcomes achieved provide useful information for organisation and optimisation of the health system.
Objectives
To describe the costs of hospital care for stroke and transient ischaemic attack (TIA) and investigate factors associated wi...
To assess if cyclical electrical stimulation (CES) is effective at increasing voluntary strength, and functional electrical stimulation (FES) is effective at improving activity aſter stroke.
Background
Participation in leisure activities is significantly impacted following acquired brain injury (ABI). Despite this being a common community rehabilitation goal, re-engagement with leisure activities following ABI is poorly addressed within Australian community rehabilitation services, which often cater to a mixed-diagnostic group of both...
Background
It is common for people with persistent spasticity due to a stroke to receive an injection of botulinum toxin-A in the upper limb, however post-injection intervention varies.
Aim
To determine the long-term effect of additional upper limb rehabilitation following botulinum toxin-A in chronic stroke.
Method
An analysis of long-term outco...
Background and Aim
Rehabilitation therapy is a key part of the recovery pathway for people with severe acquired brain injury (ABI). The aim of this study was to explore inpatients’ and their family members’ experiences of a specialist ABI rehabilitation service.
Methods
A cross sectional, prospective mixed method study was undertaken at a metropol...
Introduction
There is compelling evidence that either centre-based or home-based pulmonary rehabilitation improves clinical outcomes in chronic obstructive pulmonary disease (COPD). There are known health service and personal barriers which prevent potentially eligible patients from accessing the benefits of pulmonary rehabilitation. The aim of thi...
Background:
Discharge planning is a routine feature of health systems in many countries that aims to reduce delayed discharge from hospital, and improve the co-ordination of services following discharge from hospital and reduce the risk of hospital readmission. This is the fifth update of the original review.
Objectives:
To assess the effectiven...
Purpose
To evaluate the psychometric properties of common health-related quality-of-life instruments used post stroke and provide recommendations for research and clinical use with this diagnostic group.
Methods
A systematic review of the psychometric properties of the five most commonly used quality-of-life measurement tools (EQ-5D, SF-36, SF-6D,...
Objectives
To investigate cerebrovascular event (CVE) denials reported by registered patients to the Australian Stroke Clinical Registry, and to examine the factors associated with CVE denial.
Material and methods
CVE denials reported from January 1, 2017 to June 30, 2018 were followed up with hospitals to verify their discharge diagnosis. CVE den...
Background and purpose:
Changes to hospital systems were implemented from March 2020 in Australia in response to the coronavirus disease 2019 pandemic, including decreased resources allocated to stroke units. We investigate changes in the quality of acute care for patients with stroke or transient ischemic attack during the pandemic according to p...
Background
It is unclear whether survivors of stroke or transient ischemic attack (TIA) routinely receive, and understand, education about secondary prevention medications.
Objectives
To investigate whether survivors of stroke/TIA understand explanations about their prescribed prevention medications and associations with medication adherence, cont...
Importance: Research supports the clinical effectiveness of hospital-based occupational therapy to improve functional outcomes, but no synthesis of economic evaluations of occupational therapy services provided in these settings has been published.
Objective: To determine the economic value of occupational therapy services in acute and subacute car...
Objective:
To examine the frequency and timing of inpatient engagement in meaningful activities within rehabilitation (within and outside of structured therapy times) and determine the associations between activity type, goal awareness, and patient affect.
Methods:
This prospective observational study performed behavioral mapping in a 42-bed inp...
Discharge communication is an important component of care transition between hospitals and community care, particularly for the complex needs of stroke survivors. Despite international research and regulation, ineffective information exchange during care transitions continues to compromise patient outcomes. Primary care practitioners are increasing...
This study investigated outcomes of a community-based upper limb rehabilitation group for adult stroke survivors in metropolitan Australia. Pre-post data were extracted from medical records. Participants (n = 27) were predominantly men (n = 22, 81%); mean age 61 years (SD 17) and median time 109 days post stroke. Participants improved on upper limb...
Objectives
To evaluate key quality indicators for acute care and one-year outcomes following acute ischaemic stroke (IS), intracerebral haemorrhage (ICH), or transient ischaemic attack (TIA) by diabetes status.
Materials and Methods
Observational cohort study (2009-2013) using linked data from the Australian Stroke Clinical Registry and hospital r...
Objective
Develop and test a person-centred goal-setting package for discharge care planning in acute and rehabilitation stroke units.
Methods
A multidisciplinary, expert working group (n = 15), and consumer group (n = 4) was convened. A multistage iterative approach was used to develop and test the package. Stages included: (i) contextual underst...
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...
Purpose
To characterise the assessments and treatments that comprise “usual care” for stroke patients with somatosensory loss, and whether usual care has changed over time.
Materials and methods
Comparison of cross-sectional, observational data from (1) Stroke Foundation National Audit of Acute (2007–2019) and Rehabilitation (2010–2018) Stroke Ser...
Background
Physical therapists play a key role in providing first-line knee osteoarthritis treatments, including patient education and exercise therapy.
Objectives
Describe Australian physical therapists’ awareness of guidelines; reported practices; and beliefs about capability, opportunity, motivation, and evidence.
Methods
An online cross-secti...
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...
Background and Purpose
Although a target of 80% medication adherence is commonly cited, it is unclear whether greater adherence improves survival after stroke or transient ischemic attack (TIA). We investigated associations between medication adherence during the first year postdischarge, and mortality up to 3 years, to provide evidence-based targe...
Introduction:
After first stroke, the transition from rehabilitation to home can be confronting and fraught with challenges. Although stroke clinical practice guidelines recommend predischarge occupational therapy home visits to ensure safe discharge and provision of appropriate equipment, there is currently limited evidence to support this recomm...
Introduction
Health care expenditure has rapidly increased in Australia. Effective management of occupational therapy services is required to meet clinical demand. Improving our understanding of factors which influence occupational therapy service delivery is a vital step to manage workload distribution and optimise service efficiency. This study a...
Introduction: Stroke patients with aphasia are often excluded from person-centred goal setting as part of their clinical care, despite a recommendation for person-centred goal setting in national clinical guidelines.
Aim: To develop and field test an aphasia supplement to a person-centred goal setting package for stroke to better meet the needs of...
Despite an increase in the amount of published stroke recovery research, interventions have failed to markedly affect the trajectory of recovery poststroke. We argue that early-phase research to systematically investigate dose is an important contributor to advance the science underpinning stroke recovery. In this article, we aim to ( a) define the...
Rationale:
To address unmet needs, electronic messages to support person-centred goal attainment and secondary prevention may avoid hospital presentations/readmissions after stroke, but evidence is limited.
Hypothesis:
Compared to control participants, there will be a 10% lower proportion of intervention participants who represent to hospital (e...
Self-awareness is an important consideration in cognitive rehabilitation for clinicians working with individuals following acquired brain injury (ABI), with impaired self-awareness linked to poor outcomes. To appropriately target assessment and intervention for self-awareness, its theoretical foundation and definition must be considered. The aim wa...
Background:
Goals are vital in rehabilitation; however, how goal-setting occurs varies widely in clinical practice. This study aims to review goal-setting practices across the rehabilitation continuum within varied case mix services in Queensland, Australia.
Method:
A descriptive multisite qualitative case study with medical record audits and in...
Introduction
Stroke affects all ages. Despite increased incidence in those <65 years, little is known about age-based differences in inpatient rehabilitation management and outcomes.
Objectives
To investigate management and outcomes, comparing younger (<65 years) and older (≥65 years) patients with stroke, who received inpatient rehabilitation.
M...
Objective
Evaluated the implementation of the Good Life with osteoArthritis from Denmark (GLA:D®) for knee osteoarthritis in Australia using the RE-AIM QuEST (Reach, Effectiveness, Adoption, Implementation, Maintenance Qualitative Evaluation for Systematic Translation) framework.
Design
Physiotherapists completed surveys before and after GLA:D® tr...
Objective
To compare the processes and outcomes of care in patients who had a stroke treated in urban versus rural hospitals in Australia.
Design
Observational study using data from a multicentre national registry.
Setting
Data from 50 acute care hospitals in Australia (25 urban, 25 rural) which participated in the Australian Stroke Clinical Regi...
Objective: We aim to report the accuracy of linking data from a non‐government‐held clinical quality registry to national claims data and identify associated sources of systematic bias.
Methods: Patients with stroke or transient ischaemic attack admitted to hospitals participating in the Australian Stroke Clinical Registry (AuSCR) were linked with...
Background: Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e. IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of...
Background: Anxiety and depression are common post-stroke and impact quality-of-life (QoL). The EQ-5D three-level version (EQ-5D-3L) is increasingly used to routinely measure health-related QoL in stroke populations, but its potential value for detecting anxiety or depression is uncertain. We sought to examine the agreement and convergent validity...
Purpose
Guidelines recommend that carers of stroke survivors should be engaged early in rehabilitation. There has been limited research implementing exercise programs that include carers. The aims of this study were to develop, facilitate, and evaluate an intervention, the Carers Count group, an exercise-based group for stroke survivors and their c...
Background: Urinary and fecal incontinence are disabling impairments after stroke that can be clinically managed with electrical stimulation.
Aim: The purpose of this systematic review was to determine the effectiveness of non-implanted electrical stimulation to reduce the severity of post-stroke incontinence.
Summary of Review: Clinical trials of...
Purpose
To identify the impact of upper limb spasticity on stroke survivors by linking their shared experience to the International Classification of Functioning, Disability, and Health (ICF).
Methods
Ten community dwelling adults with a chronic stroke and spasticity, who had completed an upper limb rehabilitation trial participated in semi-struct...
Background:
Less than half of stroke survivors will be able to use their arm at 6 months post-stroke. Guidelines recommend the use of intensive upper limb exercise programs to optimize recovery; however, there has been limited research exploring experiences of participation in intensive programs.
Aim:
To identify factors influencing adherence to...
Introduction
This systematic review appraises the measurement quality of tools which assess activity and/or participation in adults with upper limb spasticity arising from neurological impairment, including methodological quality of the psychometric studies. Differences in the measurement quality of the tools for adults with a neurological impairme...
Background
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) codes are commonly used to identify patients with diseases or clinical conditions for epidemiological research. We aimed to determine the diagnostic agreement and factors associated with a clinician-ass...
Objectives
Somatosensory loss is common after stroke with one-in-two individuals affected. Although clinical practice guidelines recommend providing somatosensory rehabilitation, this impairment often remains unassessed and untreated. To address the gap between guideline recommendations and clinical practice, this study sought to understand the fac...
Background:
There is a compelling rationale that effective communication between hospital allied health and primary care practitioners may improve the quality and continuity of patient care. It is not known which methods of communication to use, nor how effectively they facilitate the transition of care when a patient is discharged home from hospi...
We present information on acute stroke care for the first wave of the COVID-19 pandemic in Australia using data from the Australian Stroke Clinical Registry (AuSCR). The first case of COVID-19 in Australia was recorded in late January 2020 and national restrictions to control the virus commenced in March. To account for seasonal effects of stroke a...
Background
Hospital arrival via ambulance influences treatment of acute stroke. We aimed to determine the factors associated with use of ambulance and access to evidence-based care among patients with stroke.
Methods
Patients with first-ever strokes from the Australian Stroke Clinical Registry (2010–2013) were linked with administrative data (emer...
Background
The Good Life with osteoArthritis from Denmark (GLA:D®) program incorporates guideline-based patient education and exercise-therapy for osteoarthritis to implement guidelines into practice. We evaluated the implementation of GLA:D® for knee osteoarthritis within Australian physiotherapy practice using the RE-AIM QuEST (Reach, Effectivene...
Dose articulation is a universal issue of intervention development and testing. In stroke recovery, dose of a nonpharmaceutical intervention appears to influence outcome but is often poorly reported. The challenges of articulating dose in nonpharmacological stroke recovery research include: (1) the absence of specific internationally agreed dose re...
Background:
To enable development of effective interventions, there is a need to complete systematic early-phase dose articulation research. This scoping review aimed to synthesize dose articulation research of behavioral motor interventions for stroke recovery.
Methods:
MEDLINE and EMBASE were systematically searched for dose articulation studi...
The COVID-19 pandemic has necessitated adoption of telerehabilitation in services where face-to-face consultations were previously standard. We aimed to understand barriers to implementing a telerehabilitation clinical service and design a behaviour support strategy for clinicians to implement telerehabilitation. A hybrid implementation study desig...
Driving simulators are a relatively underutilized therapy tool that provide an opportunity for older drivers with a range of health-related problems to participate in simulated driving scenarios in a low cost and safe environment. The aim of this paper is to (i) describe the use of a Forum 8 driving simulator prior to a driver assessment, (ii) deta...
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...
Purpose:
The aim of this study was to describe differences in long-term outcomes for patients discharged to inpatient rehabilitation facilities (IRFs) following stroke compared to patients discharged directly home or to residential aged care facilities (RACFs).
Materials and methods:
Cohort study. Data from the Australian Stroke Clinical Registry...
Introduction
Recent advances in Australia mean that it is possible to link national clinical registries with government held administrative datasets. However, formal evaluations of such activities and the potential impact for research are lacking.
Objectives and Approach
We aimed to assess the feasibility and accuracy of linking registrants from t...
Background
Brain injury rehabilitation is an expensive and long‐term endeavour. Very little published information or debate has underpinned policy for service delivery in Australia. Within the context of finite health budgets and the challenges associated with providing optimal care to persons with brain injuries, members of the public were asked ‘...
Background
Electronic communication is used in various populations to achieve health goals, but evidence in stroke is lacking. We pilot tested the feasibility and potential effectiveness of a novel personalised electronic self-management intervention to support person-centred goal attainment and secondary prevention after stroke.
Methods
A phase I...
Introduction
Returning to work is a goal for many people after brain injury. The failure to return to work after injury brings both economic and personal (quality of life) costs to those living with stroke or brain injury, their families, and society. This study explored the barriers to providing work‐focused interventions during hospital‐based reh...