Ruth N Barker

James Cook University | JCU

Introduction: Workforce development is a key strategy for building the capacity and capability of a workforce. Accordingly, rural and remote practising allied health professionals require relevant and accessible continuing professional development to enhance their knowledge and skills and improve consumer health outcomes. This study explored the i...

Objectives: To investigate factors which influence stroke survivors' decision-making about their rehabilitation and the prospect of taking recovery-promoting drugs, to enhance their recovery. Methods: Seventeen stroke survivors who had undertaken stroke rehabilitation, and three spouses, participated in focus groups and individual interviews in...

Understanding the health status of a population or community is crucial to equitable service planning. Among other uses, data on health status can help local and national planners and policy makers understand patterns and trends in current or emerging health and well-being, especially how disparities relating to geography, ethnicity, language and l...

Purpose: People with disability in regional, rural and remote Australia have poorer service access compared to people from metropolitan areas. There is urgent need for reform. This study's aim was to explore the needs and aspirations of people with lived experience of disability in Far North Queensland (FNQ) to inform a new service framework. Mat...

Purpose: The aim of this study was to explore factors that influence stroke survivors' ability to persevere with home-based upper limb practice. Methods: A qualitative descriptive study embedded within a theoretical framework was conducted. Data were collected through semi-structured focus group, dyadic, and individual interviews. The Theoretica...

Yolŋu, Aboriginal people from Arnhem Land, Australia are at risk of Machado-Joseph disease, with progressive loss of speech. Yolŋu are interested in developing augmentative and alternative communication (AAC) systems in their own languages. This research aimed to develop a culturally responsive process to explore and create a core vocabulary word l...

Background and purpose Individuals with multiple sclerosis (MS) want health advice regarding participation in their choice of exercise. To address this need, a flexible exercise participation programme (FEPP) was developed, underpinned by the MS aerobic exercise guidelines and supported by a physiotherapist using behaviour change techniques. The ai...

Yolŋu (Aboriginal Australians of northeast Arnhem Land) are interested in developing augmentative and alternative communication (AAC) systems in their own languages to support communication opportunities and participation for their family members living with Machado-Joseph disease. Designing AAC systems in Aboriginal languages requires consideratio...

Introduction Access to augmentative and alternative communication (AAC) systems in languages other than English and multilingual AAC systems remains limited for many people with complex communication needs, despite a growing interest in this field, and an acknowledged need for culturally responsive AAC practice. Purpose The purpose of this scoping...

BACKGROUND University affiliated student-led healthcare services have emerged in response to challenges faced by universities in securing quality clinical placements for healthcare students. Evidence of the benefits and challenges of student-led healthcare services as service providers is also mounting. However, further investigation is needed to e...

Background: University-affiliated student-led health care services have emerged in response to the challenges faced by universities in securing quality clinical placements for health care students. Evidence of the health care benefits and challenges of student-led health care services is growing, while evidence of clinical placement performance re...

Objectives: To co-create a culturally responsive student-implemented allied health service in a First Nations remote community and to determine the feasibility and acceptability of the service. Design: Co-creation involved a pragmatic iterative process, based on participatory action research approaches. Feasibility and acceptability were determi...

Aims: To focus on the needs, challenges and opportunities to improve access to cardiac rehabilitation (CR) (Heart: Road to health [HRH]) for Aboriginal and Torres Strait Islander peoples in rural and remote (R&R) areas of North Queensland. Context: It is known that there is insufficient access to HRH for Aboriginal and Torres Strait Islander peo...

Safe shelter from cyclones for individuals with disabilities, who are at greater risk of injury and death than other populations, requires close attention. The purpose of this study was to gain the perspective of individuals with disabilities on the experience of sheltering during the three most recent severe tropical cyclones in northern Queenslan...

Background Machado-Joseph Disease (MJD), or Spinocerebellar Ataxia Type 3 (SCA3), is a genetic disorder that causes progressive muscle weakness, loss of motor control, ataxia and permanent physical disability. Sleep disturbances are associated with MJD but remain poorly understood. Objective To investigate frequency and characteristics of sleep di...

Introduction: In student-led healthcare services, health students take responsibility for the management and delivery of health services as part of clinical training. Like all healthcare services, student-led healthcare services need to be evaluated to ensure they provide high quality, safe and cost-effective services. The aim of this literature re...

Objective: To address access to cardiac rehabilitation (CR) for people in R&R areas, this research aimed to investigate: (1) post discharge systems and support for people returning home from hospital following treatment for heart disease (HD). (2) propose changes to improve access to CR in R&R areas of NQ. Setting: Four focus communities in R&R...

Objective To assess implementation of in-patient cardiac rehabilitation (Phase-1-cardiac rehabilitation), impact on people in rural and remote areas of Australia and potential methods for addressing identified weaknesses. Design Exploratory case study methodology using qualitative and quantitative methods. Qualitative data collection via semi-stru...

Objectives To explore the process of learning for allied health students providing a student-implemented service for older Yolŋu in remote East Arnhem, Northern Territory, Australia. Design An exploratory qualitative study following an 8-week student-implemented service. Setting Nhulunbuy and Yirrkala and surrounding remote Aboriginal communities...

Introduction: Stroke survivors recovering in rural and remote locations often have little or no access to rehabilitation services. The purpose of this study was to review the literature on recovering in rural and remote Australia, from the perspective of stroke survivors. Use of technology to support recovery was also explored. Methods: A system...

Background/Aims Heart disease is the largest single cause of death and contributes to poor quality of life and high healthcare costs in Australia. There are higher rates of heart disease in rural and remote areas, with the highest rates in Aboriginal and Torres Strait Islander people. Cardiac rehabilitation is known to improve health outcomes for p...

Background and purpose: The flexible exercise participation program (FEPP) is a novel intervention developed to enable individuals with multiple sclerosis (MS) participate and progress in an exercise or sport of their choice. The FEPP is underpinned by guidelines on aerobic exercise for individuals with MS and is supported by a physiotherapist usi...

Purpose: The aim of this systematic review was to identify models of community disability, rehabilitation and lifestyle service delivery in non-metropolitan areas of Australia, and to describe these models through an Integrated People-Centred Health Services (IPCHS) lens. Materials and methods: We identified peer-reviewed studies published betwe...

Objective To evaluate the development and implementation of the Allied Health Rural Generalist Program, a two‐level online post‐graduate education program, which includes Level 1, an entry‐level non‐award pathway program, and Level 2, a Graduate Diploma in Rural Generalist Practice. Design A convergent mixed methodology evaluation in two overlappi...

Purpose Community rehabilitation is an essential health service that is often not available to remote Australians. This paper describes the first cycle of a collaborative project, between local community members, allied health professionals and a university, to co-design a community rehabilitation and lifestyle service to support adults and older p...

Background Technology is being increasingly investigated as an option to allow stroke survivors to exploit their full potential for recovery by facilitating home-based upper limb practice. This review seeks to explore the factors that influence perseverance with technology-facilitated home-based upper limb practice after stroke. Methods A systemat...

Purpose: Recovering from stroke in remote Australia has rarely been considered, even though rehabilitation services are generally scarce. The primary purpose of this study was to explore stroke recovery, from the perspective of stroke survivors in remote northwest Queensland (NWQ), to explicate the lens through which they view recovering. The seco...

Physical activity has positive health implications for individuals living with neurodegenerative diseases. The success of physical activity programs, particularly in culturally and linguistically diverse populations, is typically dependent on their alignment with the culture, lifestyle and environmental context of those involved. Aboriginal familie...

Introduction: Writing a manuscript for publication is a challenge for those health practitioners whose primary role is to provide clinical services. The aim of this study was to increase the capacity of allied health practitioners who are employed in a clinical setting to submit manuscripts for publication in peer-reviewed journals.Methods: An acti...

Introduction Individuals with minimal disability from multiple sclerosis (MS) requested advice on finding the right balance, between too much and too little exercise, when participating in their choice of sport or exercise. To optimise exercise participation during the early stages of the disease, a flexible exercise participation programme (FEPP)...

Objectives: To describe rates of hospitalisation and Coaching on Achieving Cardiovascular Health referral, for Queensland's adults with heart and related disease, and comparisons between Aboriginal and Torres Strait Islander and non-Indigenous peoples in northern Queensland. Design: Descriptive retrospective epidemiological study of Queensland H...

Purpose: Yolŋu are Aboriginal Australians from northeast Arnhem Land in the Northern Territory (NT). Machado–Joseph disease (MJD) prevalence in the NT Aboriginal population is the highest in the world. Yolŋu living with progressive dysarthria associated with MJD could benefit from augmentative and alternative communication (AAC). However, there are...

Objectives Machado-Joseph disease (MJD) is the most common spinocerebellar ataxia worldwide. Prevalence is highest in affected remote Aboriginal communities of the Top End of Australia. Aboriginal families with MJD from Groote Eylandt believe ‘staying strong on the inside and outside’ works best to keep them walking and moving around, in accordance...

Objective: To investigate the effect of exercise on high-level mobility (i.e. mobility more advanced than independent level walking) in individuals with neurodegenerative disease. Data sources: A systematic literature search was conducted in Medline, CINAHL, Scopus, SportDiscus and PEDro. Study selection: Randomised controlled trials of exerci...

Objective The aim of this study was to explore the experience of participation in sport and exercise for individuals with multiple sclerosis (MS) with minimal disability. The objectives were to gain an understanding of key factors that influence participation in sport and exercise and to determine support required by individuals with MS to particip...

Machado Joseph Disease (MJD) (spinocerebellar ataxia 3) is a hereditary neurodegenerative disease causing progressive ataxia and loss of mobility. It is the most common spinocerebellar ataxia worldwide. Among Aboriginal families of Groote Eylandt and related communities across Australia's Top End, MJD is estimated to be more prevalent than anywhere...

This study investigated experiences of people with physical disabilities in recent severe cyclones affecting Queensland, Australia. The aim was to explore factors that influence the capacity of people with physical disabilities to prepare, evacuate, and recover from cyclone events, to inform disability inclusive disaster risk reduction activities....

Objective: To investigate the efficacy and safety of drug interventions to promote motor recovery post-stroke. Data sources: CENTRAL, CINAHL, Embase, MEDLINE, SCOPUS and Web of Science. Study selection: Published human randomized controlled trials in which the primary intervention was a drug administered to promote motor recovery post-stroke, vs...

INTRODUCTION: Morbidity and mortality from heart disease continues to be high in Australia with cardiac rehabilitation (CR) recognised as best practice for people with heart disease. CR is known to reduce mortality, reoccurrence of heart disease, hospital readmissions and costs, and to improve quality of life. Australian Aboriginal and Torres Strai...

People with physical disabilities are highly vulnerable during natural disasters. The interaction of individual, societal and environmental factors impact on their ability to prepare, evacuate and recover from disaster events. This paper provides a review of the current body of knowledge on the lived experiences of adults with a physical disability...

Background: Stroke survivors with severe upper limb disability need opportunities to engage in task-oriented practice to achieve meaningful recovery. Objective: To compare the effect of SMART Arm training, with or without outcome-triggered electrical stimulation to usual therapy, on arm function for stroke survivors with severe upper limb disabi...

Objective: To analyse trends in length of hospital stay before and after the implementation of the Community Rehabilitation Northern Queensland Service (CRNQ) in Townsville, Australia. Design: Retrospective analysis of collected administrative data provided by the data custodian Townsville Hospital Health Service District. Setting: All patients d...

Purpose: The purpose of this study was to investigate how an individual’s social determinants of health are affected by the acquisition of physical disability in adulthood. The secondary aim was to report the described facilitators and barriers to living with a disability. Method: This qualitative study used an exploratory, descriptive approach. Ni...

Study design: Sequential mixed method design. Objectives: Determine factors associated with community participation for individuals with spinal cord injury (SCI). Setting: Queensland, Australia. Methods: Phase I consisted of a quantitative telephone survey of 270 people who had sustained a SCI within the past 50 years. To verify and interpre...

Background/Aims: For people with neurological conditions, informal carers form an important part of the rehabilitation journey. The aim of the current study was to assess the economic and quality of life outcomes for someone caring for a person undertaking a community rehabilitation programme. Methods: A prospective study was conducted of a commun...

Purpose: To evaluate the impact of a person-centred, community rehabilitation service on outcomes for people with a neurological condition, in the first year of service. Method: A prospective, observational, pre-post study was conducted with 206 people who had a neurological condition and attended the rehabilitation service to restore function (...

Community Rehabilitation northern Queensland (CRnQ) is a service for individuals with neurological conditions such as stroke, Parkinson’s disease or cerebral palsy. Inclusion of people from Indigenous, rural and remote communities is emphasised given their poor access to services yet their high rates of disability.

This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the partici...

Aim: To evaluate factors that may contribute to the decision of the consultant medical officer (CMO) to: (1) admit a person with stroke to inpatient rehabilitation from acute hospitalisation; and (2) continue or cease inpatient rehabilitation. Methods: A web-based survey of CMOs practising in Queensland Australia, who were members of the Australian...

Background: Severe arm disability is considered to indicate poor potential to recover arm function. Objective: Determine if stroke survivors with severe upper arm disability can achieve a clinically important change in arm function on discharge from inpatient rehabilitation. Methods: 618 stroke survivors from 16 inpatient rehabilitation units...

A good motor outcome after stroke is often equated with independence in functional performance. However, for patients with severe motor disability a good outcome is unlikely, but an important change may be achievable. Determine if patients admitted to inpatient rehabilitation with severe motor disability can achieve clinically important improvement...

Background: To retrain upper limb function after stroke, a high dose of activity-related therapy is recommended. However, observational studies indicate that the dose undertaken is minimal. While it is speculated that those with severe disability will perform less therapy, this remains to be explored. Objective: Quantify the dose and content of upp...

Objective: To evaluate the effect of altering a single component of a rehabilitation programme (e.g. adding bilateral practice alone) on functional recovery after stroke, defined using a measure of activity. Data sources: A search was conducted of Medline/Pubmed, CINAHL and Web of Science. Review methods: Two reviewers independently assessed e...

Recovery of upper limb function after stroke is poor. The acute to subacute phase after stroke is the optimal time window to promote the recovery of upper limb function. The dose and content of training provided conventionally during this phase is however, unlikely to be adequate to drive functional recovery, especially in the presence of severe mo...

Background: The SMART (SensoriMotor Active Rehabilitation Training) Arm is a nonrobotic device designed to allow stroke survivors with severe paresis to practice reaching. It can be used with or without outcome-triggered electrical stimulation (OT-stim) to augment movement. The aim of this study was to evaluate the efficacy of SMART Arm training w...

Primary objective: To describe the effects of extracorporeal shock wave therapy (ESWT) on neurogenic heterotopic ossification (NHO). Research design: A single case study was considered the most appropriate methodology in this situation. Methods and procedures: The subject was a 43 year old female 10 years post-traumatic brain injury with recur...

People with traumatic spinal cord injury (SCI), although proportionally fewer in number, are known to be high users of primary health care services; however, details of their visits to GPs are unclear. This study presents information about GP utilisation patterns of 193 people with SCI over a 5-year period. Results demonstrate substantially greater...

When permitted access to the appropriate forms of rehabilitation, many severely affected stroke survivors demonstrate a capacity for upper limb functional recovery well in excess of that formerly considered possible. Yet, the mechanisms through which improvements in arm function occur in such profoundly impaired individuals remain poorly understood...

Exercise interventions can enhance mobility after stroke as well as prevent falls in elderly persons. Investigate whether an exercise intervention can enhance mobility, prevent falls, and increase physical activity among community-dwelling people after stroke. A randomized trial with blinding of physical outcome assessment was conducted through loc...

Aim: A self-management approach to upper limb management following stroke has received little attention in the literature. The aim of the study was to investigate the impact of occupational therapists’ and physiotherapists’ standard practice on clients’ and carers’ self-management of upper limb recovery. Method: Fifteen clients, 7 carers, 11 occu...

To track changes in quality of life and function for people with spinal cord injury (SCI) along the lifespan. A wave panel design in which data were collected annually over 5 years across 6 strata that represented different periods since injury. Telephone interviews with participants in their home environment. People (n=270) who had sustained a tra...

Upper limb recovery after stroke is unacceptably poor. As few as one in five stroke survivors regain functional use of the arm, compared with four out of five who regain the ability to walk again. With more people surviving strokes, and with an increase in severe disability, greater demand on services has led to a reduction in hospital length of st...

Objectives: To review current and explore future applications of neuromuscular electrical stimulation (NMES) to restore or retrain upper limb (UL) recovery after stroke. Methods: Short summaries of NMES applications that have been investigated and a discussion of future research directions are presented. Results: Neuromuscular electrical stimulatio...

To investigate the effect of interventions that promote upper limb (UL) recovery in stroke survivors with severe paresis. A systematic search of the scientific literature from January 1970 to March 2009 was conducted using CINAHL, Cochrane, PEDro, Pubmed and Web of Science. keywords used included stroke, severe, hemiplegia, UL, task-oriented, robot...

This exploratory study was undertaken to investigate the mechanisms that contributed to improvements in upper limb function following a novel training program. Surface electromyography (EMG) was used to examine training-induced changes in the pattern of triceps and biceps activation during reaching tasks in stroke survivors with severe paresis in t...

Stroke is the most common disabling neurological condition in adults. Falls and poor mobility are major contributors to stroke-related disability. Falls are more frequent and more likely to result in injury among stroke survivors than among the general older population. Currently there is good evidence that exercise can enhance mobility after strok...

Prospective cross-sectional survey. To compare quality of life (QOL) for people with spinal cord injury (SCI) and their able-bodied peers and to investigate the relationship between QOL and disability (impairments, activity limitations and participation restrictions) across the lifespan, for people with SCI. A community outreach service for people...

Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of a new nonrobotic training device, the Sensorimotor Active Rehabilitation Training (SMART) Arm, that was used with or without electromyography-triggered electrical stimulation of triceps brachii to augment elbow extension, permitting...

To identify factors which contribute to upper limb recovery, from the perspective of stroke survivors. A retrospective cross-sectional survey was administered by post to 220 stroke survivors with upper limb impairment who were more than 3 months post-stroke. The content and language for the questionnaire were drawn from a series of focus groups and...

Objective: To examine the equivalence reliability and test-retest reliability of the Clinical Outcome Variables Scale (COVS) when administered via telephone (TCOVS) to people with spinal cord injury (SCI). Design: Equivalence (telephone administration vs in-person) and test-retest reliability study. Setting: Assessments conducted in participan...

Objective: To analyse trends in length of hospital stay before and after the implementation of the Community Rehabilitation Northern Queensland Service (CRNQ) in Townsville, Australia. Design: Retrospective analysis of collected administrative data provided by the data custodian Townsville Hospital Health Service District. Setting: All patients d...

This study investigated stroke survivors' perspective of upper limb recovery after stroke. The aim was to determine factors other than medical diagnosis and co-morbidities that contribute to recovery. The objectives were to explore how stroke survivors define recovery, identify factors they believe influence recovery and determine strategies used t...

Health care workers associated with the long-term care of ageing clients with Cerebral Palsy have reported on the adverse effects of less active daily activity programmes with resultant decreased functional mobility. While the negative effects of ageing have been reported in these clients, programmes have not been implemented to determine whether t...

Australian Aboriginal populations have an extremely high prevalence of lung disease and ear disease. In addition to an improvement in socio-economic conditions, implementation of strategies to address the problem, within the limitations of present conditions, is needed. A 5 month trial was conducted to investigate the effectiveness of a school-base...