Sallie M Cowan

• PhD
• Research Lead at St. Vincent's Hospital Melbourne

Background Subacromial pain syndrome (SPS) involving rotator cuff tendinopathy is a common cause of shoulder pain and disability. Evidence suggests that structured physiotherapy may be as effective as surgery in this condition with significant improvements demonstrated in trials involving scapular retraining, rotator cuff strengthening and flexibil...

Objective. The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED). Methods. This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen b...

Background Patellofemoral pain and osteoarthritis are prevalent and associated with substantial pain and functional impairments. Patient-reported outcome measures (PROMs) are recommended for research and clinical use, but no PROMs are specific for patellofemoral osteoarthritis, and existing PROMs for patellofemoral pain have methodological limitati...

Background Abnormal gait after anterior cruciate ligament reconstruction (ACLR) may contribute to development and/or progression of knee osteoarthritis. Objective To conduct a systematic review and meta-analysis of knee kinematics and joint moments during walking after ACLR. Methods We searched seven electronic databases and reference lists of rele...

Background Abnormal gait after anterior cruciate ligament reconstruction (ACLR) may contribute to development and/or progression of knee osteoarthritis. Objective To conduct a systematic review and meta-analysis of knee kinematics and joint moments during walking after ACLR. Methods We searched seven electronic databases and reference lists of rele...

This pilot study evaluated the immediate and four-week effects of an unloader knee brace on knee-related symptoms and performance-based function in people with knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR). Individuals with knee OA, five to 20years post-ACLR, were recruited for two within-subject randomized studies...

An important aspect of improving clinical supervision teaching skills is providing opportunities for educators to reflect on and develop confidence in their teaching approaches (Patton, 2013).

Lateral knee osteoarthritis (OA) is common following anterior cruciate ligament reconstruction (ACLR), yet gait characteristics associated with lateral knee OA after ACLR are not well understood. This cross-sectional study aimed to compare knee, trunk, pelvis, hip and ankle kinematics and moments between people with predominant lateral knee OA afte...

There is relatively little research specifically investigating patellofemoral joint osteoarthritis (PFJ OA). In particular, the source of pain in PFJ OA has not been established. One structure that may be an important contributor is the infrapatellar fat pad (IPFP). This cross-sectional study aimed to: (1) compare IPFP volume in individuals with an...

Background: Lateral knee osteoarthritis is notably common after anterior cruciate ligament reconstruction (ACLR). While valgus bracing has been investigated as an intervention for medial knee osteoarthritis (OA), little is known about the effectiveness of varus bracing for lateral knee OA after ACLR. Purpose: To determine the immediate effects o...

Hip pain and dysfunction are increasingly recognised as important causes of morbidity in younger and older adults. Pathology compromising the passive stability of the hip joint, including acetabular labral injury, may lead to increased femoral head translation, greater joint contact pressures and ultimately degenerative hip disease. Activation of h...

Achilles tendinopathy is a common injury in running sports however the exact etiology of Achilles injury is still unclear. In recent years, altered neuromotor recruitment patterns of the triceps surae have been hypothesized to create differential intra-tendinous loads leading to pathology; however, this hypothesis has not been investigated. Further...

Background The aetiology of patellofemoral pain (PFP) is multifactorial. Patellofemoral bracing can be used as a preventative method in subjects undergoing strenuous training. Objective Individuals with intrinsic risk factors for PFP could be identified to provide them with patellofemoral braces as preventative method. Setting Military cadets und...

Contemporary clinical expertise and emerging research in anterior knee pain indicate that treatment of hip muscle function will result in greater effects, if such treatments can be provided to those with hip muscle dysfunction. Thus, it is imperative to develop and evaluate a clinical assessment tool that is capable of identifying people with poor...

Post-exercise rehydration is well recognized as an important factor in recovery of elite athletes, with recent debate focused on the usefulness of intravenous (IV) fluid replacement over oral. This study compares the effect of intravenous and ad libitum oral rehydration on hydration, performance and ratings of perceived exertion (RPE) during 24 hou...

Chronic groin pain is a persistent problem that is commonly difficult to rehabilitate. Theoretical rationale indicates a relationship between the motor control of the pelvis and chronic groin pain however this link has not been investigated. This study aimed to further our understanding of the development of groin pain by investigating motor contro...

Introduction: Despite the increasing recognition of hip joint pathology as a source of pain.There have been few studies presenting the pathology found at arthroscopy. (Mitchell et al 03, Byrd et al 01) This paper lists the pathology found in 99 hips during arthroscopy. Methodology: Details of patients who had undergone hip arthroscopy in the last 4...

Symptomatic osteoarthritis can be a painful, costly and debilitating condition. Whilst there is a substantial body of literature surrounding osteoarthritis of the knee, there is less reported research on the hip joint, especially pertaining to physiotherapy intervention. This descriptive study aimed to describe current physiotherapy management of o...

Achilles tendinopathy (AT) is a common injury in running sports. While the exact aetiology of Achilles injury is still unclear, foot orthoses are often effectively employed in the conservative management of the condition. Foot orthoses have traditionally been provided for people with AT on the basis that they may reduce the rearfoot eversion associ...

Achilles tendinopathy (AT) is a common injury in running sports. While the exact aetiology of Achilles injury is still unclear, foot orthoses are often effectively employed in the conservative management of the condition. Foot orthoses have traditionally been provided for people with AT on the basis that they may reduce the rearfoot eversion associ...

To compare the effects of vastus medialis oblique (VMO) motor control retraining (MCR) and quadriceps strengthening (QS) exercises on the onset timing of the medial (VMO) and lateral (vastus lateralis, VL) quadriceps muscle. This single-blind randomized controlled trial involved 60 currently pain-free individuals with a history of anterior knee pai...

The aims of this study were to evaluate a physiotherapy-led triage clinic (PLTC) and investigate general practitioner satisfaction with the PLTC. A retrospective cohort study was undertaken from January to December 2005 at a Melbourne tertiary teaching hospital. Outcomes assessed included waiting times to first appointment, patient attendance and s...

Pua Y-H, Cowan SM, Wrigley TV, Bennell KL. Discriminant validity of the Western Ontario and McMaster Universities Osteoarthritis Index Physical Functioning Subscale in community samples with hip osteoarthritis. To evaluate, in a community hip osteoarthritis (OA) sample, the discriminant validity of the Western Ontario and McMaster Universities Oste...

Hip flexion range of motion (ROM), hip extensor strength (torque production), and hip pain are important correlates of physical function in individuals with hip osteoarthritis (OA). However, the relationships among these variables remain unclear. The purpose of this study was to examine whether hip extensor strength and hip pain mediate the associa...

To examine whether the associations of physical performance with isometric hip and knee extensors strength and passive hip flexion and internal rotation range of motion (ROM) are nonlinear in community-dwelling adults with hip osteoarthritis (OA). Participants were 100 adults (mean age 62 years) with radiographically confirmed hip OA. Physical perf...

To compare the test-retest reliability and validity of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function (PF) subscale and the Lower Extremity Functional Scale (LEFS) in community-dwelling adults with hip osteoarthritis (OA). One hundred adults with symptomatic hip OA participated in the study. Test-retest...

Delayed onset of vastus medialis obliquus activity has been described in patellofemoral pain patients. No prospective study investigating the development of patellofemoral pain has tested the onset timing of electromyographic activity of the vastus medialis obliquus and vastus lateralis muscles during a functional task. Before the development of pa...

Quadriceps strength (knee extensor torque) is an important correlate of physical function in individuals with hip osteoarthritis (OA). However, it remains unclear whether the ability to rapidly generate quadriceps torque in the early phase of muscle contraction (maximal rate of torque development [MRTD]) is also associated with physical function. T...

The purpose of this study was to investigate the role of hip muscles in patellofemoral pain (PFP), specifically by investigating neuromotor control, strength and range of motion of the hip muscles. Cross-sectional. University laboratory. Ten participants diagnosed with PFP and 27 asymptomatic controls were recruited, using standard inclusion and ex...

To examine the relative and absolute intrarater test-retest reliability of muscle strength and range of motion (ROM) measurements of the hip performed in people with hip osteoarthritis. Repeated measures. Human movement laboratory of a university. Participants (N=22; 10 men, 12 women; age range, 50-84y) with hip osteoarthritis. On 2 separate occasi...

Patellofemoral pain (PFP) is a common condition that occurs more frequently in females. Anatomical, hormonal and neuromuscular factors have been proposed to contribute to the increased incidence of PFP in females, with neuromuscular factors considered to be of particular importance. This cross-sectional study aimed to evaluate differences in the ne...

This randomized within-subject study investigated the effects of patellar tape on the onset of electromyographic (EMG) activity of vastus medialis obliquus (VMO) relative to vastus lateralis (VL), knee kinematics, and kinetics in 12 currently asymptomatic individuals with a VMO timing deficit and a history of patellofemoral pain. Participants were...

To investigate the effect of patellar taping on the amplitude of electromyographic activity (EMG) of vasti activation in subjects with and without patellofemoral pain (PFP). Ten participants with PFP and 12 asymptomatic controls were recruited to the study. The study was designed as a randomised crossover trial. Participants completed a stair stepp...

To determine the effects of age on (i) the onset of vastus medialis obliquus (VMO) activity relative to that of vastus lateralis (VL) and (ii) the onset of quadriceps activity in terminal swing relative to heel-strike, during stair descent. Sixty-six healthy men and women with no known knee pathology were recruited from the community and the Univer...

This study aimed to examine whether a physical therapy intervention, designed to reduce pain and improve the neuromotor control resulted in greater improvements in stance-phase knee flexion during stair ambulation in individuals with patellofemoral pain. The relationship between changes in stance-phase knee flexion and changes in pain, disability,...

Long-standing groin pain is a persistent problem that is commonly difficult to rehabilitate. Theoretical rationale indicates a relationship between the motor control of the pelvis and long-standing groin pain; however, this link has not been investigated. The current experiment aimed to evaluate motor control of the abdominal muscles in a group of...

To examine the test-retest reliability, validity, and responsiveness of several outcome measures in the treatment of patellofemoral pain. Evaluation of the clinimetric properties of individual outcome measures for patellofemoral pain treatment, using data collected from a previously published randomized controlled trial (RCT). General community and...

Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Arch Phys Med Rehabil 2004;85:815-22.

Reduced knee flexion is a logical gait adaptation for individuals with patellofemoral pain (PFP) to lessen the patellofemoral joint reaction force and minimise pain during stair ambulation. This gait adaptation may be related to the co-ordination of individual vasti components. This study investigated the amount of stance-phase knee flexion in indi...

The aim of this project was to assess the sensitivity and specificity of MR in the context of assessment of individuals with chronic groin pain. Nine participants with chronic groin pain and nine asymptomatic participants were recruited for the study. Participants were elite or sub elite Australian Football players and matched for position played....

Physical therapy rehabilitation strategies are commonly directed at the alteration of muscle recruitment in functional movements. The aim of this study was to investigate whether feedforward strategies of the vasti in people with patellofemoral pain syndrome can be changed by a physical therapy treatment program in a randomised, double blind, place...

To investigate the effect of physical therapy treatment on the timing of electromyographic (EMG) activity of the vasti in individuals with patellofemoral pain syndrome (PFPS). Sixty-five (42 female, 23 male) participants aged 40 yr or less (29.2 +/- 7.8 yr) diagnosed with PFPS. Participants were randomly allocated into physical therapy treatment (M...

MR arthrography has been claimed to have a very high sensitivity and specificity for diagnosing intraarticular hip joint pathology. This claim has not been supported by clinical experience in Australia. (Mitchell et al 03) In an attempt to improve the performance of MRI, 2 new techniques were developed. This paper compares the 2 new techniques and...

To examine the effect of the application of tape over the patella on the onset of electromyographic (EMG) activity of vastus medialis obliquus (VMO) relative to vastus lateralis (VL) in participants with and without patellofemoral pain syndrome (PFPS). Randomised within subject. University laboratory. Ten participants with PFPS and 12 asymptomatic...

Although physical therapy forms the mainstay of nonoperative management for patellofemoral pain, its efficacy has not been established. Significantly more pain relief will be achieved from a 6-week regimen of physical therapy than from placebo treatment. Multicenter, randomized, double-blinded, placebo-controlled trial. Seventy-one subjects, 40 yea...

Delayed onset of electromyographic activity of Vastus Medialis Obliquus relative to Vastus Lateralis in subjects with patellofemoral pain syndrome [Archives of Physical Medicine and Rehabilitation 2001;82:183-9]

To investigate the recruitment of the vastus medialis obliquus (VMO) and vastus lateralis during voluntary tasks that challenge the stability of the knee and to evaluate whether there is a change in the coordination of the postural response by the central nervous system in subjects with patellofemoral pain syndrome (PFPS). Cross-sectional. Universi...

Objective: To examine the effect of the application of tape over the patella on the onset of electromyographic (EMG) activity of vastus medialis obliquus (VMO) relative to vastus lateralis (VL) in participants with and without patellofemoral pain syndrome (PFPS). Design: Randomised within subject. Settings: University laboratory. Participants: Ten...

The purpose of this cross‐sectional study was to compare knee joint position sense (JPS) in 20 individuals with and 20 without patellofemoral pain syndrome (PFPS). Five active tests with ipsilateral limb matching responses were performed at 20° and 60° flexion under non‐weightbearing conditions, and at 40° flexion under uni‐ and bi‐lateral weightbe...

Objectives: The aim of this experiment was to investigate the recruitment of a medial and a lateral component of the quadriceps muscles during voluntary tasks that challenge the stability of the knee and thus to evaluate whether the central nervous system (CNS) recruits these muscles simultaneously or selectively to control the patella in people wi...

To determine whether electromyographic (EMG) onsets of vastus medialis obliquus (VMO) and vastus lateralis (VL) are altered in the presence of patellofemoral pain syndrome (PFPS) during the functional task of stair stepping. Cross-sectional. University laboratory. Thirty-three subjects with PFPS and 33 asymptomatic controls. Subjects ascended and d...

Study design: Test-retest reliability using a repeated measures design. Objectives: The aim of this study was to evaluate the test-retest reliability of measurement of onsets of electromyographic (EMG) activity of vastus medialis oblique (VMO) and vastus lateralis (VL) during a stair stepping task. Background: Differences in the timing of onset of...

Patellofemoral pain syndrome (PFPS) is a common condition presenting to physiotherapy and sports medicine practices. Despite its prevalence, the aetiology, pathogenesis, and recommended treatment remain unclear. One component of treatment for PFPS that has been subjected to scrutiny is patellar taping. This taping was designed to realign the patell...