Publications by authors named "Alison Harmer"
Article Synopsis
- Knee osteoarthritis (OA) is a significant health problem that leads to chronic pain and decreased quality of life, with exercise being a recommended self-management strategy as there is currently no cure.
- This review evaluates the effectiveness of land-based exercise for knee OA in three ways: comparing it to control groups, to no treatment/usual care, and in combination with other interventions.
- A total of 139 randomized controlled trials involving over 12,000 participants were analyzed, focusing on outcomes like pain relief, physical function, and quality of life, with exercise interventions ranging from 2 to 104 weeks in duration.
Objective: Determine whether there is a relationship between the number of different lower-limb resistance exercises prescribed in a program and outcomes for people with knee osteoarthritis.
Methods: Systematic review with meta-regression. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase up to 4th January 2024.
Article Synopsis
- - The study aimed to compare heart and lung function at rest in people with early-onset type 2 diabetes and a matching control group without diabetes, focusing on age, sex, and body mass index (BMI).
- - Eighteen participants with early-onset type 2 diabetes and fourteen controls underwent tests including echocardiography and pulmonary function, along with blood sample analyses for various biomarkers.
- - Results showed that those with early-onset diabetes had significant differences in heart function, including worse left ventricular diastolic function and lower lung diffusing capacity compared to controls.
Article Synopsis
- The study aimed to assess whether sticking to American College of Sports Medicine (ACSM) exercise guidelines improved exercise results for people with knee osteoarthritis (OA).
- A systematic review analyzed various trials comparing exercise outcomes for those who followed the guidelines more closely (≥60% compliance) versus those who didn’t (<60% compliance).
- The findings indicated no significant differences in pain and function outcomes between higher and lower compliance groups, suggesting that simply adhering to guidelines may not impact exercise benefits for knee OA patients, although results should be considered carefully due to variability and potential biases in the studies.
Article Synopsis
- The study examines the feasibility and acceptability of implementing thrice-daily physiotherapy for hip fracture patients, with two sessions delivered by alternative staff like students and allied health professionals.
- Qualitative data from interviews with patients, carers, healthcare professionals, and physiotherapy students revealed that higher frequency physiotherapy is generally well-received and considered safe and valuable by those involved in the care process.
- Five key themes emerged from the analysis: perceptions of the intervention, implementation context, effective strategies, barriers to implementation, and future directions for the BOOST study.
Background: Hip fracture has a devastating impact on individuals and is an increasing burden for health systems and society. Compared to usual care, increased physiotherapy provision has demonstrated efficacy in improving patient and health service outcomes in this population. However, physiotherapy workforce challenges prevent sustained implementation.
View Article and Find Full Text PDFBackground: Patient-centred care is essential for high quality musculoskeletal care, however, few evidence-based opportunities exist that address the barriers to implementation for clinicians.
Objective: To develop and evaluate a simulation-based educational strategy for musculoskeletal physiotherapists to increase knowledge and confidence in patient-centred care.
Methods: Repeated-measures, single-group educational interventional descriptive study.
Background: There is growing evidence of the anti-inflammatory effect of the anti-diabetic drug metformin and its use to reduce pain. However, we currently lack studies investigating whether metformin is associated with a reduction in chronic back pain prevalence when considering physical activity levels, body mass index (BMI), and age.
Objective: To investigate whether use of metformin is associated with lower levels of reporting of chronic back pain in a large cohort with type 2 diabetes when stratified for physical activity, BMI, and age.
Objective: To determine the prevalence and predictors of physical activity, sedentary behaviour and fatigue five years after total knee replacement surgery.
Design: A longitudinal cohort study.
Setting: Community-dwelling adults who had previously undergone total knee replacement.
Background: Resilience, or the ability to bounce back from stress, is a key psychological factor that is associated with ongoing functional independence and higher quality of life in older adults in the context of chronic health conditions. Emerging research has explored resilience and patient-reported outcomes after TKA. Our primary aim was to explore the relationship between resilience and acute hospital length of stay after total knee arthroplasty (TKA).
View Article and Find Full Text PDFBackground: The perceptions of using noninvasive ventilation (NIV) during exercise in patients with COPD who are naïve to NIV is unknown. The present study aimed to examine the perceptions of using NIV during exercise in people with COPD and to determine the relationship between patient perceptions with both baseline patient characteristics and exercise outcomes.
Methods: During a trial examining the effect of NIV during exercise on dynamic hyperinflation in people with COPD who were naïve to NIV, participants completed a 5-point Likert scale questionnaire (scored strongly disagree -2 to strongly agree +2) before and after using NIV during exercise and a semi-structured interview after using NIV during exercise.
Objective: To evaluate the knowledge, skills and barriers to evidence-based practice and the impact of evidence-based practice training for physical therapy clinicians.
Methods: Physical therapists from a health district in Sydney, Australia were invited to participate. The primary outcome was the Assessing Competency in Evidence-based Medicine scale (range 0-15; 15 is high knowledge and skill) to quantify knowledge and skills.
Background: During exercise, dynamic hyperinflation (DH), measured by a reduction in inspiratory capacity (IC), increases exertional dyspnea and reduces functional capacity in many patients with severe COPD. Although noninvasive ventilation (NIV) during exercise can improve exercise duration, the effect on DH is unclear.
Research Questions: In people with COPD, resting hyperinflation, and evidence of DH during exercise, does bilevel NIV during exercise reduce DH and increase endurance time compared with exercise with no NIV, and does NIV with an individually titrated expiratory positive airway pressure (T-EPAP) reduce DH and increase exercise endurance time more than NIV with standardized EPAP (S-EPAP) of 5 cm HO?
Study Design And Methods: A randomized crossover trial in which investigators and participants were blinded between NIV interventions was performed.
Background: The aim of this study was to identify modifiable clinical factors associated with radiographic osteoarthritis progression over 1 to 2 years in people with painful medial knee osteoarthritis.
Methods: A longitudinal study was conducted within a randomised controlled trial, the "Long-term Evaluation of Glucosamine Sulfate" (LEGS study). Recruitment occurred in 2007-2009, with 1- and 2-year follow-up assessments by blinded assessors.
Background: Although there is growing evidence of metformin's pleiotropic effects, including possible effects on pain, there is a lack of studies investigating the association of metformin with the prevalence of musculoskeletal pain among a large cohort with type 2 diabetes cohort.
Methods: Cross-sectional analyses were conducted with UK Biobank data from 21,889 participants with type 2 diabetes. Type 2 diabetes, metformin use and musculoskeletal (back, knee, hip and neck/shoulder) pain were self-reported.
Alzheimer's disease (AD) and type 2 diabetes (T2D) major feature is insulin resistance. Brain and peripheral insulin resistance lead to hyperglycemia, which contributes to the development of T2D-linked comorbidities, such as obesity and dyslipidemia. Individuals with hyperglycemia in AD present with neuronal loss, formation of plaques and tangles and reduced neurogenesis.
View Article and Find Full Text PDFObjective: We investigated cross-sectional associations and whether type 2 diabetes increases the risk of musculoskeletal pain after adjusting for the presence of important comorbidities.
Methods: The study employed data from the UK Biobank participants: 495,327 in cross-sectional (2006-2010) and 16,875 in longitudinal (2014-2016) analyses. Type 2 diabetes was self-reported and subsequently confirmed during an interview.
Introduction: Incidence of total knee arthroplasty (TKA) is projected to rise 276% in 2030, and psychological distress affects up to 42% of people with knee osteoarthritis undergoing TKA, with demonstrated detrimental effects on postoperative outcomes. Few studies have assessed psychological treatment in people awaiting TKA, and these have been psychologist-delivered treatments. No evidence exists regarding psychologically-informed interventions delivered by health professionals currently embedded in TKA clinical pathways.
View Article and Find Full Text PDFBackground And Objective: Exercise is a cornerstone of management for type 2 diabetes; however, little is known about the cardiovascular (CV) response to submaximal functional exercise in people with type 2 diabetes. The aim of this study was to compare performance and CV response during a 6-minute walk test (6MWT) between people with type 2 diabetes and matched control subjects.
Methods: CV response and distance walked during the 6MWT were assessed in 30 people with type 2 diabetes, matched for age, body composition, physical activity, and estimated aerobic capacity with 34 control subjects (type 2 diabetes group: 16 men, 59.
Greater Lower Limb Fatigability in People with Prediabetes than Controls.
Med Sci Sports Exerc
May 2020
Introduction: The study purpose was to compare perceived fatigability and performance fatigability after high-velocity contractions with knee extensor muscles between people with prediabetes, people with type 2 diabetes (T2D), and controls without diabetes matched for age, body mass index, and physical activity.
Methods: Twenty people with prediabetes (11 men, 9 women: 63.1 ± 6.
Background: Although the influence of genetics on chronic low back pain (LBP) has been previously examined, few studies have investigated whether the impact of genetic factors on LBP depends on how the condition is assessed.
Methods: We investigated the contribution of genetics and environment on chronic LBP: lifetime prevalence, pain intensity (recent and worst) and activity limitation (anytime and recent) in a cross-sectional study with 1,598 adult twins. All twins answered a self-reported questionnaire about health-related questions.
Article Synopsis
- Around half of people experience back or neck pain in their lives, and those with diabetes might be more prone to chronic pain in these areas as per previous studies.
- A systematic review analyzed studies from various databases to assess the link between diabetes and back or neck pain in adults over 18, with data extracted by two reviewers.
- The results indicated that individuals with diabetes are more likely to report low back pain (OR: 1.35) and neck pain (OR: 1.24), but a longitudinal study found no future risk of developing these pains solely due to diabetes, suggesting they may co-exist rather than have a direct causal relationship.
Purpose: To investigate associations between anthropometric measures (birthweight, weight gain and current BMI) and back pain; and to determine whether these associations differ between those born with low or full birthweight.
Methods: The cross-sectional associations between the lifetime prevalence of back pain and anthropometric measures (birthweight, weight gain and current BMI) among 2754 adult twins were investigated in three stages: total sample; within-pair case-control for monozygotic and dizygotic twins together; and within-pair case-control analysis separated by dizygotic and monozygotic. Results were expressed as odds ratios (OR) and 95% confidence intervals (CI).
Diabetic neuropathy is a major complication of type 2 diabetes. Emerging evidence also suggests that people with pre-diabetes may develop similar symptoms related to nerve dysfunction. While regular exercise provides many benefits to patients with diabetes, whether exercise influences nerve function has not been established.
View Article and Find Full Text PDFBackground: Musculoskeletal conditions are common health issues with great impact on individuals. Although many factors have been associated with the development of musculoskeletal pain, such as perinatal factors, its aetiology is still poorly understood.
Objective: To systematically investigate whether perinatal factors can increase the risk of having musculoskeletal pain across the lifespan.