Macnamara, Kate Marie (Trinity College Dublin. School of Medicine. Discipline of Physiotherapy, ) Introduction: Maximal oxygen consumption (V̇O2max) is a measure of cardiopulmonary fitness, and a strong indicator of risk of cardiovascular disease (CVD); with a lower V̇O2max increasing a person's risk of CVD Our "Physiotherapy" experts can research and write a NEW, ONE-OF-A-KIND, ORIGINAL dissertation, thesis, or research proposal—JUST FOR YOU—on the precise "Physiotherapy" topic of your choice. Our final document will match the EXACT specifications that YOU provide, guaranteed. We have the necessary skills, knowledge, and experience to complete virtually any master- or doctoral-level Physiotherapy Dissertation Topics. Physio is an extremely valuable form of therapy because it helps patients to stay healthy and independent! Recent public health issues such as the obesity and COVID crises have created new challenges for physios. Also, the introduction of new technologies and new treatment breakthroughs has reshaped the capabilities of physiotherapists
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Use filters to refine the search results. Now showing items of List view Grid view Sort Options: Relevance Title Asc Title Desc Issue Date Asc Issue Date Desc Date Accessioned Physiotherapy phd thesis Date Accessioned Desc Results Per Page: 12 24 36 48 60 72 Critical Illness Survivorship: Rehabilitation and Recovery. Jones, Jennifer Rose Abotomey Survivors of critical illness can experience significant physical disability during their recovery, delaying return to activities of daily living, all negatively impacting their health-related quality of life.
Level one evidence supports the implementation of physical rehabilitation programs to address these short term sequalae. However, recent large randomized controlled physiotherapy phd thesis measuring longer term physical function and health-related quality of life do not report sustained improvement.
To better understand this phenomenon, investigations into the role of patient characteristics in responsiveness to physical rehabilitation and critical illness recovery is an emerging research area physiotherapy phd thesis is the focus of this thesis. The first study of physiotherapy phd thesis thesis is a narrative review, physiotherapy phd thesis, where 12 randomized controlled trials with conflicting results for the beneficial effects of physical rehabilitation on the physical function, health-related quality of life and health care utilization outcomes of critically ill adults were identified from a comprehensive and systematic literature search.
Through critical evaluation of these physiotherapy phd thesis controlled trials and additionally relevant studies, a theoretical construct was developed for the research of this thesis and to advance the field. In brief, the core components of the theoretical construct are in searching for the responder; investigation into potential modifiers of physical rehabilitation outcomes including patient characteristics ; tailoring rehabilitation interventions to address known physical impairments; and deciphering the prime time for responsiveness to these interventions based on patients biological and physiological recovery.
Lastly, the conclusion that more research is needed on the optimal prescription parameters of physical rehabilitation programs to guide clinical practice with consideration to facilitators and barriers to implementation of the intervention is reached. The second study is a systematic review examining the association between indicators of social and economic position within society socioeconomic position and health outcomes following critical illness.
Ten studies were included in this systematic review, with a strong focus on mortality despite survivorship being the identified challenge for critical care in the 21st century.
The higher mortality rates and poorer health-related quality of life reported for critically ill adults with a lower socioeconomic position signal that a social gradient exists in critical care.
This may indicate a clinical subgroup that would derive physiotherapy phd thesis from multimodal and interdisciplinary interventions physiotherapy phd thesis potentially alter their recovery trajectory. For the third and final study a systematic review and an individual participant data meta-analysis of randomized controlled trials was performed to examine physiotherapy phd thesis interaction between the treatment group intervention vs control and patient characteristics comorbidity, age, sex and illness severity for the performance-based physical function at hospital discharge, three and six months and health-related quality of life at three, physiotherapy phd thesis, six and 12 months outcomes of critically ill adults.
From the four randomized controlled trials included, totaling a combined sample size of over participants, comorbidity modified the effect of physical rehabilitation for the health-related quality of life instrument Physical Component Summary score of the item and item Short Form Health Surveys.
We recommend that clinicians prioritize the provision of a structured individualized physical rehabilitation program to multimorbid patients as physiotherapy phd thesis subgroup that derives significant benefit from this intervention.
In conclusion, the findings of this thesis navigate the path forward for rehabilitation research in critical care. This area, both in research and clinical practice, has previously been plagued by the heterogeneity of the patient population. Ultimately leading to the progression of the field to provide patients with the right intervention at the right time in their recovery trajectory to improve their outcomes following critical illness.
Clinical guidelines advocate exercise, physiotherapy phd thesis, weight loss for people who are overweight or have obesity physiotherapy phd thesis, and education regarding self-management as first line treatments for OA. Physiotherapists are important providers of such non-surgical physiotherapy phd thesis. As such, physiotherapy phd thesis, they have a professional responsibility to ensure that the care they provide to people with OA is safe and aligns with best practice.
Current quality indicators QIs for care of people with hip and knee OA are not designed to specifically assess physiotherapy care. Furthermore, little is known about the experiences of Australian physiotherapists and people delivering and receiving care for knee OA, and if their reported experiences align with the national Clinical Care Standard for knee OA quality statements that describe the care Australian patients should physiotherapy phd thesis offered by health professionals and health services for OA in line with current best evidence.
A panel of 62 international physiotherapists was invited to first complete an online modified-Delphi survey, followed by a priority-ranking exercise.
Recommendations were extracted from two high quality international clinical guidelines for OA. From an initial list of 70 potential recommendations including seven new recommendations generated by the expert panel30 were included in the priority-ranking exercise. The top recommendations related to providing exercise, weight management, and education as core treatments; individualised OA management; and communication approaches.
Study Two aimed to develop a patient-reported QI tool the Quality Indicators for Physiotherapy Management of Hip and Knee Osteoarthritis QUIPA tool and to assess physiotherapy phd thesis reliability and validity.
A conceptual model based on the final 30 recommendations physiotherapy phd thesis Study One was used when developing the QUIPA tool, where the four main categories of the final recommendations were synthesized to establish the three subscales of the QUIPA tool.
Patient focus groups were conducted to further refine the draft items. Patient test-retest reliability was assessed between twelve- and thirteen-weeks following their session. Construct validity was evaluated based on three predefined hypotheses, physiotherapy phd thesis. Criterion validity was assessed based on agreement between physiotherapists and participants at week one. The final QUIPA tool comprised 18 items three subscales.
The QUIPA tool demonstrated acceptable test-retest reliability for subscales and total score, but individual items showed inadequate reliability. Construct validity was adequate but criterion validity for individual items, physiotherapy phd thesis and the total score was poor. The QUIPA tool needs further refinement to improve its clinimetric properties before implementation into clinical practice.
Inductive thematic analysis was conducted, and the interview data were also deductively analysed according to the national Clinical Care Standard, physiotherapy phd thesis.
Findings revealed that physiotherapists tended to focus on a biomedically-oriented assessment with little evaluation of psychosocial factors that may impact patients with knee OA.
They perceived their primary role as providing goal-focused individualised exercise via short-term episodic care. Physiotherapists also described a mismatch between what they know and what they do when it came to manual therapy, imaging, and weight loss advice. They saw weight management, medication, and surgical advice as outside of physiotherapy scope of practice.
Participants generally presented to physiotherapists with a pre-existing OA diagnosis and were mostly comfortable with their existing knowledge about OA. They described accessing physiotherapy through various referral pathways, funding models and modes of delivery, physiotherapy phd thesis.
They consulted physiotherapists for various reasons but most commonly for assistance with knee pain and functional impairments. Participants described physiotherapy management as primarily centred on exercise therapy, physiotherapy phd thesis, often supplemented by adjunctive treatments. Participants were generally happy and satisfied with their physiotherapy experiences and described valuing the personalised care they received.
They also believed surgery was inevitable for their knee OA. Overall, physiotherapy phd thesis from the last two studies indicated that physiotherapy management of knee OA in Australia mostly aligned with the national clinical care standard and that patients were generally happy and satisfied with the physiotherapy care received.
Suggested areas to improve care delivered by physiotherapists include increased consideration of psychosocial factors that may influence OA symptoms and prognosis, attention to the language used when discussing OA i, physiotherapy phd thesis.
Findings also highlight the importance of appropriate funding mechanisms to support Australians to access physiotherapy care for their knee OA both in private and public sectors. Prehabilitation for individuals having lung cancer surgery. Shukla, Anna Non-small cell lung cancer NSCLC is the fourth most commonly diagnosed cancer in males and the fourth most commonly diagnosed cancer in females in Australia.
It is the leading cause of cancer-related mortality, being responsible for more deaths than breast, colorectal and prostate cancer combined. Pulmonary resection provides the best chance of a cure for patients with early stage lung cancer. However, pulmonary resection is associated with significant impairment in functional capacity along with a moderate risk of postoperative morbidity, particularly in frail or deconditioned patients. Prehabilitation can include a care bundle incorporating smoking cessation, diet optimization, psychosocial support and exercise, and aims to identify impairments and deliver targeted interventions that improve patient outcomes.
It provides an opportunity to decrease treatment-related morbidity, increase available treatment options for patients who would not otherwise be surgical candidates and facilitate return of patients to the highest possible functional level.
There is a growing body of evidence that supports prehabilitation as a means of preparing patients with newly diagnosed cancer for surgery by optimizing their health preoperatively. Evidence supports the implementation of prehabilitation in the preoperative care pathway of other cancer cohorts, for example colorectal, breast and prostate cancers. Unfortunately, the evidence for the effects of prehabilitation in lung cancer has lagged behind and the use of prehabilitation specifically the exercise component for patients with lung cancer is now an emerging area.
To date, exercise prior to lung cancer surgery has been shown to be safe and associated with improvements in functional capacity as well as postoperative morbidity hospital length physiotherapy phd thesis stay and rates of postoperative pulmonary complicationshowever the feasibility and acceptability of prehabilitation for patients with lung cancer is still unclear.
The two studies within this thesis physiotherapy phd thesis on the exercise component of prehabilitation in the context of surgical management of lung cancer in Australia. Preoperative physiotherapy to prevent postoperative pulmonary complications after major abdominal surgery. Boden, Ianthe Josephine Abdominal surgery is the most common major surgical procedure performed in developed countries. After surgery, postoperative pulmonary complications PPCs occur frequently and are a primary cause of morbidity, mortality, and prolonged hospital stay.
To minimise PPCs, physiotherapy is ubiquitously provided in the postoperative phase in hospitals throughout developed countries. Physiotherapy clinical trials reporting the largest reductions in PPCs have predominately tested preoperative education and training of patients to perform their own breathing exercises after surgery.
These trials were generally of low quality and therefore the results lack certainty, physiotherapy phd thesis. Currently, preoperative physiotherapy is rarely provided in Australian and New Zealand hospitals. A well-designed randomised controlled trial RCT investigating the benefit of preoperative physiotherapy to reduce PPC in a modern perioperative context was needed.
The aims of this thesis were to: consider the physiological basis for preoperative physiotherapy to minimise PPCs; to conduct a narrative and systematic review of research investigating PPC prevention with breathing exercises; and, to design and conduct an RCT, including quantitative, qualitative, physiotherapy phd thesis, and health economic outcomes, assessing the effectiveness of preoperative physiotherapy to minimise PPC after major abdominal surgery.
The Lung Infection Prevention Post Surgery Major Abdominal with Pre-Operative Physiotherapy LIPPSMAck-POP trial was a double-blinded, multicentre, RCT. In pre-admission clinics at three hospitals, patients awaiting major abdominal surgery were randomised to receive an information booklet or an additional education and breathing exercise training session, physiotherapy phd thesis. Education focussed on PPC prevention via self-directed postoperative breathing exercises.
A nested mixed-methods study investigated the impact and treatment fidelity of the intervention in 20 consecutive participants. Preventing pneumonia was very important to participants. Following surgery, Physiotherapy phd thesis incidence was halved in the intervention group adjusted hazard ratio 0.
Intervention participants had significantly reduced pneumonia rates, required fewer antibiotic prescriptions for respiratory infections, physiotherapy phd thesis, less purulent sputum, fewer positive sputum cultures, and were less likely to require oxygen therapy, physiotherapy phd thesis.
Quality adjusted life year QALY gains were less certain. Improved cost-effectiveness and QALY gains were detected when experienced physiotherapists delivered the intervention. For each PPC prevented, preoperative physiotherapy was likely to cost hospitals less than the costs to treat a PPC. This thesis analysed the evidence for the physiotherapy management of patients having abdominal surgery. A hypothesis for preoperative physiotherapy to minimise PPC after surgery was proposed, physiotherapy phd thesis.
This hypothesis was supported with qualitative, physiotherapy phd thesis, primary, secondary, and health economic quantitative outcomes within a multicentre randomised controlled trial, and through a systematic review and meta-analysis.
These findings may not be generalisable to all settings and require testing in different surgical populations, cultures, and hospital settings. Effective PPC prophylaxis needs to be investigated for patients unable to attend pre-admission clinics, those having emergency abdominal surgery and in other high-risk populations, physiotherapy phd thesis.
Early detection is paramount to ensure that infants who are at the highest risk of developmental delays are identified early to commence intervention and improve functional outcomes, physiotherapy phd thesis.
The General Movements Assessment GMA involves visual clinical recognition of patterns of spontaneous infant movement from video recordings and is a key assessment for the diagnosis of high-risk CP but is not universally accessible due to resource constraints, such as limited out-patient follow-up services. Furthermore, this thesis investigates the nuances of the GMA in relation to preterm birth.
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Macnamara, Kate Marie (Trinity College Dublin. School of Medicine. Discipline of Physiotherapy, ) Introduction: Maximal oxygen consumption (V̇O2max) is a measure of cardiopulmonary fitness, and a strong indicator of risk of cardiovascular disease (CVD); with a lower V̇O2max increasing a person's risk of CVD Some of these projects go on to publication or presentation at the state or national level. Examples of some of these published works are available through the La Crosse Institute for Movement Science (LIMS) website or recent publications Our "Physiotherapy" experts can research and write a NEW, ONE-OF-A-KIND, ORIGINAL dissertation, thesis, or research proposal—JUST FOR YOU—on the precise "Physiotherapy" topic of your choice. Our final document will match the EXACT specifications that YOU provide, guaranteed. We have the necessary skills, knowledge, and experience to complete virtually any master- or doctoral-level
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