The Physical Therapies Research Theme is a multi-disciplinary grouping which serves as a research hub for staff in Physiotherapy, Podiatry, Occupational Therapy and Arts Therapies subject areas and occasionally staff in Nursing. We conduct applied and translational research that addresses real-life issues affecting the health status and quality of life of patients, the professional practice of clinicians and the development of healthcare policy.
Organised around the two principal sub-themes of Physical Activity & Exercise Rehabilitation and Musculoskeletal & Orthopaedic Rehabilitation research activity is largely focused on the design and evaluation of assessment approaches and therapeutic intervention strategies within healthcare.
Musculoskeletal & Orthopaedic Rehabilitation research contributes to knowledge about the efficacy of surgical and rehabilitative interventions in patients with disease or injury to joints. The team leads a number of sponsored and funded large-scale programmes of research in prominent centres of orthopaedic surgical excellence involving randomised controlled trials in patients undergoing surgery for total and partial knee replacement, ligament reconstruction, injury to chondral surfaces, and in patients suffering somatic dysfunction and requiring myofascial release therapy. This research focuses attention on the relationships between neuromusculoskeletal, sensorimotor, biomechanical and psychophysiological performance capabilities, exercise stress and transformation to improved function.
Research in the area of Physical Activity & Exercise Rehabilitation includes activity focused upon evaluation of the impact of pragmatic exercise rehabilitation interventions on the physical well-being, functional capacity and quality of life of people living with long-term conditions such as Chronic Kidney Disease, Multiple Sclerosis, Cerebral Palsy, and people recovering from a Stroke. Other research explores the clinical utility and relative effectiveness of assistive technologies in the rehabilitation of people with neurological conditions (e.g. support of walking via.Functional Electrical Stimulation and Ankle-Foot Orthoses).
Key text labels for Physical Therapies Theme
Rehabilitation
Physical Activity
Assistive Technologies
Motion Analysis
Exercise Tolerance
RESEARCH EXAMPLE: Researching excercise in rehabilitation
RESEARCH EXAMPLE: Hospital versus community? What works best for rehabilitation of patients?
We've all heard the argument that you can often recover more effectively from illness and injury at home than in hospital. Some of us who have experienced serious ill health may be very aware that recovery really kicks in once the stress of the hospital experience is behind us and we are recuperating in the comfort of our own surroundings. In addition, most health professionals also now believe that care, which is individualised to the needs of the patient, also offers significant advantages over the ‘one size fits all approach’. However, are these theories actually true, and, if so, where’s the evidence?
Recently policy reviews which shape the development of our national health service recommend that improvements in service can be achieved if seamless care is tailored to the needs of each individual patient. Governmental recommendations include providing patients with services which are nearer to their local community, a shift of services from secondary care to primary care and involving patients more in the management of their own care (self-management).
If evidence could demonstrate that these approaches to services offer real improvements to the efficiency and effectiveness of care, then our over burdened NHS should reap the benefits of a healthier population with individuals requiring reduced levels of hospital and primary care support. With the challenges currently facing our increasingly overloaded NHS and the pressures on our economic climate, it is vital that we provide the evidence of services that will help us achieve efficient and enhanced rehabilitation care for patients.
Responding to these challenges, a team of QMU physiotherapists are working with Lothian Health Board and NHS trusts in England on a series of trials to compare the effectiveness of hospital and community-based treatment. The team is also looking at novel approaches to individualised rehabilitation, as well as genetic influences on the responsiveness of patients to exercise rehabilitation. The research specifically focuses on people who have had injury and surgery to joints. The success and suitability of the new rehabilitation procedures will be judged using a wide-range of measurements including those from sophisticated electronic devices, profiling of genetic markers, and from the patients’ self-perception of their capabilities to undertake everyday activities.
Nigel Gleeson, Reader in Rehabilitation Sciences, at QMU is leading the research. He explained: "Not all people respond to the same dosage of rehabilitation in the same way – what might be best for one person is not necessarily optimal for another. We need to evaluate the extent of potential increases in effectiveness and efficiency associated with a move to more individualised care from the ‘one-hat fits all’ approach that often characterises current contemporary practice. This research investigates the effects of encouraging the individual patient to self-perceive and manage areas of physical need following surgery and to negotiate with the specialists as to what treatment might be best for them in aiding recovery. Ultimately, it's about understanding and verifying the circumstances in which rehabilitation is enhanced by empowering the individual to play a key role in shaping their treatment and leading his/her own recovery."
He continued: “In addition, advancement of surgical techniques and rehabilitation has meant that rupture of ligaments or damage to the cartilage surfaces of the joint are no longer thought to be a threatening injury to a working career. However, the cost to the NHS might still be considerable as contemporary clinical practice often requires more than six-months of rehabilitation. The extent to which rehabilitation conditioning might usefully be accelerated and full recovery achieved more rapidly with less cost to the NHS, is limited by not knowing about the genetic predisposition of an individual to respond effectively to achieving the best progression towards recovery. This research hopes to identify a simple approach by which patients are matched to the most appropriate type of rehabilitation that will aid their recovering and be cost effective. The results of the research will also contribute to our understanding of how best to achieve a balance between clinical versus cost effectiveness.”
The research into enhanced rehabilitation and its assessment is unique in the UK and has already received international recognition for its quality with an award for best research paper ( French Society of Physiotherapy , 2011). The outcomes of this research should also be useful to health services in other countries and the programme of research has attracted prestigious international government scholarship funding from Oman and Pakistan.
Nigel Gleeson concluded: “Ultimately, the aim of the work undertaken by the QMU research team is to enhance care and improve quality of life for patients.”
