Bone Health Research Projects

The effects of induced thoracic kyphosis on trunk neuromuscular control and balance characteristics in an older, healthy population

The effects of postural taping in individuals with a history of osteoporotic vertebral fracture

Trunk neuromuscular control and balance characteristics in individuals with and without osteoporotic vertebral fracture           

Subregional bone mineral characteristics in individuals with and without osteoporotic vertebral fracture

Spinal biomechanics in osteoporosis

Paraspinal muscle function in individuals with and without osteoporotic vertebral fracture

Evaluation of an osteoporosis prevention and self management program.

Improving exercise prescription for postmenopausal women at risk of osteoporosis.

Efficacy of a physiotherapy intervention programme for individuals with a history of osteoporotic vertebral fracture: A randomised controlled pilot study

Falls prevention and risk assessment in the acute hospital

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The effects of induced thoracic kyphosis on trunk neuromuscular control and balance characteristics in an older, healthy population

Investigators
Alison Greig, Prof Kim Bennell, Prof Paul Hodges, Prof John Wark

Summary
Increased thoracic kyphosis associated with vertebral fracture may alter the centre of gravity and the length-tension relationship of trunk muscles thereby affecting trunk neuromuscular control and balance. This within-subject study investigates the effects of experimentally induced thoracic kyphosis on trunk neuromuscular control and balance characteristics in 24 older, healthy individuals. Participants will be tested under three conditions: induced kyphosis, placebo condition and normal upright posture. Trunk muscle activation onsets and recruitment patterns and balance characteristics will be recorded as the person responds to perturbations while standing on various bases of support.

Funding Source
Nil

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The effects of postural taping in individuals with a history of osteoporotic vertebral fracture

Investigators
Alison Greig, Prof Kim Bennell, Prof Paul Hodges, Prof John Wark

Summary
Vertebral fractures are a major clinical manifestation of osteoporosis and are associated with increased thoracic kyphosis. Physiotherapists often use postural taping in this patient group with the postulated aims being postural correction and altered activity of the muscles involved in postural maintenance. This study aims to investigate the efficacy of postural taping in 24 individuals with osteoporotic vertebral fractures. Participants will be tested under three conditions: whilst wearing postural tape, placebo tape and no tape. Trunk muscle activity onsets and recruitment patterns, thoracic posture and balance characteristics will be recorded during functional activities and during perturbations applied to the person while they stand on varying bases of support.

Funding Source
Nil

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Trunk neuromuscular control and balance characteristics in individuals with and without osteoporotic vertebral fracture

Investigators
Alison Greig, Prof Kim Bennell, Prof Paul Hodges, Prof John Wark

Summary
Osteoporotic vertebral fractures are an important public health concern. Altered trunk neuromuscular control and balance strategies may contribute to the increased risk of future fracture seen in those with osteoporosis. This cross-sectional study will compare individuals with osteoporotic vertebral fractures (n=20); individuals with osteoporosis and no vertebral fractures (n=10); and a control group of aged matched normals (n=10). The osteoporotic vertebral fracture group will be further dichotomized into those with more and less severe thoracic kyphosis in order to further investigate the effects of thoracic kyphosis on the outcome measures. The trunk muscle activation onsets and recruitment patterns and balance characteristics will be recorded as participants respond to perturbations while standing on varying bases of support.

Funding Source
Nil

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Subregional bone mineral characteristics in individuals with and without osteoporotic vertebral fracture

Investigators
Andrew Briggs, Prof John Wark, Susan Kantor, Prof Nick Fazzalari, Alison Greig, Prof Kim Bennell

Summary
Dual energy x-ray absorptiometry (DXA) will be used in a novel approach to measure subregional bone mineral density in lumbar vertebral bodies. Specific regions of interest within the vertebral centrum will be selected by manipulating the densitometer software. Short term in vivo precision will be examined for selecting subregions and for re-positioning of patients. Accuracy of the protocol will be established by comparing DXA derived subregional BMD with histomorphometric analysis of the same vertebral subregions using cadaver spines. Apparent subregional bone density will then be compared among individuals with and without osteoporotic vertebral fracture. This study may help to improve our understanding of the mechanisms underlying osteoporotic vertebral fractures.

Funding Source
Nil

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Spinal biomechanics in osteoporosis

Investigators
Andrew Briggs, Tim Wrigley, Dr Bev Phillips, Alison Greig, Prof Kim Bennell,

Summary
Different prevalence rates of vertebral fracture exist among individuals with comparable bone mineral density (BMD). This suggests that either current measurement of BMD is not sufficiently sensitive or that other factors must also operate to influence fracture risk. This study will explore vertebral loading in the thoracic and lumbar region. Vertebral loading will be calculated from T1-L5 using radiographs and digital imaging with flexion moments used as an index of vertebral load. The segmental loading profiles will be compared between individuals with and without osteoporotic vertebral fracture. X-rays will also be used to measure thoracic and lumbar spine curvature, intervertebral disc integrity and vertebral geometry.

Funding Source
Physiotherapy Research Foundation Seeding Grant

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Paraspinal muscle function in individuals with and without osteoporotic vertebral fracture

Investigators
Andrew Briggs, Prof Kim Bennell, Prof Paul Hodges, Tim Wrigley, Alison Greig

Summary
Osteoporotic vertebral fractures present a major public health problem. This study will explore paraspinal muscle activity, which is believed to influence the risk of vertebral fracture. Comparing muscle activity between individuals with and without fracture may help to improve our understanding of underlying fracture mechanisms. The electromyographic recruitment characteristics, principally relative onset times and amplitude of contraction, will be measured in the paraspinal muscles using fine wire electrodes. The recruitment characteristics will be compared between individuals with and without fracture as subjects respond to both internal and external trunk perturbations. Both types of perturbation are employed to determine if any muscle recruitment differences exist for a feedforward compared to a feedback motor control loop.

Funding Source
Nil

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Evaluation of an osteoporosis prevention and self management program

Investigators
Kate Francis, Dr Bernadette Matthews, Prof Kim Bennell, Dr Richard Osborne, Prof Willem van Mechelen

Summary
Osteoporosis is a major and growing public health problem. Self-management courses for people with chronic conditions such as osteoporosis have been recommended on the premise that they help patients better manage their condition and contribute to preventive behaviour, ultimately improving health and reducing healthcare costs. However, there has been no comprehensive evaluation of the efficacy of osteoporosis specific programs, particularly in the Australian setting. This randomised controlled trial aims to determine the effectiveness of an established 4-week community-based prevention and self-management program for individuals who have or are at risk of osteoporosis. Questionnaires will be utilised to assess changes in osteoporosis knowledge, skill and technique transfer, and attitudes towards maximising bone health and minimising symptoms in 260 older individuals. This research will provide comprehensive information on the program's impact on participants, as well as the quality of education supplied.

Funding Source
Early Career Researcher Grant, The University of Melbourne

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'Bones For Life'

Improving exercise prescription for postmenopausal women at risk of osteoporosis.

Investigators
Prof Kim Bennell, Dr Bernadette Matthews, Karen Bolton, Elin Wee, Prof John Wark

Summary
Osteoporotic related hip fractures are common in Australia and have serious implications for mortality, morbidity and cost. This randomized controlled trial will evaluate whether a 12 month exercise program together with adequate calcium intake, is effective in reducing bone loss and improving falls risk factors in postmenopausal women at risk of sustaining an osteoporotic fracture. Postmenopausal women with low bone density will be randomised to either an exercise or control group and measured before and after the intervention. The results of this study have implications for directing exercise guidelines and promoting the important role of safe physical activity in this population.

FundingSource
Swisse Vitamins Pty Ltd, YMCA Victoria

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Efficacy of a physiotherapy intervention programme for individuals with a history of osteoporotic vertebral fracture: A randomised controlled pilot study

Investigators
Prof Kim Bennell, Dr Bernadette Matthews, Judy Larsen, Margaret Sherburn, Alison Greig, Prof John Wark

Summary
Vertebral fractures are common in the osteoporotic population, and these spinal fractures can lead to pain, abnormal posture, reduced function and reduced quality of life. This pilot study will investigate the effectiveness of a physiotherapy treatment program which aims to increase back extensor muscle strength and endurance, decrease thoracic kyphosis, improve static and dynamic balance, and improve function and quality of life in individuals with osteoporosis. Results of this study will develop further understanding of the appropriate treatment options for individuals with osteoporotic vertebral fractures and provide the impetus for the progression into a larger clinical trial

Funding Source
ANZ Charitable Trusts

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Falls prevention and risk assessment in the acute hospital

Investigators
Willeke Walsh, Prof Kim Bennell, Dr Keith Hill

Summary
Falls are a serious health issue which affect the faller, their families/carers and health care providers. With an increasing elderly population the physical, psychological and economic cost of falls has the potential to rise considerably. Falls can occur in hospitals and limited research has been conducted in this area, especially in the acute setting. Falls prevention is ideal and best addressed in a multifactorial manner. This project involves the design of a falls assessment tool appropriate to the acute setting. The tool will identify particular patient specific risk factors, as well as provide a framework from which appropriate strategies to decrease the potential outcomes of falls can be determined. Testing of predictive validity and inter- and intra- rater reliability will be completed on a typical acute hospital population

Funding Source
Victorian Department of Human Services Aged Care Division

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