Evaluating the responsiveness and clinical utility of the Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC)

Mr Nicholas Sheahan1, Dr  Rosamund  Harrington, Dr Alison Nelson, Associate Professor Loretta Sheppard

1The Institute For Urban Indigenous Health, Brisbane, Australia

Introduction: Research suggests a current dearth of culturally responsive outcome measures for use with First Australian peoples. Most outcome measurement tools have been developed with participants from Western backgrounds. The Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC) is an outcome measure that has been specifically designed to consider the more holistic views of health held by First Australians. This research aimed to determine the responsiveness and clinical utility of ATOMIC when applied to First Australian adults within an urban context.

Methods: This research was conducted as two studies. Study 1 investigated the responsiveness of ATOMIC to change over time using data gathered from First Australian clients, tracking changes in their goal achievement pre- and post- intervention.  Study 2 investigated the clinical utility of ATOMIC (i) from the perspective of the client to determine whether they understood the purpose of the tool and whether it aligned with their philosophical views on health care; and (ii) from the perspective of the clinicians using the tool

Results: Study 1: Paired t-tests showed a statistically significant increase (p=0.00) in ATOMIC scores pre (mean = 1.8) and post (mean = 8) intervention. Effect size (Cohen d) was calculated as 2.1 and thus also statistically significant. Both calculations indicate ATOMIC is responsive to change. Study 2: Synthesis of interview and focus group data resulted in four overarching themes. These were (i) First Australians are on their own journey and are adept at self-managing their conditions (ii) ATOMIC is a clinically useful outcome measure, that is acceptable to First Australian clients and clinicians, (iii) ATOMIC supports culturally responsive goal-setting, and (iv) ATOMIC supports occupational therapy practice

Conclusion: This research demonstrates ATOMIC is a responsive and clinically useful outcome measure when used with urban First Australian adults.


Biography:

Nick recently graduated with honours from an occupational therapy degree at the Australian Catholic University. He is passionate about helping others and has a strong interest in First Australian health. Nick is employed as an occupational therapist with The Institute for Urban Indigenous Health and he feels that his role at IUIH allows him to contribute to the health and wellbeing of his clients in a positive and holistic manner. He is passionate about evidence-based practice and hopes to positively contribute to the occupational therapy profession for many years to come

Measuring the Value of the Specialist Management with Acute Rehabilitation Treatment (SMART) Program

Ms Jamie Hunter1, Dr Kristy Coxon2, Ms Caitlyn Robson1

1Westmead Hospital, Westmead, Australia, 2Western Sydney University, Penrith, Australia

Background: The Specialist Management with Acute Rehabilitation Treatment (SMART) program provides multi-disciplinary rehabilitation to acute patients at Westmead Hospital. This program is open to patients across the hospital who have achievable rehabilitation goals. The SMART team work with complex and diverse patients who experience a wide range of rehabilitation outcomes. This study aims to measure changes in patient function from program admission to discharge and identify characteristics of patients most likely to benefit from the program.

Methods: A retrospective file audit was conducted collecting Australasian Rehabilitation Outcomes Centre and Activity Based Funding data for all patients admitted to the SMART program in 2017 and 2018.  Demographic, medical and treatment data were extracted. The Functional Independence Measure (FIM) was used to measure change in function from acute-rehabilitation admission to discharge and compared using Paired t tests. Service outcomes including length of stay, functional change, and discharge destination were modelled using linear and logistic regression to identify patient and service characteristics predicting service outcomes.

Results: Data analysis and extraction is currently underway with approximately 400 patients admitted to SMART in 2017 and 2018.  To date, preliminary data from 2017 (n= 210) indicate patients admitted to the SMART program had an average age of 63 years, experienced an average SMART length of stay of 12 days, functional change of 16 points on the FIM, with a daily FIM efficiency of 2.6 points. Outcomes were linked to both patient and service characteristics including age, diagnosis and length of admission prior to acute-rehabilitation.

Discussion: Measuring patient and service outcomes of acute-rehabilitation helps identify the value and impact of early multi-disciplinary intervention in the acute-rehabilitation phase. Findings may guide referral criteria, and help tailor service provision and rehabilitation timing to maximise service outcomes.


Biography:

Jamie Hunter is an occupational therapist with a Masters of Primary Health Care and a clinical background in rehabilitation and neurology. Jamie is senior Occupational Therapist on the SMART (acute-rehabilitation) team at Westmead Hospital and is a member of the Western Sydney Allied Health Research Steering Committee and the ACI Rehabilitation Network’s Data Measurement and Outcomes Committee.

Dr Kristy Coxon is a registered occupational therapist with a PhD in Public Health from the University of Sydney and a background in clinical practice education and research. Kristy is Academic Course Advisor for the occupational therapy program at Western Sydney University and holds a research fellow position in the Injury Division of The George Institute for Global Health.  Kristy has established a strong research profile in the areas of transport, community mobility, safety and injury prevention. Kristy has presented papers at conferences both nationally and internationally, and has published her research in internationally recognised peer-reviewed journals.

Caitlyn Robson is a 4th year Honours Student at the Western Sydney University

The Allied Health national best practice data sets – are we there yet?

Catherine Stephens1, Kristy Perkins

1Department of Health, Brisbane, Australia, 2West Moreton Hospital and Health Service, Ipswich, Australia

Background: The National Allied Health Data Working Group (NAHDWG), a collaboration of representatives from jurisdictions and the National Allied Health Classification Committee (NAHCC), was formed in 2016 to guide the expansion of nationally consistent allied health data collection. The addition of clinical data to the activity and administrative data of the Allied Health Minimum Data Set (AHMDS), was seen as imperative to build a clearer picture of allied health services, identify patients and conditions which allied health professionals treat; determine the effectiveness of allied health interventions and demonstrate the contribution of allied health services to health outcomes.

Methods: A series of workshops with the NAHDWG was held to identify ongoing AHMDS items, data elements from health sector national minimum data sets and additional clinical elements for inclusion, their definitions and code sets. Extensive consultation was subsequently undertaken across the public health sector in each jurisdiction.

Results: Four Allied Health National Best Practice Data Set Specifications for the Admitted Patient, Non-Admitted Patient and Non-Admitted Patient Emergency Department contexts as well as one for Non-Individual Patient Attributable and Clinical Support Activities have been developed. The data sets have been endorsed by the National Health Data and Information Standards Committee and published on METeOR, the Australian Institute of Health and Welfare’s Metadata Online Registry.

Discussion: The ability to collect nationally consistent allied health activity and clinical data is seen as a priority for allied health leaders. Drivers include the provision of standardised data allowing analysis, reporting and benchmarking to demonstrate the value of allied health services and inform service requirements and the ability to inform information technology and data system development. The endorsed data sets provide nationally recognised standards to enable the achievement of these goals. Future work will focus on implementation and use of the data items.


Biography:

Catherine Stephens is an experienced physiotherapist having worked clinically in public and private healthcare settings in Australia and overseas.  She has worked in the Allied Health Professions’ Office of Queensland since 2006 and is currently the Director, Governance, Standards and Policy. She has a strong interest in the collection and utilisation of allied health data to demonstrate the value of allied health care, to inform the optimal allocation of allied health resources and to influence broader health care policy.

Service change and Supporting Lifestyle and Activity Modification after Transient Ischaemic Attack (S+SLAM-TIA): Measuring the value of implementing an evidence based secondary stroke prevention program into a health service

Dr Heidi Janssen1,2,3, Mr Chris Catchpole1, Ms Anne Sweetapple1, Ms Gillian Mason3, Ms Diana Colvin2, Ms Anjelica Carlos1, A/Prof Coralie English2, Prof Louise Ada4, Prof Robin Callister2, Ms Maria Sammut2, Mr Tony Edser5, Dr Carlos Garcia Esperon1, Ms Michelle Russell1, Mr Ashley Young1, Dr Dianne Marsden1, Ms Ena Fisher1, Dr Peter MacIsaac3, Dr Gary Crowfoot2, Prof Frini Karayanidis2, A/Prof Frederick Rohan Walker2, Dr Lin K Ong2, Ms Monique Hourne1, Prof Andrew Searles3, Prof John Attia3, Mr Jonathan  Holt1, Prof John Wiggers1, Ms Rhonda Walker1, Ms Derene Anderson1, A/Prof Michael Pollack1, Prof Neil James Spratt1, Prof Michael Nilsson2, Dr Kirsti Haracz2, Prof Christopher Levi6

1Hunter New England Local Health District, Newcastle, Australia, 2University of Newcastle, Newcastle, Australia, 3Hunter Medical Research Institute, Newcastle, Australia, 4The University of Sydney, Sydney, Australia, 5Planet Fitness Health Clubs, Newcastle, Australia, 6The Sydney Partnership for Health, Education, Research & Enterprise (SPHERE), Sydney, Australia

Background: Patients are at greater risk of having recurrent cardiovascular events within 5 years after transient ischaemic attack (TIA). Despite the evidence that participation in a secondary stroke prevention program significantly reduces recurrent stroke risk, no such programs were available to NSW Health TIA patients. The Hunter New England Local Health District’s (HNELHD) Community Stroke Team sought to address this service gap.

Method: The Supporting Lifestyle and Activity Modification after TIA (SLAM-TIA) pilot program was developed utilising existing HNELHD resources and telehealth services. It was delivered in a community gym and supported patient self-management of stroke risk reduction through group education and exercise. Evaluation of this pilot program informed the non-randomised controlled trial currently underway, Service change +SLAM-TIA (S+SLAM-TIA). S+SLAM-TIA will determine the effect at a patient and service level of implementation of the SLAM-TIA program. The aim is to detect a 0.5SD difference (Cohen’s d=0.5) between groups in the co-primary outcomes of time in moderately-vigorous physical activity (MVPA) (accelerometry) and systolic blood pressure (SBP) (i.e. 15.5 min in MVPA & 9 mmHg in SBP) (80% power, adjusted p-value of 0.025, n= 86 patients/group). Semi-structured interviews will determine (i) patient experience (ii) barriers and enablers to participation in exercise and in service implementation, and (iii) ways to build and maintain referral partnerships. Health utilisation costs will be calculated using NSW Health Activity Based Funding Portal and a tailored Client Services Receipt Inventory.

Results: The pilot program (24 patients) resulted in a significant reduction in SBP (14.6 ± 10.2 mmHg, p<0.001); increased participation in exercise beyond the program; and high patient satisfaction. Data collection for the S+SLAM-TIA trial is ongoing.

Discussion: Piloting and subsequent evaluation of a new program informed a clinical trial which will measure the value at a patient and service level of implementation of an evidence based secondary stroke prevention program.


Biography: To be confirmed

Comparative analysis and lessons learned from ten consulting reviews of Allied Health services across Australasia

Ms Janice Mueller1, Dr Rosalie Boyce2, Mr Ian Rowe1

1Waipiata Consulting Ltd, Coromandel Town, New Zealand, 2Rosalie Boyce Consulting Pty Ltd, Brisbane, Australia

Consultancy-led external reviews of allied health typically result in a re-alignment of services, organisation, staffing and strategy.  In this presentation, the results of ten large scale external reviews conducted by the authors are examined for themes and lessons with a view to informing the way allied health services conduct their business across clinical operations, practice development, research infrastructure, staffing, training and development and data systems.

The genesis of external reviews vary, however at their heart is a desire to harvest greater value from allied health. The catalyst for a review is often a realisation that a history of restructuring, or changes in service profiles in other parts of the organisation has provoked a slow erosion of the capacity of allied health to provide an adequate quantum of service. The impetus for a review is often triggered by a chorus of influential non-allied health voices directed at the Chief Executive saying: ‘it’s not good enough’; until a tipping point is reached.

Increasingly, the stimulus is the quest for embedding allied health in primary care-led models of service delivery. Whatever the trigger, there is a typically a desire to  release the human capital and service delivery value in a fiscally constrained environment, while optimising service delivery and evaluating leadership and professional governance models.

While each review is unique, a mixed methods approach is always used. Critical to this process is listening to and respecting the voice of the allied health practitioners themselves and other shareholders. Each review provides an opportunity for their voice, to be central in informing recommendations.

Six principles have been developed to guide the critical analysis of the service(s), and any subsequent recommendations. Common challenges that each allied health review has identified will be discussed; key vulnerabilities in all organisations will be identified as they impact on allied health structures, governance; service provision and practitioners themselves. Finally, some advice will be provided to optimise learning opportunities for each organisation from such a review.


Biography:

Janice is a Director of Waipiata Consulting Ltd, a specialist health consultancy business providing health management consultancy services. She has extensive experience in governance, leading change management, strategic planning, service reviews, workforce development and professional regulation.

Janice is the current Chair of the Physiotherapy Board of New Zealand and has been a board member since 2010. She is a Life Member of Physiotherapy New Zealand and was awarded the ‘International Allied Health Award for Development’ for an outstanding contribution to advancing allied health leadership’ in 2018 by the network of International Chief Health Professions Officers (ICHPO). She is also a member of the InterRAI Governance Board (NZ), chairs the INPTRA Membership Committee and is a member of the HWNZ Allied Health Workforce Advisory Group.

Experiences mapping allied health clinical terminology to SNOMED CT-AU

Alicia Chaplain1, Catherine Stephens2, Donna Truran3, Kylynn Loi4

1Allied Health Professions’ Office of Queensland, Department of Health, Herston, Australia, 2Allied Health Professions’ Office of Queensland, Department of Health, Herston, Australia, 3Australian eHealth Research Centre, CSIRO, Sydney, Australia, 4Australian eHealth Research Centre, CSIRO, Herston, Australia

Background: Health services are undergoing dramatic changes in the way that information is collected, stored and reported upon with the introduction of electronic medical records (EMRs). There is now an increasing need to represent clinical information in a format that computers can read, transfer and share. The use of clinical terminologies and reporting of such data have become increasingly important for allied health clinical services.

Queensland Health has done extensive work to create clinical code sets for the public sector to align with the Allied Health National Best Practice Data Set clinical items – Assessment type and measure, clinical findings, interventions and indicator for allied health intervention.

Method: Queensland Health allied health clinical code sets were reviewed by the Australian eHealth Research Centre (CSIRO) and mapped to the Systematised Nomenclature of Medicine – Clinical Terms Australia (SNOMED CT-AU) using a source data method. Terms identified by: Audiology, Exercise Physiology, Occupational Therapy, Nutrition and Dietetics, Physiotherapy, Podiatry, Psychology, Speech Pathology and Social Work, were included in scope for this project.

Results: The mapping process identified duplicate terms and gaps between professions code sets, resulting in the development of four subsets for Allied Health with no profession specific partitions. These sets contained approximately 4000 terms and an expanded set of these terms will soon be available as the Allied Health Clinical Reference Set, in SNOMED CT-AU.

Discussion: The Allied Health Clinical Reference Set represents a starting point for terminology implementations in EMRs used by allied health in the public sector. Use of SNOMED CT-AU will ensure the accuracy and interoperability of allied health data collection so the value of allied health can be appropriately measured. This terminology content will be deployed in a service event form in Cerner integrated electronic medical record in Queensland.


Biography:

Alicia Chaplain is a Senior Workforce Officer for the Allied Health Professions’ Office of Queensland. She is a registered occupational therapist and has worked in a clinical capacity for over 10 years in Australia and the United Kingdom.  She developed an interest in eHealth and standards through her work in the United Kingdom, in the development of clinical information systems for community occupational therapists. She has since worked across eHealth standards and Health ICT project delivery in Queensland.

Alicia has a keen interest in data and information management for allied health, and in her current role is progressing work to ensure the value of allied health services are demonstrated for the benefit of patients and clinicians. Her most recent project mapping allied health terminology to SNOMED CT-AU was completed last year and enables allied health information to be at the forefront of digital transformation in Australia.

Alicia Chaplain is a Senior Workforce Officer for the Allied Health Professions’ Office of Queensland. She is a registered occupational therapist and has worked in a clinical capacity for over 10 years in Australia and the United Kingdom.  She developed an interest in eHealth and standards through her work in the United Kingdom, in the development of clinical information systems for community occupational therapists. She has since worked across eHealth standards and Health ICT project delivery in Queensland.

Alicia has a keen interest in data and information management for allied health, and in her current role is progressing work to ensure the value of allied health services are demonstrated for the benefit of patients and clinicians. Her most recent project mapping allied health terminology to SNOMED CT-AU was completed last year and enables allied health information to be at the forefront of digital transformation in Australia.

Dedicating resources to allied health digital informatics – an exercise in value optimisation

Mr Ryan Mcvey1

1Queensland Health – Darling Downs, Toowoomba, Australia

BACKGROUND

Within the public health system, allied health services are consistently required to demonstrate value whilst identifying and optimising additional efficiencies. Timely access to accurate and relevant data necessary to achieve this is often challenging, particularly where resourcing is variable.

METHODS

An allied health data and informatics position was established with appointment conditional on qualification in a relevant allied health profession. Key role objectives focussed on improving reporting, increasing performance, assisting managers to create local service changes and implementing a cohesive approach to allied health data utilisation.

Results were assessed 18 months after implementation using:

1) Changes in divisional performance indicators, and

2) A survey of users (managers and clinicians) accessing reporting solutions.

RESULTS

The overall results suggest that dedicated informatics resources improve allied health performance metrics and facilitate effective manager performance.

Through the development of a suite of simple reporting solutions as well as targeted education activities, managers and senior clinicians reported:

  • Improved confidence in independently accessing, interpreting and using the required data, including successfully advocating for additional staffing;
  • Improved visibility of allied health services provided across 29 facilities, covering more than 90,000km2.

Additionally, an increase in clinical events and improved patient access times (>50% improvement) were observed. Local and statewide networks were developed for collaboration and resource development, resulting in the creation of similar roles in other health services.

Four key enablers for success were identified:

  • Executive support
  • Incumbent possesses detailed knowledge of allied health models and context
  • Timely access to relevant and accurate data
  • Focus on improving data literacy

IMPACT

Allied Health services typically capture large volumes of data. Until staff have both timely access to the required data and the skills to accurately interrogate that data, the full potential of the data sets stored will not be realised. This project provides important lessons for allied health services that aspire to understand and utilise available data.


Biography:

With a background as a physiotherapist in both Australia and the UK, Ryan McVey has a detailed understanding of allied health service delivery models. He uses this knowledge to create informative and engaging reporting solutions that assist managers to understand their services and demonstrate the value that allied health services adds to an organisation. As the Allied Health Workforce Development Officer – Data and Informatics within Darling Downs Health he is responsible for driving the digital agenda for allied health.

A guide for quality assessment of instrumental gait analysis data

Ms Stella Kravtsov1, Dr Ettie Ben-Shabat2, Dr  Corey  Joseph1, Dr Anna  Murphy1

1Monash Health,  2Alfred Health,

Background: Instrumental gait analyses (GA) are used both clinically and in research. They provide valuable objective quantitative measurements of spatiotemporal, kinematic and kinetic gait parameters. When conducting systematic reviews researchers are required to assess the quality of study designs and methodology. Criteria are recommended for assessing different types of study designs such as intervention-controlled, pre-post intervention and observation type studies. To the best of our knowledge, no such criteria are recommended for assessing the quality of data reported from studies of instrumental GA.

Method: Based on a literature review and discussion panel we developed a list of 10 criteria for assessing the quality of data reported from instrumental GA. These criteria were then used in a systematic review designed to examine the instrumental GA parameters used for studying participants with lower limb spasticity.

Results: Thirty-seven papers were included in the systematic review. Thirty-four full research papers, of which 4 reported on 0-3/10 criteria, 26 on 3-5/10, and 4 on 6-7/10.

Criteria most commonly reported:

  1. Gait speed tested 91%
  2. If the GA system is 2D/3D 88%
  3. Make and version of GA system (brand, number of cameras, capture rate) 85%
  4. Biomechanical model used (evidence based) 77%
  5. Marker placement procedure (assess validity) 65%

Criteria infrequently reported:

  1. Anthropometric measurements procedure 15%
  2. University / hospital-based systems (establish likely rigour of system testing) 14%

Criteria never reported:

  1. Average systematic error of the GA system (accuracy)
  2. Reliability of the GA system (consistent performance)
  3. Reliability and repeatability of the person applying the markers

Discussion: It is difficult to evaluate the quality of data reported in instrumental GA studies due to lack of standard reporting criteria. We developed and tested 10 standard reporting criteria that can be used when assessing the quality of instrumental GA data.


Biography: To be confirmed

Lack of systematic approach to assessing adult lower limb spasticity: A systematic review

Ms Stella Kravtsov1, Dr Ettie Ben-Shabat2, Dr  Corey  Joseph1, Dr Anna  Murphy1

1Monash Health, 2Alfred Health,

Background: Spasticity may adversely affect function and may be treated with Botulinum Toxin A (BoNT-A) injections, which are muscle specific and costly. The efficacy of BoNT-A injections depends on the accuracy of the assessment. Spastic muscles are selected based on differential resistance to rapid and slow muscle lengthening, and its manifestation in function. Such assessment is often conducted prior to instrumental gait analyses. We examined the clinical assessment of adults’ lower leg spasticity, in studies of instrumental gait analysis.

Method: Searches were conducted to identify studies where adult participants with lower limb spasticity were assessed with instrumental gait analyses. Databases: Medline, EMBASE, CINAHL, AMED, Cochrane and PEDro. Data was examined for the spasticity assessment tools used, and the muscles tested.

Results:

Thirty-seven studies were included. Spasticity was assessed with the:

  • Modified Ashworth Scale n=32
  • Modified Tardieu Scale n=5
  • Duncan-Ely test n=3
  • Levin & Hui-Chan Spasticity Index n=1
  • Spasticity Index based on EMG n=1
  • Multiple measurements n=5

Muscle assessed were:

  1. “Ankle plantar-flexors” n=11,
  2. “Triceps Surae” n=11,
  3. Gastrocnemius n=5,
  4. Soleus n=2,
  5. Tibialis-Posterior n=1,
  6. Rectus-Femoris n=5,
  7. Quadriceps n=9,
  8. Hamstrings n=6,
  9. Unspecified muscles n=4

In most studies muscles were tested in functional groups:

  • Ankle Plantar-Flexors (muscles 1-5) n=25
  • Knee extensors (muscles 6+7) n=14
  • Knee flexors (muscle 8) n=6
  • Two or 3 muscle groups n=12

Discussion: The Modified Ashworth Scale is commonly used for assessing spasticity, despite its lack of differentiation between resistance to rapid and slow muscle lengthening. Plantar-flexors were the muscle group most frequently tested, often with no attempts to differentiate between individual muscles. Knee extensors were tested infrequently, which is surprising considering the prevalence of stiff knee gait. Against expectations, spasticity assessment in instrumental gait analysis studies is poorly reported. Spasticity assessment is best conducted comprehensively (all possible muscle groups) and systematically (muscle specific).


Biography: To be confirmed

Instrumental gait analysis parameters for assessing lower limb spasticity: A systematic review

Ms Stella Kravtsov1, Dr  Ettie Ben-Shabat2, Dr  Corey  Joseph1, Dr Anna  Murphy1

1Monash Health, 2Alfred Health, ,

Background: Upper motor neuron lesions may cause spasticity (impairment), which in turn may affect walking (function). Instrumental gait analyses (GA) provide detailed and sensitive analysis of walking. We conducted a systematic review to identify the spatiotemporal, kinematic and kinetic parameters used in instrumental GA for assessing adults with lower limb spasticity.

Method: Data bases searched: Medline, EMBASE, CINAHL, AMED, Cochrane and PEDro. Inclusion criteria: empirical studies, adult participants, reported measurements of lower limb spasticity and instrumental GA. Exclusion criteria: interventions or history of orthopaedic surgery, GA studies published before 1991 and non-English manuscripts. At least two independent investigators reviewed each paper, and rated its quality (Quality Assessment Tools-NIH: good/fair/poor).

Results: Thirty-seven studies were included: 17 pre-post intervention (71% fair quality), 15 observational (73% fair), 4 controlled intervention (75% good) and 1 case study (poor). Total participants n=766 (489 stroke, 102 HSP,65 TBI, 46 SCI, 64 other). Spasticity was mainly assessed with the Modified Ashworth Scale n=32. In 8 studies direct correlation between spasticity and instrumental GA data was examined (significant correlation marked*).

  • Main spatiotemporal parameters:
  • Gait velocity n=30*, Cadence n=15*
  • Step stride/length n=15*, Step width n=7*
  • Duration of: Stance n=16, Swing n=7, Double leg support n=6*
  • Main kinematic parameters:
  • Amplitude/total ROM/Excursion n=10 (multiple parts of gait cycle-ankle n=7 cycle, hip n=6, knee n=11, pelvis n=3)
  • Peak angle n=16 (ankle n=16, knee n=10, hip n=9)
  • Angle at heel-strike/toe-off/midstance n=8:
  • Angular velocity n=8 (ankle n=3, knee n=4, hip n=2)
  • Main kinetic parameters:
  • Parameters were multiple and variable, most common being: Peak moment n=4 and peak power n=3.
  • EMG data supplemented instrumental GA data in 12 studies.

 

Discussion: Spatiotemporal and kinematic parameters were most comprehensively studied with instrumental GA. The parameters sensitive to spasticity were: gait velocity, cadence, step/stride length, step width and duration of double leg support. These findings confirm that spasticity does affect function.


Biography: To be confirmed

12

NAHC Conferences

2007, Hobart (7th NAHC)

2009, Canberra (8th NAHC)

2012, Canberra (9th NAHC)

2013, Brisbane (10th NAHC)

2015, Melbourne (11th NAHC)

2017, Sydney (12th NAHC)

2019, Brisbane (13th NAHC)

Conference Managers

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