The paper “Comparison of balance changes after inspiratory muscle or Otago exercise training” comes from Dr Ferraro`s PhD where, under the supervision of Professor McConnell, Dr Gavin and Associate Professor Wainwright, he looked at the effects of inspiratory muscle training on balance and physical performance with older adults.
This latest paper looks at the potential benefit of inspiratory muscle training as an alternative to standard balance training intervention. The findings of this pragmatic parallel study support the hypothesis that 8 weeks of unsupervised, individual, home-based inspiratory muscle training, improves balance ability to a similar extent to supervised, group-based balance training in healthy older adults.
The article is now fully available as open access here
The article titled “The effects of 8 weeks of inspiratory muscle training on the balance of healthy older adults: a randomized, double-blind, placebo-controlled study” has been published by Physiological Reports.
It is the first research to describe the effects of inspiratory muscle training (i.e. breathing exercises that improve the strength of inspiratory muscles) on static and dynamic balance (measured with the clinical tool mini-BEST) and functional mobility (such as Timed Up and Go and 5 sit to stand tasks) with community dwellers older adults (aged 65+).
To examine the effects of 8‐week unsupervised, home‐based inspiratory muscle training (IMT) on the balance and physical performance of healthy older adults. Fifty‐nine participants (74 ± 6 years) were assigned randomly in a double‐blinded fashion to either IMT or sham‐IMT, using a pressure threshold loading device. The IMT group performed 30‐breath twice daily at ~50% of maximal inspiratory pressure (MIP). The sham‐IMT group performed 60‐breaths once daily at ~15% MIP; training was home‐based and unsupervised, with adherence self‐reported through training diaries. Respiratory outcomes were assessed pre‐ and postintervention, including forced vital capacity, forced expiratory volume, peak inspiratory flow rate (PIFR), MIP, and inspiratory peak power. Balance and physical performance outcomes were measured using the shortened version of the Balance Evaluation System test (mini‐BEST), Biodex® postural stability test, timed up and go, five sit‐to‐stand, isometric “sit‐up” and Biering–Sørensen tests. Between‐group effects were examined using two‐way repeated measures ANOVA, with Bonferroni correction. After 8‐week, the IMT group demonstrated greater improvements (P ≤ 0.05) in: PIFR (IMT = 0.9 ± 0.3 L sec−1; sham‐IMT = 0.3 L sec−1); mini‐BEST (IMT = 3.7 ± 1.3; sham‐IMT = 0.5 ± 0.9) and Biering–Sørensen (IMT = 62.9 ± 6.4 sec; sham‐IMT = 24.3 ± 1.4 sec) tests. The authors concluded that twice daily unsupervised, home‐based IMT is feasible and enhances inspiratory muscle function and balance for community‐dwelling older adults.
Therefore, in just a couple of days, thanks to the staff of the Orthopedic Research Institute who provided the location, we started shooting, and here is part of the interview:
I would like to thank Davon, Sacha and all the BU staff for this interview, it was great, and I really hope that helps to have more people involved in public engagement activities.
Following the full script of the interview.
Could you tell us a little bit of your self
My name is Francesco Ferraro, and I am a PhD Student here at Bournemouth University. Currently, I am working on a project which aims to understand the effects of inspiratory muscles training on balance and functional mobility for healthy older adults. The goal is to develop an innovative and effective training for falls prevention.
Before arriving here at BU, I obtained a Bachelor Degree in sports science from University of Rome Foro Italico while in the meantime I was working as a football coach and after I moved to Naples for complete my Master Degree in sports science prevention and wellness. There I worked on motion analysis in young adults, while in the meantime I was a trainer of the Italian Federation of Weightlifting.
Could you tell us your favourite public engagement opportunity at BU?
It is hard to tell, I have enjoyed all the events in which I took part including Pint of Science, Café Scientific, The Festival of Learning, lecturing at University of Third Age and others.I gained something from each of them, and I gave something at each of them. But if I have to pick one, and only one I would say the Festival of Learning. Among all the events FOL is the one who gives you the opportunity to meet all kind of people.
You have the opportunity to explain your research to a very young audience, as well as people with excellent knowledge in your field, while surrounded by members of the BU Staff, BU students and colleagues that are there to help you and motived you.
Why do you find public engagement a good asset to both your research and the community?
My study aims to understand the effect of inspiratory muscle training on balance and functional mobility. My final purpose is to develop a strategy to prevent falls accidents in people over 65.
Therefore it is a research for the community as any other research, especially in health and social science, is done for the people. Hence what would be the point to work for the community and do not explain to them what you are doing? As researchers we have the opportunity to share with others much more than a picture on Twitter, or Instagram, we have the opportunity to share knowledge, ideas and instead of likes, we will have more questions, more curiosity and the chance to give to the audience our ideas.
At Café Scientifique, the public was really engaging in the fact your research was trying to better the wellbeing of the older generation. Why do you think people are so engaged in your research?
At Café Scientifique I was able to give to them my idea. Instead of explaining right away what my research does I told them the idea behind it and why is important to research on it. The reason why we had a great respond must be sought in my past years of work in the public engagement.
Any research is fascinating in is way, but is crucial to share it with others, not only peers and experts but also with the people for which the research is done.
You use your public engagement to advertise the need for participants in your current research, is this an effective way of getting the participants you need?
Yes, it is. But it is not the reason why I do public engagement. I have been introduced to public engagement by my supervisors: Alison McConnell, James Gavin and Thomas Wainwright with the aim to share what learned and discuss it with others.
If you were to advice new researchers about public engagement, what would you say to them?
Do it if you want to do it.
Public engagement is not easy especially if you do it because you “have to”. Do it if you want to share your research if you want to challenge yourself, if you want to meet the community then you will make a great event. You must have the right motivation if you do it just to “hunting” participants it won’t be neither correct or fun, and people will understand, with the result that you and your research will lose trust.
What do you gain most from public engagement?
Motivation – to work more for the community, to help people to learn and understand what we are doing here at the BU and how it helps their wellbeing.
Confidence – have the opportunity to talk to 50, 100 or even 200 people at each event, has grown my confidence inside and outside the University.
Knowledge – I do believe that everyone has a story to tell and you can learn a lot from it. I am always surprised at the questions that I receive.
People curiosity drives my curiosity as well and helps me to think and re-think at my research.
What are you going to do next?
I do have a couple of projects going on, but I will take part in the next Festival of Learning (third year in a row), and I will see what other opportunities the public engagement team will give to us.
The past Saturday I was given the opportunity to present my pilot study titled “The influence of inspiratory muscle training on balance and functional mobility in healthy older adults” at the Young Life Scientists Symposium (YLS) held in Derby (see related poster).
Purpose of the pilot was to gain an understanding of the effect of 8 weeks inspiratory muscle training upon balance and functional mobility outcomes (including Five-Sit-To-Stand, Time Up and Go, Mini-Best test and others) in older adults (65 and over). The results have led to a double-blind random control trial which will be completed by the beginning of 2018.
The YLS is organised by PhD students and Post-Doc’s for other PhD students and early career researchers it aims to give the opportunity to network and discuss research matters via poster and oral communication in a positive and constructive environment.
This year symposium was focusing on three major sections: nutrition, exercises for ageing and metabolic disease in ageing. Speakers from all the UK discussed their works, and I had the chance to collect feedbacks explaining my methods and methodology.
I would like to thank Bournemouth University and my supervisors who helped me to achieve this opportunity.
I am currently doing a research placement at Bournemouth University as part of the Nuffield programme, which gives people at the end of their first year of A-levels a chance to work with professionals in science based professions.
Alongside PGR Francesco Ferraro, I have been predominantly working on his study on inspiratory muscle training and how by using a device called POWERbreathe is possible to improve inspiratory muscles strength.
I will be at Bournemouth University for four weeks where at the end I am going to write a report that will hopefully be published by the Young Scientist Journal.
My report is going to be on the Timed Up and Go test (TUG). It is going to include information about what the TUG test is, as well as how it can help us to predict falls and measure stability.
My whole aim of this placement is to gain research skills that will help me later in life as I intend to pursue a medical career.
On the 20th July, I got the chance to use two surgical simulators:
The Orthopaedic Research Institute (ORI) contains the Ossim SimK total knee replacement simulator, and the VirtaMed knee arthroscopy. This is the only lab in Europe where the two simulators are together.
Indeed, the ORI produces high-quality research which helps doctors and students to understand and learn more about many fields, including orthopaedic surgery, knee and hip replacements. With the aid of Shayan Bahadori (Orthopaedic Research project manager), I progressed from drilling holes into a piece of woods to trying a full knee replacement. Next, I got to try my hand at a knee arthroscopy which I found very challenging.
From trying these surgical simulators, I have learned that perseverance and resilience are essential. At first, I found that even just drilling holes into a piece of wood using the simulator was incredibly hard. However, as I used and practiced the simulators more, I could feel myself improving and progressing in the fundamental skills required.
This is a valuable experience to have gained as it is essential for all careers, not just medical ones.
In conclusion, continuing my placement, I hope to assist in the carrying out of respiratory muscles tests and I hope that by the end of my internship I will have a greater understanding of what it takes to conduct a research study and also how the data collected can be used and analysed.
Monday 10th April, 10.00 – 11.30 at Lansdowne Campus
In this masterclass, Tom Wainwright will share how he and Professor Middleton formed the Orthopaedic Research Institute; how they presented the concept to the board and the considerations that they believe made their pitch successful. It is hoped that delegates will be able to draw parallels from this experience that may be useful in different research contexts.
This is part of the Leading Innovation Masterclasses series.
There are three final masterclasses in May: ‘Developing Interdisciplinarity’ with Professor Barry Richards, ‘Benchmarking your students’ digital experience’ with Jisc’s Sarah Knight, and ‘The clinical doctorate model – Enabling Practitioner Research’ with Professor Vanora Hundley.
It’s British Science Week 2017 and to celebrate we’re sharing some of our science research stories, to highlight some of the fantastic research taking place here at BU. Today we’re looking at the Orthopeadic Research Institute (ORI).
Living well in older age is increasingly becoming a concern for our society. A key priority for our health services is to enable people to stay healthy and independent for as long as possible. BU’s newly established Orthopaedic Research Institute (ORI) is addressing this need by carrying out research to improve orthopaedic practices and patient care, thus supporting people to improve their activity levels and mobility as they age. Orthopaedics will become a critical issue as our population ages, as longer and more active lives will increase the risk that joints will wear out and replacements or treatments will be needed.
Deputy Head of ORI Associate Professor Tom Wainwright explains: “Knee and hip problems are going to become more prevalent, so we’re going to need better solutions to manage that; whether it’s better surgical procedures or better nonsurgical interventions. We have some very effective treatments in orthopaedics, but they’re not 100% effective, so part of our role is to work out how to make them better – improve them, through developing better surgical techniques, testing new medical techonology or developing better rehabilitation processes.”
Between them, Associate Professor Wainwright and Head of ORI Professor Rob Middleton have a wealth of clinical and research expertise. Professor Rob Middleton is a practising orthopaedic surgeon, specialising in hip replacement, while Associate Professor Wainwright is a physiotherapist and clinical researcher. They carried out research alongside their clinical practice before joining BU and have a national and international reputation for their work to date.
One of their biggest successes so far is speeding up the recovery process after hip and knee surgery, which has led to their work being cited in best practice health guidelines around the world. This approach, called Enhanced Recovery after Surgery, seeks to minimise the impact of surgery and accelerate recovery by employing strategies throughout the patient pathway, to improve outcomes and reduce the need for medical interventions. Their research into this area was a first in the UK for orthopaedics and demonstrated its value to patient care, as well as showing an improvement in patient and staff satisfaction and leading to significant cost savings to hospitals.
A more recent example of their work is a programme developed with local partners in Dorset called CHAIN – Cycling Against Hip Pain – which is designed to help people to live well with conditions such as osteoarthritis and to improve their mobility. The programme provides a combination of education and static cycling sessions,designed to improve mobility and increase people’s confidence in managing their conditions. The results have been excellent, with patients reporting improvements in walking, finding daily living tasks easier and most importantly, decreases in pain. Even the least likely candidates have seen improvements, demonstrating the value of education and exercise in improving patient care and in helping to reduce or delay the need for further medical interventions.
“As well as developing interventions to help patients recover from surgery and manage their conditions. We also work with a number of global orthopaedic companies to test and run clinical trials
on the latest orthopaedic technology,” says Associate Professor Wainwright. “We work with companies such as ZimmerBiomet, Lima Corporate, and Firstkind Ltd to ensure that their technology is delivering the best possible outcomes for patients.”
One example of their work with ZimmerBiomet was to explore ways to improve the technology used in hip replacements. The hip joint is a ball and socket joint and one of the risks of hip replacement is dislocation; where the new ball comes out of the socket. ORI’s research has shown that a larger ball reduces the risk of dislocation, and does not adversely affect the rate of wear.
“We currently have five trials underway within local hospitals and more to come,” explains Associate Professor Wainwright. “These trials are looking at different ways that we can improve the medical technology used in orthopaedics and means that not only are we contributing to improving future care, but we’re also bringing the latest technology to Dorset and improving care in the local area. As Dorset has a very high proportion of orthopaedic surgeries, there is potentially a very large group of people we can benefit.”
“We take a very interdisciplinary approach to our research. Establishing ourselves within BU is a real advantage for us, because we can draw on the expertise of colleagues in other areas of research, including other health professionals, psychologists, technologists and engineers,” explains Associate Professor Wainwright, “Ultimately, our driving force is that we wantto ensure that everyone gets the best possible treatment for their condition – it’s just the right thing to do.”