Tagged / ORI

Article published in Physiological Reports

 

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+).

The research is part of Francesco Ferraro PhD journey. Journey guided with the supervision of Professor Alison McConnell, Dr James Gavin and Tom Wainwright

The article is now fully available as open access here

https://doi.org/10.14814/phy2.14076

Abstract

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.

Young Life Scientists’ symposium: Frontiers in Musculoskeletal Health, Ageing and Disease

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.

Thank you for reading.
Francesco.

 

Masterclass: An innovative approach to setting up a Research Hub

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.

Find out more about these and book a place at the following link:
Leading Innovation – Masterclasses

Lifelong health and wellbeing: improving orthopaedic practice and patient care

ORI-3

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.”

Wainwright, T.W., Immins, T. and Middleton, R.G., (2015) A cycling and education programme to promote self-management and to increase functional ability in patients with osteoarthritis of the hip. Osteoarthritis and Cartilage, 23 (2), 372.

Howie, D.W., Holubowycz, O.T., Middleton,R. and Grp, L.A.S., (2012) Large Femoral Heads Decrease the Incidence of Dislocation After Total Hip Arthroplasty A Randomized Controlled Trial. Journal of Bone and Joint Surgery – American Volume, 94A (12), 1095- 1102.

Wainwright, T. and Middleton, R., (2010) An orthopaedic enhanced recovery pathway. Current Anaesthesia and Critical Care, 21 (3), 114-120.

ORI was established at BU thanks to generous funding from the Dorset Local Enterprise Partnership (LEP).

This article appeared in the 2016 Bournemouth Research Chronicle. Download a copy of the magazine, or view the articles online.