Dr Vivienne Travlos is a Respiratory Physiotherapist at the MND Association of Western Australia and Principal Physio at Breathe Physio. She has a PhD, MSc of (Management of hildhood Disability) a GradCert in university teaching. This episode is all you want to know about neuro respiratory. We chat neuromuscular disorders, respiratory pathophysiology and disease, night respiration, airway clearance, assessment and measurement, intervention according to severity. Also heard answers to listeners questions - evidence base, physio role across the complex disability continuum of care.

2.03 Welcome & Career Pathway

8.59 PhD – Adolescents with NMD physical health & mental wellbeing

12.59 What are neuromuscular disorders? What resp issues occur?

18.25 Night respiration issues

21.49 NIV

26.15 Lung volume recruitment

31.00 Airway clearance

39.46 EBP in neuro respiratory

43.19 Key outcome measures

49.22 Lung tissue integrity

52.49 Future proofing

1.00.44 Reflection

Links & Resources

Email: [email protected]

Physiotherapists: A vital part of MND multi-disciplinary care

Viviennes' LinkedIn

Vivienne's phd papers/ research gate

Neuro Respiratory Physiotherapy Academy (Jac Agostinello)

MND Western Australia

MND Victoria

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A/Prof Simone Dorsch is a lecturer in neurological physiotherapy at Australian Catholic University in Sydney and a Director at the StrokEd collaboration. Simone holds a Masters of Health Science (Neurological Physiotherapy) and a PhD in increasing strength after stroke from University of Sydney. We spend time talking about strength training after stroke, dose and intensity of practice, courses offered by Stroke Ed including the Upper Limb Stroke Rehab Massive Online Open Course (MOOC) that ran for the first time in June 2024.

There’s chats about empowerment in rehab, the family role, personalising practise and what interventions we should and shouldn’t be using.

0 Intro
23.00 Current roles & career
45.00 MOOC UL stroke rehab
14.45 Stroke Ed courses
17.50 Coaching
21.10 How much to ‘talk’ as a physio
24.20 Empowerment & engagement
29.05 Strength training
32.45 Clinical reasoning framework of TST
35.10 What interventions we should be doing
38.30 Teaching how to practice - how not to scare people off
41.30 Hands-on approaches
44.30 Personalising practise
53.20 Family empowerment
57.10 Definition of Bobath in studies

Links

Simone’s ACU profile 

Simone’s X 

Simone’s phd papers/ research gate

LinkedIn 

Stroke Ed website

Caitlin reed episode link 

Other StrokeEd presenters episodes:

Dr Annie McCluskey 

Dr Kate Scrivener

Resources

Articles discussed in episode:

Xu Wen Eng 2014 Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

Bobath Systematic reviews: 

https://www.sciencedirect.com/science/article/pii/S183695532030103X'

https://www.sciencedirect.com/science/article/pii/S1836955322001151

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We are chatting with James McQuillan one of the Australian Steelers – the Aussie wheelchair rugby team. Not just that but an Australian Steeler who has had an incredible journey from recreational sportsman to national representative in just over 11 months. In this episode James shares his story, the injury that led him to having a SCI, how he came to be part of the Steelers, and all about Wheelchair Rugby as a sport. He also tells us about being an elite sportsman, his SCI rehab journey, nerve & tendon transfer surgeries to get more function in his upper limbs and some tips for working with people with SCI. Enjoy!

2.00 Intro

2.34 sec Bio

6.44 Wheelchair Rugby

11.48 Classification

13.05 Getting into para sport

17.53 Equipment required

17.54 Fitness for elite wheelchair rugby & SCI

21.46 Role in Aussie Steelers 

25.55 Nerve transfer & Tendon transfer surgeries

30.31 Rehab – knowledge, motivation, prioritising

36.12 What rehab clinicians did well 

45.12 Reflection

Resources

Forged In Steel - Australian Steelers documentary

Paralympics media release 

SCI PT guidelines sciptguide.com

Paralympics websites
https://www.9now.com.au/paralympic-games-paris-2024
https://www.paralympic.org.au/
https://olympics.com/en/paris-2024/paralympic-games

Austin Health Nerve  & tendon transfer team

Links

Instagram @jamesmcquillan5

James' LinkedIn

ANZ Smashing through barriers

Paris 2024 Profile

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Dr Jess Nolan recently completed her PhD on Lateropulsion. Jess is a physio from Perth, Australia. Her credentials include BSc (Physio) - Curtin Uni, Grad Dip (Neuro Rehab) – UWA, member of ANZSO Emerging Stroke Clinician Scientist Committee, and Physio Working Party for the Stroke Foundation Living Guidelines. Jess worked as a senior physio, a physio coordinator of stroke services and is now at Curtin University in a teaching & research role.  This episode is all about Jess’ PhD journey and results. Lots of lateropulsion clinical application in this one. 

2.00 sec Intro

2.28 Career pathway/Interest in Lateropulsion

8.45 What is lateropulsion? Can it be mild?

13.20 Prevalence

14.05 Outcome Measures

18.29 Verticality

22.38 Assessing SVV – bucket method

23.00 PhD results - LOS needs, ANSNAP LOS predication accuracy, 1 year outcomes

37.10 Unknown pathophysiology of lateropulsion

40.20 Other components of lateropulsion – SPV – graviception, vestib impairment

43.35 Treatment

49.22 Fear of falling

50.45 Education

53.01 Treatment 2.0

56.28 What’s next for this work

1.04.17 Erin & Matt's reflection

Articles discussed in episode:

Lateropulsion prevalence: Dai 2022 systematic review 

Assessment of verticality: Piscicelli  & Pérennou 2017 

Lesion location: Van Der Waal 2023 systematic review

Thalamic involvement: Rosenzopf 2023   

Treatment approaches: Paci 2023 scoping review 

Lateropulsion outcome measures: Koter 2017

4 Point Pusher Score validation: Chow 2019   

Lateropulsion & falls (inpatient): Lewis, Heinemann...Nolan 2024

Links

Jessica's Linkedin

Twitter @jessnolan__

Check out the episode webpage for Jess' PhD papers

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This episode is all about codesign. Dr Emily Ramage is a neuro physio & expert in an approach to codesign called Integrated Knowledge Translation. She’s used the methodology through her PhD (codesign of a PA intervention aimed at reducing secondary stroke risk) & in other projects which she speaks about in the episode. Emily's PhD work was piloted as part of the ENAbLE pilot trial involving physical activity AND diet intervention, we heard about it in our episode with Coralie English (season 1 Website    Apple podcasts)

Emily’s recently been an Allied Health Research Translation lead in Victoria & an Implementation Research Associate for the international AVERT program at the Florey in Melbourne. She’s affiliated with the University of Newcastle, the University of Melbourne & is a member of the Emerging Leader’s Group for the International Stroke Recovery and Rehabilitation Alliance.

1.47 Introduction

2.05 Career pathway

6.55 Doing a PhD as a mum

11.45 When a PhD is advertised by a researcher team

19.10 End-user collaboration in research

20.20 Emily’s PhD – codesign of PA for secondary stroke risk

25.32 What does codesign mean?

36.00 Power differentials in codesign

39.51 Running IKT workshops – communication; knowledge & language diversity

45.02 Will codesign become a check box?

48.00 World Stroke Organisation Future Leader Program

Articles/Resources discussed in episode:

Fit for purpose. Co-production of complex behavioural interventions. A practical guide and exemplar of co-producing a telehealth-delivered exercise intervention for people with stroke

Secondary prevention of stroke. A telehealth-delivered physical activity and diet pilot randomized trial (ENAbLE-pilot)

iREBOUND 

ISRRR – International Stroke Recovery and Rehabilitation Alliance

Stroke Foundation module – Working effectively with people with lived experience to design, conduct and promote stroke research

Links

Link in Marlena Klaic’s ep Victorian AH Research Translation Lead:  Website    Apple podcasts

Link to Prof Coralie English’s ep: Website    Apple podcasts

Emily’s LinkedIn 

World Stroke Bio 

Twitter @emilyrramage

Email – [email protected]

Episode webpage: http://aneurophysio.com/emily-ramage

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Dr Julie Vaughan-Graham is an IBITA Basic and Advanced Tutor, holds a Masters degree in neuro rehabilitation and a PhD investigating the clinical reasoning process of expert Bobath physiotherapists. She owns her own clinical practice in Toronto, and developed the online iNeuroRehab training courses. Julie also holds a post-doctoral fellowship and adjunct lecturer position with the Department of Physical Therapy, University of Toronto. 

This episode focuses on The Bobath Concept, clinical reasoning and the Model of Bobath Clinical practice which Julie co-developed. It picks up from our previous Bobath episodes with Janet Stevens (season 1) and Dr Kim Jennings (season 2), going deeper, and addressing some of the criticisms of the Bobath concept.

2.00     Introduction

2.41 Career pathway 

16.20 PhD findings – 

How Bobath instructors problem solve & clinically reason

22.00 Model of Bobath Clinical Practice 

26.48 Bobath and the RCT 

28.45 Applying the Bobath concept – Hemiplegic UL example

36.47 Using sensory cues in Bobath

43.38 Using the Bobath Concept is a skill to develop 

47.25 Neuroscience & Bobath

53.50 Movement diagnosis & hypotheses

57.53 Discrete interventions vs Bobath Concept (a framework of intervention)

Papers and References

IBITA Model of Bobath Clinical Practice

Julie's ResearchGate

Professional & Scholarly activities

Links

Julie’s private practice in Toronto, Canada

iNeuroRehab

Julie's LinkedIn

Candanian Bobath Instructors Association profile

Janet Steven’s episode Webpage    Apple podcasts

Dr Kim Jennings episode Webpage     Apple podcasts

Episode webpage: https://aneurophysio.com/julie-vaughan-graham/

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This month we are chatting with Dr. Sarah Milne from Murdoch Children’s Research Institute who is also the Coordinator of the Friedreich's Ataxia Clinic at Monash Health in Melbourne, Australia. Sarah is an expert in hereditary cerebellar ataxias and after completing her PhD in 2018 she is trying to bolster the evidence base about the right rehab for people with Friedreich’s Ataxia. 

This episode will appeal to people treating Friedreich’s Ataxia or any of the inherited cerebellar ataxias, and to anyone who sees people with cerebellar pathology. Also of interest are the chats about challenges of rehabilitation research. The audio quality in this episode isn’t up to our usual standard with a lot of static happening – sorry!

2.01 Intro & career pathway

4.38 Friedreich’s ataxia

7.00 How is Friedreich’s ataxia different to the hereditary cerebellar ataxias?

8.36 Phenotypes in neurological conditions and the RCT paradigm

11.20 PhD results   

15.02 State of the Friedreich’s ataxia evidence

16.49 Ataxia outcome measures 

20.03 Ataxia assessment

24.25 Compensation vs optimal cerebellar functioning

27.00 What can imaging tell us about cerebellar conditions?

29.55 Treatment 

36.16 Efficacy vs Effectiveness, challenges of rehab trials 

39.23 Aquatic physio for this population

41.43 Episode reflection

Links
Research Gate
PhD - 4 studies – Pilot rehabilitation trial for people with Friedreich’s Ataxia. Clinical audit of LL spasticity relationship with ataxia severity & function. Sensitivity of balance, gait measures and instrumented measures of gait & balance change over time.

LinkedIn

University of Melbourne profile

Articles discussed:
Brain Changes Associated with Postural Training in Patients with Cerebellar Degeneration

Home aerobic training for cerebellar degenerative diseases: a randomized controlled trial

Cycling regimen induces spinal circuitry plasticity and improves leg muscle coordination in individuals with spinocerebellar ataxia

Predictors of loss of ambulation in Friedreich's ataxia

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publis

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Dr. Kate Scrivener is a Senior Lecturer of Physiotherapy at Macquarie University, Sydney, Australia where she’s an educator and researcher. She’s also an educator with the Stroke Ed collaboration and that energy for education & innovation has seen her develop the REPS app and website - a set of exercise programs designed to help stroke survivors exercise at home, and the TRAIN program - a clinician’s guide to effective task specific training. Until recently she also worked clinically at Concentric Rehab in Sydney. She’s the lead investigator on the HiWalk trial and is involved in a number of other projects we didn’t get to talk about in the episode.

Kate’s episode zeros in on a number of her passion areas:
-  Education - making neuro easier to understand for students and implementing evidence into practice for practicing physios. 
-  Improving mobility, especially in the chronic phase in the community
-  Increasing dose of therapy

All this culminates in her HiWalk trial which has just finished recruitment.

There’s plenty to take away from this episode.

2.02 Intro – Work roles & life balance, neuro career

7.17 Teaching Neuro

10.21 TRAIN modules

11.42 Career pathway

15.19 Stroke Ed courses – practical ways to apply stroke guidelines

19.44 Australian NSF guidelines – to what setting do they apply? 

20.44 Interest in rehab in community sector 

23.48 HiWalk project

28.19  Intervention research pipeline - basing research trials on intervention feasibility 

31.47 Interest in walking after stroke, PhD

35.48 We need clinical researchers

36.34 Do you need a PhD to be a clinician researcher? 

41.22 HiWalk intervention package

43.10 Are reps the best way to quantify dose?

52.10 Kate’s favourite ways to increase dose of therapy

55.36 Post episode reflection

Links

Macquarie Uni profile 

Linked In profile

ResearchGate 

REPS app – download on Android or link TASK program website 

TRAIN program – A clinician’s guide to effective task specific training 

Articles discussed in the episode

Stroke survivors have fallen into a ‘black hole’ editorial

Schneider 2016 systematic review – amount of additional usual therapy  to improve activity after stroke 

Kate’s PhD articles – Exercise dose and mobility outcomes post stroke see Kate's ResearchGate

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Barby Singer is a Professor in the School of Medical & Health Science at Edith Cowan University in Perth, Western Australia. She is an APA Neurological Physiotherapist, a Fellow of the Australian College of Physiotherapists by Original Contribution in 2011 and has more than 40 years of clinical and academic experience in neurological rehabilitation. Barby has been a key leader in Australia for post-graduate neurological education both at the tertiary level and at the Australian Physiotherapy Association. She has held various roles in the Australian College of Physiotherapists and her passion for positive changes has led to a number of changes in the examination process for Fellowship by Specialisation and the new career pathway framework. In 2021 she was bestowed with the APA’s elite Honoured Member status.

Barby holds a PhD in hypertonicity management, a Post Graduate Diploma in Health Sciences (Neurosciences), a Master of Science and a Diploma Physio which she completed way back in 1980 in Auckland, NZ.

Barby’s research interests include management of spasticity for people with acquired brain injury, self management support for people with long term neuro conditions, measuring outcomes in neuro rehab and interventions to improve recovery of arm function after acquired brain injury. 

There is a ton to unpack with Barby but this episode focuses on here thoughts on clinical education both for clinician learning and for patient management, the APA career pathway framework, hypertonicity, and serial casting. We also talk about Advanced practice and physio specialisation in countries and whether pay is sufficient for these highly trained physios. So lots to check out, we hope you enjoy it.

2.02 Intro

3.23 Barby’s varied career

4.40 Physios need to be educators

8.47 APA career framework

12.11 Rural specialist 

15.29 Clinical Mentorship in the new career framework

17.47 Industry shortage

21.04 Remuneration for advanced or specialist Physios

24.47 Advanced practice opportunities in neuro

26.19 Barby’s interest in hypertonicity & PhD

31.37 Anterior knee pain botulinum toxin

34.38 Spasticity definition & measurement

38.10 Hypertonicity management - where we’ve gone wrong

43.17 Role of serial casting

52.29 Working with PhD students

58.11 Episode reflection

Links

Barby’s Edith Cowan University Profile page

Barby’s ResearchGate

Barby’s Linked In

APA career pathway framework

Papers Barby talks about in the episode:

Sutherland et al., 2022 - Do randomised controlled trials evaluating functional outcomes following botulinum neurotoxin-A align with focal spasticity guidelines? A systematic review

Williams et al., 2020 A synthesis and appraisal of clinical practice guidelines, consensus statements and Cochrane systematic reviews for the management of focal spasticity in adults and children

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Dr Kim Jennings is an Advanced Bobath tutor with over 35 years of clinical expertise. Kim became a Bobath Tutor in 2000 and an Advanced Tutor in 2012. She holds a clinical doctorate in physiotherapy at La Trobe University investigating barriers and facilitators to implementation of the Bobath concept and a Master of Public Health from Monash University. We get the lowdown about what sparked her interest in Bobath, what makes people choose to apply it or not apply it in practice, how the concept has changed over time, and where Bobath sits in evidence based practice. She also tells us all about a Clinical Doctorate and what her research found about factions in the neuro physio community.

If you'd like to listen to more of an intro to The Bobath Concept check out Season 1, Episode 9 with Janet Stevens https://aneurophysio.com/janetstevens/
https://podcasts.apple.com/au/podcast/a-neuro-physio-podcast/id1493324068?i=1000484935724

3.00 Intro

3.30 Bobath career pathway

9.03 Working with culturally diverse populations

11.19 IBITA – Tutors around the world

14.30 Who are Bobath courses for?

16.40 How Bobath has changed over time

26.00 What is a clinical doctorate?

29.50 Kim’s research - Implementation of the Bobath concept

45.24 The lack of RCT evidence for Bobath

53.50 Personalisation of rehab

55.10 The need for more research  

1:08.40 Episode reflection

Links
Australian Bobath Training Association https://www.bobathaustralia.org/

International Bobath Instructors Training Association https://ibita.org/

British Bobath Tutors Association https://www.bbta.org.uk/

The Bobath Concept has Changed - paper in Journal of Physiotherapy

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.