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Cheltenham, Australia

Davis A.,Kingston Center | Murphy A.,Kingston Center | Haines T.P.,Allied Health Clinical Research Unit | Haines T.P.,Monash University
Journal of the American Podiatric Medical Association | Year: 2013

Background: Footwear selection is important among older adults. Little is known about factors that influence footwear selection among older women. If older women are to wear better footwear that reduces their risk of falls and foot abnormalities, then a better understanding of the factors underlying footwear choice is needed. This study aims to identify factors that drive footwear selection and use among older community-dwelling women with no history of falls. Methods: A cross-sectional survey using a structured, open-ended questionnaire was conducted by telephone interview. The participants were 24 women, 60 to 80 years old, with no history of falls or requirement for gait aids. The responses to open-ended questions were coded and quantified under a qualitative description paradigm. Results: The main themes identified about footwear selection were aesthetics and comfort. Aesthetics was by far the main factor influencing footwear choice. Wearing safe footwear was not identified as a consideration when purchasing footwear. Conclusions: This study indicates that older women are driven primarily by aesthetics and comfort in their footwear selection. These footwear drivers have implications for health-care providers when delivering fall and foot health education. Source

Haines T.P.,Monash University | Haines T.P.,Allied Health Clinical Research Unit | Hill A.-M.,University of Queensland | Hill A.-M.,The University of Notre Dame Australia
Journal of Clinical Epidemiology | Year: 2011

Objective: This study seeks to examine whether existing study-level data meta-analysis approaches can be used to produce unbiased and precise effect estimates relative to meta-analyses conducted using patient-level data, where a recurrent event is the outcome of interest. Study Design and Setting: Data from two studies focusing on the prevention of falls in the hospital setting (N = 1,838 total) was divided into the three hospital sites from which data were collected. Outcome data were considered as recurrent event survival data, single event survival data, count data, rate data, and binary data. A range of analysis approaches were considered. Results: Andersen-Gill, negative binomial, bootstrap resampling, and modified relative risk analysis approaches produced congruous point estimates of effect, whereas modified relative risk analysis produced considerably smaller standard errors. Pooled effect point estimates derived from these approaches were not consistent when using study-level data as opposed to patient-level data, and 95% confidence intervals were excessively wide when between-study heterogeneity was present. Conclusion: Conducting meta-analysis using patient-level data (if possible) or presenting results from individual trials without pooling of effect estimates may be preferable to presenting pooled effect estimates from meta-analysis of study-level data, where the outcome is a recurrent event. © 2011 Elsevier Inc. All rights reserved. Source

Haines T.P.,Allied Health Clinical Research Unit | Haines T.P.,Monash University | Kuys S.,University of Queensland | Clarke J.,St Andrews War Memorial Hospital | And 2 more authors.
Journal of Evaluation in Clinical Practice | Year: 2011

Rationale, aims and objectives Inpatient rehabilitation of patients following stroke can be resource intensive, with optimal models of service delivery unclear. This study investigates the dose-response curves between physiotherapy service delivery variables and balance and function clinical outcomes. Method This was a multi-centre (15 sites), prospective, cohort study involving patients (n = 288) admitted for rehabilitation following stroke conducted across two states in Australia. Physiotherapy department resource provision variables were collected and examined for association with change in patient function and balance outcomes (Functional Independence Measure, step test, functional reach test) measured at admission and discharge from inpatient care. Results A greater amount of log-transformed physiotherapy department resource provision was associated with greater improvement in the functional independence measure [Regression coefficient (95% CI): 4.05 (1.15, 6.95)] and functional reach test [46.43 (17.03, 75.84)], while physiotherapist time provided to patients was associated with greater improvement for the step test [0.15 (0.03, 0.28)], and functional reach [0.35 (0.19, 0.52)]. Conclusion Receiving a higher rate of physiotherapist input is an important factor in attaining a greater amount of recovery in function and balance outcomes; however, the improvement by patients who received the greatest amount of input was highly variable. © 2010 Blackwell Publishing Ltd. Source

James A.M.,Cardinia Casey Community Health Service | Williams C.M.,Cardinia Casey Community Health Service | Haines T.P.,Allied Health Clinical Research Unit | Haines T.P.,Monash University
Journal of Foot and Ankle Research | Year: 2010

Background: Posterior Heel pain can present in children of 8 to 14 years, associated with or clinically diagnosed as Sever's disease, or calcaneal apophysitis. Presently, there are no comparative randomised studies evaluating treatment options for posterior heel pain in children with the clinical diagnosis of calcaneal apophysitis or Sever's disease. This study seeks to compare the clinical efficacy of some currently employed treatment options for the relief of disability and pain associated with posterior heel pain in children.Method: Design: Factorial 2 × 2 randomised controlled trial with monthly follow-up for 3 months.Participants: Children with clinically diagnosed posterior heel pain possibly associated with calcaneal apophysitis/Sever's disease (n = 124).Interventions: Treatment factor 1 will be two types of shoe orthoses: a heel raise or prefabricated orthoses. Both of these interventions are widely available, mutually exclusive treatment approaches that are relatively low in cost. Treatment factor 2 will be a footwear prescription/replacement intervention involving a shoe with a firm heel counter, dual density EVA midsole and rear foot control. The alternate condition in this factor is no footwear prescription/replacement, with the participant wearing their current footwear.Outcomes: Oxford Foot and Ankle Questionnaire and the Faces pain scale.Discussion: This will be a randomised trial to compare the efficacy of various treatment options for posterior heel pain in children that may be associated with calcaneal apophysitis also known as Sever's disease.Trial Registration: Trial Number: ACTRN12609000696291. Ethics Approval Southern Health: HREC Ref: 09271B. © 2010 James et al; licensee BioMed Central Ltd. Source

Haines T.P.,Monash University | Haines T.P.,Allied Health Clinical Research Unit | Bell R.A.R.,Patient Safety Center | Varghese P.N.,Patient Safety Center | Varghese P.N.,Geriatric Assessment and Rehabilitation Unit
Journal of the American Geriatrics Society | Year: 2010

OBJECTIVES: To evaluate the efficacy of a policy to introduce low-low beds for the prevention of falls and fall injuries on wards that had not previously accessed low-low beds. DESIGN: This was a pragmatic, matched, cluster randomized trial with wards paired according to rate of falls. Intervention and control wards were observed for a 6-month period after implementation of the low-low beds on the intervention wards. Data from a 6-month period before this were also collected and included in analyses to ensure comparability between intervention and control group wards. SETTING: Public hospitals located in Queensland, Australia. PARTICIPANTS: Patients of 18 public hospital wards. INTERVENTION: Provision of one low-low bed for every 12 on a hospital ward, with written guidance for identifying patients at greatest risk of falls. MEASUREMENTS: Falls and fall injuries in the hospital measured using a computerized incident reporting system. RESULTS: There were 10,937 admissions to control and intervention wards combined during the pre-intervention period. There was no significant difference in the rate of falls per 1,000 occupied bed days between intervention and control group wards after the introduction of the low-low beds (generalized estimating equation coefficient=0.23, 95% confidence interval=-0.18-0.65, P=.28). The rate of bed falls, falls resulting in injury, and falls resulting in fracture also did not differ between groups. Some difficulties were encountered in intervention group wards in using the low-low beds as directed. CONCLUSION: A policy for the introduction of low-low beds did not appear to reduce falls or falls with injury, although larger studies would be required to determine their effect on fall-related fractures. © 2010, Copyright the Authors. Source

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