18 results found
Ward S, MacDermott EJ, Deane J, et al., 2022, Clinical characteristics of symptomatic hypermobility in children and young people: A scoping review protocol, Physiotherapy Practice and Research, Vol: 43, Pages: 63-69, ISSN: 2213-0683
INTRODUCTION: Joint hypermobility (JH) is a term used to define active or passive joint range of motion that is beyond normal range, accounting for age, sex, and ethnicity. Symptomatic hypermobility is a term that can be used when symptoms are thought to be associated with JH. Children and young people with symptomatic hypermobility complain of musculoskeletal symptoms but also may report symptoms from other domains including gastrointestinal, cardiovascular, psychological, and urogenital. Many of these symptoms are not included in formal diagnostic criteria yet may impact negatively on their quality of life. The pattern of these symptoms may change with age. PURPOSE: To map the literature on clinical characteristics of symptomatic hypermobility in an age and developmental context, to improve our understanding and assist in the clinical assessment of children and young people with symptomatic hypermobility. METHODS: This systematic scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology. Studies that include children and young people from birth to 24 years with a confirmed diagnosis of symptomatic hypermobility, HSD or hEDS using internationally recognised criteria or equivalent diagnoses will be included. Data extraction and analysis will be undertaken using an iterative process. DISCUSSION: Mapping and synthesis of the data will be carried out and gaps and limitations in the literature will be acknowledged. Results will be disseminated in a peer reviewed journal. The search strategy will be made available publicly for transparency.
Deane J, Clunie G, 2021, Healthcare professionals in research (HPiR) Facebook community: a survey of U.K. doctoral and postdoctoral healthcare professionals outside of medicine, BMC Medical Education, Vol: 21, ISSN: 1472-6920
BackgroundHealthcare professionals outside of medicine (HCPs), including nurses, midwives and allied health professionals, are increasingly involved in research for patient benefit. Their challenge is to negotiate inter-professional or professionally isolated contexts. The aims of this study were to evaluate the ‘Healthcare Professionals in Research’ (HPiR) Facebook group (a self-directed and confidential peer support group for doctoral and postdoctoral HCPs) including engagement, the experiences of doctoral and postdoctoral HPiR members and to identify future career challenges using an on-line survey.MethodsThe HPiR Facebook group was launched in May 2019. Five HCP Community managers (CMs) were trained in on-line platform curation, moderation and screening. An on-line survey was designed to capture data from HPiR members. A purposive sampling approach was applied. Respondents were required to be doctoral and postdoctoral HCPs and a registered member of the HPiR group. Respondents represented a range of healthcare professions, 79 % of whom had over ten years clinical experience. Membership growth and engagement was analysed. Descriptive statistics were used to present numerical data. Qualitative data were analysed thematically.Results96 members were admitted to the group within the first month. All members were actively engaged with group content. 34/96 doctoral and postdoctoral HCPs completed the survey. Most members joined for networking (88 %) and peer support (82 %) purposes. Analysis of text responses showed difficulties in balancing a clinical academic career and highlighted the consequences of undefined clinical academic roles and pathways.ConclusionsDoctoral and postdoctoral HCPs value the opportunities that HPiR provides for peer support and connection with fellow HCPs. HPiR has the potential to strengthen research capacity, support research skill development and drive change within the clinical academic community. Clinical
Deane JA, Lim AKP, McGregor AH, et al., 2021, Understanding the impact of lumbar disc degeneration and chronic low back pain: a cross-sectional electromyographic analysis of postural strategy during predicted and unpredicted postural perturbations, PLoS One, Vol: 16, ISSN: 1932-6203
People with chronic low back pain (LBP) exhibit changes in postural control. Stereotypical muscle activations resulting from external perturbations include anticipatory (APAs) and compensatory (CPAs) postural adjustments. The aim and objective of this study was to determine differences in postural control strategies (peak amplitude, APAs and CPAs) between symptomatic and asymptomatic adults with and without Lumbar Disc Degeneration (LDD) using surface electromyography during forward postural perturbation. Ninety-seven subjects participated in the study (mean age 50 years (SD 12)). 3T MRI was used to acquire T2 weighted images (L1-S1). LDD was determined using Pfirrmann grading. A bespoke translational platform was designed to deliver horizontal perturbations in sagittal and frontal planes. Electromyographic activity was analysed bilaterally from 8 trunk and lower limb muscles during four established APA and CPA epochs. A Kruskal-Wallis H test with Bonferroni correction for multiple comparisons was conducted. Four groups were identified: no LDD no pain (n = 19), LDD no pain (n = 38), LDD pain (n = 35) and no LDD pain (n = 5). There were no significant differences in age or gender between groups. The most significant difference between groups was observed during forward perturbation. In the APA and CPA phases of predictable forward perturbation there were significant differences ankle strategy between groups (p = 0.007–0.008); lateral gastrocnemius and tibialis anterior activity was higher in the LDD pain than the LDD no pain group. There were no significant differences in the unpredictable condition (p>0.05). These findings were different from the remaining groups, where significant differences in hip strategy were observed during both perturbation conditions (p = 0.004–0.006). Symptomatic LDD patients exhibit different electromyographic strategies to asymptomatic LDD controls. Future LBP electromyographic research should benefit from considering asses
Deane JA, Papi E, Phillips A, et al., 2020, Reliability and minimal detectable change of the ‘Imperial Spine’ marker set for the evaluation of spinal and lower limb kinematics in adults, BMC Research Notes, Vol: 13, ISSN: 1756-0500
ObjectivesAs a step towards the comprehensive evaluation of movement in patients with low back pain, the aim of this study is to design a marker set (three rigid segment spine, pelvic and lower limb model) and evaluate the reliability and minimal detectable change (MDC) of this marker set in healthy adults during gait and sit to stand (STS) tasks using three dimensional motion capture.ResultsThe ‘Imperial Spine’ marker set was used to assess relative peak angles during gait and STS tasks using the minimum recommended sample size (n = 10) for reliability studies with minimum Intraclass Correlation Coefficient (ICC) of 0.70, optimum ICC 0.90 and 9 trials replicated per subject per task. Intra- and inter-tester reliability between an experienced and inexperienced user was examined. ICC, mean, standard error (SEM), Bland Altman 95% limits of agreement (LOA) and MDC were computed.ICC values demonstrated excellent intra- and inter-tester reliability in both tasks, particularly in the sagittal plane (majority ICCs > 0.80). SEM measurements were lower in gait (0.8–5.5°) than STS tasks (1°-12.6°) as were MDC values. LOA demonstrated good agreement. The ‘Imperial Spine’ marker set is reliable for use in healthy adults during functional tasks. Future evaluation in patients is required.
Deane JA, Pavlova A, Lim A, et al., 2020, Is intrinsic lumbar spine shape associated with Lumbar Disc Degeneration? An exploratory study, BMC Musculoskeletal Disorders, Vol: 21, Pages: 1-10, ISSN: 1471-2474
Background: Lumbar disc degeneration (LDD) is a condition associated with recurrentlow back pain (LBP). Knowledge regarding effective management is limited. As a steptowards the identification of risk, prognostic or potentially modifiable factors in LDDpatients, the aim of this study was to explore the hypothesis that intrinsic lumbar spineshape is associated with LDD and clinical outcomes in symptomatic adults. Methods: 3T MRI was used to acquire T2-weighted sagittal images (L1-S1) from 70healthy controls and LDD patients (mean age 49 years, SD 11, range 31-71years). Statistical Shape Modelling (SSM) was used to describe lumbar spine shape.SSM identified variations in lumbar shape as ‘modes’ of variation and quantifieddeviation from the mean. Intrinsic shape differences were determined between LDDgroups using analysis of variance with post-hoc comparisons. The relationshipbetween intrinsic shape and self-reported function, mental health and quality of lifewere also examined.Results: The first 7 modes of variation explained 91% of variance in lumbarshape. Higher LDD sum scores correlated with a larger lumbar lordosis (Mode 1 (55%variance), P=0.02), even lumbar curve distribution (Mode 2 (12% variance), P=0.05),larger anterior-posterior (A-P) vertebral diameter (Mode 3 (10% variance), P=0.007)and smaller L4-S1 disc spaces (Mode 7 (2% variance), P≤0.001). In the presence ofrecurrent LBP, LDD was associated with a larger A-P vertebral diameter (Mode 3) anda more even lumbar curvature with smaller L5/S1 disc spaces (Mode 4), which wassignificantly associated with patient quality of life (P=0.002-0.04, r p =0.43-0.61)).Conclusions: This exploratory study provides new evidence that intrinsic shapephenotypes are associated with LDD and quality of life in patients. Longitudinalstudies are required to establish the potential role of these risk or prognostic shapephenotypes.
Favier C, Deane J, McGregor A, et al., 2019, Design and preliminary testing of a low-cost balance perturbation system for the evaluation of real life postural adjustment on public transport, Journal of Medical Engineering and Technology, Vol: 43, Pages: 356-362, ISSN: 0309-1902
Balance recovery mechanisms are of paramount importance in situations like public transport where sudden loss of equilibrium can occur. These mechanisms can be altered by aging or pathological disorders. However it is almost impossible to investigate these phenomena in real-life conditions, and the safe environment of a laboratory is needed. This paper investigates how jerk perturbations in the transverse plane similar to those experienced on public transport can be simulated in a controlled manner. A platform capable of producing horizontal perturbations with a person standing on it was developed. Accuracy, repeatability, and load sensitivity of the system were assessed with repeated trials in all four directions of movement. Comparison between the destabilising effect experienced on public transport and the postural response to perturbations from the platform was also made by tracking acceleration of the centre of mass of four subjects in these two situations. Results show that balance perturbations representative of real-life situations, such as standing on public transport, can accurately and repeatedly be produced in a safe and controlled environment with a low-cost and low-maintenance system. Coupled to motion capture technology, the system can be used for pathology assessment and rehabilitation treatments.
Deane JA, Mcgregor A, 2016, Current and Future Perspectives on Lumbar Degenerative Disc Disease: a UK survey exploring specialist multidisciplinary clinical opinion., BMJ Open, Vol: 6, ISSN: 2044-6055
Objectives: Despite lumbar degenerative disc disease (LDDD) being significantly associatedwith non-specific low back pain and effective treatment remaining elusive, specialistmultidisciplinary clinical stakeholder opinion remains unexplored. The present studyexamines the views of such experts.Design: A reliable and valid electronic survey was designed to establish trends usingtheoretical constructs relating to current assessment and management practices. Cliniciansfrom the Society of Back Pain Research (SBPR) U.K. were invited to take part. Quantitativedata was collated and coded using Bristol On-line Surveys (BOS) software, and contentanalysis used to systematically code and categorise qualitative data.Setting: Specialist multidisciplinary spinal interest group in the U.K.Participants: 38/141 clinically active, multidisciplinary SBPR members with specialistspinal interest participated. 84% had greater than 9 years postgraduate clinical experience.Interventions: NoneOutcome Measures: Frequency distributions were used to establish general trends inquantitative data. Qualitative responses were coded and categorised in relation to each themeand percentage responses calculated.Results: LDDD symptom recurrence, in the absence of psychosocial influence, wasassociated with physical signs of joint stiffness (26%), weakness (17%), joint hypermobility(6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasonswhy some experience pain and others do not. No one management strategy was supportedexclusively or with consensus. Regarding effective modalities, there was no significantdifference between AHP and Medic responses (p= 0.1-0.9). The future of LDDD care wasexpressed in terms of improvements in patient communication (35%), patient education(38%) and treatment stratification (24%).
Deane JA, Mcgregor A, Aspden R, et al., 2016, Lumbar spine curvature varies with modic changes and disc degeneration in asymptomatic individuals, Britspine
Lyell M, Simmonds JV, Deane JA, 2016, A study of UK Physiotherapists' knowledge and training needs in hypermobility and hypermobility syndrome, Physiotherapy Practice and Research
Pavlova A, Deane JA, Aspden R, et al., 2015, Lumbar spine curvature varies with modic changes and disc degeneration in asymptomatic individuals, Britspine
Billings S, Deane J, Bartholomew J, et al., 2015, Knowledge and perceptions of Joint Hypermobility and Joint Hypermobility Syndrome amongst paediatric physiotherapists, Physiotherapy Practice and Research, Vol: 36, Pages: 33-41, ISSN: 2213-0691
OBJECTIVES: To explore knowledge and perceptions of Joint Hypermobility (JHM) and Joint Hypermobility Syndrome (JHS) amongst paediatric physiotherapists and to determine training needs. DESIGN: National online survey. SETTING AND PARTICIPANTS: UK paediatric physiotherapists were surveyed through the interactive website of the Chartered Society of Physiotherapy (iCSP). INTERVENTION: A previously validated, self-report questionnaire with minor modifications was distributed nationally via iCSP. RESULTS: Ninety-one questionnaires were completed with representation from all NHS regions. 84% (76/91) of respondents had 6 or more years of experience. Fifty-one percent (46/91) of physiotherapists had received no pre- or post-registration training about JHS. Seventy-nine percent (72/91) were confident in their ability to diagnose JHM, while 54% (49/91) were confident in their ability to diagnose JHS. The physiotherapists had better knowledge of the articular features than the non-articular features of JHS with mean knowledge scores of 63.8% and 54.7% respectively. Eighty percent (73/91) of physiotherapists perceived JHS to have significant impact on quality of life. Education and reassurance, home exercises, proprioception, closed chain exercises, postural education and orthotics, were perceived by more than 80% respondents as effective. Ninety-seven percent (88/91) indicated a need for continuing professional development (CPD) training. CONCLUSIONS: The majority of respondents considered JHS to impact significantly on quality of life. Participants had greater confidence in diagnosing JHM than JHS and had better knowledge of the articular features than the non-articular features of JHS. Results suggest that undergraduate and CPD education is required to facilitate greater understanding of the assessment and management of this multi-system condition.
Deane JA, McGregor AM, 2015, Clinical Interpretations of Degenerative Lumbar Disc Disease, Society of Back Pain Research, Publisher: British Editorial Society of Bone and Joint Surgery, ISSN: 2049-4408
Rombaut L, Deane J, Simmonds J, et al., 2015, Knowledge, Assessment, and Management of Adults With Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type Among Flemish Physiotherapists, AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS, Vol: 169, Pages: 76-83, ISSN: 1552-4868
McGregor AH, Henley A, Morris TP, et al., 2012, An Evaluation of a Postoperative Rehabilitation Program After Spinal Surgery and Its Impact on Outcome, SPINE, Vol: 37, Pages: E417-E422, ISSN: 0362-2436
Kenyon J, Kenyon K, 2009, Musculoskeletal Pathology, The Physiotherapist's Pocketbook Essential Facts at Your Fingertips, Editors: Deane, Publisher: Elsevier Health Sciences, ISBN: 9780702039591
The second edition of this extremely popular book has been updated and expanded to make it even more invaluable during clinical practice.
Deane JA, 2009, Developing Research Interests, Getting Involved in Research A Pocket Guide, ISBN: 9781904400264
Deane JA, Toscke J, McGregor AM, 2008, Evaluation of a rehabilitation programmed for patients following spinal surgery, Eurospine
Deane JA, Keer R, Simmonds JV, 2008, Physiotherapists’ perceptions about hypermobility and hypermobility syndrome (HMS): a pilot survey of London-based hospitals, IFOMT 9th International Federation of Orthopaedic Manipulative Therapists' Conference
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