NeuRA Magazine #19

5 minutes with…


Dr Julie Brown works in the lab and in the field to understand what sort of injuries are most commonly suffered by Australian children, and how we can best prevent those injuries from occurring. Specifically, her group is studying how injuries occur in children when they are involved in crashes, and how changes to the types and design of restraints used by children can reduce serious injuries and death.

Dr Julie Brown

Why is child injury prevention research so essential?

Unintentional injury continues to be the leading cause of death and disability among children in Australia. And in NSW alone, around 60 children die every year from unintentional injury and a further 20,000 are hospitalised, so you can imagine nationwide and worldwide the numbers are quite staggering.

In researching ways to keep kids safe, and coming up with solutions are we creating strict rules for children at places like swimming pools and trampoline parks that take away opportunities for fun and adventure?
We don’t want to wrap our children in cotton wool, we really do want them to engage in activities that promote appropriate, healthy development. But what we really want is to find ways for children to do this while minimising the risk of serious injuries because the consequences can be really severe and lifelong. Head injuries can have significant impacts on the physical, cognitive, behavioural and even emotional development of children. We want to encourage children to participate in physical activities, to have fun, take part in developmentally appropriate activities, but not expose them to preventable risks of life-threatening or disabling injury.

One of your recent studies found that there has been a small increase in sprains and fractures in kids under the age of 16 as a result of injuries sustained at trampoline parks. Tell me about some of the changes you suggested as result of this research.
The Australian Trampoline Parks Association have been really fantastic in working with us as part of our research, and the outcomes of this is that, with Kidsafe Australia, we have seen the introduction of a new Australian standard that will govern the operation and management of these centres. That level of intervention will have a lot of impact on reducing the risk of injury to kids using these parks.

What other areas of child safety does your research cover and how do you identify issues ahead of time?
We use epidemiological studies to identify problems and define the nature of child injury in Australia, then we use surveys, fieldwork and laboratory studies to identify risk factors for particular types of injury. Then we work with clinicians or industry bodies to develop real, tangible countermeasures that address the problems.

Are there any main areas of concern that you see?
For a number of years we’ve been studying the safety of children in cars because, although travelling in cars is a daily activity, it is a global problem. By 2030, the World Health Organization estimates that traffic injuries are likely to become the fifth leading cause of death and the seventh leading cause of disability among children across the world. So in the last decade or so we’ve really been focussing on getting children into the right type of restraint for their age. We’ve seen some great results with more and more children using appropriate types of restraint systems, but our more recent studies have shown that we still have some problems with the restraints being used correctly. About 1 in 2 children will have some error in how the restraint is being used. So this is our current focus; trying to reduce these errors.
We’ve been working with parents and others who use child restraints to develop better communication about how to use restraints correctly. We’ve also been developing, in the laboratory, new methods to study the interaction between children and the restraint system. Some of the errors are introduced when parents are installing the restraints, but children introduce others themselves. For example, taking their arms out of the harness.

So you’re recording real-world examples of how child restraints are used and translating them to research, rather than using studies to inform people as to how to use the restraints.
That’s exactly right. We’re watching kids in real cars and using methods to objectively identify the features of restraints that are more likely to be associated with errors in use. We’re about to start a new program, using these methods, to define the specific features of the restraints that are important for children maintaining correct use while they’re in cars.

To access to the NeuRA Magazine #19 Young researchers story click here

See what’s going on at NeuRA


Brain and Knee Muscle Weakness Study

Why Does Quadriceps Weakness Persist after Total Knee Replacement? An Exploration of Neurophysiological Mechanisms Total knee replacement is a commonly performed surgery for treating end-staged knee osteoarthritis. Although most people recover well after surgery, weakness of the quadriceps muscles (the front thigh muscles) persists long after the surgery (at least for 12 months), despite intensive physiotherapy and exercise. Quadriceps muscle weakness is known to be associated with more severe pain and greatly affect daily activities. This study aims to investigate the mechanisms underlying weakness of the quadriceps muscles in people with knee osteoarthritis and total knee replacement. We hope to better understand the relationship between the changes of the brain and a loss of quadriceps muscle strength after total knee replacement. The study might be a good fit for you if you: Scheduled to undergo a total knee replacement; The surgery is scheduled within the next 4 weeks; Do not have a previous knee joint replacement in the same knee; Do not have high tibial osteotomy; Do not have neurological disorders, epilepsy, psychiatric conditions, other chronic pain conditions; Do not have metal implants in the skull; Do not have a loss of sensation in the limbs. If you decide to take part you would: Be contacted by the researcher to determine your eligibility for the study Be scheduled for testing if you are eligible and willing to take part in the study Sign the Consent Form when you attend the first testing session Attend 3 testing sessions (approximately 2 hours per session): 1) before total knee replacement, 2) 3 months and 3) 6 months after total knee replacement. The testing will include several non-invasive measures of brain representations of the quadriceps muscles, central pain mechanisms, and motor function and questionnaires. Will I be paid to take part in the research study? You will be reimbursed ($50.00 per session) for travel and parking expenses associated with the research study visits. If you would like more information or are interested in being part of the study, please contact: Name: Dr Wei-Ju Chang Email: Phone: 02 9399 1260 This research is being funded by the Physiotherapy Research Foundation.