Projects

This is a trial designed to test a new intervention to support people with early stage dementia and their carers. The research combines three existing interventions based on self-management, health promotion and e-learning into one extended educational program. The aim is to improve self-efficacy by equipping and empowering people with dementia and their carers with relevant knowledge, information and skills in the early stages of the disease. We hope to prevent unnecessary excess disability, premature loss of function or institutionalization and ultimately support people to live well with dementia in their own home for as long as possible.

There is emerging evidence that visuo-spatial processing is involved in balance control during gait. Importantly, visuo-spatial processing may be key for fall avoidance as it enables one to precisely remember the position and physical characteristics of upcoming hazards; an essential skill for the safe navigation of everyday environments. Yet, investigations of visuospatial processing use for obstacle avoidance have been restricted to animal studies and young adults. No studies have been undertaken in older people or people with Parkinson’s Disease for whom visuo-spatial processing deficits are evident and associated with impaired postural control.

This series of studies will investigate visuo-spatial processing required for obstacle avoidance and navigation in older people, older people at high risk of falls and people with Parkinson’s Disease. We will use motion capture to investigate behavioural outcomes and a freely-worn brain imaging device, functional near-infrared spectroscopy to study cortical activation in regions of interest. We will conduct two experiments one involving an obstacle crossing task and another, a stepping task.

We hypothesize that older age, Parkinson’s Disease and increasing task complexity will result in increased risk of tripping and impaired visuo-motor performance, in the obstacle crossing task and in the stepping task, respectively.

This research will greatly improve our understanding of central mechanisms for fall risk and build on our recent behavioural work in this area.

Prof David Goldstein (UNSW), Dr Susanna Park (U Sydney), Dr Matt McCrary (UNSW), Dr Jasmine Menant, Dr Carole Harris (UNSW), A/Prof David Simar (UNSW)

This randomised-controlled trial led by Professor David Goldstein (Director of the Translational Cancer Research Network, UNSW) and Dr Susanna Park (U Sydney) and funded by a CAG Seed Grant from UNSW, aims to investigate the benefits and mechanisms of exercise rehabilitation in people with chemotherapy-induced peripheral neuropathy and encompasses physical function assessments, nerve function studies, animal models and quality of life surveys.

Chemotherapy-induced peripheral neuropathy is a common and distressing complication in cancer survivors, leading to reduced quality of life, gait and balance deficits, and increased fall risk. No recommended treatment options for chemotherapy-induced peripheral neuropathy currently exist, although there is emerging evidence demonstrating that exercise may be an effective rehabilitation strategy to improve function and reduce symptom burden in chemotherapy-induced peripheral neuropathy.

The clinical component of the trial aims to investigate the effects of an 8-week exercise (balance, resistance, aerobic) program (versus usual care) on balance and gait in cancer survivors with chemotherapy-induced peripheral neuropathy.

Cancer survivors with chemotherapy-induced peripheral neuropathy first undertake a comprehensive assessment of chemotherapy-induced peripheral neuropathy symptoms, patients’ motor function and neurophysiologic parameters. They are then randomly allocated to one of two groups: an 8-week exercise intervention or usual care. Participants are re-assessed immediately following the intervention as well as 6 months later to assess the durability of effects of the intervention.

We hypothesize that the exercise intervention will lead to significant improvements in functional mobility, balance, and gait. Findings from this randomised-controlled trials will determine the merits of exercise as a treatment for cancer survivors with chemotherapy-induced peripheral neuropathy and provide a basis for future

optimisation of exercise treatment for implementation in clinical practice.

Miss Angeliki Stivactas (Masters student UNSW), Dr Phu Hoang, Prof Stephen Lord, Dr Jasmine Menant

Gait dysfunction in Mulitple Sclerosis is an important risk factor for falls. Although there is detailed biomechanical evidence of impaired gait patterns in people with Multiple Sclerosis, there is a paucity of objective empirical data relating specific lower limb muscle strength deficits and gait impairments. Most studies to date have used manual muscle testing to investigate lower limb muscle strength and/or have only focused on knee flexors and extensors.

In this study, we aim to identify weak lower limb muscles contributing to gait impairment in Multiple Sclerosis.

Our experimental protocol involves a comprehensive assessment of isometric strength in eight major lower limb muscle groups using electronic strain gauges. We then conduct a full lower-limb gait analysis using motion capture and force platforms. We will conduct statistical analyses to determine which weak muscle groups are significantly associated with markers of gait impairment in Multiple Sclerosis (eg. knee range of motion during the gait cycle). We are also planning to use electromyography on the identified deficient muscle groups in a subset of participants.

Our research will identify the muscle groups contributing to poor gait, likely causing imbalance and trips in people with Multiple Sclerosis. This work is crucial for developing progressive resistance training programs that directly target weak muscle groups to improve gait in people with Multiple Sclerosis.

Dr Purves-Tyson is an Associate Investigator in a cross-discipline collaboration between researchers from multiple facilities in a pilot study investigating the microbial diversity of people experiencing schizophrenia both in the early stages of illness and in established illness, in relation to metabolic parameters, inflammation and intervention with diet and exercise.

The pathophysiology of dopamine dysregulation in schizophrenia involves alterations at the level of the level. Given that inflammatory mediators such as cytokines can influence the functional properties of midbrain dopamine neurons, midbrain inflammation may play a role in schizophrenia by contributing to presynaptic dopamine abnormalities. Thus, we are examining inflammatory markers in dopaminergic areas of the midbrain of people with schizophrenia and matched controls.