Dr Siobhan Schabrun

TRANSLATE: Improving the translation of research evidence into practice

Effective, safe and cost-efficient healthcare is achieved when treatment is evidence based. Yet, it takes 17 years on average for research evidence to be translated into clinical care. This results in the overuse of ineffective treatments – those that do more harm than good – and the underuse of effective treatments – those that can improve symptoms and promote faster recovery after illness of injury. As a result, there is a huge gap between the healthcare people should receive and the care they do receive. TRANSLATE seeks to reduce the evidence-clinical care gap by implementing and monitoring evidence-based models of care in private practice.

BRAIN-Boost: Non-invasive brain stimulation combined with exercise for knee OA

Osteoarthritis is a major global health problem with no cure. Exercise is the cornerstone of conservative treatment, but effects on pain and physical function are at best, moderate. Non-invasive brain stimulation has the potential to bolster the effects of exercise therapy, resulting in greater improvements in pain and function than can be achieved with exercise alone. Here we will investigate this possibility in a randomized controlled trial of people living with knee osteoarthritis.

DISCOVER-pain: Discovery of a cortical biomarker signature for pain

Low back pain (LBP) is ranked as the top single cause of disability worldwide. Costs have risen faster than for any other health condition and LBP is now equal to ischemic heart disease, and second only to cancer, as the costliest health condition. Approximately 40% of people who experience acute LBP develop chronic pain. These individuals are unresponsive to treatment, experience high levels of pain, struggle to perform daily tasks and frequently develop psychosocial comorbidities. The enormous scale of the problem is matched only by the mystery that accompanies it: despite decades of research, why some people develop chronic LBP while others do not, remains unknown.

The identification of biomarkers that can predict who will develop chronic LBP is a holy grail of pain research. Our new research has uncovered evidence for a unique biomarker signature that appears to predict i) an individual’s susceptibility to high pain severity, even before pain begins and ii) an individual’s susceptibility to developing chronic LBP following an acute episode. These biomarkers are now undergoing detailed investigation in on-going studies.

UNmaPPed: Understanding the physiology of persistent pain

People in pain move differently. Yet, the biological basis for altered movement in pain is poorly understood. This lack of understanding has led to treatments for persistent pain that target generic symptoms with limited effect. This NHMRC-funded trial is the first to examine how different aspects of the nervous system are altered in pain and how this relates to movement. This information will guide the development of new treatment strategies for persistent pain in future.

UPWaRD: Understanding persistent pain where it resides – in the brain.

Persistent musculoskeletal pain is one of the most significant health issues in the developed world. Termed a ‘Western epidemic’, low back pain is the most common form of persistent musculoskeletal pain and a leading cause of suffering and disability. Despite the enormity of the problem, many current therapies target generic symptoms, not underlying mechanisms, with limited effect. In 2010, the Australian National Pain Summit concluded ‘the management of pain is shockingly inadequate’. This assessment is not surprising given that critical information on the biological changes that underpin persistent low back pain is lacking. The UPWaRD study is a 5-year NHMRC-funded trial that investigates the role of brain plasticity, along with biological changes in the spinal cord, hormonal changes, genetics and stress, in the development of persistent low back pain.

https://www.upwardbackpainstudy.com