NeuRA Post-Doctoral Fellow, MS Senior Physiotherapist
UNSW Conjoint Lecturer. ACU Clinical Fellow
+612 9399 1832
I have been working as a clinical physiotherapist with people with multiple sclerosis (MS) for 15 years. My research interests focus on rehabilitation in MS. Specifically, I am trying to address a few important questions in MS: 1/ What are the characteristics of fallers and frequent fallers in MS; 2/ Are these characteristics amendable via physiotherapy interventions, and 3/ can exercise, beside well-documented short term benefits, slow down progression in MS?
In rehabilitation medicine in MS, there is strong evidence indicating that exercises are beneficial for people with MS in maintaining or improving their functions. However, there is some recent evidence suggesting that exercise may have the impact on slowing down the natural progression of MS. The question “can exercise slow down progression of MS” is what I would like to address in the next 5 years.
In basic science I have developed a method (Hoang’s method) that allows non-invasive measurements of passive properties of muscles. The method has been recognised, improved and used by a few groups in the world with more than 100 citations. The method has also been applied to investigate the properties of muscles in neurological populations who have developed joint contracture. The next step is to use the method to investigate the effectiveness of interventions targeted muscle and joint contractures.
Prof Stephen Lord, Dr Phu Hoang, 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.
There are currently over 20,000 people living with Multiple Sclerosis (MS) in Australia. Bowel and bladder problems, mainly in the form of constipation and urinary incontinence, affect more than half of these people. These problems have traditionally been managed using a combination of manual and pharmacological interventions. However, such solutions are usually only partially effective. Therefore, a non-invasive method of improving bowel and bladder function for people with MS is urgently needed.
The abdominal muscles play a major role during defecation and urination. Surface electrical stimulation of the abdominal muscles, termed Abdominal Functional Electrical Stimulation (Abdominal FES), has been shown to improve bowel function after spinal cord injury, with a case study suggesting this technique may also improve bowel function in MS. There is also limited evidence that Abdominal FES can improve bladder control.
We are currently undertaking the first significant study to investigate the effectiveness of Abdominal FES to improve the bowel and bladder function of people with MS. By making use of the most advanced motility testing system currently available, we hope to be able to definitively assess whether Abdominal FES could be a useful treatment solution for people with MS.
TEODORA BOJANIC ILP Student
DR RACHEL MCBAIN Postdoctoral fellow
DR PETER NICKOLLS
Honorary Senior Research Officer
: +612 9399 1013
DR ANNE BUTLER Research Officer
DR CHAMINDA LEWIS PhD student