Prof Stephen Lord
TEAM LEADER PROFILE
Professor Stephen Lord is a Senior Principal Research Fellow at Neuroscience Research Australia, Sydney, Australia. He has published over 400 papers in the areas of balance, gait and falls in older people and is acknowledged as a leading international researcher in his field. His research follows two main themes: the identification of physiological risk factors for falls and the development and evaluation of fall prevention strategies. Key aspects of this research have been the elucidation of sensorimotor factors that underpin balance and gait and the design and evaluation of exercise programs for older people including those at increased risk of falls, i.e. people with Parkinson’s disease, stroke, dementia and frailty. His methodology and approach to fall-risk assessment has been adopted by many researchers and clinicians across the world and he is actively engaged in initiatives aimed at implementing falls prevention evidence into policy and practice.
Projects Prof Stephen Lord is currently involved with
CURRENT PROJECTS
Treating dizziness in older people
Despite effective treatments being available, up to 40% of older people with reported dizziness remain undiagnosed and untreated. A multidisciplinary assessment battery, with new validated assessments of vestibular impairments is required for diagnosing and treating older people with dizziness. This project will therefore aim to conduct a randomised-control trial of a multifaceted dizziness intervention based on a multidisciplinary assessment, and develop a multiple profile assessment of dizziness for use in Specialist Clinics.READ MORE
Treating dizziness in older people
Preventing further falls in people who call an ambulance as a result of a fall – a randomised contro
Many older people suffer a fall and it is not uncommon for older fallers to require paramedic care following such events. Routine transportation to hospital is of questionable value and may not be an effective or efficient use of resources. This randomised controlled offered non-transported fallers a new model of care following fall-related paramedic care.READ MORE
Preventing further falls in people who call an ambulance as a result of a fall – a randomised controlled trial
Patterns of use and cost to the ambulance service of fall-related injury in older people
While the pattern of ambulance use have been studied extensively, the associated costs which are influenced by a variety of factors are still being explored. This program of research aims to better understand what is driving costs within the ambulance service, explore pathways to optimise resource use and evaluate models of care to streamline health care provided to older adults.READ MORE
Patterns of use and cost to the ambulance service of fall-related injury in older people
Understanding and preventing physical and cognitive decline and falls in older people with dementia
Falls and functional decline are common in people with dementia. Falls are more likely to result in injury, death and institutionalisation when compared to older people without dementia. There is limited evidence that falls can be prevented in people with dementia. Strategies aimed at maintaining independence and preventing decline and falls are urgently needed. This research will a) further our understanding of fall risk and functional decline and b) explore novel fall and decline prevention programs, including the use of technology in older people with dementia.
READ MORE
Understanding and preventing physical and cognitive decline and falls in older people with dementia
Innovative approaches to prevent falls in older people
Physical exercise training has been the primary focus of single interventions trials to reduce falls and advance healthy ageing. However, high attrition rates suggest that current approaches are not sufficient to guarantee long-term adherence to exercise in the majority of older adults.READ MORE
Innovative approaches to prevent falls in older people
Novel methods for fall prediction in older people
Technological advances have enabled less expensive ways to quantify physical fall risk in the homes of older people.READ MORE
Novel methods for fall prediction in older people
Understanding the effects of sleep disruption in people with Multiple Sclerosis
Investigating the role that sleep disruption plays in people with Multiple SclerosisREAD MORE
Understanding the effects of sleep disruption in people with Multiple Sclerosis
Adapting the Physiological Profile Assessment to assess upper limb function
This study will produce simple tests that can be used in population studies and patient group clinics. It will provide normative data for documenting the type and severity of upper limb Motor Impairments and provide the impetus to develop strategies to improve function in ageing and other disorders, such as stroke, Parkinson’s disease, arthritis and peripheral neuropathy.READ MORE
Adapting the Physiological Profile Assessment (PPA) to assess upper limb function
Everyday fatigue and fall risk in older people
This study will determine whether a busy day of physical activity (‘real world’ fatigue) impacts balance and mobility measures in older people. It will determine the importance of fatigue as a fall risk factor in older people, and provide significant information with respect to the value of mitigating fatigue as a fall prevention strategy.READ MORE
Everyday fatigue and fall risk in older people
Development of wearable sensor assessment tools
Many fall risk assessment tools are available for use in clinical settings. However, the predictive accuracy is limited. This study has assembled the largest wearable sensor data library of “freezes” in people with Parkinson’s disease. It provides great scope for identifying pre-freeze gait characteristics which ultimately may be used to trigger cues for freeze prevention.READ MORE
Development of wearable sensor assessment tools for clinic and remote (at-home) settings
Interactive step training to reduce falls in people with MS
More than 50% of people with multiple sclerosis will fall over a 3 month period. A clinical trial is being conducted in 500 people with multiple sclerosis who have difficulties with mobility and balance. We hope results of this study will provide solid scientific evidence to include in fall management programs for people with this condition.READ MORE
An interactive step training RCT to reduce falls in people with multiple sclerosis
Training to prevent falls in older people
To date, no studies have examined the potential for cognitive or cognitive-motor training to prevent falls in older people, despite good evidence of fall-related cognitive and physical improvements following both intervention types. Building on our initial work, we have developed and validated a home-based computerised training intervention that can be delivered identically, either while seated (cognitive) or while standing and undertaking balance exercises (cognitive+motor). Our project will also uncover cognitive-motor interactions and their neural pathways related to falls, via state-of-the-art imaging techniques that measure brain structure and functional changes. This intervention addresses both physical and cognitive fall risk factors. It holds promise for a cost-effective fall prevention strategy with multiple health benefits for older people.READ MORE
A RCT of cognitive-only and cognitive-motor training to prevent falls in older people
NEURA FALLSCREEN
INTERVIEW WITH PROFESSOR STEPHEN LORD
RESEARCH TEAM
VICKY SMITH Executive Assistant
JESSICA TURNER Research Assistant
JOANNE LO Research Assistant
CAMERON HICKS Research Assistant
DR ESTHER VANCE Senior Research Assistant
DANIELA MEINRATH Masters student
DR YOSHIRO OKUBO
JOANA CAETANO PhD student
MAYNA RATANAPONGLEKA Research Assistant
PROF CATHIE SHERRINGTON Senior research officer
PUBLICATIONS
Home-based step training using videogame technology in people with Parkinson's disease: a single-blinded randomised controlled trial.
Song J, Paul SS, Caetano MJD, Smith S, Dibble LE, Love R, Schoene D, Menant JC, Sherrington C, Lord SR, Canning CG, Allen NE
To determine whether 12-week home-based exergame step training can improve stepping performance, gait and complementary physical and neuropsychological measures associated with falls in Parkinson's disease. Overall, home-based exergame step training was not effective in improving the outcomes assessed. However, the improved physical function in the lower disease severity intervention participants as well as the self-reported improved mobility in the intervention group suggest home-based exergame step training may have benefits for some people with Parkinson's disease.
Physiological risk factors for falls in older people with lower limb arthritis.
Sturnieks DL, Tiedemann A, Chapman K, Munro B, Murray SM, Lord SR
To investigate physiological risk factors for falls in people with self-reported lower limb arthritis. Older people with lower limb arthritis are at increased risk of falling due to deficits in neuromuscular systems. A physiological falls-risk profile based on mean test scores for the arthritis group highlights deficits in muscular strength, knee proprioception, and standing balance, indicating the need for targeted falls prevention interventions for this population.
The physiology of falling: assessment and prevention strategies for older people.
Lord SR, Sturnieks DL
Balance calls upon contributions from vision, peripheral sensation, vestibular sense, muscle strength, neuromuscular control and reaction time. With increased age, there is a progressive loss of functioning of these systems and an increased likelihood of falls. Falls can mark the beginning of a decline in function and independence and are the leading cause of injury-related hospitalisation in older people. By using simple tests of vision, leg sensation, muscle strength, reaction time and standing balance, it is possible to identify accurately older people at risk of falls and assess intervention outcomes. This approach overcomes the limitations associated with traditional methods of assessing falls risk via medical diagnoses, including varied severity between individuals. Using a physiological approach provides information at the impairment and functional capacity levels to assist in understanding falls and developing and evaluating optimal falls prevention strategies for older people.