A5000014406- Musculoskeletal pain and rehabilitation
- Stroke Rehabilitation and Recovery
- Health Systems, Economic Evaluations, Quality of Life
- Peripheral Artery Disease Management
- Osteoarthritis Treatment and Mechanisms
- Chronic Disease Management Strategies
- Nutrition and Health in Aging
- Ethics in Clinical Research
- Health Policy Implementation Science
- Voice and Speech Disorders
- Reconstructive Surgery and Microvascular Techniques
- Pregnancy and preeclampsia studies
- Meta-analysis and systematic reviews
- Maternal and fetal healthcare
- HIV Research and Treatment
- Health disparities and outcomes
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Cerebral Palsy and Movement Disorders
- Poverty, Education, and Child Welfare
- Head and Neck Cancer Studies
- Maternal and Perinatal Health Interventions
- Spine and Intervertebral Disc Pathology
- Frailty in Older Adults
- Total Knee Arthroplasty Outcomes
- Lower Extremity Biomechanics and Pathologies
Nuffield Orthopaedic Centre
2018-2023
University of Oxford
2018-2023
Keele University
2022
University of Exeter
2022
BackgroundIn women with late preterm pre-eclampsia, the optimal time to initiate delivery is unclear because limitation of maternal disease progression needs be balanced against infant complications. The aim this trial was determine whether planned earlier initiation reduces adverse outcomes without substantial worsening neonatal or outcomes, compared expectant management (usual care) in pre-eclampsia.MethodsIn parallel-group, non-masked, multicentre, randomised controlled done 46 maternity...
Abstract Background Neurogenic claudication (NC) is a debilitating spinal condition affecting older adults’ mobility and quality of life. Methods A randomized controlled trial 438 participants evaluated the effectiveness physical psychological group intervention (BOOST program) compared to physiotherapy assessment tailored advice (best practice [BPA]) for adults with NC. Participants were identified from clinics (community secondary care) general records 2:1 BOOST program or BPA. The primary...
Introduction Neurogenic claudication due to spinal stenosis is common in older adults. The effectiveness of conservative interventions not known. aim the study estimate clinical and cost-effectiveness a physiotherapist-delivered, combined physical psychological intervention. Methods analysis This pragmatic, multicentred, randomised controlled trial. Participants are intervention (Better Outcomes for Older people with Spinal Trouble (BOOST) programme) or best practice advice (control)....
Purpose The ‘Oxford Pain, Activity and Lifestyle’ (OPAL) Cohort is a longitudinal, prospective cohort study of adults, aged 65 years older, living in the community which investigating determinants health later life. Our focus was on musculoskeletal pain mobility, but designed with flexibility to include new elements over time. This paper describes design, data collection baseline characteristics participants. We also compared OPAL nationally representative sources. Participants randomly...
Objective To test the effectiveness of a behaviour change physiotherapy intervention to increase physical activity compared with usual rehabilitation after total hip replacement (THR) or knee (TKR). Design Multicentre, pragmatic, two-arm, open, randomised controlled, superiority trial. Setting National Health Service providers in nine English hospitals. Participants 224 individuals aged ≥18 years, undergoing primary THR TKR deemed ‘moderately inactive’ ‘inactive’. Intervention received...
Cross-sectional analysis of the Oxford Pain, Activity and Lifestyle (OPAL) Cohort Study.The aim this study was to assess prevalence back pain (BP) leg determine their relationship with adverse health states among older adults in England.Epidemiological data describing BP England is lacking.A total 5304 community-dwelling (aged 65-100 years) enrolled OPAL cohort who provided on were included. Participants classified into four groups based reports pain: no BP, only, which likely be neurogenic...
The aim of this study is to develop and validate two models predict 2-year risk self-reported mobility decline among community-dwelling older adults.We used data from a prospective cohort people aged 65 years over in England. Mobility status was assessed using the EQ-5D-5L question. were based on outcome: Model 1, any at 2 years; 2, new onset persistent problems years. Least absolute shrinkage selection operator logistic regression select predictors. performance C-statistics, calibration...
To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities on mobility or self-care limitations among older adults.We used baseline, cross-sectional data from the Oxford Pain, Activity Lifestyle (OPAL) study. Participants were community-dwelling adults aged 65 years who completed a postal questionnaire. reported demographic information, OA, limitations. We modified Poisson regression models to independent combined relative risks (RR) limitations, excess risk due...
Abstract Background Exercise is recommended for all people with osteoarthritis. However, these recommendations are based on randomised clinical trials including an average age between 60 and 70 years, findings cannot reliably be generalised to aged 80 years or older. Rapid loss of muscle occurs after age, older more likely also have other health conditions that contribute difficulties daily activities impact their response exercise. To improve care osteoarthritis, it thought a tailored...
Background Back pain frequently affects older people. Knowledge about back in people and evidence to inform clinical care was lacking, particularly for with neurogenic claudication due spinal stenosis, which is a debilitating condition. Objectives To understand reduce the burden of on by increasing knowledge developing evidence-based treatment strategies. Design We completed six work packages. These were not undertaken chronologically as there overlap between Work package 1: Refine...
Abstract Background Neurogenic claudication is a common spinal condition affecting older adults that has major effect on mobility and implicitly independence. The effectiveness of conservative interventions in this population not known. We describe the statistical analysis plan for Better Outcomes Older people with Spinal trouble (BOOST) randomised controlled trial. Methods/design BOOST pragmatic, multicentre, parallel, two-arm, Participants are community-dwelling adults, 65 years or older,...
Background Missing data is a common issue in randomised controlled trials. There need to rigorously test means of participant retention. This embedded trial aims examine the effect on postal response rates printing trial’s primary outcome pink versus white paper. Methods Our Study Within A Trial (SWAT) was run within behaviour-change intervention host for patients following hip or knee replacements. Participants were receive measure printed either sheet paper 11 (21 page) 6-month follow-up...
To determine the feasibility of a randomised controlled trial to estimate effectiveness and cost-effectiveness rehabilitation intervention following neck dissection (ND) after head cancer (HNC). Two-arm, open, pragmatic, parallel, multicentre, trial. Two UK NHS hospitals. People who had HNC in whom ND was part their care. We excluded those with life expectancy six months or less, pre-existing, long-term neurological disease affecting shoulder cognitive impairment. Usual care (standard...
Abstract Background Exercise is recommended for all people with osteoarthritis. However, these recommendations are based on randomised clinical trials including an average age between 60 and 70 years, findings cannot reliably be generalised to aged 80 years or older. Rapid loss of muscle occurs after age, older more likely also have other health conditions that contribute difficulties daily activities impact their response exercise. To improve care osteoarthritis, it thought a tailored...