A Neuro Physio Podcast Matt Wingfield & Erin Bicknell

This month we are chatting with Dr. Sarah Milne from Murdoch Children’s Research Institute who is also the Coordinator of the Friedreich's Ataxia Clinic at Monash Health in Melbourne, Australia. Sarah is an expert in hereditary cerebellar ataxias and after completing her PhD in 2018 she is trying to bolster the evidence base about the right rehab for people with Friedreich’s Ataxia. 
This episode will appeal to people treating Friedreich’s Ataxia or any of the inherited cerebellar ataxias, and to anyone who sees people with cerebellar pathology. Also of interest are the chats about challenges of rehabilitation research. The audio quality in this episode isn’t up to our usual standard with a lot of static happening – sorry!

2.01 Intro & career pathway
4.38 Friedreich’s ataxia
7.00 How is Friedreich’s ataxia different to the hereditary cerebellar ataxias?
8.36 Phenotypes in neurological conditions and the RCT paradigm
11.20 PhD results   
15.02 State of the Friedreich’s ataxia evidence
16.49 Ataxia outcome measures 
20.03 Ataxia assessment
24.25 Compensation vs optimal cerebellar functioning
27.00 What can imaging tell us about cerebellar conditions?
29.55 Treatment 
36.16 Efficacy vs Effectiveness, challenges of rehab trials 
39.23 Aquatic physio for this population
41.43 Episode reflection

Links
Research Gate
PhD - 4 studies – Pilot rehabilitation trial for people with Friedreich’s Ataxia. Clinical audit of LL spasticity relationship with ataxia severity & function. Sensitivity of balance, gait measures and instrumented measures of gait & balance change over time.
LinkedIn
University of Melbourne profile


Articles discussed:
Brain Changes Associated with Postural Training in Patients with Cerebellar Degeneration

Home aerobic training for cerebellar degenerative diseases: a randomized controlled trial
Cycling regimen induces spinal circuitry plasticity and improves leg muscle coordination in individuals with spinocerebellar ataxia

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Dr. Kate Scrivener is a Senior Lecturer of Physiotherapy at Macquarie University, Sydney, Australia where she’s an educator and researcher. She’s also an educator with the Stroke Ed collaboration and that energy for education & innovation has seen her develop the REPS app and website - a set of exercise programs designed to help stroke survivors exercise at home, and the TRAIN program - a clinician’s guide to effective task specific training. Until recently she also worked clinically at Concentric Rehab in Sydney. She’s the lead investigator on the HiWalk trial and is involved in a number of other projects we didn’t get to talk about in the episode.
Kate’s episode zeros in on a number of her passion areas:
-  Education - making neuro easier to understand for students and implementing evidence into practice for practicing physios. 
-  Improving mobility, especially in the chronic phase in the community
-  Increasing dose of therapy
All this culminates in her HiWalk trial which has just finished recruitment.
There’s plenty to take away from this episode.
2.02 Intro – Work roles & life balance, neuro career
7.17 Teaching Neuro
10.21 TRAIN modules
11.42 Career pathway
15.19 Stroke Ed courses – practical ways to apply stroke guidelines
19.44 Australian NSF guidelines – to what setting do they apply? 
20.44 Interest in rehab in community sector 
23.48 HiWalk project
28.19  Intervention research pipeline - basing research trials on intervention feasibility 
31.47 Interest in walking after stroke, PhD

35.48 We need clinical researchers
36.34 Do you need a PhD to be a clinician researcher? 
41.22 HiWalk intervention package
43.10 Are reps the best way to quantify dose?
52.10 Kate’s favourite ways to increase dose of therapy
55.36 Post episode reflection

Links
Macquarie Uni profile 
Linked In profile
ResearchGate 
REPS app – download on Android or link TASK program website 
TRAIN program – A clinician’s guide to effective task specific training 

Articles discussed in the episode
Stroke survivors have fallen into a ‘black hole’ editorial
Schneider 2016 systematic review – amount of additional usual therapy  to improve activity after stroke 
Kate’s PhD articles – E
Meet Yourself: A Journey Back to PurposeWelcome to Meet Yourself, a journey through time where the past and present...Listen on: Apple Podcasts   Spotify
Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Barby Singer is a Professor in the School of Medical & Health Science at Edith Cowan University in Perth, Western Australia. She is an APA Neurological Physiotherapist, a Fellow of the Australian College of Physiotherapists by Original Contribution in 2011 and has more than 40 years of clinical and academic experience in neurological rehabilitation. Barby has been a key leader in Australia for post-graduate neurological education both at the tertiary level and at the Australian Physiotherapy Association. She has held various roles in the Australian College of Physiotherapists and her passion for positive changes has led to a number of changes in the examination process for Fellowship by Specialisation and the new career pathway framework. In 2021 she was bestowed with the APA’s elite Honoured Member status.
Barby holds a PhD in hypertonicity management, a Post Graduate Diploma in Health Sciences (Neurosciences), a Master of Science and a Diploma Physio which she completed way back in 1980 in Auckland, NZ.
Barby’s research interests include management of spasticity for people with acquired brain injury, self management support for people with long term neuro conditions, measuring outcomes in neuro rehab and interventions to improve recovery of arm function after acquired brain injury. 
There is a ton to unpack with Barby but this episode focuses on here thoughts on clinical education both for clinician learning and for patient management, the APA career pathway framework, hypertonicity, and serial casting. We also talk about Advanced practice and physio specialisation in countries and whether pay is sufficient for these highly trained physios. So lots to check out, we hope you enjoy it.
2.02 Intro
3.23 Barby’s varied career
4.40 Physios need to be educators
8.47 APA career framework
12.11 Rural specialist 
15.29 Clinical Mentorship in the new career framework
17.47 Industry shortage
21.04 Remuneration for advanced or specialist Physios
24.47 Advanced practice opportunities in neuro
26.19 Barby’s interest in hypertonicity & PhD
31.37 Anterior knee pain botulinum toxin
34.38 Spasticity definition & measurement
38.10 Hypertonicity management - where we’ve gone wrong
43.17 Role of serial casting
52.29 Working with PhD students
58.11 Episode reflection

Links
Barby’s Edith Cowan University Profile page
Barby’s ResearchGate
Barby’s Linked In
APA career pathway framework


Papers Barby talks about in the episode:
Sutherland et al., 2022 - Do randomised co
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Like our podcast and want to support us?
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Dr Kim Jennings is an Advanced Bobath tutor with over 35 years of clinical expertise. Kim became a Bobath Tutor in 2000 and an Advanced Tutor in 2012. She holds a clinical doctorate in physiotherapy at La Trobe University investigating barriers and facilitators to implementation of the Bobath concept and a Master of Public Health from Monash University. We get the lowdown about what sparked her interest in Bobath, what makes people choose to apply it or not apply it in practice, how the concept has changed over time, and where Bobath sits in evidence based practice. She also tells us all about a Clinical Doctorate and what her research found about factions in the neuro physio community.

If you'd like to listen to more of an intro to The Bobath Concept check out Season 1, Episode 9 with Janet Stevens https://aneurophysio.com/janetstevens/
https://podcasts.apple.com/au/podcast/a-neuro-physio-podcast/id1493324068?i=1000484935724

3.00 Intro

3.30 Bobath career pathway
9.03 Working with culturally diverse populations
11.19 IBITA – Tutors around the world
14.30 Who are Bobath courses for?
16.40 How Bobath has changed over time
26.00 What is a clinical doctorate?
29.50 Kim’s research - Implementation of the Bobath concept
45.24 The lack of RCT evidence for Bobath
53.50 Personalisation of rehab
55.10 The need for more research  
1:08.40 Episode reflection

Links
Australian Bobath Training Association https://www.bobathaustralia.org/
International Bobath Instructors Training Association https://ibita.org/
British Bobath Tutors Association https://www.bbta.org.uk/
The Bobath Concept has Changed - paper in Journal of Physiotherapy



Meet Yourself: A Journey Back to PurposeWelcome to Meet Yourself, a journey through time where the past and present...Listen on: Apple Podcasts   Spotify
Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Dr. Simon Mills is the principal clinician in the South Australian Brain Injury Rehabilitation Service. He recently completed his PhD (University of Adelaide) in postural alignment and recovery of mobility after acquired brain injury, focusing on brain injury survivors with severe mobility impairment. Simon has 20 years clinical experience and his research interests include methods for clinical assessment, biomechanics and enhancing effectiveness of rehab intervention. 

Intro 4.05
Career Pathway 4.48
Simon’s PhD – postural alignment and mobility in ABI 9.25
The emphasis people put on regaining mobility 14.43
Physio role in cognition 20.46
Measurement of postural alignment 24.40
Why is postural alignment important? 31.04
Interpreting postural observations to find impairments 35.15
Application of results across populations 42.14
Future development of Simon’s research 46.10


Simon's PhD – Postural alignment and recovery of mobility after acquired brain injury – focused on severe mobility impairment
Papers:
Improvement in postural alignment is associated with recovery of mobility after complex acquired brain injury: An observational study
Improving physical mobility is critical for wellbeing in people with severe impairment after an acquired brain injury: a qualitative study
Is there a relationship between postural alignment and mobility for adults after acquired brain injury? A systematic review
Research gate - https://www.researchgate.net/profile/Simon-Mills-3
Twitter - @SimonJMillsPT
Email - Simon.Mills@sa.gov.au
Meet Yourself: A Journey Back to PurposeWelcome to Meet Yourself, a journey through time where the past and present...Listen on: Apple Podcasts   Spotify
Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Professor Susan Hillier is a Professor of Neuroscience and Rehabilitation and Dean of Research in Allied Health and Human Performance at the University of South Australia. Her teaching and research interests are broadly in neuroscience and rehabilitation. She has particular interest in the role of afferent stimulation and training using multi-modal feedback. Susan is also trained in Feldenkrais and works clinically at the university private practice. She is especially experienced in Cochrane and other Systematic reviews. We cover most of these topics in this episode! – check out the show notes below. 

Intro 6.16
Proprioception Research 7.15
Sensory perception 10.00
Feldenkrais training 15.50
The Neuroscience Behind Body Image workshops 23.30
Afferent Feedback – know what you're doing to make better choices 26.00
Clinical Reasoning & Generating new ideas in practice 30.20
Supervising PhD students 35.15
Obtaining grant funding 37.57
Gender discrepancy in research 40.08
Systematic reviews 49.06


Prof Hillier's Research Gate
https://www.researchgate.net/profile/Susan-Hillier
 
Uni SA profile
https://people.unisa.edu.au/susan.hillier
Meet Yourself: A Journey Back to PurposeWelcome to Meet Yourself, a journey through time where the past and present...Listen on: Apple Podcasts   Spotify
Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.