Elizabeth Tully - Academia.edu (original) (raw)

Papers by Elizabeth Tully

Cardiopulmonary physical therapy journal, Jul 1, 2018

Purpose: There is a paucity of functional outcome measures that specifically target the thoracic ... more Purpose: There is a paucity of functional outcome measures that specifically target the thoracic region and none that are specific for use in people following cardiac surgery. The aim of this study was to develop a functional questionnaire for this purpose and investigate its psychometric properties. Methods: Participants who underwent cardiac surgery were included in this single-site, observational study (part A, n = 38 and part B, n = 25). The investigators developed a 13-item Functional Difficulties Questionnaire (FDQ) informed by the literature, theory, and clinical practice. The questionnaire and measures of physical function, pain, and health-related quality of life (HRQOL) were completed at 4 time points by 38 participants to investigate internal consistency, convergent validity, and responsiveness to change of the FDQ (part A). A different group of 25 participants completed the questionnaire twice within a single day to investigate test–retest reliability, and minimal detectable change (MDC) was calculated (part B). Results: The questionnaire showed good internal consistency (Cronbach alpha coefficient = 0.971); moderate to good correlation with assessments for HRQOL 3 months postoperatively (rho = 0.54–0.65 for 5 36-Item Short Form Health Survey subscales) and total pain at all postoperative time points (rho = 0.55–0.69); a responsiveness to change with significant differences in scores across time (Χ2 [3, n = 38] = 41.37, P ≤ 0.0001); and excellent test–retest reliability (intraclass correlation 0.918). The MDC was 16.35 cm out 130 cm. Conclusions: The FDQ is an appropriate functional outcome measure specific to the thoracic region for people after cardiac surgery. It may also be suitable for use by clinicians and researchers assessing the thoracic region within other surgical or medical populations, and this warrants further investigation.

British Journal of Sports Medicine, Apr 1, 2005

The book was difficult to access as it was very broad based and general and tended to be repetiti... more The book was difficult to access as it was very broad based and general and tended to be repetitive. It was difficult to identify the most suitable audience. Although it contained examples from research studies, no referencing to source material was included.

Prehospital and Disaster Medicine, Dec 1, 1995

Awareness of the risk of spinal-cord damage in moving an unconscious person with a suspected neck... more Awareness of the risk of spinal-cord damage in moving an unconscious person with a suspected neck injury into the "lateral recovery position," coupled with the even greater risk of inadequate airway management if the person is not moved, has resulted in a suggested modification to the lateral recovery position for use in this circumstance. It is proposed that the modification to the lateral recovery position reduces movement of the neck. In this modification, one of the patient's arms is raised above the head (in full abduction) to support the head and neck. The position is called the "HAINES modified recovery position." HAINES is an acronym for High Arm IN Endangered Spine. Neck movements in two healthy volunteers were measured by the use of video-image analysis and radiographic studies when the volunteers were rolled from the supine position to both the lateral recovery position and the HAINES modified recovery position. For both subjects, the total degree of lateral flexion of the cervical spine in the HAINES modified recovery position was less than half of that measured during use of the lateral recovery position (while an open airway was maintained in each). An unconscious person with a suspected neck injury should be positioned in the HAINES modified recovery position. There is less neck movement (and less degree of lateral angulation) than when the lateral recovery position is used, and, therefore, HAINES use carries less risk of spinal-cord damage.

Manual Therapy, Nov 1, 2001

The usual activity level and history of low back pain was determined by questionnaire in 614 youn... more The usual activity level and history of low back pain was determined by questionnaire in 614 young Australians (9-27 years); dancers (25%), gymnasts (5%) and a control group who did not participate in dance or gymnastics for > or =6 hours/week during the previous three months (70%). These groups demonstrated significantly different activity levels (dancers >gymnasts >controls). Of all respondents, 34% experienced pain of more than two days duration in the previous year, and 50% in all previous years. The incidence and magnitude of pain in the previous year was significantly greater in the dancers and gymnasts (P<0.05) compared to the controls. The incidence of pain was not linked to the average total hours of activity until this exceeded 30 hours per week. There was no significant difference in the incidence of pain in the previous year between control group respondents who did and did not undertake regular activity. The average hours of activity per incident was approximately 20 hours for the dancers and approximately 5 hours for the other groups. This study has demonstrated that back pain in active and inactive adolescents presents a significant challenge for health-care practitioners involved in the management and prevention of symptomatic spinal disorders.

Journal of Dance Medicine & Science

One-hundred-and-twenty healthy volunteers (ranging in age from 10 to 25 years), completed a quest... more One-hundred-and-twenty healthy volunteers (ranging in age from 10 to 25 years), completed a questionnaire concerning the type and amount of regular activity and history of low back pain. There were 41 who participated in at least 6 hours of dance per week and 79 non-dancers. Computer-based analysis of videotape records examined sagittal standing posture and thoracolumbar flexion-extension mobility On average, dancers undertook 19 h/wk more regular activity (p = 0.0001), were lighter by 7 kg (p = 0.001), had straighter standing postures (p < 0.001) and greater thoracic and lumbar sagittal excursions (by 23° and 9°, respectively) (p < 0.01). One or more episodes of back pain of at least two days duration was experienced by 24% of all subjects in the past year, and 18% recalled at least one episode of back pain in earlier years. Dancers experienced significantly more back pain in the last year, and in earlier years, compared to non-dancers (37% versus 18% and 24% versus 14%, resp...

International Journal of Therapy and Rehabilitation, 2014

AimsTo investigate whether thoracic exercises result in improved pain, range of movement and heal... more AimsTo investigate whether thoracic exercises result in improved pain, range of movement and health-related quality of life (HRQOL) following open heart surgery (OHS), and to evaluate patient perception of the role of thoracic exercises in recovery.MethodsA single-blinded pilot trial was conducted in a tertiary public hospital in Australia. Thirty-eight participants who underwent OHS were randomly allocated to an experimental (Group 1, n=23), or control (Group 2, n=15) group. All participants were prescribed a twice-daily walking programme postoperatively. The experimental group also completed a progressive, individualised thoracic exercise programme. Baseline pre-operative measures of shoulder and thoracic range of movement, pain and HRQOL were repeated at 4 weeks following discharge and 3 months postoperatively. Participants also rated their perceptions of the role of exercise and its contribution to physical recovery.FindingsAt 4 weeks following discharge, the experimental group ...

Spine, 2002

Study Design. A two-group experimental design with repeated measures on one factor was used. Obje... more Study Design. A two-group experimental design with repeated measures on one factor was used. Objective. To describe the relation between movement of the hip and lumbar spine during active hip flexion in healthy young adults and children. Summary of Background Data. Many descriptions of hip movement and procedures for clinically assessing the range of hip joint flexion do not take into account the substantive range of lumbar spine motion that normally accompanies hip flexion. Posterior pelvic rotation, representative of lumbar flexion during hip flexion, has been incorrectly regarded as a compensatory movement. Methods. Unilateral full range active hip (knee) flexion was examined using computer-aided video analysis in 22 healthy young adults and 22 healthy children. Results. Except for the first 3°to 5°of the upward movement of hip flexion, hip and lumbar spine motion was concurrent in both phases of the test movement in children and adults. On the average, every 3°of hip motion was accompanied by 1°of lumbar motion. Throughout the upward movement, the relative contribution of hip movement decreased while that of the lumbar spine increased. During the downward movement, the hip returned nearly to its original starting position while the lumbar spine remained noticeably flexed. Conclusions. There is a concurrent motion of the lumbar spine-pelvis and hip during normal hip flexion that is analogous with the well-known scapulohumeral rhythm accompanying elevation of the shoulder. Failure to measure or account for the contribution of the lumbar spine to hip flexion could overestimate the range of hip flexion by as much as 33.3%.

Spine, 2009

Study Design. Longitudinal, repeated-measures study. Objective. The aim of this study was to dete... more Study Design. Longitudinal, repeated-measures study. Objective. The aim of this study was to determine changes in sagittal spinal posture in older adults during standing and sitting after a Pilates-based exercise program. Summary of Background Data. Pilates exercise is purported to improve posture, however, few peer-reviewed articles are available to provide scientific support. Most previous studies were conducted in young dancers, and the effect of Pilates exercise on spinal posture in older adults remained unclear. Methods. Thirty-four healthy older adults aged over 60 years volunteered for this study. A two-dimensional PEAK Motus motion analysis system was used to measure sagittal spinal angles. Participants were tested on 2 occasions before the exercise program to establish a baseline measure, and undertook a supervised Pilates-based exercise program twice weekly for 10 weeks. Participants were tested on another 2 occasions, immediately after the exercise program, and after a short-term follow-up. Results. Baseline measures in both standing and sitting postures remained unchanged except for the lumbar spine angle in sitting. Immediately after the Pilates-based exercise program, older adults stood with slightly decreased thoracic flexion and sat with slightly increased lumbar extension. No significant differences were found during the follow-up period. Conclusion. The individually designed Pilates-based exercise program was feasible for healthy older adults, and the high attendance rate supports the suitability of the exercise program over a long period. Considering the variability of the baseline measure, small improvement was only observed in the thoracic kyphosis during standing. The long-term effect of Pilates exercise requires further investigation.

Spine, 2010

A cross-sectional study to examine the sagittal kinematics of spine and lower limb movement durin... more A cross-sectional study to examine the sagittal kinematics of spine and lower limb movement during sit-to-stand (STS). To describe the sagittal kinematics of the spine and lower limb in healthy older adults during STS from 2 seat heights. Older adults with age-related changes in the neuromusculoskeletal system are likely to have difficulty in STS. However, little is known about movement of the spinal regions and their interaction with the lower limb during STS, and the effect of seat height. Thirty-two healthy older adults aged over 60 years were videotaped performing STS from 2 seat heights. A 2-dimensional video motion analysis system with a revised sagittal model was used to measure angular displacement and velocity for the cervical, thoracic, lumbar spine, and the lower limb joints. Concurrent flexion in the hip joint and lumbar spine was accompanied by extension in the thoracic, lower, and upper cervical spine as the trunk leaned forward. After the buttocks lifted off (LO) the chair, the movement interaction in the spine and hip joint was reversed. Some significant age-related changes during STS included downward head tilt at LO, decreased lumbar range of motion, and a large between-participant variation in the movement ratios. Statistically significant differences in the temporal parameters, angular displacement, and velocity were also found when standing from a lower chair. This study provides a detailed description of STS in healthy older adults, which has implications for rehabilitation of elderly patients who have difficulty with this activity. Clinicians need to be aware of the concurrent contribution of the hip joint and lumbar spine to trunk forward lean, the importance of thoracic extension during the pre-LO phase and the downward gaze at LO in healthy older adults.

Skeletal Radiology, 2007

Objective Several measures can quantify thoracic kyphosis from radiographs, yet their suitability... more Objective Several measures can quantify thoracic kyphosis from radiographs, yet their suitability for people with osteoporosis remains uncertain. The aim of this study was to examine the validity and reliability of the vertebral centroid and Cobb angles in people with osteoporosis. Design and patients Lateral radiographs of the thoracic spine were captured in 31 elderly women with osteoporosis. Thoracic kyphosis was measured globally (T1-T12) and regionally (T4-T9) using Cobb and vertebral centroid angles. Multisegmental curvature was also measured by fitting polynomial functions to the thoracic curvature profile. Canonical and Pearson correlations were used to examine correspondence; agreement between measures was examined with linear regression. Results Moderate to high intra-and inter-rater reliability was achieved (SEM = 0.9-4.0°). Concurrent validity of the simple measures was established against multisegmental curvature (r=0.88-0.98). Strong association was observed between the Cobb and centroid angles globally (r=0.84) and regionally (r=0.83). Correspondence between measures was moderate for the Cobb method r=0.72), yet stronger for the centroid method (r=0.80). The Cobb angle was 20% greater for regional measures due to the influence of endplate tilt. Conclusions Regional Cobb and centroid angles are valid and reliable measures of thoracic kyphosis in people with osteoporosis. However, the Cobb angle is biased by endplate tilt, suggesting that the centroid angle is more appropriate for this population.

Physiotherapy, 2002

Summary Background and purpose It has been suggested that hypermobile joints may have disturbed p... more Summary Background and purpose It has been suggested that hypermobile joints may have disturbed proprioception which could compound their mechanical predisposition to injury and degeneration. Accordingly, this study investigated position sense in young adults with increased knee mobility. Methods After determining the passive limit of extension in the non-dominant knee of 44 healthy adults (35 women, 9 men, aged 18 to 29 years), five active position sense tests, each followed by an ipsilateral limb matching response, were administered within an average 13.4° of the passive extension limit. Following computer analysis of videotape images of the test and response positions, position sense accuracy was calculated as the average of the five test-response mismatches, and reliability as the standard deviation from this average. Results Although knee extension mobility and position sense were poorly correlated, analysis of variance revealed greater accuracy (1.5° versus 2.4°, p versus 2.2°, p Conclusions Actively tested, position sense accuracy and reliability were normal in young adults with asymptomatic increased knee mobility. Further studies are required to clarify the status of active position sense in subjects with symptomatic hypermobility.

Physical Therapy, 2010

BackgroundRehabilitation of elderly patients with sit-to-stand (STS) dysfunction includes retrain... more BackgroundRehabilitation of elderly patients with sit-to-stand (STS) dysfunction includes retraining coordinated movement among participating body segments. Although trunk position is considered important, spinal movement has not been measured.ObjectiveThe aim of this study was to describe the sagittal thoracolumbar kinematics and hip-lumbar interaction during the STS task in elderly people who were healthy in order to guide physical therapists in developing treatment strategies.DesignThis was an observational study.MethodsTen retroreflective markers were attached to the midline thoracolumbar spine, pelvis, and right lower limb of 41 elderly people who were healthy. A 2-dimensional video analysis system was used to measure sagittal thoracic, lumbar, hip, and knee joint angles during the STS task. Maximal available flexion-extension angles in these joints and regions also were determined.ResultsPrior to buttocks lift-off, forward trunk lean comprised concurrent hip and lumbar flexion...

Manual Therapy, 2009

A revised model of skin marker placement with the two-dimensional (2D) PEAK Motus system was used... more A revised model of skin marker placement with the two-dimensional (2D) PEAK Motus system was used to investigate the effect of aging on sagittal range of spinal motion. Twenty-four healthy young adults and twenty-two healthy older adults were videotaped while performing the movements of flexion and extension in each spinal region d cervical, thoracic and lumbar spine. Alternative movement tests that may allow a greater range of motion (ROM) for thoracic extension and lumbar flexion were also investigated. Older adults demonstrated significantly decreased flexion/extension ranges in the cervical, thoracic and lumbar spine. The movement of cat-stretch in the all-fours position allowed greater thoracic extension, and the movement of toe-touch in standing permitted greater lumbar flexion. This study provides reference data for sagittal ranges of spinal motion in healthy young and older adults as measured by a 2D imaged-based system. The sagittal model of skin marker placement used in this study can have a broader application for ROM measurement in the clinical setting using a digital camera and freely downloadable software.

Manual Therapy, 2010

The 2D PEAK Motus motion analysis system was used to measure the sagittal lumbofemoral rhythm dur... more The 2D PEAK Motus motion analysis system was used to measure the sagittal lumbofemoral rhythm during active hip (knee) flexion in standing in 34 healthy older adults whose movement may be influenced by age-related changes in the neuromusculoskeletal system. When the thigh was raised, the lumbar spine moved concurrently with the hip joint throughout the movement. Approximately 5 of initial hip flexion occurred before 1 of lumbar flexion. Overall, the lumbar spine contributed 26.6% (29.3) of the total thigh movement (pelvis þ hip joint) during the upward (110.2) movement phase. Compared to children and young adults, older adults demonstrated some age-related differences in sagittal lumbofemoral rhythm, including decreased hip flexion and a large variation in the hip-to-lumbar movement ratio. Clinicians and exercise instructors need to be aware of the concurrent movement interaction between the hip joint and lumbar spine when measuring hip flexion range or when instructing abdominal, hip, or lumbar exercises. The potential influence of limited range of motion of either hip or lumbar component on the movement should also be addressed.

Australian Journal of Physiotherapy, 1999

This prospective cohort study evaluated the relationship of hamstring and lumbar spine flexibilit... more This prospective cohort study evaluated the relationship of hamstring and lumbar spine flexibility to hamstring injury. Sixty-seven senior male Australian Rulesfootballerswere videotaped while performing a toe-touch test from erect standing. The Peak Motion Measurement System was used to obtain measurements of end range hip flexion, lumbar flexion, toe-touch distance (TTD) and the ratio of lumbar spine flexion to hip flexion. Over the following football season, eight subjects (11.9 per cent) sustained a hamstring strain. Results showed no significant difference between the hamstring injured or uninjured players for any of the measured variables with no variable able to predict the likelihood of injury (p > 0.05). In this cohort, the toe-touch test would not •appear to be a useful screening tool to identify footballers .at risk for hamstring strain. [Bennell K, Tully E and HarveyN(1999):Does the toe-touch test predict hamstring injury in Australian Rules footbaUers?

Journal of Manipulative and Physiological Therapeutics, 2009

Objective: Changes in posture are of concern because of their association with pain or impaired p... more Objective: Changes in posture are of concern because of their association with pain or impaired physical function. Previous studies that have used computer-aided video motion analysis systems to measure posture have been compromised by the use of problematic models of skin marker placement. This study aimed to quantify and compare sagittal spinal posture in standing and sitting between young and older adults using a two-dimensional PEAK Motus system and a revised skin marker model. Methods: Twenty-four healthy young adults and 22 healthy older adults volunteered for this study. The angles of the upper and lower cervical spine, thoracic spine, lumbar spine as well as the orientations of the head, neck, and pelvic plane with respect to an external reference were measured in the standing and sitting positions. Results: Compared to young adults, healthy older adults demonstrated a forward head posture, with increased lower cervical spine flexion and increased upper cervical extension in both positions. Older adults also sat with significantly increased thoracic kyphosis and decreased lumbar spine flexion. Conclusion: The angular relationship between adjacent spinal regions in the sagittal plane can be objectively quantified using image-based analysis. The concept that the anteroposterior tilt of the pelvis in standing dictates the lumbar and thoracic curves was supported by the correlations between these adjacent regions in both age groups. The model of skin marker placement used in this study can have a broader application as a clinical tool for image-based postural assessment.

Journal of Biomechanics, 2006

Gait & Posture, 2005

This study aimed to determine the sagittal movement relationships between thoracic, lumbar spine ... more This study aimed to determine the sagittal movement relationships between thoracic, lumbar spine and hip joints during sit-to-stand (STS). Forty-seven healthy young adults were videotaped performing STS at their preferred speed from a chair set at 100% knee height. Forward trunk lean prior to buttock lift-off (LO) was accomplished by concurrent lumbar and hip flexion (1:3). As the lumbar spine flexed the thoracic spine extended, resulting in a LO trunk angle of 45.78 (AE5.88) with respect to a horizontal reference. Following LO, the hip(s) and lumbar spine extended and the thoracic spine flexed, with the standing thoracic angle approximating the initial thoracic posture in sitting.