Our research in the

Improving Clinical Care theme

The Improving Clinical Care theme includes research staff, research students and professional staff from a variety of backgrounds including physiotherapy, chiropractic, rheumatology and emergency medicine.

Australia’s CareTrack study showed that Australians get the right care at only 60% of healthcare visits. In this theme, we work with clinicians, patients and policymakers to implement the latest research knowledge so that patients receive the very best healthcare – every time.

IMH-led projects

We hope that implementation of a new model of care for acute low back pain will make an enormous difference to the health outcomes of patients when visiting an emergency department (ED) and improve the quality of emergency services.

The SHaPED trial aims to improve ED practices through implementing an evidence-based model of care for acute low back pain and evaluating the effects on healthcare services, patient outcomes, and cost compared with usual emergency care. Low back pain patients presenting to EDs often receive complex and unnecessary interventions (e.g. imaging and opioids) yet miss out on the basics of care such as advice on how to self-manage the condition. The Agency for Clinical Innovation (ACI) has recently published a model of care for acute low back pain. The key messages for practice are that non-serious acute low back pain does not require imaging, simple analgesics should be the first option for medicine, and patients should be managed as outpatients. Timely referral and scheduled follow-up reviews are also recommended. At present, active implementation of the ACI model of care and its effects have not been evaluated, and passive dissemination (i.e. publication on a website) is unlikely to change ED practices.

This project is no longer recruiting.

Principal Investigator:  Professor Chris Maher

Chief Investigators: Dr Gustavo Machado, Dr Bethan Richards, Dr Chris Needs, Dr James Edwards, Dr Eileen Rogan, Dr Rochelle Facer, Dr David Lord Cowell, Professor Ian Harris, Professor Rachelle Buchbinder, Ms Danielle Coombs, Associate Professor Laurent Billot, Professor Kirsten Howard and Professor Kirsten McCaffery.

For more information about this project, please visit the SHaPED Trial Website or contact Dr Gustavo Machado. The project has received ethics approval from Sydney Local Health District, is funded by Sydney Health Partners, and is endorsed by the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network.

ACTRN12617001160325

Collaborative projects

ANZMUSC Clinical Trials Network has been established by research leaders with funding from the National Health and Medical Research Council (NHMRC) for five years (2018-2022) and is being led by Monash University.

ANZMUSC Clinical Trials Network’s vision is to optimise musculoskeletal health through high quality, collaborative clinical research. They aim to do this through identifying key clinical research questions, improving the quality of research, increasing translation of research into policy and practice, fostering collaborations, endorsing clinical research, and advancing research through mentoring and education.

Principal Investigator: Professor Rachelle Buchbinder – Monash University

Institute for Musculoskeletal Health Investigators: Professor Chris Maher, Professor Ian Harris, Professor Jane Latimer and Professor Christine Lin.

For more information, please visit ANZMUSC Clinical Trials Network.

The intention of the trial is to validate a new treatment approach for chronic low back pain leading to clinically meaningful reduction in pain intensity at six weeks post treatment.

The RESOLVE Trial aims to test two interventions targeting the brain to treat chronic low back pain. New research shows that it may be possible to retrain the brain to reduce chronic low back pain. Participants are allocated to one of two intervention groups, both attending 12 one-hour treatment sessions. The first intervention program will include: discussion of your low back pain; laser therapy and pulsed electromagnetic energy for your lower back, non-invasive brain stimulation; mental movement training; physical movement training; and training to improve your sense of touch. The second intervention program will include: low back pain experience, transcranial direct current stimulation, cranial electrical stimulation, low-intensity laser therapy and pulsed electromagnetic energy.

This project is currently recruiting. You may be eligible to participate in this study if you have low back pain for longer than three months, between 18 – 70 years old and live in the Sydney metropolitan area.

Principal Investigator: Associate Professor James McAuley

Institute for Musculoskeletal Health Investigator: Professor Chris Maher

For more information on this NeuRA trial, please contact the RESOLVE team or call 02 9399 1627. This NHMRC Project Grant has received ethics approval from University of New South Wales Human Research Ethics Committee.

ACTRN12615000610538

The intention of the trial is to demonstrate McKenzie based self-management as a low-cost, simple method for reducing the burden of low back pain.

The SAFE Trial aims to assess the effectiveness of McKenzie based self-management in reducing the recurrence of low back pain. While the recurrence of low back pain is very common, there is limited evidence on interventions that are effective in preventing relapse. Participants are randomly allocated to one of two treatment groups: participants allocated to the intervention group attend two 30 minute sessions with a physiotherapist and participants allocated to the control group receive advice over the phone and a self-management booklet.

This study is currently recruiting. You may be eligible to participate if you have recovered from an episode of non-specific low back pain in the past six months, are 18 years or older and not taking any medication for low back pain.

Principal Investigator: Associate Professor Mark Handcock

Institute for Musculoskeletal Health Investigator: Professor Chris Maher

For more information on this Macquarie University trial, please contact Mr Tarcisio Folly de Campos. The study has received ethics approval from Macquarie University Human Research Ethics Committee and funding from the International Mechanical Diagnosis and Therapy Research Foundation.

ACTRN12616000926437

This aim of this trial is to compare the effectiveness of a single ultrasound-guided injection of platelet-rich plasma (PRP), glucocorticoid or saline (placebo) for the treatment of Tennis Elbow. In addition, the trial is aiming to compare the cost-effectiveness of these treatments. Lateral epicondylitis or tennis elbow is a common musculoskeletal condition which affects 15% of workers in at-risk industries. The high costs to the individual and society – related to sick leave and disability – demonstrate a clear need to assess the most cost-effective therapies. Participants will be screened including an ultrasound performed to confirm the diagnosis, to ensure that they are eligible for the study. Outcomes will be assessed at baseline and multiple time points over a year.

This study is currently recruiting. You may be eligible to participate if you have experienced lateral elbow pain for six weeks or more and have an ultrasound-confirmed lesion.

Principal Investigator: Prof Rachelle Buchbinder

Institute for Musculoskeletal Health Investigator: Dr Bethan Richards

For further information about this Monash Department of Clinical Epidemiology at Cabrini Hospital trial, please contact Dr Allison Bourne. The study has received ethics approval from Cabrini Human Research Ethics Committee and has received NHMRC funding.

ACTRN12613000616774

Theme leader: Professor Chris Maher

BAppSc(Phty), GradDipAppSc(ExSpSc), GradDipAppSc(ManipPhty), PhD, DMedSc, FACP, FAAHMS

Professor Chris Maher is an NHMRC Principal Research Fellow and Fellow of the Australian Academy of Health and Medical Sciences. His clinical training is in physiotherapy and he is a fellow of the Australian College of Physiotherapy. Chris is best known for his clinical research evaluating the management of low back pain which has been published in leading journals including New England Journal of Medicine, Lancet, Annals of Internal Medicine and British Medical Journal.