The MRC Annual Report for 2008 is now available for download. In 2008, MRC researchers attracted $1.9M in research funding, and published 2 books, 7 book chapters and 81 peer-reviewed journal articles.

Composite interference screws containing calcium phosphate for anterior cruciate ligament graft fixation could improve implant/bone integration and thereby reduced tunnel widening and graft slippage. This study by MRC visiting fellow Martin Lind, Dr Kate Webster and A/Prof Julian Feller investigated the effect of polylactate/hydroxyapatite interference screw (HA/PLLA) screw used for tibial graft fixation on tunnel widening and clinical outcomes compared with a metal interference screw. We hypothesized less tibial tunnel widening with HA/PLLA screws compared to metal screws. One hundred patients with HA/PLLA screw tibial fixation were compared with 100 patients with metal screw tibial fixation. Tibial tunnel widening was measured on AP and lateral radiographs taken at 12 months follow-up. Tibial tunnel widening at the level of the metal screw group was 36% and 38% on AP and lateral radiographs, respectively. Tunnel widening was lower in the HA/PLLA group with mean tunnel widening of 30% and 32% on AP and lateral radiographs respectively. The use of a polylactate/hydroxyapatite interference screw resulted in less tibial tunnel widening than a metal screw around the screw but did not affect clinical outcome or objective knee laxity (more from The Knee...)

Congratulations to MRC / Podiatry PhD student Martin Spink (pictured) who was awarded best research poster at the Australasian Podiatry Conference held on the Gold Coast from May 12-16. MRC Director A/Prof Hylton Menz was awarded the best research presentation, and PhD students Gerard Zammit and Christian Barton delivered podium presentations.

The second edition of Falls in Older people: Risk Factors and Strategies for Prevention, co-authored by A/Prof Hylton Menz and colleagues from the Prince of Wales Medical Research Institute, has been awarded the Australasian Journal on Ageing book award for 2008. In awarding the prize, book editor Prof Yvonne Wells stated that "This is an impressively thorough exploration of fall risks and preventive strategies, with strong academic credentials".

For more details, click here.

The aim of this study by A/Prof Hylton Menz and colleagues from the Prince of Wales Medical Research Institute and University of Wollongong was to systematically investigate the influence of various walking surfaces and footwear characteristics on the ability to terminate gait rapidly in young and older people. Subjects walked at a self-selected speed in eight randomized shoe conditions (standard versus elevated heel, soft sole, hard sole, high-collar, flared sole, bevelled heel and tread sole) on three surfaces: control, irregular and wet. In response to an audible cue, subjects were required to stop as quickly as possible in three out of eight walking trials in each condition. Time to last foot contact, total stopping time, stopping distance, number of steps to stop, step length and step width post-cue and base of support length at total stop were calculated from kinematic data collected using two CODA scanner units. The older subjects took more time and a longer distance to last foot contact and were more frequently classified as using a three or more-steps stopping strategy compared to the young subjects. The wet surface impeded gait termination, as indicated by greater total stopping time and stopping distance. Subjects required more time to terminate gait in the soft sole shoes compared to the standard shoes. In contrast, the high-collar shoes reduced total stopping time on the wet surface. These findings suggest that older adults have more difficulty terminating gait rapidly than their younger counterparts and that footwear is likely to influence whole-body stability during challenging postural tasks on wet surfaces (more from Gait and Posture...)

MRC research fellow Jodie McClelland recently returned from the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) conference in Osaka, Japan, where she presented the results of her recently completed PhD on knee biomechanics following total knee replacement surgery.

For more details on ISAKOS, and to download the abstracts, click here.

Plantar hyperkeratotic lesions (corns and calluses) are common in older people and are associated with pain, mobility impairment and functional limitations. However, little has been documented in relation to the frequency or distribution of these lesions. The aim of this study by MRC researchers Martin Spink and A/Prof Hylton Menz was to document the occurrence of plantar hyperkeratotic lesions and the patterns in which they occur in a random sample of older people. A medical history questionnaire was administered to a random sample of 301 people living independently in the community aged between 70 and 95 years, who also underwent a clinical assessment of foot problems, including the documentation of plantar lesion locations, toe deformities and the presence and severity of hallux valgus. Of the 301 participants, 180 (60%) had at least one plantar hyperkeratotic lesion. Those with plantar lesions were more likely to be female, have moderate to severe hallux valgus, a larger dorsiflexion range of motion at the ankle, and spent more time on their feet at home. No associations were found between the presence of plantar lesions and body mass index, obesity, foot posture, dominant foot or forefoot pain. A total of 53 different lesions patterns were observed, with the most common lesion pattern being "roll-off" hyperkeratosis on the medial aspect of the 1st metatarsophalangeal joint (MPJ), accounting for 12% of all lesion patterns(more from Journal of Foot and Ankle Research...)

Every year more than 25,000 knees are replaced in Australia. While surgery is often successful, helping prevent some of the problems that lead to bad knees would be better. To do this we need to know more about the way various forces aff ect the knee says Dr Pazit Levinger, who is using a complex system of gait analysis to learn more about the walking pattern of people with painful knee conditions. ‘Preventative measures can then be devised to correct the gait and hopefully prevent deterioration of the joint,’ she says. Dr Levinger, a Postdoctoral Research Fellow in La Trobe University’s Musculoskeletal Research Centre, visualises the interplay of forces on patients’ knees using a three-dimensional motion analysis system in combination with computer intelligence. The state-of-the-art equipment helps investigate the recovery of patients after knee surgery, measuring their walking pattern such as joint angles and forces, length of step, step time and stride length (more from La Trobe Bulletin...)

Transcutaneous electrical stimulation using kilohertz-frequency alternating current (AC) became popular in the 1950s with the introduction of "interferential currents," promoted as a means of producing depth-efficient stimulation of nerve and muscle. Later, "Russian current" was adopted as a means of muscle strengthening. This article by MRC researcher A/Prof Alex Ward reviews some clinically relevant, laboratory-based studies that offer an insight into the mechanism of action of kilohertz-frequency AC. It is concluded that the stimulation parameters commonly used clinically (Russian and interferential currents) are suboptimal for achieving their stated goals and that greater benefit would be obtained using short-duration (2-4 millisecond), rectangular bursts of kilohertz-frequency AC with a frequency chosen to maximize the desired outcome (more from Physical Therapy...)

Dr Alankar Ambadas Ramteke, MBBS, MS (Orth) has joined the MRC as a visiting orthopaedic fellow for 6 months. Alankar is assistant professor in the Department of Orthopaedics and Traumatology at Grant Medical College, Mumbai, India. During his time with the MRC, Alankar will be working on a project with Dr Kate Webster, Jodie McClelland and A/Prof Julian Feller assessing outcomes in patients who have undergone total knee replacement surgery with computer-assisted navigation.

The aim of this systematic review by PhD student George Murley and colleagues was to evaluate the literature pertaining to the effect of foot posture, foot orthoses and footwear on lower limb muscle activity during walking and running. A database search of Medline, CINAHL, Embase and SPORTDiscus without language restrictions revealed 504 citations for title and abstract review. Three articles were translated to English and a final 46 articles underwent a two-tiered quality assessment. Thirty-eight articles displayed adequate reporting of electromyographic methodology and qualified for detailed review including a second quality assessment using a modified version of the Quality Index. Some evidence exists that: (i) pronated feet demonstrate greater electromyographic activation of invertor musculature and decreased activation of evertor musculature; (ii) foot orthoses increase activation of tibialis anterior and peroneus longus, and may alter low back muscle activity; and (iii) shoes with elevated heels alter lower limb and back muscle activation. Most studies reported statistically significant changes in electromyographic activation, although these findings were often not well supported when confidence intervals were calculated. Most important, however, is that there is a need for further research of more rigorous methodological quality, including greater consensus regarding standards for reporting of electromyographic parameters (more from Gait and Posture...)

Clare Ardern has joined the MRC as a PhD student. Clare completed her Honours degree in physiotherapy last year and will be working with the knee orthopaedics group.

Three protocol papers for MRC randomised controlled trials have been published in BioMed Central open access journals:

• Efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people: study protocol for a randomised trial (link)

• Efficacy of intra-articular hyaluronan (Synvisc) for the treatment of osteoarthritis affecting the first metatarsophalangeal joint of the foot (hallux limitus): study protocol for a randomised placebo controlled trial (link)

• Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease: protocol for an economic evaluation alongside a clinical trial (link)

PhD student Stuart McDonald received the Wyeth Young Investigator Award ($1,000 cash prize) at the recent Australian and New Zealand Bone and Mineral Society’s 18th annual meeting at the Hilton on the Park in Melbourne in September for the work entitled: Transient upregulation of certain smooth muscle-associated proteins in osteoprogenitor cells of early, soft fracture callus: implications for the fracture repair process.  Extending his work in relation to the smooth-muscle-like nature of early fracture callus; he reported that gene expression of a large number smooth muscle-related proteins transiently increase and peak in fracture callus around 7 days after fracture and return towards unfractured levels by 21 days post-fracture. These increases in expression of smooth muscle-associated proteins provide further evidence of this tissue’s smooth muscle-like nature and implicate that cells of this callus contract in a smooth muscle-like fashion to create static tension. Static tension is likely to stimulate differentiation of smooth muscle-like bone stem (osteoprogenitor) cells into bone forming cells and therefore facilitate fracture healing.

The new open access journal, Journal of Foot and Ankle Research (JFAR), the publication of the Australasian Podiatry Council and the Society of Chiropodists and Podiatrists (SCP), was officially launched by Mr Mike Potter at the SCP conference in Bournemouth on October 23-25, 2008 (see picture). MRC researchers A/Prof Hylton Menz and Dr Karl Landorf are Editor and Deputy Editor, respectively.

The objestive of this study by a team of researchers, including MRC director A/Prof Hylton Menz, was to develop screening tools for predicting falls in nursing home and intermediate-care hostel residents who can and cannot stand unaided. A prospective cohort study was conducted in 2005 residential aged care facilities in northern Sydney, New South Wales, June 1999-June 2003. Ability to stand unaided was identified as a significant event modifier for falls. In people who could stand unaided, having either poor balance or two of three other risk factors (previous falls, nursing home residence, and urinary incontinence) increased the risk of falling in the next 6 months threefold (sensitivity, 73%; specificity, 55%). In people who could not stand unaided, having any one of three risk factors (previous falls, hostel residence, and using nine or more medications) increased the risk of falling twofold (sensitivity, 87%; specificity, 29%). It was concluded that these two screening models are useful for identifying older people living in residential aged care facilities who are at increased risk of falls. The screens are easy to administer and contain items that are routinely collected in residential aged care facilities in Australia (more from the Medical Journal of Australia...)

MRC researcher Dr Pazit Levinger was recently featured in a Channel 9 National News featured regarding her research on gait, balance and falls in older people.

• To view the full story on the Channel 9 website, click here

The purpose of this study by MRC researchers Gerard Zammit, Dr Karl Landorf Dr Shannon Munteanu and A/Prof Hylton Menz was to evaluate differences in dynamic plantar pressure distribution between older people with and without radiographically confirmed osteoarthritis (OA) of the first metatarsophalangeal joint (first MPJ) of the foot. Dynamic plantar pressure recordings using the TekScan MatScan(R) system were obtained during barefoot level walking in 40 older participants; 20 with radiographically confirmed OA of the first MPJ displaying less than 55 degrees of passive dorsiflexion, and 20 with no evidence of OA in the first MPJ displaying greater than 55 degrees of passive dorsiflexion. Group comparisons between the variables maximum force and peak pressure were made for seven different regions underneath the right foot (heel, midfoot, first MPJ, second MPJ, third to fifth MPJs, hallux, and lesser toes). Compared to the control group, participants with OA of the first MPJ exhibited 34% greater maximum force (7.9 +/- 2.5 vs. 5.9 +/- 1.7 kg, p = 0.005) and 23% higher peak pressure (1.6 +/- 0.3 vs. 1.3 +/- 0.3 kg/cm(2), p = 0.001) under the hallux. Similar results were also found under the lesser toes with 43% greater maximum force (5.0 +/- 1.9 vs. 3.5 +/- 1.4 kg; p = 0.006) and 29% higher peak pressure (0.9 +/- 0.2 vs. 0.7 +/- 0.2 kg/cm(2), p = 0.018). No significant differences were found to exist between groups for any other plantar region. These findings indicate that OA of the first MPJ is associated with significant changes in load-bearing function of the foot, which may contribute to the development of secondary pathological changes associated with the condition, such as plantar callus formation and hyperextension of the hallux interphalangeal joint (more from Journal of Orthopaedic Research...)

The Muscle Function and Rehabilitation and Back and Neck Pain research groups in the MRC were recently featured in the Musculoskeletal Physiotherapy Association's magazine In Touch.

• To download a PDF of the article, click here

MRC researcher A/Prof Tim Bach was recently featured on the ABC's science program Catalyst. The olympics special edition of the program featured a story on the use of "blades" prostheses and was filmed in the MRC Movement Laboratory. Also featured was Australian paralympian Don Elgin and MRC staff Jodie McClelland and Jo Wittwer.

• To read a transcript or stream the story, click here
• To download the story as an MP4, click here
• To download the story as a WMV, click here

The aim of this study by MRC researchers Dr Nora Shields, Prof Nicholas Taylor and Prof Karen Dodd was to determine whether progressive resistance training improves muscle strength, muscle endurance, and physical function in adults with Down syndrome. 20 adults with Down syndrome (13 men, 7 women; mean age, 26.8+/-7.8 y) were randomly assigned through a concealed allocation block randomized method to either an intervention group (n=9) or a control group (n=11). The intervention was a supervised, group progressive resistance training program, consisting of 6 exercises using weight machines performed twice a week for 10 weeks. Participants completed 2 to 3 sets of between 10 to 12 repetitions of each exercise until they reached fatigue. The control group continued with their usual activities. The results indicated that the intervention group showed significant improvement in upper-limb muscle endurance compared with the control group, and a trend toward an improvement in upper-limb muscle strength. There were no significant differences between the groups for lower-limb muscle performance or physical function measures. No major adverse events for the intervention were noted. It was concluded that progressive resistance training is a safe and feasible fitness option that can improve upper-limb muscle endurance in adults with Down syndrome (more from Archives of Physical Medicine and Rehabilitation...).

Increased load on the knee joint by excessive levels of impact forces during initial contact has been suggested to lead to knee osteoarthritis (OA). Asymmetric loading after knee replacement may also relate to the development of OA in the contralateral limb. Therefore, the aim of this study by MRC researchers Dr Pazit Levinger, Dr Kate Webster and A/Prof Julian Feller was to investigate the heel strike transient vertical force and subsequent lower extremity kinematic, kinetic and spatio-temporal parameters during level walking between the operated and the contralateral limbs in patients 12 months following unilateral knee replacement. A six camera motion analysis system with a force plate was used to investigate the differences between limbs in the heel strike transient vertical GRF and its relative timing, and hip, knee and ankle angles and moments at initial contact, as well as spatio-temporal parameters during the stance phase of walking in 19 subjects with unilateral knee replacement. Paired t tests showed a significant difference in the contralateral limb relative to the operated limb in the heel strike transient magnitude (p=0.03), hip moment (p=0.01), knee moment (p=0.02) and ankle moment (p=0.03). No significant differences were found for the joint angles at heel contact or the spatio-temporal parameters (p>0.05). The heel strike transient magnitude was lower for the operated limb with no differences in the spatio-temporal parameters or the joint angles at initial contact between the limbs. Differences in the hip, knee and ankle moments were also found indicating an asymmetric loading of the impact force at initial contact on the lower extremity. The current findings may indicate an asymmetric loading on the knee joint and therefore may be clinically relevant in patients undergoing unilateral knee replacement (more from The Knee...).

A COL5A1 gene variant was shown to be associated with chronic Achilles tendinopathies (TEN) in a South African (SA) population. The aim of this case-control genetic association study by MRC researcher Prof Chris Handley and colleagues was to (i) investigate the BstUI and DpnII restriction fragment length polymorphisms (RFLP) in a second population from Australia and (ii) to identify a predisposing haplotype for TEN in both populations. Eighty-five Australian and 93 SA TEN, as well as, 210 Australian and 132 SA control Caucasian subjects were genotyped for the BstUI (rs12722) and DpnII (rs13946) RFLPs, as well as, markers rs10858286, rs3196378, rs11103544, rs4504708 and rs3128575. Results indicated that the BstUI RFLP (P<0.001), as well as markers rs3196378 (P=0.003) and rs11103544 (P=0.003), were associated with TEN in the Australian cohort. Individuals with a BstUI RFLP CC genotype had a significant decreased risk of developing TEN versus any other genotypes (OR=0.42, 95% CI 0.20-0.86, P=0.017). The TTCT and TTCC haplotypes (rs13946, rs12722, rs3196378 and rs11103544) were inferred to be under- (P=0.038) and over-represented (P<0.001) compared to all other haplotypes, respectively, in the tendinopathy group when the combined Australian and SA cohorts were analysed. It was concluded that the (i) BstUI RFLP is associated with chronic Achilles tendinopathy in a second population and (ii) a region within COL5A1 3'-UTR may predispose individuals to an increased risk of developing TEN (more from the British Journal of Sports Medicine...).

The objective of this study by MRC researchers Dr Mrna Ilic, Dr Belinda Martinac, Dr Tom Samiric and Prof Chris Handley was to investigate the effect of glucosamine on the loss of newly synthesized radiolabeled large and small proteoglycans by bovine tendon, ligament and joint capsule. The kinetics of loss of (35)S-labeled large and small proteoglycans from explant cultures of tendon, ligament and joint capsule treated with 10mM glucosamine was investigated over a 10-day culture period. The kinetics of loss of (35)S-labeled small proteoglycans and the formation of free [(35)S]sulfate were determined for the last 10 days of a 15-day culture period. The proteoglycan core proteins were analyzed by gel electrophoresis followed by fluorography. The results indicated that glucosamine at 10mM stimulated the loss of small proteoglycans from ligament explant cultures. This was due to the increased loss of both macromolecular and free [(35)S]sulfate to the medium indicating that glucosamine affected the release of small proteoglycans as well as their intracellular degradation. The degradation pattern of small proteoglycans in ligament was not affected by glucosamine. In contrast, glucosamine did not have an effect on the loss of large or small proteoglycans from tendon and joint capsule or large proteoglycans from ligament explant cultures. The metabolism of cells in tendon, ligament and joint capsule was not impaired by the presence of 10mM glucosamine. It was concluded that glucosamine stimulated the loss of small proteoglycans from ligament but did not have an effect on small proteoglycan catabolism in joint capsule and tendon or large proteoglycan catabolism in ligament, tendon or synovial capsule (more from Osteoarthritis and Cartilage...).

Heel lifts are a treatment option for low back pain (LBP), whilst high-heeled shoes have been linked to LBP development. This study by MRC PhD student Christian Barton evaluated the effects of in-shoe 20mm high bilateral heel lifts on trunk muscle activity. Activity of the erector spinae (ErSp), internal oblique and external oblique muscles was evaluated using surface electromyography in 15 young (20.7+/-0.9 years) healthy female participants. Measures were taken during overground gait, both immediately and following two days habituation to the heel lifts. Immediately following the addition of the heel lifts, levels of ErSp muscle activity in the 5% epoch following heel strike increased by 19.2% (p<0.05). Following habituation, levels of ErSp muscle activity in the 5% epoch prior to heel strike increased by 24.1% (p<0.05), and a 14ms (p<0.001) earlier onset of ErSp muscle activity prior to heel strike was observed. These results indicate the heel lifts altered muscle activity reactively around heel strike (i.e. greater activity after heel strike) immediately after application and proactively (i.e. earlier onsets and greater activity prior to heel strike) after short term habituation. When put in context of previous research on trunk muscle activity in LBP populations, these changes may be important considerations for the aetiology, treatment and prevention of LBP (more from the Journal of Electromyography and Kinesiology...).

Foot Problems in Older People: Assessment and Management by A/Prof Hylton Menz provides a comprehensive guide to the assessment and management of foot and ankle problems in older people. Areas covered include the epidemiology of foot problems, functional implications, assessment of the older person with foot problems, common foot problems and their management, foot and ankle manifestations of common systemic conditions, wound management, footwear and orthotic considerations, surgical considerations and outcome assessment. Each chapter provides a comprehensive and critical review of the literature as well as providing practical evidence-based guidelines for clinicians. Foot Problems in Older People is now available from Churchill Livingstone / Elsevier.

For more information, click here.

Dr Jon Ford has joined the MRC / School of Physiotherapy as a research fellow. Jon leads a research team of higher degree students investigating the management of low back pain, and was previously employed at the University of Melbourne.

For more information about the back pain research group, click here.

Elin Wee has joined the MRC as a research officer. Elin is a physiotherapist and was previously employed as a research assistant at the University of Melbourne.

Elin will be working on the NHMRC-funded trial into the efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people.

Dr Mohammadreza Fotoohabadi ("Reza") has joined the MRC as a research officer. Reza recently completed his PhD at the University of Melbourne and holds a bachelor degree in physiotherapy and two Masters degrees from Shiraz University and Beheshtee University in Iran.

Reza will be working on the NHMRC-funded trial into the efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people.

The 3rd Australian and New Zealand Falls Prevention Conference will be held in Melbourne, Victoria from the 12-14 October 2008 and is an initiative of the Australian and New Zealand Falls Prevention Society (ANZFPS). MRC researchers Prof Keith Hill and A/Prof Hylton Menz are on the conference organising committee. It will follow on the success of the two earlier conferences: 2006 in Brisbane and 2004 in Sydney. The ANZFPS was formed in 2006 to support and promote falls prevention research, policy, practice and education across all settings, working toward the goal of reducing falls and falls injuries among older people in Australia and New Zealand. Activities range from health promotion and health ageing approaches, through to multifactorial multidisciplinary interventions for those with high levels of risk, and from individual focus through to organisation and system-wide approaches.

To download the conference flyer, click here.

This study by Monash University researchers Dr Peter Kent and Prof Jenny Keating, and MRC researcher Prof Nicholas Taylor investigated the assessment of acute (<12 weeks duration) nonspecific low back pain (NSLBP) by primary care clinicians. The aims were to determine the methods used, whether methods differ across professional disciplines, and the extent to which clinicians assess across domains of health. Survey data were gathered from 651 primary care clinicians from six professional disciplines (Physiotherapy, Manipulative Physiotherapy, Chiropractic, Osteopathy, General Medicine, and Musculoskeletal Medicine). The results indicated that the methods used by different professional disciplines to assess NSLBP vary considerably, as 44 out of 48 assessment techniques showed significantly different utilisation rates across professions. Furthermore, assessment across domains of health in this condition was variable, as clinicians commonly assess physical impairments and pain and less commonly assess activity limitation and psychosocial function (100% of clinicians very frequently or often assess physical impairment, 99% assess pain, 21 assess activity limitation, and 7% assess psychosocial function). Adoption of greater standardisation of assessment by clinicians may require demonstration of the capacity of this standardisation to improve patient outcomes (more from Manual Therapy...)

Plantar heel pain is soreness or tenderness of the heel that is restricted to the sole of the foot. It often radiates from the central part of the heel pad or the medial tubercle of the calcaneum, but may extend along the plantar fascia into the medial longitudinal arch of the foot. Severity may range from an irritation at the origin of the plantar fascia, which is noticeable on rising after rest, to an incapacitating pain. This systematic review by MRC researchers Dr Karl Landorf and A/Prof Hylton Menz reached the following conclusions regarding the evidence for heel pain treatments: Casted orthoses (custom-made insoles) may improve function (but not pain) at 3 months in people with plantar heel pain compared with a sham orthosis, but they may be no better than appropriate prefabricated orthoses; supportive taping may improve pain in the short term at 1 week, but we found no evidence on its effectiveness beyond 1 week; we don't know whether heel pads, heel cups , or night splints reduce pain; corticosteroid injections are commonly used to treat plantar heel pain, but we don't know whether they reduce pain compared with placebo or other treatments; we don't know whether local anaesthetic injections, alone or added to corticosteroids , improve pain relief compared with corticosteroids alone; extracorporeal shock wave therapy may reduce pain, but we don't know for sure that it is beneficial; we don't know whether laser treatment, ultrasound, or surgery reduce symptoms compared with sham treatment or no treatment, and; we don't know whether stretching exercises reduce pain compared with no treatment or other treatments (more from BMJ Clinical Evidence...)

Although footwear has been linked to falls in older people, it remains unclear as to which shoe features are beneficial or detrimental to balance in older people. This study by A/Prof Hylton Menz and colleagues from the Prince of Wales Medical Research Institute systematically investigated how footwear features affect balance and stepping in older people. 29 community-dwelling older people undertook tests of postural sway, maximal balance range, coordinated stability and choice-stepping reaction time in a standard shoe and seven other shoes that differed from the standard shoe in one feature only, namely: elevated heel (4.5 cm), soft sole, hard sole, flared sole, bevelled heel, high heelcollar and tread sole. The results revealed significantly increased sway in the elevated heel versus the standard shoe condition. A footwear performance index based on the sum of zscores across three tests (sway, coordinated stability and choice-stepping reaction time) normalized to the standard condition indicated that the elevated heel was most detrimental to balance whereas a high heel-collar and a hard sole showed trends towards being beneficial (more from Gerontology...)

Dr Katja Tecklenburg from the University of Innsbruck, Austria has joined the MRC as a visiting orthopaedic fellow. Katja will undertake surgical training with A/Prof Julian Feller and will conduct clinical gait analysis research with the Orthopaedics Research Group. Katja's research project will focus on gait analysis of patients with patellar instability.

The aim of this study by MRC researchers George Murley and Dr James Wickham was to characterize the electromyographic (EMG) profile of tibialis posterior during barefoot walking in order to establish a reference database for neutral foot posture. Fifteen participants had their foot posture screened using the six-item Foot Posture Index. Bipolar intramuscular electrodes were inserted into tibialis posterior and peroneus longus utilizing ultrasound guidance. Surface electrodes were placed over medial gastrocnemius, peroneus brevis and tibialis anterior. EMG and footswitch gait characteristics were recorded whilst participants completed 10 barefoot walking trials. Individual and grand ensemble averages were used to characterize the intensity profiles for each muscle. Results indicated that for most of the participants, tibialis posterior displayed two bursts of EMG activity, with the first burst during the initial contact phase and the second burst during midstance. It was concludedthat the EMG profile of tibialis posterior during the gait cycle appeared to be highly variable among participants. However, the authors believe that EMG findings from the participants with neutral foot posture in this study may be used for comparison to EMG patterns in people with abnormal foot posture and individuals affected by musculoskeletal disease (more from the Journal of Electromyography and Kinesiology...)

The DM Myers Medal for the best Health Sciences Honours thesis in 2007 is to be awarded to physiotherapy student Sarah Warby. Sarah’s research project, entitled ‘The most appropriate electrical stimulation frequency to reduce shoulder subluxation post stroke’ was supervised by MRC members Dr Alex Ward and Stacey Lucas-Toumbourou. Sarah is the second DM Myers Medal winner to be supervised by MRC member Dr Alex Ward. The first was John Ozcan, whose thesis titled ‘A comparison of true and premodulated interferential current’ won the medal in 2002.

MRC researchers Dr Shannon Munteanu, Dr Karl Landorf, A/Prof Hylton Menz and adjunct researcher A/Prof Jill Cook (Deakin University) have been awarded US$30,000 from the Prescription Foot Orthotic Laboratory Association (PFOLA) to study the effectiveness of customised functional foot orthoses in the treatment of Achilles tendinopathy.

Leading balance and falls researcher Prof Keith Hill was recently appointed Professor of Allied Health at Northern Health, and has also joined the MRC's Gait, Balance and Falls and Muscle Function and Rehabilitation research groups.