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UCL Great Ormond Street Institute of Child Health

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Physiotherapy

Lead Contact: Prof Eleanor Main (e.main@ucl.ac.uk)

physiotherapy wide

 

The Physiotherapy research group offers postgraduate training and teaching, on a full-time or part-time basis. We also run taster courses.

 

Introduction 

We are working towards improving physiotherapy treatments for patients suffering from cardio-respiratory conditions by:

  • Evaluating therapeutic effects of different techniques in specific populations using robust and sensitive outcome measures
  • Understanding how good clinical decisions are made and increasing benefit and minimising risk in treatments involving critically ill patients
  • Investigating the physiological basis of different components of airway clearance techniques as well as unforeseen consequences of such treatments.

Aims 

  • To improve the therapeutic benefits of physiotherapy and minimise the potential for any harm or risk to patients undergoing such treatments
  • To better understand the physiological basis for traditional therapeutic strategies and physiotherapy interventions and their role in current policy and practice
  • To develop and use sensitive and appropriate outcome measures and improve the evidence base for cardio-respiratory physiotherapy
  • To understand how the process of clinical reasoning and decision making can differentiate expert from novice physiotherapy practitioners, and use this knowledge to pre-empt training requirements

Current Projects 

  • Characterisation of treatment profiles, including timing, magnitude and repeatability, patterns and hand surface pressure area of forces applied during physiotherapy
  • Safety and efficacy of on-call and weekend physiotherapy treatments
  • Measures of clinical decision making and evaluation of physiotherapy interventions and techniques purported to improve clinical outcomes
  • Development of novel monitoring techniques (including Lung Clearance Index, Electric Impedance Tomography and Novel Pliance pressure mats) to evaluate the efficacy of different therapeutic interventions
  • Evaluation of current key issues in Cardiorespiratory Physiotherapy, including:

    • The effects of intermittent positive pressure breathing on regional lung ventilation
    • The relative benefits and limitations of ventilator versus manual hyperinflation
    • Factors influencing change in peak expiratory flow during chest physiotherapy
    • Consensus on the physiotherapy management of asymptomatic infants with cystic fibrosis
    • PIF / PEF flow relationship and two phase gas liquid interaction
    • Oxygen delivery systems on exercise performance in patients who are hypoxaemic on activity
    • The importance of preoperative physiotherapy for adults undergoing upper gastrointestinal surgery in terms of postoperative pulmonary complications
    • The use of abdominal binders for improving peak expiratory flow during chest wall vibrations in ventilated patients
    • Validated tools for diagnosing chronic hyperventilation syndrome
    • Optimising critical care rehabilitation programs