CURRENT PROJECTS

Train High Eat Low for Osteoarthritis (THE LO Study) - NHMRC funded

Osteoarthritis (OA) is one of the most prevalent chronic conditions among older adults, with the medial tibio-femoral joint being most frequently affected. The knee adduction moment is recognised as a surrogate measure of the medial tibio-femoral compartment joint load and therefore represents a valid intervention target.

THE LO study (Train High, Eat Low for Osteoarthritis), is a randomised controlled trial that is investigating the effects of a unique, targeted lifestyle intervention in overweight/obese adults with symptomatic medial knee osteoarthritis, combining gait retraining, Program Resistance Training (PRT), and a low glycemic index (GI)/high protein diet. The object is to investigate if these three interventions or the combination of all will decrease the risk of arthritis progression by reducing abnormal loading on the knee joint.

Potential participants attend assessment sessions which include: Knee x-ray, body composition scan, blood test, 24-hour urine sample, questionnaires, gait (walking) biomechanical analysis, dietary assessment, muscle strength and endurance tests, functional tests, activity monitors, 24 hour ambulatory blood pressure monitoring. Once the participants have concluded the assessment stage, they are randomised into one of our five groups (1.Gait, 2.PRT 3.Low GI/high protein diet 4.Combination of these three 5.Lifestyle care and will be training for one year. Assessment measures will be reassess at 6 months and 12 months follow up.

THE LO study will provide the first direct comparison of the long-term benefits of gait retraining, progressive resistance training and a high-protein/low-glycaemic-index energy-restricted diet, separately and in combination, on joint load, radiographic progression, symptoms, and associated co-morbidities in overweight/obese adults with OA of the knee.

Research has shown that weight loss, increase muscle strain and minor changes to walking technique can reduce the amount of knee pain experienced by those with osteoarthritis. This study is looking at the best way to reduce knee pain and progression of osteoarthritis.
This free program includes a complete medical screening and functional assessment of your knee osteoarthritis. Activities are fully supervised by experience health professionals and will be conducted over 12 months at The University of Sydney, Faculty of Health Sciences, Lidcombe Campus.

THELO contact - Yareni Guerrero Ayala on (02) 9351 9826 or email: ygue4491@uni.sydney.edu.au

Brief behavioral counselling intervention for peripheral artery disease (BIP)

The BIP study is a multi-site trial that has been designed at the University of Sydney and James Cook University in Queensland aims to explore the effectiveness of a counselling intervention to improve physical activity in patients with blocked leg arteries. Previous research has shown that brief behavioral counselling can be effective in improving physical activity and reduce the requirement for surgical intervention in patients with blocked leg arteries. Therefore, results obtained from the BIP study might help to understand if the presentation of physical activity recommendations to patients with blocked leg arteries can be improved. The study involves a minimum of 12 visits to Lidcombe campus of the University of Sydney over a 24 month period. All participants will have their level of physical activity assessed and will have blood collected at 0, 4, 12 and 24 months. At the start of the study participants will be randomised into one of two different groups.
1. Either receive information about the management of vascular disease via 4 phone calls or
2. Two visits and 2 phone calls.
The research study includes a thorough medical screening and education on peripheral artery disease, stress test, assessment of claudication severity, and other physiological measures.

Contacts: Yian Dam-Noble on (02) 9036 7437 or email: yian.dam@sydney.edu.au

Guy Wilson on (02) 9351 9046 or email: guyw@uni.sydney.edu.au

The SMART Trial: Study of Mental Activity and Regular Training

This research study is now conducting a 72 month follow up very soon. The original randomised control trial had investigated whether mental and/or physical exercise can prevent negative changes in thinking and memory in older adults. The main aim was to determine whether mental and physical exercise, either alone or in combination, could reduce the rate of decline in brain function in older persons at risk for such decline. Dementia is a serious problem for society at the individual, family, community and government level. New ways to help prevent the onset of dementia are therefore a high priority, because at the moment medical treatment only helps a fraction of affected individuals and for a limited period of time. We defined ‘at-risk’ as those older individuals with early changes in thinking or memory on screening tests, but who otherwise do not have severe memory loss (dementia) or changes in daily functioning caused by such memory loss. The study was conducted by a group of physicians and investigators from the University of Sydney. Participants were randomised into one of 4 groups; 1 = Cognitive and PRT, 2 = Cognitive and Ex Sham, 3 = PRT and Cog Sham and the 4th Cog sham and Ex sham
Eligibility Criteria; must be over 55 years of age, with mild memory impairment, and willing to participate in an 18-month study, which includes supervised training 2 days per week for the first 6 months.
Testing included a paper and pencil cognitive test to determine if a meet our ‘at-risk’ criteria, Medical history, physical examination, and medications review by a study, Blood tests for metabolic health and nutritional status. Included in the blood tests will be an analysis of your DNA, which will allow for investigation of variations in known genes.

(Funded by the NHMRC)

Graded Resistance Exercise and Type 2 Diabetes in Older Adults (The GREAT2DO Study)

Currently, there nearly 200 million adults with diabetes in the world, with this number estimated to rise to 333 million by the year 2025. Approximately 20% of older Australians have type 2 diabetes, 50% of it undiagnosed. Older adults comprise the largest group of adults with diabetes in Australia and internationally, and the excess morbidity, mortality and health care expenditures (government and personal) associated with this condition are rising rapidly, highlighting the urgent need to address strategies for this global epidemic.

We will use high velocity progressive resistance training (PRT), as it is the most specific way to target the most abundant and most insulin-resistant fast twitch muscle fibres in diabetes, and it has been shown to help prevent diabetes in high-risk adults. PRT has been shown to reduce blood pressure and improve dyslipidaemia and systemic inflammation, the risk factor profile linked to cardiovascular disease in this cohort.

The GREAT2DO Study aims to define the mechanisms of adaptation, feasibility, safety, and long-term adherence to Power Training to improve health outcomes for this fast growing population. Translation into clinical practice and generalisability is enhanced by the community setting we have chosen for implementation, the 12 month intervention and 5 year follow-up, and the typical older diabetic patients with metabolic syndrome and multiple co-morbidities we will recruit.

This randomised controlled clinical trial aims to show for the first time that high velocity PRT added to usual medical care of older adults with type 2 diabetes and metabolic syndrome is an extremely novel, strongly evidence-based, and potentially powerful adjunctive treatment for the epidemic of type 2 diabetes and its associated cardiovascular risk profile in older adults.

(Funded by the NHMRC; Recruitment has closed for this study)

Knowledge and Awareness of Anti-Doping in the Sporting Community

Despite the implementation of the World Anti-Doping Agency (WADA) code, some athletes continue to engage in doping behaviour and their knowledge and understanding of these substances may be of concern. This study proposes to anonymously survey a diverse and representative sample of about 3000 athletes at elite/sub-elite athletes from a range of sports and their coaches in order to:

  1. determine their awareness and knowledge of the Anti-Doping Policy & testing procedures;
  2. investigate their level of knowledge about prohibited substances; and
  3. examine their attitudes and behaviours towards doping in sport.

The results will also provide an understanding of the psychological reasons for doping and thus enable the future development of educational and anti-doping strategies in athletes based on preventative measures.

(Funded by Dept Health and Ageing, Anti-Doping Research program)

The Good Vibrations Study: Optimal Standing Posture in Whole Body Vibration for Muscle and Bone Improvements in Older Adults

This six-month randomised controlled trial aims to investigate the optimal standing posture (knees locked vs. flexed) to produce improvements in muscle and bone characteristics.

A comprehensive profile of bone and muscle function, mass, architecture and strength will be made by state of the art quantitative computed tomography (pQCT), X-ray absorptiometry (DEXA), blood markers and functional testing.

Whole body vibration (WBV) is a novel exercise modality with recent reported benefits to muscle and bone in humans. WBV uses high-frequency mechanical stimuli which are generated by a vibrating platform and transmitted through the body where they load the bone and stimulate muscle sensory receptors. Vibration application to the whole body has now been reported to improve muscle strength, bone mineral density balance and mobility.

Many studies have used various protocols for testing mechanical loading on the human skeleton through vibration. There is a need for further research to establish WBV as a safe and efficient way of improving strength and preventing muscle deterioration and fracture in humans.

Sydney Diabetes Prevention Program (SDPP) Mandarin-speaking substream data analysis

This data subset was collected as part of a larger translational study (Sydney Diabetes Prevention Program) evaluating the effectiveness of lifestyle modification interventions through five goals.
This analysis aims to determine:
1. the association between baseline physical activity level and body composition and metabolic outcomes.
2. the effectiveness of the implementation of a behaviour change strategy.
The results of this analysis will determine the effectiveness of a behavioural intervention on the uptake of physical activity, body composition and metabolic outcomes among Mandarin-speaking Chinese people.

Determinants of physical activity engagement among Chinese Australians

Although research has shown that behaviour change strategies are effective in encouraging uptake of physical activity, such strategies are not commonly used in Chinese populations. A more developed understanding of the determinants that influence physical activity behaviour is required as we cannot assume that the determinants that impact upon physical activity in Caucasian populations are identical for Chinese populations.

Through the administration of two questionnaires, we aim to identify the determinants to physical activity engagement among a convenience sample of Chinese-born Australian migrants. Health and physical performance assessments, in combination with the questionnaires, will aim to explore whether determinants are related to current physical activity behaviour, metabolic risk and functional mobility. The results of this project will identify the determinants that require attention when encouraging Chinese Australians to engage in physical activity.