Rotator cuff dysfunction is common in athletes involved with overhead sports. Secondary subacromi... more Rotator cuff dysfunction is common in athletes involved with overhead sports. Secondary subacromial impingement is a common cause of pain for patients with rotator cuff dysfunction. Exercise rehabilitation and manual therapy can be used in the treatment of subacromial impingement to decrease pain, increase functionality and support a return to activity. The current case report describes a 24-year old patient with supraspinatus tendinosis and secondary subacromial impingement who was experiencing pain when playing tennis, and during daily activities involving overhead movements. Osteopathic manual therapy and rehabilitation was undertaken leading to significant improvements in pain and function over a 6-week period. The current case report describes an evidence-informed approach to the management of subacromial
impingement syndrome whilst incorporating a manual therapy technique, balanced ligamentous tension, that has received little attention in the literature.
Meniscal injury is one of the most common knee soft tissue injuries, commonly affecting young ath... more Meniscal injury is one of the most common knee soft tissue injuries, commonly affecting young athletes and an older, degenerative population. Treatment largely depends on the type and extent of the injury with arthroscopic repair or meniscectomy being mainstays. Although non-surgical approaches have been described, there is no published literature regarding a combination of indirect osteopathic techniques and rehabilitation in the management of these injuries. The current case report follows a 20-year-old male presenting with a 5-day history of acute knee pain, following trauma during an Australian Rules Football (AFL) match. An 8-week management plan of indirect osteopathic techniques and a tailored rehabilitation program was implemented. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lower Extremity Functional Scale questionnaires were utilised to measure outcomes. After the 8-week treatment and rehabilitation program, the patient had exceeded the minimum detectable change score for all outcome measures. This case report suggests that osteopathic manipulative treatment and rehabilitation may be an alternative, non-surgical approach in the management of post-traumatic meniscal injuries.
Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, w... more Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, which he had experienced for 24 hours after spending the previous day helping his brother to move house. He had difficulty ambulating and most movements aggravated the pain. There were no lower limb symptoms and no red flags present on history or examination. He was otherwise well and was not taking any regular medications.
Background Interprofessional education is increasingly included in health profession education pr... more Background Interprofessional education is increasingly included in health profession education programs as governments strive to improve patient care and outcomes through interprofessional teams. Objective To investigate Australian osteopathy students perceptions of interprofessional relationships. Design Single administration of a questionnaire to students explore perceptions of interprofessional relationships. Setting Two Australian university-based osteopathy programs. Methods Students completed the Interdisciplinary Education Perception Scale (IEPS) and a demographic questionnaire. Descriptive data were generated for each of the IEPS items, total and factor scores. Ordinal logistic regression was used to evaluate the association between the IEPS items and the demographic variables: age; gender; university; and year level. Cronbach’s alpha was calculated as the reliability estimate. Participants Students enrolled in the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia). Results Responses from 319 students were analysed (63% response rate). The mean total IEPS score was 246.46 (± 23.79). No association was observed for the demographic variables and eleven of the IEPS items in the regression models. Moderate odds ratios were observed for year 3 students in relation to their perception of autonomy and respect, where these perceptions were less positive compared to students in other year levels. Age, gender and university were significant in the regression models for other IEPS items however these odds ratios were either trivial or small. Cronbach’s alpha was 0.818 indicating an acceptable internal structure for the 18-item IEPS. Conclusions The perception of Australian osteopathy students towards interprofessional relationships was largely positive, and not associated with demographics such as age, gender, program year level and the university they were attending. Students identified positive aspects such as the need to cooperate with other professions and that osteopaths are well trained. Where demographics were associated with an IEPS item, the odds ratio was typically trivial to small. Aspects that may also need to be improved were identified, including the students’ perception of the status of osteopathy in the eyes of other health professions. The data from the present study could be used to inform the development of interprofessional programs involving osteopaths and osteopathy students. Further work to replicate the results of the present study is required.
Mid-portion Achilles tendinopathy is a common injury in sporting populations. There is conflictin... more Mid-portion Achilles tendinopathy is a common injury in sporting populations. There is conflicting evidence about the best approach to conservative management. This report focuses on the rehabilitation of an Achilles tendinopathy utilising osteopathic manual therapy (OMT) and a structured exercise program in a semi-professional volleyballer. The patient presented with a 4-month history of right mid-portion Achilles tendon pain that begun after a lateral inversion sprain of the right ankle. The primary complaint was pain impacting the patients vertical jump performance. The patient complained of pain that was greatest in the morning and at the beginning of a training session prior to warming up. The inventory therapy was a combination of OMT and rehabilitation. The manual therapy was complemented with a rehabilitation program. Outcomes were assessed with the Victorian Institute of Sport Assessment- Achilles (VISA-A), visual analogue scales (VAS), painful arc, London Hospital Test, soleus lunge test and maximum vertical jump. This case presented many challenging management options including a resolving right ankle lateral inversion sprain, a past history of contralateral Achilles tendinopathy and a high training load. The case demonstrated the importance of patien-tcentred practice. It was integral that the patient’s role as a semi-professional athlete on the volleyball court was analyzed closely in order to replicate different facets of his game, so that the rehabilitation program could support a return to performance at the highest level. Once the initial deficits in mobility and strength were addressed, the rehabilitation program focus moved to injury prevention.
Background: Measurement of the educational environment has become more common in health professio... more Background: Measurement of the educational environment has become more common in health professional
education programs. Information gained from these investigations can be used to implement and measure
changes to the curricula, educational delivery and the physical environment. A number of questionnaires exist to
measure the educational environment, and the most commonly utilised of these is the Dundee Ready Educational
Environment Measure (DREEM).
Methods: The DREEM was administered to students in all year levels of the osteopathy program at Victoria
University (VU), Melbourne, Australia. Students also completed a demographic survey. Inferential and correlational
statistics were employed to investigate the educational environment based on the scores obtained from the DREEM.
Results: A response rate of 90% was achieved. The mean total DREEM score was 135.37 (+/− 19.33) with the scores
ranging from 72 to 179. Some subscales and items demonstrated differences for gender, clinical phase, age and
whether the student was in receipt of a government allowance.
Conclusions: There are a number of areas in the program that are performing well, and some aspects that could be
improved. Overall students rated the VU osteopathy program as more positive than negative. The information obtained
in the present study has identified areas for improvement and will enable the program leaders to facilitate
changes. It will also provide other educational institutions with data on which they can make comparisons with
their own programs.
Introduction: The Interdisciplinary Education Perception Scale (IEPS) is used to assess the perce... more Introduction: The Interdisciplinary Education Perception Scale (IEPS) is used to assess the perception of one’s own profession and the relationship of that profession to others. A number of models of the IEPS exist within the literature. Objective: The aim of the present study was to explore the most appropriate factor structure of the IEPS in an Australian health profession student and clinical educator population. Method: The IEPS was completed online. Confirmatory factor analysis (CFA) using the Maximum Likelihood Estimation method was employed for the analysis. The data were entered into each of the 4 IEPS models identified in the literature. Result: Data did not adequately fit any of the models identified in the literature. Two of the models described in the literature appeared to be stronger than that proposed by the original IEPS authors. Conclusion: Further research using both CFA and item response theory is required to improve the psychometrics of the IEPS.
Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, w... more Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, which he had experienced for 24 hours after spending the previous day helping his brother to move house. He had difficulty ambulating and most movements aggravated the pain. There were no lower limb symptoms and no red flags present on history or examination. He was otherwise well and was not taking any regular medications.
Rotator cuff dysfunction is common in athletes involved with overhead sports. Secondary subacromi... more Rotator cuff dysfunction is common in athletes involved with overhead sports. Secondary subacromial impingement is a common cause of pain for patients with rotator cuff dysfunction. Exercise rehabilitation and manual therapy can be used in the treatment of subacromial impingement to decrease pain, increase functionality and support a return to activity. The current case report describes a 24-year old patient with supraspinatus tendinosis and secondary subacromial impingement who was experiencing pain when playing tennis, and during daily activities involving overhead movements. Osteopathic manual therapy and rehabilitation was undertaken leading to significant improvements in pain and function over a 6-week period. The current case report describes an evidence-informed approach to the management of subacromial
impingement syndrome whilst incorporating a manual therapy technique, balanced ligamentous tension, that has received little attention in the literature.
Meniscal injury is one of the most common knee soft tissue injuries, commonly affecting young ath... more Meniscal injury is one of the most common knee soft tissue injuries, commonly affecting young athletes and an older, degenerative population. Treatment largely depends on the type and extent of the injury with arthroscopic repair or meniscectomy being mainstays. Although non-surgical approaches have been described, there is no published literature regarding a combination of indirect osteopathic techniques and rehabilitation in the management of these injuries. The current case report follows a 20-year-old male presenting with a 5-day history of acute knee pain, following trauma during an Australian Rules Football (AFL) match. An 8-week management plan of indirect osteopathic techniques and a tailored rehabilitation program was implemented. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Lower Extremity Functional Scale questionnaires were utilised to measure outcomes. After the 8-week treatment and rehabilitation program, the patient had exceeded the minimum detectable change score for all outcome measures. This case report suggests that osteopathic manipulative treatment and rehabilitation may be an alternative, non-surgical approach in the management of post-traumatic meniscal injuries.
Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, w... more Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, which he had experienced for 24 hours after spending the previous day helping his brother to move house. He had difficulty ambulating and most movements aggravated the pain. There were no lower limb symptoms and no red flags present on history or examination. He was otherwise well and was not taking any regular medications.
Background Interprofessional education is increasingly included in health profession education pr... more Background Interprofessional education is increasingly included in health profession education programs as governments strive to improve patient care and outcomes through interprofessional teams. Objective To investigate Australian osteopathy students perceptions of interprofessional relationships. Design Single administration of a questionnaire to students explore perceptions of interprofessional relationships. Setting Two Australian university-based osteopathy programs. Methods Students completed the Interdisciplinary Education Perception Scale (IEPS) and a demographic questionnaire. Descriptive data were generated for each of the IEPS items, total and factor scores. Ordinal logistic regression was used to evaluate the association between the IEPS items and the demographic variables: age; gender; university; and year level. Cronbach’s alpha was calculated as the reliability estimate. Participants Students enrolled in the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia). Results Responses from 319 students were analysed (63% response rate). The mean total IEPS score was 246.46 (± 23.79). No association was observed for the demographic variables and eleven of the IEPS items in the regression models. Moderate odds ratios were observed for year 3 students in relation to their perception of autonomy and respect, where these perceptions were less positive compared to students in other year levels. Age, gender and university were significant in the regression models for other IEPS items however these odds ratios were either trivial or small. Cronbach’s alpha was 0.818 indicating an acceptable internal structure for the 18-item IEPS. Conclusions The perception of Australian osteopathy students towards interprofessional relationships was largely positive, and not associated with demographics such as age, gender, program year level and the university they were attending. Students identified positive aspects such as the need to cooperate with other professions and that osteopaths are well trained. Where demographics were associated with an IEPS item, the odds ratio was typically trivial to small. Aspects that may also need to be improved were identified, including the students’ perception of the status of osteopathy in the eyes of other health professions. The data from the present study could be used to inform the development of interprofessional programs involving osteopaths and osteopathy students. Further work to replicate the results of the present study is required.
Mid-portion Achilles tendinopathy is a common injury in sporting populations. There is conflictin... more Mid-portion Achilles tendinopathy is a common injury in sporting populations. There is conflicting evidence about the best approach to conservative management. This report focuses on the rehabilitation of an Achilles tendinopathy utilising osteopathic manual therapy (OMT) and a structured exercise program in a semi-professional volleyballer. The patient presented with a 4-month history of right mid-portion Achilles tendon pain that begun after a lateral inversion sprain of the right ankle. The primary complaint was pain impacting the patients vertical jump performance. The patient complained of pain that was greatest in the morning and at the beginning of a training session prior to warming up. The inventory therapy was a combination of OMT and rehabilitation. The manual therapy was complemented with a rehabilitation program. Outcomes were assessed with the Victorian Institute of Sport Assessment- Achilles (VISA-A), visual analogue scales (VAS), painful arc, London Hospital Test, soleus lunge test and maximum vertical jump. This case presented many challenging management options including a resolving right ankle lateral inversion sprain, a past history of contralateral Achilles tendinopathy and a high training load. The case demonstrated the importance of patien-tcentred practice. It was integral that the patient’s role as a semi-professional athlete on the volleyball court was analyzed closely in order to replicate different facets of his game, so that the rehabilitation program could support a return to performance at the highest level. Once the initial deficits in mobility and strength were addressed, the rehabilitation program focus moved to injury prevention.
Background: Measurement of the educational environment has become more common in health professio... more Background: Measurement of the educational environment has become more common in health professional
education programs. Information gained from these investigations can be used to implement and measure
changes to the curricula, educational delivery and the physical environment. A number of questionnaires exist to
measure the educational environment, and the most commonly utilised of these is the Dundee Ready Educational
Environment Measure (DREEM).
Methods: The DREEM was administered to students in all year levels of the osteopathy program at Victoria
University (VU), Melbourne, Australia. Students also completed a demographic survey. Inferential and correlational
statistics were employed to investigate the educational environment based on the scores obtained from the DREEM.
Results: A response rate of 90% was achieved. The mean total DREEM score was 135.37 (+/− 19.33) with the scores
ranging from 72 to 179. Some subscales and items demonstrated differences for gender, clinical phase, age and
whether the student was in receipt of a government allowance.
Conclusions: There are a number of areas in the program that are performing well, and some aspects that could be
improved. Overall students rated the VU osteopathy program as more positive than negative. The information obtained
in the present study has identified areas for improvement and will enable the program leaders to facilitate
changes. It will also provide other educational institutions with data on which they can make comparisons with
their own programs.
Introduction: The Interdisciplinary Education Perception Scale (IEPS) is used to assess the perce... more Introduction: The Interdisciplinary Education Perception Scale (IEPS) is used to assess the perception of one’s own profession and the relationship of that profession to others. A number of models of the IEPS exist within the literature. Objective: The aim of the present study was to explore the most appropriate factor structure of the IEPS in an Australian health profession student and clinical educator population. Method: The IEPS was completed online. Confirmatory factor analysis (CFA) using the Maximum Likelihood Estimation method was employed for the analysis. The data were entered into each of the 4 IEPS models identified in the literature. Result: Data did not adequately fit any of the models identified in the literature. Two of the models described in the literature appeared to be stronger than that proposed by the original IEPS authors. Conclusion: Further research using both CFA and item response theory is required to improve the psychometrics of the IEPS.
Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, w... more Case A man aged 42 years, who works as a police officer, presented with severe lower back pain, which he had experienced for 24 hours after spending the previous day helping his brother to move house. He had difficulty ambulating and most movements aggravated the pain. There were no lower limb symptoms and no red flags present on history or examination. He was otherwise well and was not taking any regular medications.
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Papers by chris macfarlane
impingement syndrome whilst incorporating a manual therapy technique, balanced ligamentous tension, that has received little attention in the literature.
education programs. Information gained from these investigations can be used to implement and measure
changes to the curricula, educational delivery and the physical environment. A number of questionnaires exist to
measure the educational environment, and the most commonly utilised of these is the Dundee Ready Educational
Environment Measure (DREEM).
Methods: The DREEM was administered to students in all year levels of the osteopathy program at Victoria
University (VU), Melbourne, Australia. Students also completed a demographic survey. Inferential and correlational
statistics were employed to investigate the educational environment based on the scores obtained from the DREEM.
Results: A response rate of 90% was achieved. The mean total DREEM score was 135.37 (+/− 19.33) with the scores
ranging from 72 to 179. Some subscales and items demonstrated differences for gender, clinical phase, age and
whether the student was in receipt of a government allowance.
Conclusions: There are a number of areas in the program that are performing well, and some aspects that could be
improved. Overall students rated the VU osteopathy program as more positive than negative. The information obtained
in the present study has identified areas for improvement and will enable the program leaders to facilitate
changes. It will also provide other educational institutions with data on which they can make comparisons with
their own programs.
impingement syndrome whilst incorporating a manual therapy technique, balanced ligamentous tension, that has received little attention in the literature.
education programs. Information gained from these investigations can be used to implement and measure
changes to the curricula, educational delivery and the physical environment. A number of questionnaires exist to
measure the educational environment, and the most commonly utilised of these is the Dundee Ready Educational
Environment Measure (DREEM).
Methods: The DREEM was administered to students in all year levels of the osteopathy program at Victoria
University (VU), Melbourne, Australia. Students also completed a demographic survey. Inferential and correlational
statistics were employed to investigate the educational environment based on the scores obtained from the DREEM.
Results: A response rate of 90% was achieved. The mean total DREEM score was 135.37 (+/− 19.33) with the scores
ranging from 72 to 179. Some subscales and items demonstrated differences for gender, clinical phase, age and
whether the student was in receipt of a government allowance.
Conclusions: There are a number of areas in the program that are performing well, and some aspects that could be
improved. Overall students rated the VU osteopathy program as more positive than negative. The information obtained
in the present study has identified areas for improvement and will enable the program leaders to facilitate
changes. It will also provide other educational institutions with data on which they can make comparisons with
their own programs.