NIHRDataInsights/HRCSData huggingface dataset:
Title: Longitudinal cohort study of subjects referred to Physiotherapy with musculoskeletal shoulder pain to determine factors and characteristics which may predict functional recovery over a 6 month period commencing at the start of Physiotherapy.
Funder: Department of Health (England)

Abstract: The most effective treatment for shoulder pain is not known. Physiotherapy is recommended as the first choice of treatment. At present, it is not possible to identify which patients will benefit from physiotherapy. Objective: To identify which patient characteristics and factors, assessed at the first physiotherapy consultation, are related to outcome of shoulder pain following physiotherapy treatment. Design: All patients who are eligible and agree to take part in the study, from a number of participating centres, will be followed from their first physiotherapy assessment to follow up at 6 months. Expected outcome: Identification of a number of factors in the initial assessment which may predict outcome from physiotherapy. Anticipated benefits: Will help distinguish between patients who will benefit from physiotherapy, and those who will go on to have persistent symptoms and benefit from earlier referral to the multidisciplinary team for a surgical opinion or chronic pain management.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING;6.7 PHYSICAL
Health categories: MUSCULOSKELETAL
Title: Beliefs and adherence to medicines in patients with rheumatoid arthritis: the influence of ethnicity
Funder: Department of Health (England)

Abstract: Patients’ beliefs and perceptions play an important role in adherence to prescribed medicines. This is an important issue as about 40 percent of patients with chronic diseases do not take their medications as prescribed. Several studies have documented that there are differences between individuals from different ethnic groups in the way that medications are viewed. Potentially, these views and barriers may have a damaging effect on disease outcomes. However, the issue of adherence has not been studied between ethnic groups in rheumatology. This project aims to investigate the relationship between beliefs about medicines, satisfaction with information about medicines and adherence across two ethnic groups. The project will use questionnaires and interviews to examine the reasons for poor adherence and will develop strategies to tackle this.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING;6.1 PHARMACEUTICALS
Health categories: MUSCULOSKELETAL
Title: Predicting response to Intra-Articular Steroid Therapy in symptomatic knee osteoarthritis
Funder: Department of Health (England)

Abstract: Osteoarthritis (OA) of the knee is common, however, there are few effective therapies. Steroid injections have been used in management, however, the results of studies have been variable. The aim of this study is to determine what factors predict response to steroid injections in knee OA. Such data will help in better targeting therapy to affected individuals. 120 men and women with symptomatic knee OA will be recruited. Those who take part will complete a baseline questionnaire, have a knee examination, and also magnetic resonance scan (MRI) - to determine the presence and extent of any structural changes within the joint. The knee will be aspirated and 80mg of depomedrone (steroid) injected. Subjects will have a repeat MRI after one week and will be followed regularly by telephone to determine when their pain recurs. Analysis will focus on what factors at baseline predict the response and duration of therapy.


Research activity codes: 6.1 PHARMACEUTICALS
Health categories: MUSCULOSKELETAL
Title: The classification of low back pain with associated leg pain in primary care. Development and evaluation of empirically based subgroups.
Funder: Department of Health (England)

Abstract: Background: Back pain that spreads down the leg is associated with a poorer prognosis and higher health care costs than 'simple low back pain'. Identifying those whose leg pain is caused by nerve root involvement is important for optimum management but has rarely been investigated in primary care. Objectives: To identify clinically relevant subgroups of back and leg pain patients and investigate the contribution of clinical findings in identifying nerve root pain. Design: Cross sectional observational study with nested reliability study. Outcomes: Key findings from clinical assessment to guide clinicians in classification and management of back and leg pain patients.


Research activity codes: 1.4 METHODOLOGIES AND MEASUREMENTS
Health categories: MUSCULOSKELETAL
Title: An investigation of the screening properties of the Coping Strategies Questionnaire 24 (CSQ24) in a chronic low back pain population.
Funder: Department of Health (England)

Abstract: The purpose of the research is to establish if the CSQ24 can be used to categorise chronic back pain patients into high, medium, and low risk groups. After being categorised patients will either receive a one-off treatment and education session, normal physiotherapy care, or specialist physiotherapy care. The aim is to discover if it is possible for the CSQ24 to be used to help decide the most efficient pathway of care for chronic back pain patients.The study outlined above continues eight years of research into, and clinical practice with, back pain patients. The clinical lectureship award will help me further develop my research and clinical skills and will potentially improve the care of back pain patients throughout the trust and nationally. The time provided by the program will also help me to disseminate my research findings so far, and those of the proposed trial.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MUSCULOSKELETAL
Title: The challenges of living with Ankylosing Spondylitis throughout the life course
Funder: Department of Health (England)

Abstract: Ankylosing Spondylitis [AS] is a long term condition affecting the spine which impacts on all aspects of a person’s life. Self-management is crucial to prevent spinal fusion and disability. There is currently little understanding of how AS affects people at different stages of the disease process.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MUSCULOSKELETAL
Title: Treating chronic pain by using visual illusions to modulate body perception disturbance
Funder: Department of Health (England)

Abstract: Current medications for longstanding pain can provide limited benefit and are often costly to tightening NHS budgets. This research aims to provide patients with an affordable drug-free option for pain relief. Background work has produced evidence that computer-generated illusionary changes of the painful body, created by the MIRAGE system, can improve symptoms in those with chronic musculoskeletal pain. We will undertake a robust clinical trial to identify how effective the MIRAGE system is at reducing chronic pain. This will be established by comparing data between two patient groups (with and without the illusionary intervention) and determining how often and long treatment sessions need to be to achieve improvements. Patients and therapists will be involved in developing the intervention further to ensure it is suitable for clinical practice. We aim to create genuine changes to the way in which people with musculoskeletal pain are treated within five years from Lectureship completion.


Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL;6.3 MEDICAL DEVICES
Health categories: MUSCULOSKELETAL
Title: Understanding the contribution of the motor and sensory systems to the generation and perpetuation of pain and how these systems may be modulated for the relief of pain
Funder: Department of Health (England)

Abstract: Chronic pain has a significant impact on the individual's life and on society at large. The objectives of this research are to gain a greater understanding of the mechanisms that drive chronic pain, to better understand the characteristics of people who have pain and to inform the development of treatments to relieve pain. A series of studies using clinical, laboratory and brain imaging assessments will address these issues. Expected outcomes include new knowledge of why pain starts, why it may continue, how individual’s symptoms vary, potential target areas for future treatments and how new therapies may relieve pain.


Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES;5.3 MEDICAL DEVICES
Health categories: MUSCULOSKELETAL
Title: A biomechanical assessment of passive recumbent inter-vertebral motion in the mid lumbar spine in symptomatic and asymptomatic participants, and relationship to MRI endplate abnormalities in symptomatic participants.
Funder: Department of Health (England)

Abstract: Objectives: Measure the motion in the spine and evaluate this for the investigation of chronic low back pain (CLBP).Design: Comparison of motion between vertebrae in people with CLBP and those without using video x-rays. Subsidiary analysis of MRI abnormalities against motion in those with CLBP.Expected Outcomes: To find out if those with CLBP have detectable mechanical disruption in their spines.Anticipated Benefits: Knowing if CLBP is mechanical or not would facilitate treatment, leading to better health, occupational and social care decisions, and reduce the amount of ineffective treatment. If this is related to MRI abnormalities it could lead to further study of diagnosing mechanical CLBP without radiation.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: MUSCULOSKELETAL
Title: The impact, frequency and care of foot problems in people with Rheumatoid Arthritis.
Funder: Department of Health (England)

Abstract: Rheumatoid arthritis is a common disease causing repeated episodes of inflammation, pain and stiffness in joints. The foot is one of the most commonly affected areas but has been relatively under-investigated. This project will document personal experiences of foot involvement from detailed patient interviews, find what proportion of patients receive foot care by a large survey, and discover why some patients do not receive foot care by comparing them to those who do so. We suspect many patients do not receive adequate foot care and that our results will strengthen the argument for the provision of appropriate foot services


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MUSCULOSKELETAL
Title: Central pain processing in knee osteoarthritis: does it predict pain severity and response to arthroplasty?
Funder: Department of Health (England)

Abstract: Study design: A mixed methods study which includes conducting a systematic review, qualitative research methods and quantitative research methods.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: MUSCULOSKELETAL
Title: A mixed methods study to evaluate the clinical and cost-effectiveness of a self-managed exercise programme versus usual physiotherapy for chronic rotator cuff disorders.
Funder: Department of Health (England)

Abstract: Shoulder pain is the third most common reason for consultation with a physiotherapist and up to one-quarter of the general population might experience an episode at any one time. Disorders of the shoulder muscles and tendons (rotator cuff) are thought to be the commonest cause of this pain but the long-term outcome is frequently poor despite treatment. Patients with this disorder typically receive a course of physiotherapy where the value of exercise against gravity or resistance (loaded exercise) is promising but appears to be underutilised. The purpose of this study is to evaluate whether a self-managed loaded exercise programme is more effective than usual physiotherapy in reducing pain and improving shoulder function in people with rotator cuff disorders.


Research activity codes: 6.7 PHYSICAL
Health categories: MUSCULOSKELETAL
Title: Body schema in adolescent idiopathic scoliosis
Funder: Department of Health (England)

Abstract: The proposed research aims to reduce usage of intrusive and costly interventions currently prescribed for adolescent idiopathic scoliosis (AIS) such as long-term bracing and surgery. It aims to achieve this by identifying potentially modifiable deficits in sensori-motor integration known to be related to altered body schema (the internal representation of the body held within the brain), which may lead to the development of novel therapeutic strategies. Alterations in body schema have been suggested as a potential factor in the development of AIS but have yet to be formally investigated. The proposed research has the potential for significant patient benefit and reduced NHS costs in the management of this condition


Research activity codes: 5.7 PHYSICAL
Health categories: MUSCULOSKELETAL
Title: Barriers and facilitators to implementation of NICE clinical guidance in UK practice: elective orthopaedic surgery for the treatment of end stage arthritis with total hip replacement.
Funder: Department of Health (England)

Abstract: Evidence based practice is aimed at reducing variation within the NHS. It ensures that the most clinically and cost-effective procedures are used to treat patients. This research explores decision-making for hip replacement by orthopaedic surgeons, to identify potential barriers and facilitators to the implementation of evidence based guidance in practice. The research will include an initial meta-ethnographic review, followed by ethnographic case studies (interviews, observations and document analysis) of two orthopaedic centres in NHS hospitals. The findings will inform the design of an intervention aimed at improving uptake and understanding of evidence by orthopaedic surgeons in the NHS.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: MUSCULOSKELETAL
Title: 2013 Doctoral Fellowship: Development of an Intervention to increase physical activity in chronic pain patients
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Northern Ireland has the highest rate of chronic pain in the UK2. It is the main contributor to the cost of medically related benefits and long-term sick leave in Northern Ireland2. The receipt of medically related benefits in Northern Ireland doubles the rest of Great Britiain3. Individuals with chronic pain have lower levels of Physical Activity (PA)4 suffer poorer quality of life5 and have a higher risk of developing cardiovascular disease, cancer and of all cause mortality compared with those with no pain4,6,7. The role of PA in reducing these risks is well documented8, 9 however; individuals with chronic pain often hold the erroneous belief that PA is potentially harmful and display fear avoidance behaviours10, 11 reducing any likelihood of engagement in PA without targeted intervention. Aim: In line with MRC guidance12 - Systematically develop an intervention to increase PA in Osteoarthritis (OA) and low back pain (LBP) the most common cause and site of chronic pain13. Objectives: 1. Conduct a Systematic review to determine the extent to which current interventions map to the ‘Com-b’ method of behaviour change, determine if there are key components associated with greater effects. 2. Conduct a qualitative analysis of focus groups and interviews with clinicians, service users and other key stakeholders to develop theory. Use theory and results from section 1 to design an intervention. 3. Conduct a mixed method study to test the feasibility of the intervention in 3 cohorts (n=12 per cohort). Complete a qualitative analysis following each cohort to refine and further develop the intervention.


Research activity codes: 5.7 PHYSICAL;6.7 PHYSICAL
Health categories: MUSCULOSKELETAL
Title: Programme Grant Application in Bio Tribology of Articular Cartilage and Substitution Interventions
Funder: Engineering and Physical Sciences Research Council

Abstract: Osteoarthritis affects at least 15% of the population. Currently, apart from pharmacological intervention and pain relief the only effective treatment is end stage total joint replacement. Current total joint replacement surgery is highly successful in patients over 65 with relatively low demands, with success rates over 90% at ten years. Osteoarthritis is being diagnosed in increasing numbers of younger and more active patients, who have expectations of an active life style and desire to remain functional and working for extended periods. However, current joint replacement is not as successful in younger patients, with long term wear and osteolysis in the hip and knee, associated with loss of fixation/bone, loosening and higher revision rates. Revision of failed prostheses is currently a large operating burden in the NHS, and these operations are generally more expensive with increased morbidity compared to primary arthroplasty. There is a reluctance to utilise end stage joint replacement in younger and more active patients, and there is a desire to develop tissue sparing substitution treatments and regenerative treatments for early degenerative disease in articulating joints. There is a need to develop research capacity in the functional biotribology of articular cartilage to support research and development of cartilage substitution therapies and regenerative interventions and enable a new generation of pre-clinical studies to be undertaken to accelerate of the translation of new technology to the patient and enhance the safety and efficacy through better short term predictions of long term clinical outcomes.The overall aim of this programme is to develop a new research platform to study the biotribology of full scale, whole natural joints, over extended periods of time, under representative physiological and anatomical conditions (through in vitro experimental and computational models). Once established these novel simulation systems for cartilage biotribology will allow us to work collaboratively with academic and industrial groups to investigate and support development of new surgical interventions for cartilage substitution and regenerative therapies for early intervention in osteoarthritis. Three important natural articulating joint systems of the hip, the knee and the spine will be addressed. The findings from the programme grant will be valuable in helping industry and manufacturers of advanced medical products to develop improved and safer intervention therapies, and for surgeons to make better informed about decisions on use of new therapies. The work will also inform regulatory and standard bodies such as MHRA (UK), FDA (USA) and ISO. This will have tremendous economic benefit to the UK NHS as well as social benefit to the patients.


Research activity codes: 5.2 CELLULAR AND GENE THERAPIES;5.4 SURGERY
Health categories: MUSCULOSKELETAL
Title: Miniature Ultrasonic Cutting Devices for High Precision Minimal Access Orthopaedic Surgical Procedures
Funder: Engineering and Physical Sciences Research Council

Abstract: Currently, ultrasonic cutting devices consist of a Langevin piezoelectric transducer attached to a cutting blade both tuned to resonate in a longitudinal mode at a low ultrasonic frequency, usually in the 20-50 kHz range. Ultrasonic cutting devices are su


Research activity codes: 5.4 SURGERY
Health categories: MUSCULOSKELETAL
Title: Pain rehabilitation: E/Motion-based automated coaching
Funder: Engineering and Physical Sciences Research Council

Abstract: Almost 1 in 7 UK citizens suffer from chronic pain, much of which is mechanical lower back pain with no treatable pathology. Pain management rehabilitative programs suffer from two shortcomings: (a) there are too few resources in the health care system to


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MUSCULOSKELETAL
Title: Handheld microindentation - a direct assessment of bone fracture risk
Funder: Engineering and Physical Sciences Research Council

Abstract: Osteoporotic fractures are a major and increasing problem for both patients and society as a whole. The NHS is already spending well over a £1bn a year for treating patients with osteoporotic fractures and with the ever increasing life expectancy more and more patients will need treatment. It is estimated that 1 in 3 women over fifty and 1 in 5 men will suffer from an osteoporotic fracture. Yet an effective diagnosis is lacking to this point and the most commonly used assessment of bone mineral density or bone mass using X-ray techniques is seemingly inaccurate for individual patients. In part the problem is originating from the fact that bone mass is a surrogate and dose not account for the quality of bone and changes in material properties, which may be independent of bone mineral density. Therefore complementary tests could improve the diagnosis significantly and help in early identification and treatment of osteoporosis and osteopenia. Recently a microindentation was used in a pilot study on a cohort of patients. Indenting patient's tibiae that could clearly identify patients that had a recent osteoporotic fracture from a group of controls. While this is informative, further research is required to understand the correlation between bone mass, microindentation measurements and conventional assessment of in vitro bone tissue fragility. We propose ot acquire a microindentation device, which would be the first one in the UK to conduct further studies with the aim to judge potential future use for screening of patients and for laboratory studies.


Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES
Health categories: MUSCULOSKELETAL
Title: pH-Responsive hollow particle gels for cartilage regeneration
Funder: Engineering and Physical Sciences Research Council

Abstract: Osteoarthritis (OA) is the gradual degeneration of cartilage covering the bony ends of joints. It is a debilitating disease which develops in 33% of adults in the mid 40s and affects 15% of the worlds population. The cost of OA treatment for the UK National Health Service (NHS) was £850M in 2007 (5% of the NHS budget) and is increasing. There is an urgent need for an injectable fluid that transforms into a gel in the body that provides both immediate load support to damaged cartilage and results in regeneration of cartilage tissue. Hollow polymer particles have potential to enable regeneration of cartilage tissue. In our proof-of-concept study we established a new injectable fluid containing pH-responsive biodegradable hollow polymer particles that change from a fluid to a gel at physiological conditions. In this proposal we aim to establish methods for linking the hollow particles together to prepare injectable gels that are both mechanically stable and are able to be disassembled on demand using molecules that naturally occur in the body. These are essential steps which, if successful, will result in design rules for preparing injectable, high strength, hollow particle gels that could enable a new OA therapy. This ambitious proposal greatly extends our earlier study and will be conducted by a postdoctoral research associate over a period of 30 months.


Research activity codes: 1.3 CHEMICAL AND PHYSICAL SCIENCES
Health categories: MUSCULOSKELETAL