BAIL's Tales: November

Kia ora from the BAIL team

BAIL and Burwood Hospital were very well represented at the recent Australasian Faculty of Rehabilitation Medicine (AFRM) and New Zealand Rehabilitation Association (NZRA) combined conference in Wellington in October. The conference theme was building an enabling society and there were wide ranging presentations considering the many factors that contribute to making a society enabling or disabling.

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left to right - Jo Nunnerley, Dr Debbie Snell, Dr Jennifer Dunn, Jason Nicholls
Front John Bourke

A number of BAIL lead research projects were presented and well received at the conference.
Two BAIL researchers received special mentions for their presentations. Congratulations to John Bourke
for wining best student presentation and to Dr Debbie Snell for runner up best new and emerging researcher presentation.

Here is a summary of some of the presentations from the BAIL team:

Evaluating quality of life outcomes following joint replacement: psychometric evaluation of a short form of the WHOQOL-bref.
Presenters: Deborah Snell, Richard Siegert, Lois Surgenor, Jen Dunn, Gary Hooper.
In this presentation we discussed the validation of a brief measure (8 items) to evaluate quality of life in people who have had hip or knee replacements. We were looking for a valid and short measure of quality of life to use with an older cohort of patients, bearing participant burden in mind. We have since implemented this measure into our routine follow up of patients having joint replacements at Burwood (replacing a longer measure) and are finding much less missing data and fewer complaints about the nature of questions.

Untangling symptoms: post-concussion syndrome or chronic pain?
Presenters: Deborah Snell, Rachelle Martin, Sandy Macleod, Lois Surgenor, Richard Siegert, Jean Hay-Smith, Gary Hooper, Tracy Melzer, Tim Anderson.
In this presentation we discussed findings of our research looking at the similarities and differences between people with persisting post-concussion symptoms after a mild traumatic brain injury and those with chronic pain symptoms. Findings suggested depression was a key factor underpinning chronicity of symptoms in our sample. Depressive symptoms appeared mediated by negative recovery expectations, lack of social support, feeling invalidated by health and insurance providers, feeling bewildered by on-going symptoms and having no clear rehabilitation pathway to wellness. This presentation generated a lot of discussion at the conference.

Internet use by people living with neurological conditions: a scoping study.
Presenters: Claire Freeman, Richard Siegert, Deborah Snell, Martin Sullivan, Duncan Babbage.
This poster reported on the results of a scoping review looking at the impact of the internet in the lives of people living with neurological impairment. The review identified potential for far reaching health and wellbeing benefits for disabled people by accessing the internet for knowledge about their condition and health, social interaction and support. This literature also identified barriers to internet use by disabled people that included socio-economic limitations, rurality, cultural and attitudinal issues, a lack of skills and confidence with new technology, and physical and cognitive impairments.

Fatigue during inpatient rehabilitation: a pilot study as a knowledge translation activity.
Presenters: Brain Injury Rehabilitation Service Journal Club group, led by Dr Deborah Snell.
The Burwood Brain Injury Rehabilitation Service (BIRS) journal club group is an example of a knowledge translation activity where clinicians meet monthly to review research evidence relating to clinical practice. Fatigue as a special topic was reviewed during meetings in 2014. From this review the group determined to carry out a pilot study to test the assumption that daily and weekly variability in patient reported energy levels impacted on inpatient rehabilitation outcomes. This poster reported on the findings of the pilot study and showed that in this small study sample, pre-admission fatigue and fatigue level at discharge appeared significantly associated with rehabilitation progress. This has raised awareness regarding the need to consider pre-injury fatigue levels for people admitted to BIRS for neurological rehabilitation.

The ready to roll survey of New Zealand wheelchair users’ emergency preparedness.
Presenters: Jason Nicholls, Jennifer Dunn, Deborah Snell
The Ready to Roll (RTR) study sought to identify the level of and barriers to, emergency preparedness amongst wheelchair users in New Zealand. RTR participants reported much lower levels of personal preparedness for emergencies and more barriers to preparedness than those reported for the general population in New Zealand. This is a concerning finding given the increased vulnerability of people with disabilities in emergency situations. We are working on following this study up with implementing recommendations to improve emergency preparedness amongst wheelchair users.

Wheelchair users’ experience of community inclusion following the Canterbury earthquakes: a thematic analysis.
Presenters: John Bourke, Jean Hay-Smith, Deborah Snell, and Philip Schluter.
This study explored what one section of the disability community, people who use wheelchairs, perceived to be the individual and social determinants of (non) inclusion and (non) participation in the community in the three years following the 2010/11 Canterbury earthquakes. Findings suggested we have an unprecedented opportunity to reduce many pre- and post-earthquake barriers to community inclusion identified by participants. Adequate consultation from local authorities and developers regarding the needs of people who use wheelchairs could greatly enhance opportunities for community inclusion and reduce feelings of isolation, frustration, and difference.

If you would like to find out more about our research projects come and see us in the Marshland Room or check out our website (
Finally a BIG thank you to those who completed our recent survey – your feedback was very helpful and we are looking to tailor our educational activities next year to take your feedback into account. Watch out for invitations to educational workshops and research presentations in 2016.

BAIL Research Peer Group meeting Dates for 2016

Here are our 2016 dates for those of you with awesome planning skills.
Thurs 18 Feb : Thurs 5 May : Thurs 23 June : Thurs 3 Nov.
Be sure to be on our list to receive your invitation. If you are not on the regular invitation mailing list and would like to come, just let me know.

Hans Wouters – Operations Manager Burwood Academy of Independent Living.