FACULTY OF HEALTH AND SOCIAL CARE SCIENCES

HEART: Research projects

Current projects

Exercise-induced cardiac dysfunction
Description: Following severe and prolonged exercise, many diagnostic tests indicate that the heart has been damaged. However it is not clear whether the heart is genuinely damaged or whether the tests reflect normal cardiac responses.
Researchers: Adrian Haggett, Kingston University; Dr Les Ansley, Northumbria University; Professor Andrew Jewell
Funding: Faculty of ScienceOpens new window Kingston University
Prevalence of respiratory disease in the elderly
Description: An evaluation of respiratory symptoms and prevalence of respiratory disease in a healthy older population, based on the results of the English longitudinal study of ageingOpens new window
Researchers: Apostolos Papachristos; Dr Rachel Garrod; Dr Meena Kumari
Funding: Faculty of Health and Social Care Sciences
Goals and planning for patients with chronic obstructive pulmonary disease (COPD)
Description: A study evaluating goal setting in COPD (what do patients understand by the term 'goals' and do they have the skills to set goals and achieve them), and evaluating the ways in which therapists can help patients identify goals and overcome physical and metal barriers to achievement.
Researchers: Rachel Summers, Dr Rachel Garrod
Funding: SouthWest London Academic NetworkOpens new window
Exercise and activity in older people
Description: Exercise and activity in older people has the potential to improve health and well-being and to prevent and help manage long-term conditions. This project is run in conjunction with the Public Health Department of Wandsworth Primary Care Trust.
Researchers: Ted Poulter, Wandsworth Teaching Primary Care Trust; Dr Rachel Garrod
Funding: Wandsworth Teaching Primary Care TrustOpens new window
Effect of exercise on the inflammatory reponse in patients with chronic obstructive pulmonary disease (COPD)
Description: Patients with COPD may demonstrate exaggerated inflammatory responses to exercise. The type, intensity and duration of exercise influence this effect. This study sets out to clarify some of the acute inflammatory responses to exercise in COPD and compare these to healthy subjects.
Researchers: Jane Canavan; Dr Rachel Garrod; Professor Andy Jewell
Funding: St George's Hospital Therapies Research Fund
Publications:
  • Garrod R, Ansley P, Canavan JL, Jewell A. Exercise and the inflammatory response in chronic obstructive pulmonary disease (COPD)-does training confer anti-inflammatory properties in COPD? Medical Hypotheses. 2007:68:291-298
  • Canavan JL, Garrod R, Marshall J, Jackson D, Ansley P, Jewell A. Measurement of the acute inflammatory response to walking exercise in COPD: effects of pulmonary rehabilitation. International Journal of COPD. 2007:2(3):347-353
Exercise and fatigue in patients with chronic obstructive pulmonary disease (COPD)
Description: Chronic fatigue is an important feature of patients with COPD. This study aims to identify the predictors of fatigue in COPD and determine the influence of exercise in this condition.
Researchers: Agnieszka Lewko; Dr Rachel Garrod
Funding: Part-funded by GlaxoSmithKlineOpens new window
Publications:
  • Lewko A, Marshall J, Canavan J, Garrod R. Ambulatory oxygen therapy assessment: A comparative study of physiological response to incremental shuttle and six-minute walking tests. Physiotherapy 2007;93: 261-266
Frequency and circumstances of falls in people with neuromuscular diseases
Description: This study will survey the incidence and circumstances of falls in people with Charcot-Marie-Tooth disease, sensory neuropathy, distal hereditary motor neuropathy and distal myopathy.
Researchers: Dr Gita Ramdharry; Louise Entwhistle, Professor Mary Reilly, MRC Centre for Neuromuscular Diseases, UCL/UCLH
Funding: NIHR CAT Clinical LectureshipOpens new window
Characterising balance impairment and falls risk in people with neuromuscular diseases
Description: This laboratory based study will accurately measure static and dynamic balance responses and relate to presenting impairments to explore the determinant factors of instability and falls. Subjects will be people with Charcot-Marie-Tooth disease, sensory neuropathy, distal hereditary motor neuropathy and distal myopathy.
Researchers: Dr Gita Ramdharry; Professor Mary Reilly, MRC Centre for Neuromuscular Diseases UCL/UCLH; David Tropman, Medical Physics and Clinical Engineering, St George’s Healthcare NHS Trust
Funding: NIHR CAT Clinical LectureshipOpens new window
Publications:
  • Ramdharry G, Day B, Reilly M, Marsden J. Hip Flexor Fatigue limits walking in Charcot-Marie-Tooth Disease. Muscle & Nerve 2009; Jul;40(1):103-11.
  • Ramdharry G, Pollard A, Marsden J, Reilly M. Comparing gait performance of people with Charcot-Marie-Tooth disease who do and do not wear ankle foot orthoses. Journal of the Peripheral Nervous System 2010; 15 (Supplement) p31
The effect of post operative physical training on activity after curative surgery for Non Small Cell Lung Cancer : Restoring Activity Post Surgery (RAPS)
Description: To evaluate the effect of a structured, physiotherapy led cycle ergometry strength training programme provided early after surgery for lung cancer on activity, quadriceps muscle strength, exercise tolerance and quality of life.
Researchers: Gill Arbane; Dr Rachel Garrod; Professor Andy Jewell
Funding: British Lung FoundationOpens new window

Completed projects

Exercise intervention for breast cancer survivors
Description: Breast cancer is a common disease, and while treatment produces good results, breast cancer survivors continue to suffer with long-term problems such as fatigue and depression. This study provides women with a tailored exercise regime which helps to combat these problems.
Researchers: Dr Jenny Hewitt, Faculty of Health and Social Care Sciences; Dr Ken van Someren, English Institute of Sport; Dr Rachel Garrod; Professor Andy Jewell
Funding: Faculty of ScienceOpens new window, Kingston University
Publications:
  • Hewitt JA, Mokbel K, van Someren KA, Jewell AP, Garrod R. Exercise for breast cancer survival: the effect on cancer risk and cancer-related fatigue (CRF). Int J Fertil Womens Med. 2005 50: 231-9. Review.
Exercise intervention for patients with multiple myeloma
Description: Multiple myeloma is a malignant disease that results in bone pain and bone destruction. Researchers tailored an exercise programme to individual patients, which they followed three times per week. Results demonstrated significant improvements in well-being and reduction of fatigue.
Researchers: Lara Groeneveldt, University College London; Dr Kwee Yong, University College London; Dr Shirley D’Sa, University College London; Dr Rachel Garrod; Professor Andy Jewell
Funding: Cancer Research UKOpens new window
Publications:
  • Groeneveldt LJ, Garrod R, Yong KL, Dangwa F, Jewell AP, van Someren K, Rabin N, Nicholls L, D’Sa SP. An exercise training programme produces significant improvements in quality of life (QoL), muscle strength and cardiorespiratory function in patients with myeloma. Blood, Nov 2007; 110: 3323
Large arterial haemodynamics in patients with cystic fibrosis
Description: This project aims to provide further insight into the role played by extra-pulmonary co-morbidities in adult patients with cystic fibrosis, as their life expectancy improves. The study provides a measure of arterial stiffness during exercise and at rest, helping us understand more about cardiovascular complications in cystic fibrosis.
Researchers: Dr James Hull, Kingston University; Dr Rachel Garrod
Funding: Faculty of Health and Social Care Sciences
Publications:
  • Hull JH, Ansley L, Garrod R, Dickinson JW. Exercise induced bronchoconstriciton in athletes – should we screen? Med Sci Sports Exerc 2007 Dec;39(12):2117-24
  • Hull JH, Knight RK, Castle N, Ho TB. Nebulised DNAse in the treatment of life threatening asthma. Resuscitation 2007 Jul; 74(1):175-7
Strengthening hip flexors to improve walking distance in people with Charcot-Marie-Tooth disease
Description: This project investigated the impact and treatment of gait impairments in people with Charcot-Marie-Tooth disease, with a focus on exploring specific training to improve walking endurance.
Researchers: Dr Gita Ramdharry; Alex Pollard, Professor Mary Reilly (PI), MRC Centre for Neuromuscular Diseases, UCL/UCLH; Professor Jon Marsden, University of Plymouth
Funding: Muscular Dystrophy CampaignOpens new window
Publications:
  • Ramdharry G, Day B, Reilly M, Marsden J. Hip Flexor Fatigue limits walking in Charcot-Marie-Tooth Disease. Muscle & Nerve 2009; Jul;40(1):103-11.
  • Ramdharry G, Pollard A, Marsden J, Reilly M. Comparing gait performance of people with Charcot-Marie-Tooth disease who do and do not wear ankle foot orthoses. Journal of the Peripheral Nervous System 2010; 15 (Supplement) p31
The effect of early post-operative physical training on quality of life after thoracotomy for lung cancer: a randomised controlled trial
Description: This study explores the effects of an exercise programme provided early after surgery for lung cancer. Patients are given a home exercise programme with monthly physiotherapy visits; this additional support is compared to usual care. Outcome measurements are exercise tolerance, muscle strength and quality of life.
Researchers: >Gill Arbane; Dr Rachel Garrod
Funding: St George’s Hospital Therapies Research Fund
Publications:
  • Arbane G, Jackson D, Tropman D, Garrod R 2010 Evaluation of an early exercise intervention after thoracotomy for non small cell lung cancer (NSCLC), effects on quality of life, muscle strength and exercise tolerance: randomised controlled trial. Lung Cancer; LUNG3582; 10.1016/j.lungcan.2010.04.025
Activity monitoring in people with Charcot-Marie-Tooth disease
Description: This project investigated the activity levels and energy expenditure of 20 people with Charcot-Marie-Tooth disease, over a 7 day period compares with healthy, matched control subjects.
Researchers: Dr Gita Ramdharry; Alex Pollard, Professor Mary Reilly (PI), MRC Centre for Neuromuscular Diseases, UCL/UCLH; Professor Jon Marsden, University of Plymouth; Kate Hallsworth, Sarah Moore, University of Newcastle
Funding: Muscular Dystrophy CampaignOpens new window
Publications: Pollard A, Ramdharry G, Moore S, Hallsworth K, Marsden J, Reilly M. Comparing activity levels between people with Charcot-Marie-Tooth disease and healthy controls: a pilot study. Journal of the Peripheral Nervous System 2010; 15 (Supplement) p30
Effects of physical activity top up ‘PAT on the back’ programme on exercise capacity and healthcare utilisation for people with chronic obstructive pulmonary disease (COPD)
Description: Patients with COPD can attend pulmonary rehabilitation (PR). Current research shows that the benefits of PR decline 6-12 months after treatment. Maintenance shows little additional benefit, but the effects of a short term ‘top up’ programme has not been tested. This study sets out to evaluate the effectiveness of a four week, once weekly physical activity top up programme delivered 6 months after PR on exercise capacity and quality of life compared with no top up.
Researchers: Gill Arbane, Dr Rachel Garrod; Ted Poulter, Wandsworth Teaching Primary Care Trust;
Funding: St George’s Hospital Therapies Research Fund
Publications: Arbane G, Jackson D, Tropman D, Garrod R 2010 Evaluation of an early exercise intervention after thoracotomy for non small cell lung cancer (NSCLC), effects on quality of life, muscle strength and exercise tolerance: randomised controlled trial. Lung Cancer; LUNG3582; 10.1016/j.lungcan.2010.04.025
Identifying neuropathic back and leg pain: a cross-sectional study
Description: Low back pain is a widespread problem with a lifetime prevalence of 80% and therefore a large effect on both individuals and society. Despite this, the underlying cause of roughly 90% of back pain is not known. We analysed the results of using the painDETECT neuropathic pain screening questionnaire in a group of 343 patients in south east England presenting for physiotherapy with low back pain with or without leg pain. We related the results to established standardised measures of pain severity (NRS), disability (RMDQ), anxiety and depression (HADs), and quality of life (SF-36v2) for comparison between three pain groups- likely nociceptive, unclear, possible neuropathic.

The questionnaire also investigated the presence of leg pain as an indicator for neuropathic pain in the clinical setting. We also used the data to investigate if the range of passive atraight leg raise (PSLR) is associated with neuropathic pain and to assess whether the questionnaire is a useful tool for detecting nerve root compression by MRI scans.

59% (n=204) reported likely nociceptive, 25% (n=85) unclear, and 16% (n=54) possible neuropathic pain. The neuropathic pain group reported significantly higher pain levels, disability scores, anxiety and depression levels, lesser quality of life, and reduced PSLR compared to the other pain groups (p<0.05). The majority of participants screened to the neuropathic group (96%) reported pain radiating to the leg; however, leg pain was more common in patients with nociceptive pain. Lastly, no relationship was demonstrated between participants reporting neuropathic pain and positive MRI scans for nerve root compression.
Researchers: Dr Iain Beith; Andrew Kemp; Jonathan Kenyon; Matthew Prout, John Chestnut
Funding: Faculty of Health and Social Care Sciences