Evaluating the effectiveness of a multidisciplinary hypertonicity service to inform the development of a state-wide service model for management of hypertonicity post brain injury

About the Project

Project aims and objective:

This project intends to generate new knowledge regarding multidisciplinary hypertonicity management outcomes for patients with brain injury to improve service access and delivery. 

The primary aim of this project is to evaluate and refine the PAHTS delivery model for future state-wide implementation by investigating the pattern of outcomes of hypertonicity patients.

Anticipated key benefits include consistent, easily accessible and high-quality hypertonicity management, promoting improved function and daily life participation for all Queensland patients.

Project significance:

Disability related to hypertonicity is a significant issue for people with brain injury and the health system. Hypertonicity, including spasticity, involves significant muscle over-activity and is experienced by up to 42% of patients post stroke and 75% of patients following severe traumatic brain injury.  Consequences of hypertonicity include joint contractures, pressure areas, muscle weakness and tightness, pain, and impaired balance and mobility. Healthcare costs associated with hypertonicity are substantial owing to hospital readmissions and medical support (e.g. falls and fractures). Management of hypertonicity can counteract these problems by improving function and decreasing hospital readmission rates.  Currently, the Princess Alexandra Hospital (PAH) provides the only specialist multidisciplinary service in Queensland meaning that geographical distance is a major barrier to management of hypertonicity in this state. Our team will address this inequity.

The Queensland State-wide Adult Brain Injury Rehabilitation Plan 2016-2026 aims to provide a specialised network of brain injury rehabilitation services, including hypertonicity management, comprising a tertiary service at PAH and four hub services to provide care across Queensland. The PAH has routinely collected encompassing assessment data over an eight-year period on 340 hypertonicity patients. The substantial database provides opportunity for a comprehensive analysis to identify patterns and trends for successful hypertonicity management. Examining the effectiveness of this service is critical to development of a best practice service model to enhance service capacity across the state and ensure all Queenslanders have optimal health care.

Expected outcome:

Disability related to hypertonicity is a significant issue for people with traumatic brain injury and the health system. Hypertonicity, including spasticity, involves significant muscle over-activity and is experienced by up to 75% of patients following severe traumatic brain injury.  Consequences of hypertonicity include joint contractures, pressure areas, muscle weakness and tightness, pain, and impaired balance and mobility. Healthcare costs associated with hypertonicity are substantial owing to hospital readmissions and medical support (e.g. falls and fractures). Management of hypertonicity can counteract these problems by improving function and decreasing hospital readmission rates.  Currently, the Princess Alexandra Hospital (PAH) provides the only specialist multidisciplinary service in Queensland meaning that geographical distance is a major barrier to management of hypertonicity in this state. Our team will address this inequity. Project findings will inform the development of a service framework, procedures and protocols to enable the establishment of four hypertonicity hub services across the state to provide consistent, effective assessment and hypertonicity management for patients following brain injury.

Project Status:

The project commenced in 2019 and is in the stage of dissemination findings from the study.

Project Funding:

This project is funded by a Hopkins Centre Seed Grant and the Motor Accident Insurance Commission (MAIC).

The project is proudly supported by Griffith University and the Division of Rehabilitation at Princess Alexandra Hospital, Metro South Hospital and Health Service.

Research Team:

Catherine Cave, THC, Griffith University and Division of Rehabilitation, Princess Alexandra Hospital, Metro South Hospital and Health Service 

Dr Letitia Burridge, Hopkins Centre, Griffith University 

Micky Nascimento, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Hospital and Health Service

Marie Kayssar, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Hospital and Health Service

Janelle Griffin, THC, Griffith University and Division of Rehabilitation, Princess Alexandra Hospital, Metro South Hospital and Health Service

Janelle Gesch, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Hospital and Health Service

Dr Rachael Nunan, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Hospital and Health Service

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