Shaping better rehabilitation journeys:
The dedicated team of researchers and clinicians at the John Walsh Centre for Rehabilitation Research (JWCRR) are leading the way in improving the rehabilitation journey for people with injuries ranging from spinal cord injury to disability related to ageing.
The Centre, which is based at NSLHD and the Kolling Institute and works closely with the University of Sydney, leads and participates in a broad range of basic, clinical and implementation science research studies related to rehabilitation and disability.
The interdisciplinary team is led by Professor Ian Cameron and includes about 20 clinician/researchers in spinal cord injury, severe traumatic brain injury, musculoskeletal injury and psychosocial health, who work together to address real-world problems. Their findings have contributed to policies, guidelines and models of care at a local, state, national and international level.
One of the major research focuses is contributing to policies on work-related and motor vehicle accident injury and furthering understanding of what effect compensation systems have on the health of people with injuries.
The team's work has informed significant changes to legislation including the NSW
Motor Vehicle Injuries Act 2017, which established a new scheme of third-party insurance aimed at better supporting people injured in motor vehicle accidents.
The Centre's long history of working in partnership with NSW compensation agencies was further cemented in 2021 with a $9.6 million grant from the NSW State Insurance Regulatory Authority (SIRA) and icare to fund research over five years to support health and recovery outcomes for injured people in NSW.
The Centre's work has also contributed to paradigm shifts in thinking about recovery from injury, especially around the often-neglected area of psychological factors related to injury.
For example, its research has shown that road traffic injury will result in serious mental disorders like depression and post-traumatic stress disorder in at least 30% of survivors.
This has led to the development of new models of care to provide early intervention and avoid long-term psychological impacts from both the injury, and from being involved in a compensation claim.
The researchers are also undertaking influential research into rehabilitation from traumatic brain injury, spinal cord injury and age-related injury such as falls (see below).
JWCRR has affiliations with the University of Sydney's new Flagship Centre for research on musculoskeletal health and both the Neurosciences and Pain and Musculoskeletal Priority Research Areas of the Kolling Institute, and also plays an important role in education of both research students and other healthcare professionals.
Research highlights and current projects include:
Spinal cord injury (SCI): Professor Lisa Harvey developed online training modules for the management of people with SCI (in conjunction with the International Spinal Cord Society) that have been translated into four different languages and accessed by 50,000 healthcare professionals to date. The Centre's academics have published the most papers in the leading journal in this area,
Spinal Cord, over the last 10 years.
Professor Harvey is currently leading an international randomised trial of intensive rehabilitation treatment soon after spinal cord injury. Other studies include research led by Professor Ashley Craig on treatment for autonomic nervous system problems after spinal cord injury and a population-based study led by Professor James Middleton into long-term effects of SCI.
Severe brain injury: Associate Professor Grahame Simpson is helping to implement a Vocational Intervention Program that is being rolled out to almost 200 people with moderate to severe brain injury across NSW. He also developed and evaluated a workshop for training psychologists in how to adapt psychological therapies to meet the mental health needs of people with brain injury. He is currently collaborating with the Ingham Institute to develop a technology hub to assist people with severe traumatic brain injury with daily activities.
Cognitive impairment: Cognitive impairment, including problems with speech, memory, and poor judgement, is a substantial long-term problem for many Australians who sustain a spinal cord injury (SCI) but has long been neglected in research. Funded by icare, JWCRR research has now shown that such impairment can lead to sub-standard rehabilitation outcomes, such as higher rates of depression and anxiety, fatigue and higher risk of secondary health conditions. Professor Ashley Craig led development of rehabilitation guidelines for the management of cognitive impairment following SCI that will be evaluated in the three units in Sydney in the next three years.
Impacts of injury compensation: Professor Ian Cameron has led an extensive body of research that is widely recognised as being fundamental to understanding of the effects of compensation systems on health, with findings incorporated into legislation in NSW.
Professor Cameron and Associate Professor Trudy Rebbeck are currently undertaking studies on musculoskeletal injury, with the aim of translating evidence into treatments and investigating the effects on injury recovery in a compensation setting.
Injury-related disabilities: Professor Cameron also completed a series of influential studies and systematic reviews that have supported the development of treatments and services for older people with injury-related disabilities such as falls. The Cochrane Collaboration Review on interventions to prevent falls in older people, published in 2018, already has more than 1700 citations and has informed falls
