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Trial registered on ANZCTR
Registration number
ACTRN12612000595819
Ethics application status
Approved
Date submitted
1/06/2012
Date registered
1/06/2012
Date last updated
9/11/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of physiotherapy booster sessions on home exercise outcomes in people with knee osteoarthritis
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Scientific title
Effects of limited physiotherapy booster sessions on pain and function outcomes with home exercise in people with knee osteoarthritis
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Secondary ID [1]
280596
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Nil
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Universal Trial Number (UTN)
U1111-1131-3821
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Knee osteoarthritis
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Condition category
Condition code
Musculoskeletal
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0
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Osteoarthritis
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Physical Medicine / Rehabilitation
286888
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0
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Physiotherapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prior to entering this trial, participants will have visited a physiotherapist on 14 occasions to be taught home exercises - either a neuromuscular exercise program that focused on functional exercise and balance/co-ordination and included six exercises or a quadriceps strengthening program that comprised five exercises. During this trial, participants will be asked to continue with their home exercise program three times per week (approx 30 minutes per session) for 24 weeks. An exercise log book will be provided to participants with encouragement to record exercise sessions to assist with motivation. However, this will be an optional self monitoring tool. Participants will additionally receive two 30-minute booster physiotherapy exercise sessions at weeks 8 and 16 at the physiotherapists' clinic. At these visits, the physiotherapist will review the exercises and discuss progress with the participant. Discussion will also focus on barriers to home exercise performance and strategies to enhance adherence.
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Intervention code [1]
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Rehabilitation
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Comparator / control treatment
The control group will be asked to perform the same home exercises three times per week but will not receive the two physiotherapy booster sessions
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Control group
Active
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Outcomes
Primary outcome [1]
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Average overall knee pain during the past week using 100 mm visual analogue scale with terminal descriptors of no pain and worst pain possible
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Assessment method [1]
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Timepoint [1]
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Baseline and 24 weeks
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Primary outcome [2]
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Self reported physical function using the disease-specific Western Ontario McMaster Universities (WOMAC) Osteoarthritis Index. The physical function subscale comprises 17 questions in a Likert format
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Assessment method [2]
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Timepoint [2]
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Baseline and 24 weeks
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Secondary outcome [1]
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Average pain on walking during the past week assessed using 100 mm visual analogue scale with terminal descriptors of no pain and worst pain possible.
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Assessment method [1]
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Timepoint [1]
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Baseline and 24 weeks
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Secondary outcome [2]
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Pain subscale of the disease-specific Western Ontario McMaster Universities (WOMAC) Osteoarthritis Index
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Assessment method [2]
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Timepoint [2]
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Baseline and 24 weeks
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Secondary outcome [3]
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Perceived a) overall change, as well as change in b) pain and in c) physical function (compared to baseline) on a seven-point ordinal scale (1-much worse to 7-much better)
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Assessment method [3]
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Timepoint [3]
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24 weeks
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Secondary outcome [4]
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Health-related quality of life will be measured using the Assessment of Quality of Life instrument version two (AQoL II).
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Assessment method [4]
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Timepoint [4]
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Baseline and 24 weeks
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Secondary outcome [5]
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Habitual physical activity will be measured using the Physical Activity Scale for the Elderly (PASE), a self-report questionnaire which records both the level and type of recreational and occupational physical activity undertaken by participants over the previous week.
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Assessment method [5]
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Timepoint [5]
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Baseline and 24 weeks
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Secondary outcome [6]
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Adherence: The number of physiotherapy sessions attended will be recorded.
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Assessment method [6]
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Timepoint [6]
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24 weeks
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Secondary outcome [7]
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Adherence: to the home exercise program will be measured by asking participants via telephone, how many times they completed the home exercises in the previous week.
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Assessment method [7]
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Timepoint [7]
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Weeks 7 and 15
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Secondary outcome [8]
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Adherence to home exercise: participants will self-rate their adherence to the prescribed home exercise program using an 11-point numeric rating scale
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Assessment method [8]
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Timepoint [8]
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Baseline and 24 weeks
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Secondary outcome [9]
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Arthritis self efficacy scale
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Assessment method [9]
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Timepoint [9]
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Baseline and 24 weeks
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Secondary outcome [10]
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Pain catastrophising scale
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Assessment method [10]
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Timepoint [10]
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Baseline and 24 weeks
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Secondary outcome [11]
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Arthritis impact measurement scale
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Assessment method [11]
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Timepoint [11]
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Baseline and 24 weeks
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Secondary outcome [12]
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Coping strategies questionnaire
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Assessment method [12]
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Timepoint [12]
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Baseline and 24 weeks
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Secondary outcome [13]
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Adverse events such as increased pain from exercise and co-interventions - specially designed questionnaire
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Assessment method [13]
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Timepoint [13]
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24 weeks
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Eligibility
Key inclusion criteria
All participants who completed a clinical trial comparing the effects of a 12-week physiotherapist-supervised exercise program plus home exercises (either neuromuscular exercise or strengthening exercise) will be recruited (ACTRN12610000660088):
People were eligible for the feeder trial if they reported average knee pain over the past week greater than or equal to 25 on a 100 mm visual analogue scale, had predominant pain/tenderness over the medial knee region, and had radiographic evidence of medial tibiofemoral joint OA with varus knee alignment
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Minimum age
50
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(i) knee surgery or intra-articular corticosteroid injection within past six months; (ii) current or past (within four weeks) oral corticosteroid use; (iii) systemic arthritic conditions; (iv) history of hip or knee joint replacement or tibial osteotomy surgery; (v) any other condition affecting lower limb function; (vi) participation in a strengthening or neuromuscular exercise program within the past six months or planning to commence exercise or other treatment for knee OA; (vii) other non-pharmacological treatment for their knee pain in the past six months including physiotherapy, acupuncture, massage therapy; or (viii) unable to ambulate without a gait aid.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Consecutively numbered, sealed, opaque envelopes containing group allocation will be prepared by a researcher with no other involvement in the study. Allocation will be revealed by a person not involved in recruitment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A person not involved with the study generated the sequence a priori using the random number function in Excel. It involved
random permuted blocks according to the type of exercise (neuromuscular or strengthening) performed in the feeder trial.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/11/2011
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Actual
18/11/2011
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Date of last participant enrolment
Anticipated
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Actual
21/09/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
78
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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Level 1, 16 Marcus Clarke St
Canberra, ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Melbourne
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Address
Parkville
Vic 3010
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
284203
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Human Research Ethics Committee University of Melbourne
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Ethics committee address [1]
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Melbourne Research Office University of Melbourne Parkville Vic 3010
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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16/04/2010
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Ethics approval number [1]
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0932813.1
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Summary
Brief summary
Osteoarthritis of the knee is common in older people, giving rise to pain and loss of function. Exercise is a key treatment for knee osteoarthritis with studies revealing short-term benefits of exercise for pain and function. However, exercise is generally not effective in the longer-term due to reduced adherence. Following an initial period of more intensive exercise supervision, this randomised controlled trial will investigate whether a limited number of additional physiotherapy visits will improve outcomes with home exercise over 24 weeks.
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Trial website
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Trial related presentations / publications
Arthritis Care Res (Hoboken). 2014 Nov;66(11):1680-7. Effects of two physiotherapy booster sessions on outcomes with home exercise in people with knee osteoarthritis: a randomized controlled trial. Bennell KL, Kyriakides M, Hodges PW, Hinman RS.
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Public notes
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Contacts
Principal investigator
Name
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Prof Kim Bennell
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Address
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Department of Physiotherapy University of Melbourne Parkville Vic 3010
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Country
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Australia
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Phone
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+61 3 83444135
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Professor Kim Bennell
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Address
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Department of Physiotherapy
University of Melbourne
Parkville
Vic 3010
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Country
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Australia
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Phone
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+61 3 83444135
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Kim Bennell
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Address
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Department of Physiotherapy
University of Melbourne
Parkville
Vic 3010
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Country
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Australia
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Phone
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+61 3 83444135
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF