I am a physiotherapist and lecturer in the Graduate School of Health at UTS.
I completed my undergraduate training in physiotherapy at Notre Dame in Perth before returning to Sydney to work in private practice. I work in a multidisciplinary pain clinic translating best evidence into practice.
My research interests are chronic pain, musculoskeletal health, clinimetrics and technology in physiotherapy. My PhD investigated cognitvae factors that are involved in the transistion from acute to persistant low back pain. I have worked on large NHMRC randomised control trials and have experience conducting systematic reviews.
- AHPRA Registered Physiotherapist
- Australian Physiotherapy Association
- APA Pain Group
- Australian Pain Society
- International Association for the Study of Pain
- NSW APA Pain Group Committee
Can supervise: YES
- Low back pain
- Cognitive Psychology
- Pain Neuroscience and Management
- Transistion to Practice
- Clinical Assessment and Management
Heathcote, LC, Allen, JM, Gunn, KM, Fox, S, Harvie, DS, Olver, I, Skinner, IW, Smith, AG, Stanton, TR, Whitford, HS & Moseley, GL 2019, 'Pain Education for Adolescents and Young Adults Living Beyond Cancer: An Interdisciplinary Meeting Report', JOURNAL OF ADOLESCENT AND YOUNG ADULT ONCOLOGY, vol. 8, no. 5, pp. 529-533.View/Download from: UTS OPUS or Publisher's site
Skinner, IW, Cashin, AG & Bagg, MK 2019, 'Clarification of Reporting of Outcome Measures and Protocol Deviations in Report of a Randomized Clinical Trial', JAMA NEUROLOGY, vol. 76, no. 3, pp. 371-372.View/Download from: Publisher's site
Traeger, AC, Lee, H, Hübscher, M, Skinner, IW, Moseley, GL, Nicholas, MK, Henschke, N, Refshauge, KM, Blyth, FM, Main, CJ, Hush, JM, Lo, S & McAuley, JH 2019, 'Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back Pain: A Randomized Clinical Trial.', JAMA Neurology, vol. 76, no. 2, pp. 161-169.View/Download from: UTS OPUS or Publisher's site
Importance:Many patients with acute low back pain do not recover with basic first-line care (advice, reassurance, and simple analgesia, if necessary). It is unclear whether intensive patient education improves clinical outcomes for those patients already receiving first-line care. Objective:To determine the effectiveness of intensive patient education for patients with acute low back pain. Design, Setting, and Participants:This randomized, placebo-controlled clinical trial recruited patients from general practices, physiotherapy clinics, and a research center in Sydney, Australia, between September 10, 2013, and December 2, 2015. Trial follow-up was completed in December 17, 2016. Primary care practitioners invited 618 patients presenting with acute low back pain to participate. Researchers excluded 416 potential participants. All of the 202 eligible participants had low back pain of fewer than 6 weeks' duration and a high risk of developing chronic low back pain according to Predicting the Inception of Chronic Pain (PICKUP) Tool, a validated prognostic model. Participants were randomized in a 1:1 ratio to either patient education or placebo patient education. Interventions:All participants received recommended first-line care for acute low back pain from their usual practitioner. Participants received additional 2 × 1-hour sessions of patient education (information on pain and biopsychosocial contributors plus self-management techniques, such as remaining active and pacing) or placebo patient education (active listening, without information or advice). Main Outcomes and Measures:The primary outcome was pain intensity (11-point numeric rating scale) at 3 months. Secondary outcomes included disability (24-point Roland Morris Disability Questionnaire) at 1 week, and at 3, 6, and 12 months. Results:Of 202 participants randomized for the trial, the mean (SD) age of participants was 45 (14.5) years and 103 (51.0%) were female. Retention rates were greater than 90% at ...
Skinner, IW, Hübscher, M, Moseley, GL, Lee, H, Wand, BM, Traeger, AC, Gustin, SM & McAuley, JH 2018, 'The reliability of eyetracking to assess attentional bias to threatening words in healthy individuals.', Behavior Research Methods.View/Download from: UTS OPUS or Publisher's site
Eyetracking is commonly used to investigate attentional bias. Although some studies have investigated the internal consistency of eyetracking, data are scarce on the test-retest reliability and agreement of eyetracking to investigate attentional bias. This study reports the test-retest reliability, measurement error, and internal consistency of 12 commonly used outcome measures thought to reflect the different components of attentional bias: overall attention, early attention, and late attention. Healthy participants completed a preferential-looking eyetracking task that involved the presentation of threatening (sensory words, general threat words, and affective words) and nonthreatening words. We used intraclass correlation coefficients (ICCs) to measure test-retest reliability (ICC > .70 indicates adequate reliability). The ICCs(2, 1) ranged from -.31 to .71. Reliability varied according to the outcome measure and threat word category. Sensory words had a lower mean ICC (.08) than either affective words (.32) or general threat words (.29). A longer exposure time was associated with higher test-retest reliability. All of the outcome measures, except second-run dwell time, demonstrated low measurement error (<6%). Most of the outcome measures reported high internal consistency (α > .93). Recommendations are discussed for improving the reliability of eyetracking tasks in future research.
Lee, H, Hübscher, M, Moseley, GL, Kamper, SJ, Traeger, AC, Skinner, IW, Williams, CM & McAuley, JH 2017, 'An embedded randomised controlled trial of a Teaser Campaign to optimise recruitment in primary care.', Clinical Trials, vol. 14, no. 2, pp. 162-169.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Marketing communication and brand identity is a fundamental principle of advertising and end-user engagement. Health researchers have begun to apply this principle to trial recruitment in primary care. The aim of this study was to evaluate whether a Teaser Campaign using a series of postcards in advance of a conventional mail-out increases the number of primary care clinics that engage with a clinical trial. METHODS: Embedded randomised recruitment trial across primary care clinics (general practitioners and physiotherapists) in the Sydney metropolitan area. Clinics in the Teaser Campaign group received a series of branded promotional postcards in advance of a standard letter inviting them to participate in a clinical trial. Clinics in the Standard Mail group did not receive the postcards. RESULTS: From a total of 744 clinics that were sent an invitation letter, 46 clinics in the Teaser Campaign group and 40 clinics in the Standard Mail group responded (11.6% total response rate). There was no between-group difference in the odds of responding to the invitation letter (odds ratio = 1.18, 95% confidence interval = 0.75-1.85, p = 0.49). For physiotherapy clinics and general practice clinics, the odds ratios were 1.43 (confidence interval = 0.82-2.48, p = 0.21) and 0.77 (confidence interval = 0.34-1.75, p = 0.54), respectively. CONCLUSION: A Teaser Campaign using a series of branded promotional postcards did not improve clinic engagement for a randomised controlled trial in primary care.
Traeger, AC, Skinner, IW, Hübscher, M, Henschke, N, Moseley, GL & McAuley, JH 2017, 'What you wear does not affect the credibility of your treatment: A blinded randomized controlled study.', Patient Education and Counseling, vol. 100, no. 1, pp. 104-111.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE: Professional appearance is easily modifiable, and might alter the effects of a clinical encounter. We aimed to determine whether professional attire influences a patient's perception of treatment credibility. METHODS: We performed a single-blind randomized controlled study on 128 patients with acute non-specific low back pain who were about to receive treatment in primary care. The treating clinician was randomly allocated to wear formal attire (experimental condition) or casual attire (control condition) to the consultation. Clinicians provided a standardized briefing on the rationale behind the patient's forthcoming treatment. Treatment credibility (Credibility and Expectancy Questionnaire) was assessed immediately after this briefing. RESULTS: All patients received the experimental or control condition as allocated and provided complete primary outcome data. Formal attire had no effect on perceived treatment credibility (Mean difference between groups 1.2 [95%CI-1.1 to 3.5]). Age was the only significant predictor of treatment credibility; older patients rated treatment credibility higher (Beta=0.16 [95%CI 0.08 to 0.24]). CONCLUSION: In a trial setting, whether or not a clinician is formally dressed has no effect on perceptions of treatment credibility in patients with acute low back pain. PRACTICE IMPLICATION: Clinicians should dress comfortably without fear of losing credibility.
Traeger, AC, Skinner, IW, Hübscher, M, Lee, H, Moseley, GL, Nicholas, MK, Henschke, N, Refshauge, KM, Blyth, FM, Main, CJ, Hush, JM, Pearce, G, Lo, S & McAuley, JH 2017, 'A randomized, placebo-controlled trial of patient education for acute low back pain (PREVENT Trial): statistical analysis plan.', Brazilian Journal of Physical Therapy, vol. 21, no. 3, pp. 219-223.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Statistical analysis plans increase the transparency of decisions made in the analysis of clinical trial results. The purpose of this paper is to detail the planned analyses for the PREVENT trial, a randomized, placebo-controlled trial of patient education for acute low back pain. RESULTS: We report the pre-specified principles, methods, and procedures to be adhered to in the main analysis of the PREVENT trial data. The primary outcome analysis will be based on Mixed Models for Repeated Measures (MMRM), which can test treatment effects at specific time points, and the assumptions of this analysis are outlined. We also outline the treatment of secondary outcomes and planned sensitivity analyses. We provide decisions regarding the treatment of missing data, handling of descriptive and process measure data, and blinded review procedures. CONCLUSIONS: Making public the pre-specified statistical analysis plan for the PREVENT trial minimizes the potential for bias in the analysis of trial data, and in the interpretation and reporting of trial results. TRIAL REGISTRATION: ACTRN12612001180808 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=126…).
Lee, H, Moseley, GL, Hübscher, M, Kamper, SJ, Traeger, AC, Skinner, IW & McAuley, JH 2015, 'Understanding how pain education causes changes in pain and disability: Protocol for a causal mediation analysis of the PREVENT trial', Journal of Physiotherapy, vol. 61, no. 3, p. 156.View/Download from: Publisher's site
© 2015 Australian Physiotherapy Association. Introduction: Pain education is a complex intervention developed to help clinicians manage low back pain. Although complex interventions are usually evaluated by their effects on outcomes, such as pain or disability, most do not directly target these outcomes; instead, they target intermediate factors that are presumed to be associated with the outcomes. The mechanisms underlying treatment effects, or the effect of an intervention on an intermediate factor and its subsequent effect on outcome, are rarely investigated in clinical trials. This leaves a gap in the evidence for understanding how treatments exert their effects on outcomes. Mediation analysis provides a method for identifying and quantifying the mechanisms that underlie interventions. Aim: To determine whether the effect of pain education on pain and disability is mediated by changes in self-efficacy, catastrophisation and back pain beliefs. Design: Causal mediation analysis of the PREVENT randomised controlled trial. Participants and setting: Two hundred and two participants with acute low back pain from primary care clinics in the Sydney metropolitan area. Intervention: Participants will be randomised to receive either 'pain education' (intervention group) or 'sham education' (control group). Measurements: All outcome measures (including patient characteristics), primary outcome measures (pain and disability), and putative mediating variables (self-efficacy, catastrophisation and back pain beliefs) will be measured prior to randomisation. Putative mediators and primary outcome measures will be measured 1 week after the intervention, and primary outcome measures will be measured 3 months after the onset of low back pain. Analysis: Causal mediation analysis under the potential outcomes framework will be used to test single and multiple mediator models. A sensitivity analysis will be conducted to evaluate the robustness of the estimated mediation effects on t...
Skinner, IW, Debenham, JR, Krumenacher, SA, Bulsara, MK & Wand, BM 2014, 'Chronic Mid Portion Achilles Tendinopathy is Not Associated with Central Sensitisation', Pain and Rehabilitation- The Journal of Physiotherapy Pain Association, vol. Summer, no. 37, pp. 34-40.
Traeger, AC, Moseley, GL, Huebscher, M, Lee, H, Skinner, IW, Nicholas, MK, Henschke, N, Refshauge, KM, Blyth, FM, Main, CJ, Hush, JM, Pearce, G & McAuley, JH 2014, 'Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial', BMJ OPEN, vol. 4, no. 6.View/Download from: Publisher's site