
Overview
Background
Nadine is a physiotherapist, NHMRC Leadership Fellow (leadership level 2) focused on musculoskeletal pain and orthopaedic research, particularly clinical trials, and Academic Director of the University of Queensland's Clinical Trials Centre. Nadine is also the program lead for the Health Research Accelerator (HERA 2) program focused on innovation in clinical trials (ULTRA - UQ's Clinical Trial Capability) and a theme lead for clinical trials in the Centre of Innovation in Pain and Health Research (CIPHeR) at UQ. She is passionate about supporting multidisciplinary groups to work together, with critical mass, to design, conduct, analyse and translate the results of high quality clinical trials, in ways that improve patient and service outcomes.
Nadine is a lifetime Fellow of the Chartered Society of Physiotherapy in the UK, and has held previous National Institute for Health Research (NIHR) Senior Investigator awards and is the only physiotherapist to have held an NIHR Research Professorship in the UK. Having moved to Australia in January 2021, she was the inaugural Director of the STARS Research and Education Alliance between the University of Queensland and Metro North Health in Queensland (STARS is the Surgical, Treatment and Rehabilitation Service, the newest public hospital in Brisbane). Nadine is part of the STARS Alliance multidisciplinary team including conjoint appointments between the University and hospital, across the disciplines of physiotherapy, nursing, occupational therapy, psychology, consumer involvement in research, interdisciplinary collaborative practice in education and practice, and research management.
Nadine's research focuses on musculoskeletal pain, including low back pain, osteoarthritis and shoulder problems, and she has a particular interest in developing, testing and implementing treatments and health services. She has led or collaborated on more than 31 randomised trials, attracting over $145 million in research funding from, for example, the National Institute for Health Research (NIHR), Versus Arthritis, and the Medical Research Council in the UK, PCORI in the USA and the NHMRC and MRFF in Australia. Current examples include international collaborative RCTs funded through the NIHR-NHMRC collaborative trial scheme focused on comparative effectiveness of surgery and conservative care for persistent, severe low back pain and comparative effectiveness of different approaches to shoulder joint replacement for patients with shoulder osteoarthritis. She has supervised 15 PhD students to completion, and 19 Masters research project students (nearly all were healthcare professionals), with 5 PhDs currently in progress in the UK, Europe and Australia. Nadine has led or contributed to over 311 peer reviewed publications, including the Lancet Series on Low Back Pain in 2018.
Examples of recognition as a national and international leader in the field include:
2024 - Elected to the Board of Directors, Australian Clinical Trials Alliance (ACTA)
2024-2029 - NHMRC Investigator Grant, Leadership level 2, supporting a program of research focused on new musculoskeletal RCTs and sharing existing RCT data to answer further research questions
2023 - Stanley Paris Visiting Fellowship award, University of Otago, New Zealand, supporting visiting fellowship in March 2024
2022 - Chief Executive's Award for Research, Metro North Health and Hospital Service Research Excellence Award
2020 - Senior Investigator award from the National Institute for Health Research (NIHR) in the UK, awarded to the top 200 clinical researchers in the country
2019 - PEDro recognition for the UK FASHIoN trial - chosen by a panel of international trialists as one of the five most important physiotherapy trials published in 2014-2019.
2019 - Invited member of the International Research Strategy Advisory Committee for the Health Research Board’s (Ireland) new five year research strategy development
2018 - Miegunyah Distinguished Visiting Fellowship 2019, University of Melbourne, Australia. February-March 2019
Availability
- Professor Nadine Foster is:
- Available for supervision
- Media expert
Fields of research
Qualifications
- Bachelor (Honours), University of Ulster
- Doctor of Philosophy, University of Ulster
Research interests
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Musculoskeletal pain including low back pain pain, osteoarthritis, shoulder pain
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Rehabilitation
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Health services research
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Interprofessional collaborative practice in health services
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Clinical trials
Research impacts
How to get the right treatment to the right musculoskeletal (MSK) patient at the right time is a key challenge. Prof Foster's clinical research program is internationally renowned for establishing the effectiveness of interventions through randomised controlled trials (RCTs), and evidencing new models of care (eg. stratified and stepped care) that has widely influenced health policy and practice.
Her program of research has led to paradigm-changing discoveries, producing 311 peer reviewed full papers cited widely in >129 countries, >27 disciplines (eg. medicine, health professions, neuroscience, social sciences, engineering, decision sciences), and in 765 news outlets and underpinned 31 patents.
Four of Prof Foster's program interventions were recommended by Public Health England based on their return-on-investment (ROI) and included in a ROI tool used by >200 Clinical Commissioning Groups in England. Her research has developed internationally agreed and widely adopted core outcome sets and set the international bar for stratified care trials in musculoskeletal pain, leading to >12 trials globally including in other fields (eg. arthritis, whiplash).
Prof Foster's research has provided best evidence about treatments and challenged the 'one-size-fits-all' musculoskeletal healthcare approach, influencing 88 policy documents including NICE and the WHO, 35 guidelines in 8 countries, including the UK NICE Low Back Pain and Osteoarthritis Clinical Guidelines, and the Australian Commission on Safety and Quality in Healthcare Back Pain Standards. Her program transformed patient care pathways including the UK's National Back Pain & Sciatica Pathway. Many hospital medical centres (eg. Massachusetts General Hospital) and universities (eg. Harvard Medical School and Oxford University) cite her program of research, and collaborations with IT industry partners EMIS Health & SystmOne embedded her stratified care tools in clinical practice (eg. the STarTBack tool, with >42 language translations).
Works
Search Professor Nadine Foster’s works on UQ eSpace
2024
Conference Publication
Characteristics of sciatica patients listed for a spinal epidural steroid injection and clinical outcomes: results from the poise cohort study
Stynes, S., Daud, N., Cherrington, A., Snell, K.I.E., Konstantinou, K., O'Dowd, J., Ostelo, R., Dunn, K.M. and Foster, N.E. (2024). Characteristics of sciatica patients listed for a spinal epidural steroid injection and clinical outcomes: results from the poise cohort study. The Society for Back Pain Research (SBPR) 2024 Annual General Meeting, Aberdeen, Scotland, 13–14 June 2024. London, United Kingdom: British Editorial Society of Bone and Joint Surgery. doi: 10.1302/1358-992x.2024.15.003
2024
Journal Article
Willingness to randomize patients to lumbar spine fusion surgery or conservative care in the forensic-UK and forensic-Australia trials
Foster, N E, Bada, E, Window, P, Stovell, M, Ahuja, S, Beard, D and Gardner, A (2024). Willingness to randomize patients to lumbar spine fusion surgery or conservative care in the forensic-UK and forensic-Australia trials. Orthopaedic Proceedings, 106-B (SUPP_15), 19-19. doi: 10.1302/1358-992x.2024.15.019
2024
Journal Article
Prognostic factors and treatment effect modifiers for physical health, opioid prescription, and health care utilization in patients with musculoskeletal disorders in primary care: exploratory secondary analysis of the STEMS randomized trial of direct access to physical therapist–led care
Zouch, James, Bhimani, Nazim, Bussières, André, Ferreira, Manuela, Foster, Nadine E. and Ferreira, Paulo (2024). Prognostic factors and treatment effect modifiers for physical health, opioid prescription, and health care utilization in patients with musculoskeletal disorders in primary care: exploratory secondary analysis of the STEMS randomized trial of direct access to physical therapist–led care. Physical Therapy, 104 (8) pzae066, 1-10. doi: 10.1093/ptj/pzae066
2024
Journal Article
Agreeing priority categories and items for inclusion in a future best practice delegation framework for musculoskeletal outpatient physiotherapy services: A consensus groups study
Sarigiovannis, P., Foster, N. E., Jowett, S. and Saunders, B. (2024). Agreeing priority categories and items for inclusion in a future best practice delegation framework for musculoskeletal outpatient physiotherapy services: A consensus groups study. Musculoskeletal Science and Practice, 72 102977, 1-7. doi: 10.1016/j.msksp.2024.102977
2024
Journal Article
Knee braces for knee osteoarthritis: A scoping review and narrative synthesis of interventions in randomised controlled trials
Holden, MA, Murphy, M., Simkins, J., Thomas, MJ, Huckfield, L., Quicke, JG, Halliday, N., Birrell, FN, Borrelli, B., Callaghan, MJ, Dziedzic, K., Felson, D., Foster, NE, Ingram, C., Jinks, C., Jowett, S., Nicholls, E. and Peat, G. (2024). Knee braces for knee osteoarthritis: A scoping review and narrative synthesis of interventions in randomised controlled trials. Osteoarthritis and Cartilage, 32 (11), 1371-1396. doi: 10.1016/j.joca.2024.08.010
2024
Journal Article
Effectiveness and cost-effectiveness of radiofrequency denervation versus placebo for chronic and moderate to severe low back pain: study protocol for the RADICAL randomised controlled trial
Ashton, Kate E., Price, Cathy, Fleming, Leah, Blom, Ashley W., Culliford, Lucy, Evans, Rebecca Nicole, Foster, Nadine E., Hollingworth, William, Jameson, Catherine, Jeynes, Nouf, Moore, Andrew J., Orpen, Neil, Palmer, Cecily, Reeves, Barnaby C., Rogers, Chris A. and Wylde, Vikki (2024). Effectiveness and cost-effectiveness of radiofrequency denervation versus placebo for chronic and moderate to severe low back pain: study protocol for the RADICAL randomised controlled trial. BMJ Open, 14 (7) e079173. doi: 10.1136/bmjopen-2023-079173
2024
Journal Article
Lumbar spine fusion surgery versus best conservative care for patients with severe, persistent low back pain : a UK cross-sectional survey of clinicians and their views regarding randomization of patients into a future trial
Bada, Eniola S., Gardner, Adrian C., Ahuja, Sashin, Beard, David J., Window, Peter, Foster, Nadine E. and The FORENSIC study group (2024). Lumbar spine fusion surgery versus best conservative care for patients with severe, persistent low back pain : a UK cross-sectional survey of clinicians and their views regarding randomization of patients into a future trial. Bone and Joint Open, 5 (7), 612-620. doi: 10.1302/2633-1462.57.bjo-2023-0147.r1
2024
Journal Article
Musculoskeletal health and work: development and internal – external cross-validation of a model to predict risk of work absence and presenteeism in people seeking primary healthcare
Archer, Lucinda, Peat, George, Snell, Kym I. E., Hill, Jonathan C., Dunn, Kate M., Foster, Nadine E., Bishop, Annette, van der Windt, Danielle and Wynne-Jones, Gwenllian (2024). Musculoskeletal health and work: development and internal – external cross-validation of a model to predict risk of work absence and presenteeism in people seeking primary healthcare. Journal of Occupational Rehabilitation. doi: 10.1007/s10926-024-10223-w
2024
Journal Article
Developing an international consensus Reporting guideline for intervention Fidelity in Non-Drug, non-surgical trials: The ReFiND protocol
Sousa Filho, Luis Fernando, Farlie, Melanie K., Haines, Terry, Borrelli, Belinda, Carroll, Christopher, Mathews, Catherine, Ribeiro, Daniel C., Fritz, Julie M., Underwood, Martin, Foster, Nadine E., Lamb, Sarah E., Sanchez, Zila M. and Malliaras, Peter (2024). Developing an international consensus Reporting guideline for intervention Fidelity in Non-Drug, non-surgical trials: The ReFiND protocol. Contemporary Clinical Trials, 142 107575, 1-7. doi: 10.1016/j.cct.2024.107575
2024
Journal Article
Supporting self-management of low back pain with an internet intervention with and without telephone support in primary care (SupportBack 2): a randomised controlled trial of clinical and cost-effectiveness
Geraghty, Adam W A, Becque, Taeko, Roberts, Lisa C, Hill, Jonathan C, Foster, Nadine E, Yardley, Lucy, Stuart, Beth, Turner, David A, Hay, Elaine, Griffiths, Gareth, Webley, Frances, Durcan, Lorraine, Morgan, Alannah, Hughes, Stephanie, Bathers, Sarah, Butler-Walley, Stephanie, Wathall, Simon, Mansell, Gemma, White, Malcolm, Davies, Firoza and Little, Paul (2024). Supporting self-management of low back pain with an internet intervention with and without telephone support in primary care (SupportBack 2): a randomised controlled trial of clinical and cost-effectiveness. The Lancet Rheumatology, 6 (7), e424-e437. doi: 10.1016/s2665-9913(24)00086-9
2024
Journal Article
Squatting biomechanics following physiotherapist-led care or hip arthroscopy for femoroacetabular impingement syndrome: a secondary analysis from a randomised controlled trial
Grant, Tamara M., Saxby, David J., Pizzolato, Claudio, Savage, Trevor, Bennell, Kim, Dickenson, Edward, Eyles, Jillian, Foster, Nadine, Hall, Michelle, Hunter, David, Lloyd, David, Molnar, Rob, Murphy, Nicholas, O’Donnell, John, Singh, Parminder, Spiers, Libby, Tran, Phong and Diamond, Laura E. (2024). Squatting biomechanics following physiotherapist-led care or hip arthroscopy for femoroacetabular impingement syndrome: a secondary analysis from a randomised controlled trial. PeerJ, 12 (6) e17567. doi: 10.7717/peerj.17567
2024
Journal Article
Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study
Stynes, Siobhan, Foster, Nadine, O’ Dowd, John, Ostelo, Raymond and Konstantinou, Kika (2024). Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study. European Spine Journal, 33 (11), 4235-4242. doi: 10.1007/s00586-024-08342-2
2024
Journal Article
Health coaching intervention with or without the support of an exercise buddy to increase physical activity of people with chronic low back pain compared to usual care: a feasibility and pilot randomised controlled trial
Fritsch, Carolina G., Ferreira, Manuela L., Halliday, Mark H., Roberts, Katharine, Comachio, Josielli, Mittinty, Manasi, Sharpe, Louise, Foster, Nadine E., Stamatakis, Emmanuel, Mork, Paul J., McLachlan, Andrew J. and Ferreira, Paulo H. (2024). Health coaching intervention with or without the support of an exercise buddy to increase physical activity of people with chronic low back pain compared to usual care: a feasibility and pilot randomised controlled trial. Musculoskeletal Science and Practice, 71 102941, 1-10. doi: 10.1016/j.msksp.2024.102941
2024
Conference Publication
Optimising physiotherapy for people with lateral elbow tendinopathy – results of a mixed-methods pilot and feasibility randomised controlled trial (OPTimisE)
Bateman, M., Skeggs, A., Whitby, E., Fletcher-Barrett, V., Stephens, G., Dawes, M., Davis, D., Beckhelling, J., Cooper, K., Saunders, B., Littlewood, C., Vicenzino, B., Foster, N.E and Hill, J.C (2024). Optimising physiotherapy for people with lateral elbow tendinopathy – results of a mixed-methods pilot and feasibility randomised controlled trial (OPTimisE). Chartered Society of Physiotherapy (CSP) 2023 Annual Conference, Cardiff, United Kingdom, 24 October - 10 November 2023. London, United Kingdom: Elsevier. doi: 10.1016/j.physio.2024.04.033
2024
Conference Publication
Experiences and perceptions of patients awaiting rotator cuff repair surgery: an integrated qualitative interview study
Moffatt, M., Wade, J., Foster, N. and Littlewood, C. (2024). Experiences and perceptions of patients awaiting rotator cuff repair surgery: an integrated qualitative interview study. Chartered Society of Physiotherapy (CSP) 2023 Annual Conference, Cardiff, United Kingdom, 24 October - 10 November 2023. London, United Kingdom: Elsevier. doi: 10.1016/j.physio.2024.04.068
2024
Journal Article
An online training resource for clinicians to optimise exercise prescription for persistent low back pain: design, development and usability testing
Wood, Lianne, Dean, Sarah, Booth, Vicky, Hayden, Jill A. and Foster, Nadine E. (2024). An online training resource for clinicians to optimise exercise prescription for persistent low back pain: design, development and usability testing. Musculoskeletal Care, 22 (2) e1907, 1-13. doi: 10.1002/msc.1907
2024
Conference Publication
Physiotherapist-led exercise versus waiting-list control for patients awaiting rotator cuff repair surgery: a pilot randomised controlled trial (POWER)
Littlewood, C., Moffatt, M., Davis, D., Beckhelling, J., Wade, J. and Foster, N. (2024). Physiotherapist-led exercise versus waiting-list control for patients awaiting rotator cuff repair surgery: a pilot randomised controlled trial (POWER). Chartered Society of Physiotherapy (CSP) 2023 Annual Conference, Cardiff, United Kingdom, 24 October - 10 November 2023. London, United Kingdom: Elsevier. doi: 10.1016/j.physio.2024.04.108
2024
Journal Article
Feasibility of blinding spinal manual therapy interventions among participants and outcome assessors: protocol for a blinding feasibility trial
Muñoz Laguna, Javier, Kurmann, Astrid, Hofstetter, Léonie, Nyantakyi, Emanuela, Clack, Lauren, Bang, Heejung, Foster, Nadine E., Braun, Julia, Puhan, Milo A., Farshad, Mazda and Hincapié, Cesar A. (2024). Feasibility of blinding spinal manual therapy interventions among participants and outcome assessors: protocol for a blinding feasibility trial. Pilot and Feasibility Studies, 10 (1) 70, 1-10. doi: 10.1186/s40814-024-01492-6
2024
Journal Article
Alternative models to support weight loss in chronic musculoskeletal conditions: effectiveness of a physiotherapist-delivered intensive diet programme for knee osteoarthritis, the POWER randomised controlled trial
Allison, Kim, Jones, Sarah, Hinman, Rana S., Pardo, Jesse, Li, Peixuan, DeSilva, Anurika, Quicke, Jonathan George, Sumithran, Priya, Prendergast, Jodie, George, Elena, Holden, Melanie A., Foster, Nadine E and Bennell, Kim L. (2024). Alternative models to support weight loss in chronic musculoskeletal conditions: effectiveness of a physiotherapist-delivered intensive diet programme for knee osteoarthritis, the POWER randomised controlled trial. British Journal of Sports Medicine, 58 (10) 107793, 538-547. doi: 10.1136/bjsports-2023-107793
2024
Journal Article
Clinical and cost-effectiveness of individualised (early) patient-directed rehabilitation versus standard rehabilitation after surgical repair of the rotator cuff of the shoulder: protocol for a multicentre, randomised controlled trial with integrated Quintet Recruitment Intervention (RaCeR 2)
Mazuquin, Bruno, Moffatt, Maria, Realpe, Alba, Sherman, Rachelle, Ireland, Katie, Connan, Zak, Tildsley, Jack, Manca, Andrea, Singh, Vijay Gc, Foster, Nadine E., Rees, Jonathan, Drew, Steven, Bateman, Marcus, Fakis, Apostolos, Farnsworth, Malin and Littlewood, Chris (2024). Clinical and cost-effectiveness of individualised (early) patient-directed rehabilitation versus standard rehabilitation after surgical repair of the rotator cuff of the shoulder: protocol for a multicentre, randomised controlled trial with integrated Quintet Recruitment Intervention (RaCeR 2). BMJ Open, 14 (4) e081284, 1-9. doi: 10.1136/bmjopen-2023-081284
Funding
Current funding
Past funding
Supervision
Availability
- Professor Nadine Foster is:
- Available for supervision
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Available projects
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Exploring how the Action Falls Intervention reduces falls in stroke survivors
We are seeking a PhD candidate who is eligible for a UQ Graduate School Scholarship, to undertake a PhD in the field of falls rehabilitation following stroke. The project is part the Australian Falls In Stroke Study (FISS-Australia) Trial (https://shrs.uq.edu.au/research/fiss-australia-trial), funded by the National Health and Research Medical Council (NHMRC) and National Institute for Health Research (NIHR). The FISS-Australia trial is a national, multi-centre, randomised controlled trial that will determine the effectiveness and cost-effectiveness of the Action Falls intervention in stroke survivors who are discharged from hospital to home.
The Action Falls Intervention is a systematic falls prevention intervention involving clinician-led assessment of falls risks, followed by personalised action planning. Action Falls has been shown in previous research to reduce falls by 43% in older people living in nursing home settings in the UK and is cost effective compared to other falls interventions, but its effectiveness for reducing falls in people with stroke living at home has not been tested.
The project is led by researchers at the University of Queensland in collaboration with researchers at the University of Nottingham, La Trobe University, University of Sydney, and the University of Canberra. The overarching aim of the trial is to determine if the Action Falls intervention reduces the rate of falls in stroke survivors and is more cost effective than the usual care. The trial will include a nested, process evaluation guided by a realist approach, designed to explore the mechanisms by which Action Falls reduces falls, seeking to explore for which stroke survivors, in what circumstances Action Falls is effective.
The successful PhD candidate will use qualitative (eg. interviews with health care professionals, people with stroke and their significant others) and quantitative methods (eg. analyse data about implementation of the Action Falls intervention, frequency of falls, health care usage) to explore the Action Falls Intervention. The findings of this evaluation will inform future delivery of Action Falls to stroke survivors.
The PhD student will be supervised by a team that may include Dr Emmah Doig, Prof Pip Logan, Prof Nadine Foster, A/Professor Jacki Liddle. The PhD candidate would be based at the Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance.
Eligible candidates will be supported to apply for a UQ Graduate School Scholarship that provides a 3-year scholarship (with possible extension for 6 months if required) at a rate of $35,000 p.a. tax free.
Essential criteria: An undergraduate degree with first or second class honours in a health profession (eg. occupational therapy, physiotherapy, nursing); eligibility for admission as a PhD candidate at The University of Queensland; excellent communication skills (written and verbal) in English.
Desirable criteria: Experience in and interest in stroke and/or falls rehabilitation practice or research.
Supervision history
Current supervision
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Doctor Philosophy
Collaborative clinical practice in healthcare
Principal Advisor
Other advisors: Associate Professor Rebecca Olson, Dr Lisa Anemaat
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Doctor Philosophy
Understanding and optimising recruitment in the FORENSIC low back pain trial (FusiOn veRsus bEst coNServatIve Care)
Associate Advisor
Other advisors: Dr Jonathan Quicke
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Doctor Philosophy
Attitudes, beliefs and behaviours regarding the management of shoulder osteoarthritis
Associate Advisor
Other advisors: Dr Jonathan Quicke
Media
Enquiries
Contact Professor Nadine Foster directly for media enquiries about:
- arthritis
- back pain
- clinical trials
- joint pain
- knee pain
- musculoskeletal disorders
- osteoarthritis
- pain
- physiotherapy
- rehabilitation
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