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
2009
Journal Article
In response to: "A randomized trial of behavioral physical therapy interventions for acute and sub-acute low back pain, by George SZ et al. [Pain 2008;140:145-57]
Hill, Jonathan C., Foster, Nadine E., Main, Chris J. and Hay, Elaine M. (2009). In response to: "A randomized trial of behavioral physical therapy interventions for acute and sub-acute low back pain, by George SZ et al. [Pain 2008;140:145-57]. Pain, 142 (1-2), 164. doi: 10.1016/j.pain.2008.12.025
2009
Conference Publication
The Ninth International Forum for Primary Care Research on Low Back Pain
Cherkin, Daniel, Kovacs, Francisco M., Croft, Peter, Borkan, Jeffrey, Foster, Nadine E., Öberg, Birgitta, Urrútia, Gerard and Zamora, Javier (2009). The Ninth International Forum for Primary Care Research on Low Back Pain. Ovid Technologies (Wolters Kluwer Health). doi: 10.1097/brs.0b013e3181928f9a
2009
Journal Article
Research priorities for non-pharmacological therapies for common musculoskeletal problems: nationally and internationally agreed recommendations
Foster, Nadine E, Dziedzic, Krysia S, Windt, Danielle AWM van der, Fritz, Julie M and Hay, Elaine M (2009). Research priorities for non-pharmacological therapies for common musculoskeletal problems: nationally and internationally agreed recommendations. BMC Musculoskeletal Disorders, 10 (1) 3, 3. doi: 10.1186/1471-2474-10-3
2009
Journal Article
Validation study of a placebo acupuncture needle Commentary
Foster, N. E. (2009). Validation study of a placebo acupuncture needle Commentary. Focus on Alternative and Complementary Therapies, 14 (2), 117-119. doi: 10.1211/fact.14.2.0018
2009
Journal Article
Commentary
Foster, Nadine E. (2009). Commentary. International Journal of Therapy and Rehabilitation, 16 (2).
2009
Journal Article
Is acupuncture plus standard care more effective than sham acupuncture plus standard care in patients with osteoarthritis of the knee? Commentary
Foster, N. E. (2009). Is acupuncture plus standard care more effective than sham acupuncture plus standard care in patients with osteoarthritis of the knee? Commentary. Focus on Alternative and Complementary Therapies, 14 (3), 198-200. doi: 10.1211/fact.14.3.0018
2008
Journal Article
Pharmacist-led medication review for knee pain in older adults: Content, process and outcomes
Phelan, Mike, Blenkinsopp, Alison, Foster, Nadine E., Thomas, Elaine and Hay, Elaine M. (2008). Pharmacist-led medication review for knee pain in older adults: Content, process and outcomes. International Journal of Pharmacy Practice, 16 (6), 347-355. doi: 10.1211/ijpp.16.6.0003
2008
Journal Article
Physical Therapists’ Use of Therapeutic Exercise for Patients With Clinical Knee Osteoarthritis in the United Kingdom: In Line With Current Recommendations?
Holden, Melanie A, Nicholls, Elaine E, Hay, Elaine M and Foster, Nadine E (2008). Physical Therapists’ Use of Therapeutic Exercise for Patients With Clinical Knee Osteoarthritis in the United Kingdom: In Line With Current Recommendations?. Physical Therapy, 88 (10), 1109-1121. doi: 10.2522/ptj.20080077
2008
Journal Article
Author response
Foster, Nadine E. (2008). Author response. Physical Therapy, 88 (10). doi: 10.2522/ptj.20080077.ar
2008
Journal Article
Defining an Adequate Dose of Acupuncture Using a Neurophysiological Approach – a Narrative Review of the Literature
White, Adrian, Cummings, Mike, Barlas, Panos, Cardini, Francesco, Filshie, Jacqueline, Foster, Nadine E, Lundeberg, Thomas, Stener-Victorin, Elisabet and Witt, Claudia (2008). Defining an Adequate Dose of Acupuncture Using a Neurophysiological Approach – a Narrative Review of the Literature. Acupuncture in Medicine, 26 (2), 111-120. doi: 10.1136/aim.26.2.111
2008
Journal Article
Land- and water-based exercise therapies for musculoskeletal conditions
Dziedzic, Krysia, Jordan, Joanne L. and Foster, Nadine E. (2008). Land- and water-based exercise therapies for musculoskeletal conditions. Best Practice & Research Clinical Rheumatology, 22 (3), 407-418. doi: 10.1016/j.berh.2007.11.002
2008
Journal Article
Illness perceptions of low back pain patients in primary care: What are they, do they change and are they associated with outcome?
Foster, Nadine E., Bishop, Annette, Thomas, Elaine, Main, Chris, Horne, Rob, Weinman, John and Hay, Elaine (2008). Illness perceptions of low back pain patients in primary care: What are they, do they change and are they associated with outcome?. Pain, 136 (1), 177-187. doi: 10.1016/j.pain.2007.12.007
2008
Journal Article
Author's reply
Foster, Nadine E. (2008). Author's reply. Focus on Alternative and Complementary Therapies, 13 (1), 36-37.
2008
Journal Article
How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists
Bishop, Annette, Foster, Nadine E., Thomas, Elaine and Hay, Elaine M. (2008). How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists. Pain, 135 (1), 187-195. doi: 10.1016/j.pain.2007.11.010
2008
Journal Article
Does periosteal or intramuscular acupuncture help anxiety in patients with chronic neck and back pain?: Commentary
Foster, N. E. (2008). Does periosteal or intramuscular acupuncture help anxiety in patients with chronic neck and back pain?: Commentary. Focus on Alternative and Complementary Therapies, 13 (2), 113-115. doi: 10.1211/fact.2008.0019
2008
Journal Article
Physiotherapy added to GP care results in long-term improvements for sciatica: Commentary
Foster, Nadine E. (2008). Physiotherapy added to GP care results in long-term improvements for sciatica: Commentary. Australian Journal of Physiotherapy, 54 (3). doi: 10.1016/S0004-9514(08)70032-1
2008
Journal Article
A Consensus Approach Toward the Standardization of Back Pain Definitions for Use in Prevalence Studies
Dionne, Clermont E., Dunn, Kate M., Croft, Peter R., Nachemson, Alf L., Buchbinder, Rachelle, Walker, Bruce F., Wyatt, Mary, Cassidy, J David, Rossignol, Michel, Leboeuf-Yde, Charlotte, Hartvigsen, Jan, Leino-Arjas, Päivi, Latza, Ute, Reis, Shmuel, Gil del Real, Maria Teresa, Kovacs, Francisco M., Öberg, Birgitta, Cedraschi, Christine, Bouter, Lex M., Koes, Bart W., Picavet, H Susan J., van Tulder, Maurits W., Burton, Kim, Foster, Nadine E., Macfarlane, Gary J., Thomas, Elaine, Underwood, Martin, Waddell, Gordon, Shekelle, Paul ... Von Korff, Michael (2008). A Consensus Approach Toward the Standardization of Back Pain Definitions for Use in Prevalence Studies. Spine, 33 (1), 95-103. doi: 10.1097/brs.0b013e31815e7f94
2008
Journal Article
Trial suggests that adding single-point acupuncture to a package of physiotherapy is better for shoulder pain patients than adding mock TENS to the same physiotherapy package of care. Commentary
Foster, N. E. (2008). Trial suggests that adding single-point acupuncture to a package of physiotherapy is better for shoulder pain patients than adding mock TENS to the same physiotherapy package of care. Commentary. Focus on Alternative and Complementary Therapies, 13 (4), 276-278. doi: 10.1111/j.2042-7166.2008.tb01767.x
2008
Journal Article
A primary care back pain screening tool: Identifying patient subgroups for initial treatment
Hill, Jonathan C., Dunn, Kate M., Lewis, Martyn, Mullis, Ricky, Main, Chris J., Foster, Nadine E. and Hay, Elaine M. (2008). A primary care back pain screening tool: Identifying patient subgroups for initial treatment. Arthritis & Rheumatism, 59 (5), 632-641. doi: 10.1002/art.23563
2007
Journal Article
The value of acupuncture or exercise-based physiotherapy for patients waiting for knee replacement surgery: Commentary
Foster, N. (2007). The value of acupuncture or exercise-based physiotherapy for patients waiting for knee replacement surgery: Commentary. Focus on Alternative and Complementary Therapies, 12 (4), 272-273.
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
Attitudes, beliefs and behaviours regarding the management of shoulder osteoarthritis
Associate Advisor
Other advisors: Dr Jonathan Quicke
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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
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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