
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
2006
Journal Article
The Attitudes to Back Pain Scale in musculoskeletal practitioners (ABS-mp): The development and testing of a new questionnaire
Pincus, Tamar, Vogel, Steven, Santos, Rita, Breen, Alan, Foster, Nadine and Underwood, Martin (2006). The Attitudes to Back Pain Scale in musculoskeletal practitioners (ABS-mp): The development and testing of a new questionnaire. Clinical Journal of Pain, 22 (4), 378-386. doi: 10.1097/01.ajp.0000178223.85636.49
2006
Book Chapter
Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults
Jordan, Joanne L, Foster, Nadine E, Holden, Melanie A and Mason, Elizabeth EJ (2006). Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews. edited by Jordan, Joanne L. Chichester, UK: John Wiley & Sons, Ltd. doi: 10.1002/14651858.cd005956
2006
Journal Article
Measuring troublesomeness of chronic pain by location
Parsons, Suzanne, Carnes, Dawn, Pincus, Tamar, Foster, Nadine, Breen, Alan, Vogel, Steven and Underwood, Martin (2006). Measuring troublesomeness of chronic pain by location. BMC Musculoskeletal Disorders, 7 (1) 34. doi: 10.1186/1471-2474-7-34
2006
Journal Article
Persistent back pain - why do physical therapy clinicians continue treatment? A mixed methods study of chiropractors, osteopaths and physiotherapists
Pincus, Tamar, Vogel, Steven, Breen, Alan, Foster, Nadine and Underwood, Martin (2006). Persistent back pain - why do physical therapy clinicians continue treatment? A mixed methods study of chiropractors, osteopaths and physiotherapists. European Journal of Pain, 10 (1), 67-76. doi: 10.1016/j.ejpain.2005.01.008
2006
Journal Article
Clarification of reporting in stability systematic review [1]
Cairns, Mindy C. and Foster, Nadine E. (2006). Clarification of reporting in stability systematic review [1]. Australian Journal of Physiotherapy, 52 (4). doi: 10.1016/S0004-9514(06)70021-6
2005
Journal Article
Testing the effectiveness of an innovative information package on practitioner reported behaviour and beliefs: The UK Chiropractors, Osteopaths and Musculoskeletal Physiotherapists Low back pain ManagemENT (COMPLeMENT) trial [ISRCTN77245761]
Evans, David W., Foster, Nadine E., Underwood, Martin, Vogel, Steven, Breen, Alan C. and Pincus, Tamar (2005). Testing the effectiveness of an innovative information package on practitioner reported behaviour and beliefs: The UK Chiropractors, Osteopaths and Musculoskeletal Physiotherapists Low back pain ManagemENT (COMPLeMENT) trial [ISRCTN77245761]. BMC Musculoskeletal Disorders, 6 (1) 41. doi: 10.1186/1471-2474-6-41
2005
Journal Article
Do physical therapists in the United Kingdom recognize psychosocial factors in patients with acute low back pain?
Bishop, Annette and Foster, Nadine E. (2005). Do physical therapists in the United Kingdom recognize psychosocial factors in patients with acute low back pain?. Spine, 30 (11), 1316-1322. doi: 10.1097/01.brs.0000163883.65321.33
2005
Journal Article
Meeting the challenges of research governance
Hill, J., Foster, N., Hughes, R. and Hay, E. (2005). Meeting the challenges of research governance. Rheumatology, 44 (5), 571-2. doi: 10.1093/rheumatology/keh579
2005
Journal Article
Shoulder impingement: the effect of sitting posture on shoulder pain and range of motion
Bullock, Michael P., Foster, Nadine E. and Wright, Chris C. (2005). Shoulder impingement: the effect of sitting posture on shoulder pain and range of motion. Manual Therapy, 10 (1), 28-37. doi: 10.1016/j.math.2004.07.002
2005
Journal Article
Test-retest reliability of the Short-Form McGill Pain Questionnaire: assessment of intraclass correlation coefficients and limits of agreement in patients with osteoarthritis
Grafton, Kate V, Foster, Nadine E and Wright, Christine C (2005). Test-retest reliability of the Short-Form McGill Pain Questionnaire: assessment of intraclass correlation coefficients and limits of agreement in patients with osteoarthritis. The Clinical journal of pain, 21 (1), 73-82. doi: 10.1097/00002508-200501000-00009
2005
Journal Article
Physiotherapy management of low back pain in Thailand: a study of practice
Pensri, Praneet, Foster, Nadine E, Srisuk, Surasak, Baxter, G David and McDonough, Suzanne M (2005). Physiotherapy management of low back pain in Thailand: a study of practice. Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 10 (4), 201-12. doi: 10.1002/pri.16
2004
Journal Article
Is acupuncture a useful adjunct to physiotherapy for older adults with knee pain?: The "Acupuncture, Physiotherapy and Exercise" (APEX) study [ISRCTN88597683]
Hay, Elaine, Barlas, Panos, Foster, Nadine, Hill, Jonathan, Thomas, Elaine and Young, Julie (2004). Is acupuncture a useful adjunct to physiotherapy for older adults with knee pain?: The "Acupuncture, Physiotherapy and Exercise" (APEX) study [ISRCTN88597683]. BMC Musculoskeletal Disorders, 5 (1) 31, 31. doi: 10.1186/1471-2474-5-31
2004
Journal Article
Being a parent or grandparent with back pain, ankylosing spondylitis or rheumatoid arthritis: a descriptive postal survey
Grant, M. I., Foster, N. E., Wright, C. C., Barlow, J. H. and Cullen, L. A. (2004). Being a parent or grandparent with back pain, ankylosing spondylitis or rheumatoid arthritis: a descriptive postal survey. Musculoskeletal Care, 2 (1), 17-28. doi: 10.1002/msc.53
2003
Journal Article
Can Aspects of Physiotherapist Communication Influence Patients' Pain Experiences? A Systematic Review
Jeffels, Kirsty and Foster, Nadine (2003). Can Aspects of Physiotherapist Communication Influence Patients' Pain Experiences? A Systematic Review. Physical Therapy Reviews, 8 (4), 197-210. doi: 10.1179/108331903225003208
2003
Journal Article
Effects of TENS frequency, intensity and stimulation site parameter manipulation on pressure pain thresholds in healthy human subjects
Chesterton, Linda S, Foster, Nadine E, Wright, Christine C, Baxter, G David and Barlas, Panos (2003). Effects of TENS frequency, intensity and stimulation site parameter manipulation on pressure pain thresholds in healthy human subjects. Pain, 106 (1-2), 73-80. doi: 10.1016/s0304-3959(03)00292-6
2003
Journal Article
Reproducibility and repeatability: errors of three groups of physiotherapists in locating spinal levels by palpation
Billis, E V, Foster, N E and Wright, C C (2003). Reproducibility and repeatability: errors of three groups of physiotherapists in locating spinal levels by palpation. Manual therapy, 8 (4), 223-32. doi: 10.1016/s1356-689x(03)00017-1
2003
Journal Article
Level of distress in a recurrent low back pain population referred for physical therapy
Cairns, Melinda C., Foster, Nadine E., Wright, Christine C. and Pennington, Donald (2003). Level of distress in a recurrent low back pain population referred for physical therapy. Spine, 28 (9), 953-959. doi: 10.1097/00007632-200305010-00021
2003
Journal Article
Treatment and the process of care in musculoskeletal conditions. A multidisciplinary perspective and integration
Foster, Nadine E, Pincus, Tamar, Underwood, Martin, Vogel, Steven, Breen, Alan and Harding, Geoff (2003). Treatment and the process of care in musculoskeletal conditions. A multidisciplinary perspective and integration. The Orthopedic clinics of North America, 34 (2), 239-44. doi: 10.1016/s0030-5898(03)00011-7
2003
Journal Article
Understanding the process of care for musculoskeletal conditions--why a biomedical approach is inadequate
Foster, N E, Pincus, T, Underwood, M R, Vogel, S, Breen, A and Harding, G (2003). Understanding the process of care for musculoskeletal conditions--why a biomedical approach is inadequate. Rheumatology (Oxford, England), 42 (3), 401-4.
2003
Journal Article
Gender differences in pressure pain threshold in healthy humans
Chesterton, Linda S, Barlas, Panos, Foster, Nadine E, Baxter, David G and Wright, Christine C (2003). Gender differences in pressure pain threshold in healthy humans. Pain, 101 (3), 259-266. doi: 10.1016/S0304-3959(02)00330-5
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, Dr Nathalia Costa
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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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