
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
2022
Journal Article
Effect of inpatient rehabilitation treatment ingredients on functioning, quality of life, length of stay, discharge destination, and mortality among older adults with unplanned admission: an overview review
Lambe, K., Guerra, S., Salazar de Pablo, G., Ayis, S., Cameron, I. D., Foster, N. E., Godfrey, E., Gregson, C. L., Martin, F. C., Sackley, C., Walsh, N. and Sheehan, K. J. (2022). Effect of inpatient rehabilitation treatment ingredients on functioning, quality of life, length of stay, discharge destination, and mortality among older adults with unplanned admission: an overview review. BMC Geriatrics, 22 (1) 501, 501. doi: 10.1186/s12877-022-03169-2
2022
Journal Article
Delegation of workload from musculoskeletal physiotherapists to physiotherapy assistants/support workers: A UK online survey
Sarigiovannis, P., Foster, N. E., Jowett, S. and Saunders, B. (2022). Delegation of workload from musculoskeletal physiotherapists to physiotherapy assistants/support workers: A UK online survey. Musculoskeletal Science and Practice, 62 102631, 102631. doi: 10.1016/j.msksp.2022.102631
2022
Journal Article
Accuracy of placement of ultrasound-guided corticosteroid injection for subacromial pain (impingement) syndrome does not influence pain and function: Secondary analysis of a randomised controlled trial
Chean, Chung Shen, Raval, Parag, Ogollah, Reuben O., Hall, Alison, Roddy, Edward and Foster, Nadine E. (2022). Accuracy of placement of ultrasound-guided corticosteroid injection for subacromial pain (impingement) syndrome does not influence pain and function: Secondary analysis of a randomised controlled trial. Musculoskeletal Care, 20 (4), 831-838. doi: 10.1002/msc.1634
2022
Journal Article
Recommendations on patient-facing websites regarding diagnostic imaging for low back, knee, and shoulder pain: A scoping review
Cuff, Andrew, Jesson, Thomas, Yeowell, Gillian, Dikomitis, Lisa, Foster, Nadine E. and Littlewood, Chris (2022). Recommendations on patient-facing websites regarding diagnostic imaging for low back, knee, and shoulder pain: A scoping review. PEC Innovation, 1 100040. doi: 10.1016/j.pecinn.2022.100040
2022
Journal Article
Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial
Aanesen, Fiona, Grotle, Margreth, Rysstad, Tarjei Langseth, Tveter, Anne Therese, Tingulstad, Alexander, Løchting, Ida, Småstuen, Milada C., Van Tulder, Maurits W., Berg, Rigmor, Foster, Nadine E., Wynne-Jones, Gwenllian, Sowden, Gail, Fors, Egil, Bagøien, Gunnhild, Hagen, Roger, Storheim, Kjersti and Øiestad, Britt Elin (2022). Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial. Occupational and Environmental Medicine, 80 (1), 42-50. doi: 10.1136/oemed-2022-108637
2022
Journal Article
Comparison of walking biomechanics after physical therapist–led care or hip arthroscopy for femoroacetabular impingement syndrome: a secondary analysis from a randomized controlled trial
Grant, Tamara M., Diamond, Laura E., Pizzolato, Claudio, Savage, Trevor N., Bennell, Kim, Dickenson, Edward J., Eyles, Jillian, Foster, Nadine E., Hall, Michelle, Hunter, David J., Lloyd, David G., Molnar, Robert, Murphy, Nicholas J., O’Donnell, John, Singh, Parminder, Spiers, Libby, Tran, Phong and Saxby, David J. (2022). Comparison of walking biomechanics after physical therapist–led care or hip arthroscopy for femoroacetabular impingement syndrome: a secondary analysis from a randomized controlled trial. American Journal of Sports Medicine, 50 (12), 3198-3209. doi: 10.1177/03635465221120388
2022
Journal Article
Risk-based stratified primary care for common musculoskeletal pain presentations (STarT MSK): a cluster-randomised, controlled trial
Hill, Jonathan C, Garvin, Stefannie, Bromley, Kieran, Saunders, Benjamin, Kigozi, Jesse, Cooper, Vince, Lewis, Martyn, Protheroe, Joanne, Wathall, Simon, Chudyk, Adrian, Dunn, Kate M, Birkinshaw, Hollie, Jowett, Sue, Hay, Elaine M, van der Windt, Danielle, Mallen, Christian and Foster, Nadine E (2022). Risk-based stratified primary care for common musculoskeletal pain presentations (STarT MSK): a cluster-randomised, controlled trial. The Lancet Rheumatology, 4 (9), e591-e602. doi: 10.1016/S2665-9913(22)00159-X
2022
Journal Article
Comparing an optimised physiotherapy treatment package with usual physiotherapy care for people with tennis elbow — protocol for the OPTimisE pilot and feasibility randomised controlled trial
Bateman, M., Saunders, B., Littlewood, C., Davis, D., Beckhelling, J., Cooper, K., Skeggs, A., Foster, N. E., Vicenzino, B. and Hill, J. C. (2022). Comparing an optimised physiotherapy treatment package with usual physiotherapy care for people with tennis elbow — protocol for the OPTimisE pilot and feasibility randomised controlled trial. Pilot and Feasibility Studies, 8 (1) 178, 1-11. doi: 10.1186/s40814-022-01132-x
2022
Journal Article
Effectiveness of a telehealth physiotherapist-delivered intensive dietary weight loss program combined with exercise in people with knee osteoarthritis and overweight or obesity: study protocol for the POWER randomized controlled trial
Bennell, Kim L., Jones, Sarah E., Hinman, Rana S., McManus, Fiona, Lamb, Karen E., Quicke, Jonathan G., Sumithran, Priya, Prendergast, Jodie, George, Elena S., Holden, Melanie A., Foster, Nadine E. and Allison, Kim (2022). Effectiveness of a telehealth physiotherapist-delivered intensive dietary weight loss program combined with exercise in people with knee osteoarthritis and overweight or obesity: study protocol for the POWER randomized controlled trial. BMC Musculoskeletal Disorders, 23 (1) 733, 1-17. doi: 10.1186/s12891-022-05685-z
2022
Journal Article
Consensus for statements regarding a definition for spinal osteoarthritis for use in research and clinical practice: a Delphi study
de Luca, Katie, Chiarotto, Alessandro, Cicuttini, Flavia, Creemers, Laura, de Schepper, Evelien, Ferreira, Paulo H., Foster, Nadine E., Hartvigsen, Jan, Kawchuk, Gregory, Little, Christopher B., Oei, Edwin H., Suri, Pradeep, Vleggeert-Lankamp, Carmen, Bierma-Zeinstra, Sita M. A. and Ferreira, Manuela L. (2022). Consensus for statements regarding a definition for spinal osteoarthritis for use in research and clinical practice: a Delphi study. Arthritis Care and Research, 75 (5), 1095-1103. doi: 10.1002/acr.24829
2022
Journal Article
Clinical effectiveness of one ultrasound guided intra-articular corticosteroid and local anaesthetic injection in addition to advice and education for hip osteoarthritis (HIT trial): single blind, parallel group, three arm, randomised controlled trial
Paskins, Zoe, Bromley, Kieran, Lewis, Martyn, Hughes, Gemma, Hughes, Emily, Hennings, Susie, Cherrington, Andrea, Hall, Alison, Holden, Melanie A., Stevenson, Kay, Menon, Ajit, Roberts, Philip, Peat, George, Jinks, Clare, Kigozi, Jesse, Oppong, Raymond, Foster, Nadine E., Mallen, Christian D. and Roddy, Edward (2022). Clinical effectiveness of one ultrasound guided intra-articular corticosteroid and local anaesthetic injection in addition to advice and education for hip osteoarthritis (HIT trial): single blind, parallel group, three arm, randomised controlled trial. BMJ, 377 e068446, e068446. doi: 10.1136/bmj-2021-068446
2022
Journal Article
Arthroscopic hip surgery compared with personalised hip therapy in people over 16 years old with femoroacetabular impingement syndrome: UK FASHIoN RCT
Griffin, Damian R, Dickenson, Edward J, Achana, Felix, Griffin, James, Smith, Joanna, Wall, Peter DH, Realpe, Alba, Parsons, Nick, Hobson, Rachel, Fry, Jeremy, Jepson, Marcus, Petrou, Stavros, Hutchinson, Charles, Foster, Nadine and Donovan, Jenny (2022). Arthroscopic hip surgery compared with personalised hip therapy in people over 16 years old with femoroacetabular impingement syndrome: UK FASHIoN RCT. Health Technology Assessment, 26 (16), 1-236. doi: 10.3310/fxii0508
2022
Journal Article
Feasibility of delivering and evaluating stratified care integrated with telehealth ('Rapid Stratified Telehealth') for patients with low back pain: protocol for a feasibility and pilot randomised controlled trial
Zadro, Joshua R., Needs, Christopher, Foster, Nadine E., Martens, David, Coombs, Danielle M., Machado, Gustavo C., Adams, Cameron, Han, Christopher S. and Maher, Christopher G. (2022). Feasibility of delivering and evaluating stratified care integrated with telehealth ('Rapid Stratified Telehealth') for patients with low back pain: protocol for a feasibility and pilot randomised controlled trial. BMJ open, 12 (1) e056339, e056339. doi: 10.1136/bmjopen-2021-056339
2021
Journal Article
Integrating clinician support with intervention design as part of a programme testing stratified care for musculoskeletal pain in general practice
Protheroe, Joanne, Saunders, Benjamin, Hill, Jonathan C., Chudyk, Adrian, Foster, Nadine E., Bartlam, Bernadette, Wathall, Simon and Cooper, Vincent (2021). Integrating clinician support with intervention design as part of a programme testing stratified care for musculoskeletal pain in general practice. BMC Family Practice, 22 (1) 161, 161. doi: 10.1186/s12875-021-01507-8
2021
Journal Article
Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints: protocol for a cluster randomized controlled trial
van Tilburg, Mark L., Kloek, Corelien J. J., Pisters, Martijn F., Staal, J. Bart, van Dongen, Johanna M., de Weerd, Marjolein, Ostelo, Raymond W. J. G., Foster, Nadine E. and Veenhof, Cindy (2021). Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints: protocol for a cluster randomized controlled trial. BMC Musculoskeletal Disorders, 22 (1) 143, 1-15. doi: 10.1186/s12891-021-03989-0
2021
Journal Article
Self-management advice, exercise and foot orthoses for plantar heel pain: the TREADON pilot and feasibility randomised trial
Chesterton, Linda S., Thomas, Martin J., Hendry, Gordon, Chen, Ying, Goddin, David, Halliday, Nicola, Lawton, Sarah A., Lewis, Martyn, Mallen, Christian D., Menz, Hylton B., Foster, Nadine E. and Roddy, Edward (2021). Self-management advice, exercise and foot orthoses for plantar heel pain: the TREADON pilot and feasibility randomised trial. Pilot and Feasibility Studies, 7 (1) 92. doi: 10.1186/s40814-021-00808-0
2021
Journal Article
Implementation of a novel stratified PAthway of CarE for common musculoskeletal (MSK) conditions in primary care: protocol for a multicentre pragmatic randomised controlled trial (the PACE MSK trial)
Rebbeck, Trudy, Evans, Kerrie, Ferreira, Paulo, Beales, Darren, Sterling, Michele, Bennell, Kim L, Cameron, Ian, Nicholas, Michael, Ritchie, Carrie, Jull, Gwen, Treleaven, Julia, Trevena, Lyndal, Refshauge, Kathryn, Connelly, Luke, Foster, Nadine, Black, Deborah, Hodges, Paul, Ferreira, Manuela, Shaw, Tim J and Simic, Milena (2021). Implementation of a novel stratified PAthway of CarE for common musculoskeletal (MSK) conditions in primary care: protocol for a multicentre pragmatic randomised controlled trial (the PACE MSK trial). BMJ Open, 11 (12) e057705, e057705. doi: 10.1136/bmjopen-2021-057705
2021
Journal Article
Multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapist-led care for femoroacetabular impingement (FAI) syndrome on hip cartilage metabolism: the Australian FASHIoN trial
Hunter, David J., Eyles, Jillian, Murphy, Nicholas J., Spiers, Libby, Burns, Alexander, Davidson, Emily, Dickenson, Edward, Fary, Camdon, Foster, Nadine E., Fripp, Jurgen, Griffin, Damian R., Hall, Michelle, Kim, Young Jo, Linklater, James M., Molnar, Robert, Neubert, Ales, O’Connell, Rachel L., O’Donnell, John, O’Sullivan, Michael, Randhawa, Sunny, Reichenbach, Stephan, Schmaranzer, Florian, Singh, Parminder, Tran, Phong, Wilson, David, Zhang, Honglin and Bennell, Kim L. (2021). Multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapist-led care for femoroacetabular impingement (FAI) syndrome on hip cartilage metabolism: the Australian FASHIoN trial. BMC Musculoskeletal Disorders, 22 (1) 697, 697. doi: 10.1186/s12891-021-04576-z
2021
Journal Article
Evaluation of the First Contact Physiotherapy (FCP) model of primary care: patient characteristics and outcomes
Stynes, S., Jordan, K. P., Hill, J. C., Wynne-Jones, G., Cottrell, E., Foster, N. E., Goodwin, R. and Bishop, A. (2021). Evaluation of the First Contact Physiotherapy (FCP) model of primary care: patient characteristics and outcomes. Physiotherapy, 113, 199-208. doi: 10.1016/j.physio.2021.08.002
2021
Journal Article
Refinement and validation of a tool for stratifying patients with musculoskeletal pain
Dunn, Kate M., Campbell, Paul, Lewis, Martyn, Hill, Jonathan C., van der Windt, Danielle A., Afolabi, Ebenezer, Protheroe, Joanne, Wathall, Simon, Jowett, Sue, Oppong, Raymond, Mallen, Christian D., Hay, Elaine M. and Foster, Nadine E. (2021). Refinement and validation of a tool for stratifying patients with musculoskeletal pain. European Journal of Pain, 25 (10), 2081-2093. doi: 10.1002/ejp.1821
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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