Professor Nadine Foster

Director-Research & Education STARS

Faculty of Health and Behavioural Sciences

Overview

Nadine is a physiotherapist, lifetime Fellow of the Chartered Society of Physiotherapy in the UK, and previous National Institute for Health Research (NIHR) Senior Investigator and NIHR Research Professor in the UK. She has recently moved to the role of Professor and Director of the STARS Research and Education Alliance between the University of Queensland and Metro North Health in Queensland, Australia (STARS is the Surgical, Treatment and Rehabilitation Service, the newest public hospital in Brisbane). She leads the Research and Education portfolio within STARS, including a team of conjoint appointments between the University and hospital, across the disciplines of physiotherapy, nursing, speech therapy and occupational therapy, interdisciplinary education and research management.

Until 2020 Nadine lead a programme of musculoskeletal pain research at Keele University in the UK, serving as the School Research Director for the School of Allied Health Professions and the Director of Keele University’s Clinical Trials Unit (CTU), a nationally registered CTU in receipt of NIHR UKCRC Support funding. Her 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 22 randomised trials, attracting over £43 million in research funding from, for example, the National Institute for Health Research (NIHR), Versus Arthritis, the Medical Research Council, PCORI in the USA and the NHMRC in Australia. Examples include a 6 year NIHR Programme Grant for Applied Research on stratified primary care for patients with musculoskeletal pain (STarT MSK) and an NIHR Health Technology Assessment (HTA) trial testing stratified care for patients with sciatica (SCOPiC).

For 5 years (2015-2020) she was the NIHR Lead Training Advocate for Physiotherapy in the UK, and Chaired the NIHR/Health Education England Integrated Clinical Academic personal fellowship scheme in England in 2019 and 2020. Nadine also served as Chair of the NIHR Research for Patient Benefit research funding panel in the West Midlands in the UK. She is Past President of the Society for Back Pain Research, and was previously a member of the Steering Group for the International Forum for Back and Neck Pain Research. She has supervised 14 PhD students to completion and led or contributed to over 220 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:

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. Announced on 4 November 2019.

2019 Invited member of the International Research Strategy Advisory Committee for the Health Research Board’s (Ireland) new five year research strategy development. September-October 2019

2018 Miegunyah Distinguished Visiting Fellowship 2019, University of Melbourne, Australia. February-March 2019

Research Interests

  • Musculoskeletal pain including low back pain pain, osteoarthritis, shoulder pain
  • Rehabilitation
  • Health services research
  • Interprofessional collaborative practice in health services
  • Clinical trials
  • Using routine health record data to improve care and outcomes

Research Impacts

My health services research has made exceptional contributions across 4 linked themes:

MODELS OF CARE. Developed, established, tested & assessed impact of new models of care; stratified care, stepped care integrating health & work, & health service models increasing access - self-referral & telehealth (phone, internet, ‘blended’ ehealth & face-to-face).

AFFORDABLE HEALTH SERVICES. Public Health England (PHE) recommends 4 of my service innovations given return-on-investment (ROI); this led to a ROI tool to help payers provide cost-effective services. Most of my trials have included full cost-effectiveness analyses, so health service leaders can judge willingness-to-pay.

EVIDENCING REHABILITATION & PHYSIOTHERAPY: > 20 trials in 20 years (&>5 awards) & 3 international individual patient data (IPD) meta-analyses, I led many of the best quality studies in the field evidenced by their inclusion in for example NIHRs Themed Review showcasing how physiotherapy rehabilitation helps patients get back to doing the things that matter most. Evidenced effectiveness of physiotherapist-led services that include interventions such as exercise, psychologically-informed physiotherapy, acupuncture, manual therapy, injections & TENS.

OUTCOME MEASURES: New measures, highly cited and used, to better assess important patient outcomes & effectiveness of health services, based on consumer engagement. Internationally agreed & widely adopted definitions & core outcome sets (COS), plus studies that test outcome responsiveness & minimally important change.

Qualifications

  • Doctor of Philosophy, University of Ulster

Publications

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Grants

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Available Projects

  • Interprofessional clinical practice is poorly defined and conceptualised, limiting our ability to measure and assess it and crucially to improve it for the benefit of health service and patient outcomes. This PhD programme will review current definitions and measures in the field, before developing a better conceptualisation of it that provides a new model to better understand interprofessional practice and from that identify preferred tools or the need for a new tool with which to measure it.

  • Musculoskeletal pain conditions are the largest contributer to global disability. Compared to knee or hip osteoarthritis, there is a paucity of research evidencing rehabilitation or exercise for patients with shoulder osteoarthritis. This means that most clinical practice is based on low quality evidence, and expert opinion. This programme of research will draw from recent systematic reviews to describe current practice and treatment protocols, explore the concerns and experiences of patients and clinicians about rehabilitation and exercise, develop consensus about best practice rehabilitation before specifying a rehabilitation programme including its underpinning logic model (identifying key treatment targets, components, mechanisms and outcomes).

View all Available Projects

Publications

Book Chapter

  • Foster, Nadine E., Dunn, Kate M. and Croft, Peter (2019). Prognosis research in people with low back pain. Prognosis Research in Health Care. (pp. 247-257) edited by Foster, Nadine E., van der Windt, Danielle A., Dunn, Kate M., Croft, Peter and van der Windt, Danielle A.. Oxford, United Kingdom: Oxford University Press. doi: 10.1093/med/9780198796619.003.0011

  • Foster, Nadine Elizabeth (2016). Assessing rehabilitation: practical examples. Randomized Clinical Trials of Nonpharmacological Treatments. (pp. 309-324) edited by Isabelle Boutron, Philippe Ravaud and David Moher. Boca Raton, FL, United States: CRC Press.

  • 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

Journal Article

Conference Publication

  • 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

Grants (Administered at UQ)

Possible Research Projects

Note for students: The possible research projects listed on this page may not be comprehensive or up to date. Always feel free to contact the staff for more information, and also with your own research ideas.

  • Interprofessional clinical practice is poorly defined and conceptualised, limiting our ability to measure and assess it and crucially to improve it for the benefit of health service and patient outcomes. This PhD programme will review current definitions and measures in the field, before developing a better conceptualisation of it that provides a new model to better understand interprofessional practice and from that identify preferred tools or the need for a new tool with which to measure it.

  • Musculoskeletal pain conditions are the largest contributer to global disability. Compared to knee or hip osteoarthritis, there is a paucity of research evidencing rehabilitation or exercise for patients with shoulder osteoarthritis. This means that most clinical practice is based on low quality evidence, and expert opinion. This programme of research will draw from recent systematic reviews to describe current practice and treatment protocols, explore the concerns and experiences of patients and clinicians about rehabilitation and exercise, develop consensus about best practice rehabilitation before specifying a rehabilitation programme including its underpinning logic model (identifying key treatment targets, components, mechanisms and outcomes).