Professor Paul Hodges’ work aims to understand the physiology of spinal pain, to develop novel strategies for the prevention and treatment of spinal pain, and to understand the mechanisms for efficacy of interventions for spinal pain.
Paul has doctorates in both physiotherapy and neuroscience and his work blends neurophysiological and biomechanical methods to understand the control of movement and stability of the spine and how this changes when people have pain.
Over the past 14 years, Paul and his team have continued to make discoveries that have shaped conservative management of spinal pain. Major developments include identification of strategies used by the brain to control the spine. Notably, these strategies were changed in people with spinal pain, providing the basis for novel exercise interventions. Randomised controlled clinical trials of interventions based on these findings have repeatedly shown the intervention to be effective in a range of people with pain. Work identifying the contribution of the deep muscles of the trunk, such as transversus abdominis, to spinal control have been particularly influential internationally.
Another major breakthrough was the discovery that the requirement for trunk muscles to contribute to the control of the spine as well as breathing and continence presents potential risk to the spine. This work identified changes in the control of spine in people with incontinence and breathing disorders. Epidemiological data provided evidence for an increased risk for development of pain in people with these disorders. This work has a major impact on the treatment of incontinence, back pain and breathing disorders. Paul returned to The University of Queensland in 2001 after 5 years as a research fellow at the Karolinska Institute in Sweden and the Prince of Wales Medical Research Institute in Sydney.
Recent discoveries include novel work that is changing our understanding of how pain affects the way we move. Studies of the neural mechanisms to control the trunk and limb muscles as leading to a new interpretation, with implications for training.
In collaboration with several research groups, Paul’s clinical trials are providing a clear understanding of which interventions work for spinal pain. Perhaps more importantly, these trials are also helping us understand why the interventions work. This helps choosing the right intervention for the right person, and making interventions more effective.
Paul has received numerous National and International awards for his research. In 2006 he was awarded the ISSLS Prize from the International Society for the Study of the Lumbar Spine. This is the premier international prize for back pain research. Previously he had won Young Australian of the year in Science and Technology, Paul and his students have won more than 10 best paper awards at major International and National conferences.
In addition to his research in Brisbane, Paul has ongoing collaborations with laboratories in Sydney, Melbourne, Sweden, USA, the Netherlands, Denmark and South Africa. He has published more that 130 peer reviewed papers and book chapters and has received more than $AU10 million in research grants from the NHMRC, ARC and International research funds.
Hodges, P.W., Kaigle Holm, A. Hansson, T., Holm, S. (2006) Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine 31(25):2926-33. IF=2.676
*Winner of the 2006 ISSLS Prize (Basic Science)
Ferreira, M.L., Ferreira, P.H., Latimer, J., Herbert, R., Hodges, P.W., Jennings, M.D., Maher, C.G., Refshauge, K.M. (2007) Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial. Pain, accept 12/06.
Barker, P.J., Guggenheimer, K.T., Grkovic, I., Briggs, C.A., Jones, D.C., Thomas, C.D.L., Hodges, P.W. (2006) Effects of tensioning the lumbar fasciae on segmental stiffness during flexion and extension. Spine, 31:397–405. *Winner of the 2006 Spine Journal Young Investigator Award Winner
Smith, M. D., Russell, A., Hodges, P.W. (2006) Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Australian Journal of Physiotherapy, 52:11-16. IF=0.918
Knox, J.J., Hodges, P.W. (2006) Do you know where your arm is if you think your head has moved? Experimental Brain Research, 173(1):94-101.
Hodges, P.W., Sapsford, R., Pengel, L.H.M. (2007) Postural and respiratory functions of the pelvic floor muscles. Neurourology and Urodynamics, 26(3):362-71.
Smith, M. D., Coppieters, M., Hodges, P.W. (2007) Postural response of the pelvic floor and abdominal muscles in women with and without incontinence. Neurourology and Urodynamics, 26(3):377-85.
Mok, N.W. Brauer, S.G., Hodges, P.W. (2007) Failure to use movement in postural strategies leads to impaired trunk control in low back pain. Spine, Accept 04/07.
Smith, M., Coppieters, M., Hodges, P.W. (2007) Postural activity of the pelvic floor muscles is delayed during rapid arm movements in women with stress urinary incontinence, International Urogynecology Journal, accept 10/06.
Tsao, H., Hodges, P.W. (2007) Immediate changes in feedforward postural adjustments following voluntary motor training. Experimental Brain Research, accept 03/07