Dr Ryan Gallagher

Dr Ryan Gallagher

Conjoint Senior Lecturer

School of Health Sciences

Career Summary

Biography

Senior Physiotherapist in Neurosciences at the John Hunter Hospital and conjoint appointee in the School of Health Sciences. Ryan is a title Physiotherapist with the Australian Physiotherapy Association and a member of the Australian College of Physiotherapy. Ryan's PhD  focussed on improving the accuracy of identifying patients with Idiopathic Normal Pressure Hydrocephalus (iNPH) who would benefit from Neurosurgery and the role Physiotherapists can play. 

Ryan's research experience and publication or presentation history span multiple clinical areas including: Stroke, Telehealth,  advanced practice clinical roles and and  the role E Health and technology can play in shaping healthcare and the Physiotherapy profession into the future. Ryan has post graduate qualification in data science and machine learning with a strong interest these fields will play in healthcare currently and into the future


Qualifications

  • Doctor of Philosophy in Physiotherapy, University of New South Wales
  • Bachelor of Physiotherapy, University of Newcastle

Keywords

  • acute care
  • ehealth
  • neuroscience
  • physiotherapy

Fields of Research

Code Description Percentage
080702 Health Informatics 20
110999 Neurosciences not elsewhere classified 20
110317 Physiotherapy 60

Professional Experience

Professional appointment

Dates Title Organisation / Department
2/2/2012 -  Senior Physiotherapist Neurosciences Hunter New England Local Health District
Physiotherapy

Prestigious works / other achievements

Year Commenced Year Finished Prestigious work / other achievement Role
2019 2019 Best HDR Publication for 2019. School of Health Sciences University of Newcastle Author
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Journal article (7 outputs)

Year Citation Altmetrics Link
2020 Henderson J, Gallagher R, Brown P, Smith D, Tang K, 'Emergency department after-hours primary contact physiotherapy service reduces analgesia and orthopaedic referrals while improving treatment times', AUSTRALIAN HEALTH REVIEW, 44 485-492 (2020)
DOI 10.1071/AH18259
2019 Gallagher R, Marquez J, Osmotherly P, 'Clinimetric Properties and Minimal Clinically Important Differences for a Battery of Gait, Balance, and Cognitive Examinations for the Tap Test in Idiopathic Normal Pressure Hydrocephalus', Clinical Neurosurgery, 84 E378-E384 (2019) [C1]

© 2018 by the Congress of Neurological Surgeons. BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is treated by insertion of a ventricular peritoneal (VP) shunt. To hel... [more]

© 2018 by the Congress of Neurological Surgeons. BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is treated by insertion of a ventricular peritoneal (VP) shunt. To help identify who would benefit from a VP shunt, patients undergo a tap test (TT). Several measures can identify change from a TT, but the magnitude of change and the combination of measures that indicate the improvement from a TT is unclear. OBJECTIVE: To develop minimal clinically important differences (MCIDs) for a battery of gait, balance, and cognitive measures in relation to improvement from the TT, and to identify which combination of measures best identifies when improvement has occurred. METHODS: Observational study of iNPH patients undergoing a TT for consideration of a VP shunt. Patients completed the: The Timed Up and Go (TUG), Timed Up and Go cognition (TUG-C), Performance Oriented Mobility Assessment (Tinetti), and Berg Balance Scale (BBS) pre- and post-TT. A Global Rating of Change scale assessed patients' perceived improvements in gait and balance post-TT. RESULTS: MCIDs for the TT were (calculated as percentage changes): TUG: 13%, TUG-C: 11% Tinetti: 36%, and BBS: 20%. A combination of the TUG-C and Tinetti resulted in sensitivity of 90.28% to identify improvement, while the Tinetti and BBS resulted in specificity of 98.58% to exclude improvement from a TT. CONCLUSION: These MCIDs provide the first evidence to quantify the significance of post-TT symptom changes and provides objective data to guide recommendations for clinical management. Utilizing a combination of measures, and these MCIDs as cut off values, results in high sensitivity and specificity for identifying improvement from a TT.

DOI 10.1093/neuros/nyy286
Citations Scopus - 2Web of Science - 2
Co-authors Jodie Marquez, Peter Osmotherly
2019 Gallagher R, Bateman G, Marquez J, Osmotherly P, 'Are gait changes linked to CSF flow changes in the sagittal sinus?', Neuroradiology, 61 659-666 (2019) [C1]
DOI 10.1007/s00234-019-02192-2
Co-authors Peter Osmotherly, Jodie Marquez
2018 Gallagher R, Giles M, Morison J, Henderson J, 'Telehealth-based model of care redesign to facilitate local fitting and management of patients with a spinal fracture requiring a thoracic lumbar sacral orthosis in rural hospitals in New South Wales', AUSTRALIAN JOURNAL OF RURAL HEALTH, 26 181-187 (2018)
DOI 10.1111/ajr.12407
Citations Scopus - 2Web of Science - 2
2018 Gallagher RM, Marquez J, Osmotherly P, 'Cognitive and upper limb symptom changes from a tap test in Idiopathic Normal Pressure Hydrocephalus', Clinical Neurology and Neurosurgery, 174 92-96 (2018) [C1]

© 2018 Elsevier B.V. Objectives: To determine which cognitive and upper limb assessments can identify change in patients undergoing a Cerebrospinal fluid (CSF) tap test (TT) diagn... [more]

© 2018 Elsevier B.V. Objectives: To determine which cognitive and upper limb assessments can identify change in patients undergoing a Cerebrospinal fluid (CSF) tap test (TT) diagnosed with idiopathic Normal Pressure Hydrocephalus (iNPH). Patients and methods: Prospective observational study of 74 iNPH patients undergoing a CSF TT for consideration of a ventricular peritoneal shunt. Patients who were offered surgical intervention were classified as responders. Patients were assessed with a battery of cognitive and upper limb assessments prior to and following a CSF TT. The Timed up and go cognition (TUG-C), Montreal Cognitive assessment (MoCA) and 9-hole peg test were utilised. Results: 40 patients were classified responders. Significant differences were identified for responders for the MoCA (0.62 points) and TUG-C (-6.02 s). Only the executive function and orientation sub scores of the MoCA showed significant changes for responders. The 9 hole peg test mean change of 4.33 s for responders was not significant. Non-responder change scores for the MoCA (0.22 points), TUG-C (0.3 s) and 9 hole peg test (2.58 s) were not significant. Conclusion: The TUG-C has the potential to identify change in patients resulting from a CSF TT. While statistically significant change was found for the MoCA, a mean change of less than 1 point on this scale is unlikely to be clinically relevant. Similarly, the 9 hole peg test cannot be endorsed as an assessment tool for identifying changed performance in iNPH.

DOI 10.1016/j.clineuro.2018.09.015
Citations Scopus - 4Web of Science - 3
Co-authors Peter Osmotherly, Jodie Marquez
2018 Gallagher R, Marquez J, Osmotherly P, 'Gait and Balance Measures Can Identify Change From a Cerebrospinal Fluid Tap Test in Idiopathic Normal Pressure Hydrocephalus', Archives of Physical Medicine and Rehabilitation, 99 2244-2250 (2018) [C1]

© 2018 American Congress of Rehabilitation Medicine Objectives: To identify in patients with idiopathic normal pressure hydrocephalus (iNPH) undergoing a cerebrospinal fluid (CSF)... [more]

© 2018 American Congress of Rehabilitation Medicine Objectives: To identify in patients with idiopathic normal pressure hydrocephalus (iNPH) undergoing a cerebrospinal fluid (CSF) tap test (TT) for consideration of a ventricular peritoneal (VP) shunt: (1) gait and balance measures, which identify symptom change; (2) differences present between pre¿ and post¿CSF TT scores between patients classified as responders and nonresponder; (3) ability of patients with iNPH to accurately quantify change in their gait and balance symptoms from a CSF TT. Design: Prospective observational study. Post¿CSF TT assessment was completed 2-4 hours post. Setting: Tertiary referral neurological and neurosurgical hospital. Participants: Patients (N=74) with iNPH receiving a 30 mL CSF TT for consideration of a VP shunt. Interventions: Patients underwent a battery of gait and balance measures pre¿ and post¿CSF TT and indicated their perceived change on a global rating of change (GRC). Patients deemed to improve and offered VP shunt insertion by a neurologist or neurosurgeon were labeled responders. Main Outcome Measures: Performance oriented mobility assessment (Tinetti), Berg Balance Scale (BBS), timed Up and Go (TUG), 10-meter walk test (10MWT), GRC. Results: Forty patients were classified responders, 34 nonresponders. Significant differences were identified for responders: Tinetti (3.88 points), TUG (3.98 seconds), 10MWT (0.08 m/sec), and BBS (5.29 points). Significant differences were found for nonresponders for the Tinetti (0.91 points) and BBS (2.06 points). Change scores for responders and nonresponders were significantly different for all tests between responders and nonresponders. GRC scores for gait (+2 for responders, 0 for nonresponders) and balance (+2.5 for responders, 0 for nonresponders) were both significantly different. Conclusions: The Tinetti, BBS, and TUG can identify change in patients undergoing a CSF TT for iNPH. Patients appear to be able to accurately identify if change has occurred.

DOI 10.1016/j.apmr.2018.03.018
Citations Scopus - 9Web of Science - 9
Co-authors Peter Osmotherly, Jodie Marquez
2014 Gallagher R, Osmotherly P, Chiarelli P, 'Idiopathic normal pressure hydrocephalus, what is the physiotherapist s role in assessment for surgery?', Physical Therapy Reviews, 19 245-251 (2014) [C1]
DOI 10.1179/1743288X13Y.0000000130
Co-authors Pauline Chiarelli, Peter Osmotherly
Show 4 more journal articles

Conference (9 outputs)

Year Citation Altmetrics Link
2019 Gallagher R, Osmotherly P, Marquez J, 'Improving the selection of patients for surgery with idiopathic normal pressure hydrocephalus by using Minimally Clinically Important Differences(MCIDs) of clinical measures', Adelaide, Australia (2019)
Co-authors Peter Osmotherly, Jodie Marquez
2019 Gallagher R, Marquez J, Osmotherly P, 'Changes in performance scores following a tap test predict improvement after surgery for idiopathic normal pressure hydrocephalus', Changes in performance scores following a tap test predict improvement after surgery for idiopathic normal pressure hydrocephalus, Adelaide, Australia (2019)
Co-authors Peter Osmotherly, Jodie Marquez
2017 Gallagher R, Marquez J, Osmotherly PG, 'Can upper limb and cognitive outcome measures identify change in patients undergoing a lumbar puncture tap test with Idiopathic Normal Pressure Hydrocephalus (iNPH)?', Momentum 2017. Proceedings of Australian Physiotherapy Association Biennial Conference, Sydney (2017)
Co-authors Peter Osmotherly, Jodie Marquez
2017 Gallagher R, Marquez JL, Osmotherly PG, 'Can gait and balance measures identify individuals who respond to a lumbar puncture tap test in patients with idiopathic normal pressure hydrocephalus?', Momentum 2017. Proceedings of Australian Physiotherapy Association Biennial Conference, Sydney (2017)
Co-authors Peter Osmotherly, Jodie Marquez
2017 Gallagher R, Bateman G, Marquez J, Osmotherly PG, 'Is the sagittal sinus involved in iNPH? Analysis of MRI CSF flow studies in patients undergoing a CSF tap test(TT) for idiopathic Normal Pressure Hydrocephalus (iNPH).', Kobe, Japan (2017)
Co-authors Peter Osmotherly, Jodie Marquez
2017 Gallagher R, Marquez J, Osmotherly PG, 'Can upper limb and cognitive outcome measures identify change in patients undergoing a lumbar puncture tap test with Idiopathic Normal Pressure Hydrocephalus (iNPH)?', Kobe, Japan (2017)
Co-authors Peter Osmotherly, Jodie Marquez
2017 Gallagher R, Marquez J, Osmotherly PG, 'Can gait and balance measures identify individuals who respond to a lumbar puncture tap test in patients with idiopathic normal pressure hydrocephalus?', Kobe, Japan (2017)
Co-authors Peter Osmotherly, Jodie Marquez
2015 Gallagher R, Marquez J, Chiarelli P, Osmotherly P, 'iNPH QUEST Study: Quantifying a battery of gait, cognitive and radiological examinations to improve shunt response from the lumbar puncture tap test Interim results', Gold Coast Australia (2015)
2013 Gallagher R, Osmotherly P, Chiarelli P, 'Idiopathic normal pressure hydrocephalus. Is there a role for physiotherapists in management?',', Idiopathic normal pressure hydrocephalus. Is there a role for physiotherapists in management?', Melbourne (2013)
Show 6 more conferences
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Dr Ryan Gallagher

Position

Conjoint Senior Lecturer
School of Health Sciences
Faculty of Health and Medicine

Contact Details

Email ryan.gallagher@newcastle.edu.au
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