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Physiotherapy for the heart and lungs

JCU International Postgraduate Student of the Year Nnamdi Mgbemena.

Supplied by Nnamdi Mgbemena.

Written By

Nicolette Ward

College

College of Healthcare Sciences

Publish Date

14 December 2021

Related Study Areas

International Postgraduate Student of the Year

What does it take to be JCU’s International Postgraduate Student of the Year? Nnamdi Mgbemena is an international student from Nigeria who makes moving halfway across the world to complete a PhD in cardiopulmonary physiotherapy look easy.

“The idea to come to Australia to do a PhD started just after I finished my master's degree when I submitted an abstract to the World Physiotherapy Congress that was being held in South Africa in 2017,” says Nnamdi.

“It was at the conference that I met a couple of Australians who were friendly and encouraged me to apply for a PhD in Australia. And fortunately, I ended up being accepted by JCU and having Associate Professor Anne Jones who is the head of the physiotherapy program, along with Associate Professor Anthony Leicht from exercise and sports science, as my supervisors.

“The support I got from my supervisors, and also from the International Student Support Team at JCU, was unlike anything I had experienced at a university before. It is because of their help that I was able to settle into my new life in Australia, while staying on-track throughout my studies and completing my PhD in just under three and a half years.”

Nnamdi with his International Postgraduate Student of the Year award.
Nnamdi outdoors on the JCU campus.
Left: Nnamdi with his JCU International Postgraduate Student of the Year award. Right: Nnamdi on the JCU Townsville campus. Supplied by Nnamdi Mgbemena.

The importance of hand grip strength

For his PhD, Nnamdi further explored his Master’s area of interest in cardiopulmonary physiotherapy.

“Cardiopulmonary physiotherapy relates to the heart and lungs and is an area of specialisation that not many people are aware of. It is particularly important for people who suffer from lung or heart disease and/or who are undergoing lung or heart surgery, both in a prehabilitation (prehab) and rehabilitation (rehab) setting.

“My PhD is about using hand grip strength (HGS) as a predictor of lung function and health-related quality of life (HRQoL) in cardiac patients. Because lung function and health-related quality of life can be indicators of overall wellbeing, it is particularly important to assess such indicators in persons with heart diseases, both before and after their heart surgery.

“In clinical practice, lung function is currently assessed using a device called a spirometer. However, in rural and regional areas, there is often limited access to spirometers and/or spirometry-trained professionals. Therefore, the determination of hand grip strength as a monitoring tool for lung function can be of great benefit for patients in rural and remote areas.”

For the study, Nnamdi measured hand grip strength, lung function and health-related quality of life of cardiac patients at four timepoints. These included prior to surgery, during physiotherapy discharge from the hospital, and at six weeks and six months post-discharge.

“Hand grip strength includes the muscles of the hand and the forearm, and previous studies have shown that hand grip strength is a good indicator of lung function as it relates to the strength of the respiratory muscles, including the diaphragm, intercostal and abdominal muscles.

“For my research, I wanted to further explore the use of hand grip strength in the context of cardiac patients. If hand grip strength can be an indicator for the lung function and health-related quality of life at six weeks or six months, in essence, it can show the prognosis in the recovery process of heart surgery.”

Nnamdi’s research findings, however, unexpectedly showed that hand grip strength was only a predictor of lung function prior to cardiac surgery rather than post-surgery.

“What these findings show is how useful it can be for heart surgery patients to undergo what is termed ‘prehabilitation’ or prehab for short. Prehab is becoming a more common physio practice, particularly in relation to preventing sports injuries, but it is also an area of treatment that can be used by clinicians for cardiac patients prior to surgery.

“The research also showed that the values of lung function and health-related quality of life prior to surgery were the respective key predictors at the other three timepoints post-surgery. So, if patients’ lung function can be improved before cardiac surgery, then the research shows that they are going to have better outcomes post-surgery.

“However, it seems that there are also other predictors happening right after the cardiac surgery that relate to lung function and health-related quality of life, particularly in relation to the pain levels that these patients were experiencing around their sternums.”

Nnamdi (center) with other JCU International Student Mentors.

Supplied by Nnamdi Mgbemena.

How to stay on track and on time

Although Nnamdi admits he experienced culture shock when he first arrived in Australia, he says the support he received at JCU as well as his own personal values helped him to thrive.

“Coming from Nigeria, I naturally experienced some cultural shock when I first arrived. For example, back home we are more communal, meaning your space is everyone's space. But here it is more individualistic which took me a while to get adjusted, especially as I come from a very tightly interwoven family where we all do things together.

“Fortunately, the JCU International Students’ Office offered a great communal space in which to socialise and meet with other students in a friendly and relaxed atmosphere. They also helped me to find a room in a share house with other students from Nigeria, Japan, Ethiopia and PNG, which was a really interesting mix.

“While doing my PhD, I volunteered as an international student mentor at JCU and also had opportunities to travel to Perth for the Council of International Students’ conference and attend a leadership program for international students held in Brisbane. Throughout my studies I also worked casually at the Mater Hospital in Townsville so I was able to keep up my clinical practice while I was doing my PhD, while also doing some teaching work for the JCU physiotherapy and public health programs.

“However, I think my primary influence on being able to get the most out of my university experience was due to my cultural and family upbringing. Nigerians tend to have this resilience that is instilled in us from childhood, meaning that you don't just give up after trying something once; you keep at it until you have a breakthrough.

“Plus, as my parents always told me, that as you go through university, you need to allow the university to go through you as well.”

While Nnamdi will continue in his casual teaching role for JCU’s physiotherapy program, his long-term goal is to return to Nigeria and make an impact on the developing country’s healthcare and educational systems.

“To be an agent of change you need to give back to where you’ve come from. I feel a responsibility to be able to positively impact on my country’s next generation of health professionals and to help my country’s health system to develop and grow.”

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