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Brenda M. Button, PhD

Dept. of Respiratory Medicine, Alfred Health, Melbourne, Australia; Monash University, Dept. of Medicine, Nursing and health Sciences, Melbourne, Australia

Brenda Button (PhD)

Adjunct Clinical Associate Professor
Department of Medicine, Nursing and Health Sciences
Monash University, Melbourne

Depts. Respiratory Medicine & Physiotherapy
The Alfred Hospital
Melbourne, Australia

Dr Brenda Button started her working life as a physiotherapist specializing in cystic fibrosis at the Royal Children’s Hospital in 1990 where she worked for close on a decade. She then moved to Washington DC with her husband where he was transferred for two years where she completed her PhD via the University of Melbourne where she graduated in 1999. Since that time after returning to Melbourne, she has worked as a full time physiotherapist in the large Adult Cystic Fibrosis Centre at the Alfred Hospital, Melbourne in the Department of Respiratory Medicine and the Department of Medicine, Nursing and Health Sciences, Monash University. Therefore she has had the privilege of working with a large cohort of people with CF from newborn screening at 6 weeks of age through to old age and experienced the incredible changes in CF care and improved outcomes between1990 to the current times.

Her groundbreaking PhD research (not without controversy) investigated the effects of tipping people with lung disease (including cystic fibrosis) head down 30 - 45 degrees during traditional postural drainage chest physiotherapy from infancy to old age. The research found that these techniques caused significant gastroesophageal reflux (GOR) in many people with different chronic suppurative lung diseases. In some there were significant negative impacts on lung function including regurgitation, head aches, sinus pain and poor adherence to uncomfortable treatments. This research resulted in a change in practice worldwide with physiotherapy carried out in horizontal or head upright positions across the lifespan. The research also led to the adoption of Modern Airway Clearance Techniques such as positive expiratory pressure techniques with different devices and breathing techniques not requiring an assistant to carry out uncomfortable percussion. All these techniques are currently carried out effectively in horizontal or upright positions.

Other research interests initiated by day to day clinical questions working with patients with lung disease include the effects of exercise & exercise testing, airway clearance therapy and adherence, the use of mucolytic agents, urinary incontinence (women and men) and the prevalence of musculoskeletal problems including assessment and management in CF. The initiation and the development of the AWESCORE (Alfred Wellness Score – a 10 point short questionnaire to ascertain the wellness of the patient being assessed, taking on average one minute) has contributed positively to clinical assessment. Initiation and supervision of a Masters Student investigating the development, feasibility and validity of the A-STEP (Alfred Step Test) has resulted in a new valid (as compared with the gold standard CPET) incremental maximal exercise test on a 20 cm step which can be carried out in a standard outpatient clinic room.

She has been an accredited Airway Clearance Therapy Instructor with the International Physiotherapy Group for Cystic Fibrosis (now the ECFS PhySIIG) since 2003 and is a frequently invited speaker & course presenter in Australia, North America and Europe. She is a 2014 Winston Churchill Fellow. She has supervised two Bachelor of Science Honours students; four Masters of Science (Physiotherapy) students and four PhD students – all completed their qualifications at the Universities of Melbourne, La Trobe and Monash, Melbourne, Australia. She has more than 80 peer reviewed papers published.
b.button@alfred.org.au

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