Early Identification Of Infants Who Will Benefit From Neural Rescue Treatment
Funder
National Health and Medical Research Council
Funding Amount
$206,320.00
Summary
Lack of oxygen supply before, during or immediately after birth can lead to severe disability or death. This occurs in about 1 in every 500 births and is one of the most important but unsolved problems in pediatrics. The costs (financial and other) to both the individuals involved, and the community in general, is very high. However the outlook for those affected by this condition is improving. Recent research has focused on the development of neural rescue therapies, which may decrease the exte ....Lack of oxygen supply before, during or immediately after birth can lead to severe disability or death. This occurs in about 1 in every 500 births and is one of the most important but unsolved problems in pediatrics. The costs (financial and other) to both the individuals involved, and the community in general, is very high. However the outlook for those affected by this condition is improving. Recent research has focused on the development of neural rescue therapies, which may decrease the extent of disabilities suffered by these children. The same treatments may also be helpful in children following near drowning and head trauma. Neural rescue therapies must be applied less than 24 hours following the event which has caused the reduction in oxygen supply. Thus, before these treatments can be tested, it is necessary to find a way to quickly tell which babies may benefit from the treatments. This study will trial a new method which is inexpensive and can be used without moving the baby away from its incubator. This technique involves a new application of an established technology to detect the redistribution of water within the brain one of the earliest signs of impending brain cell death. The research team consists of medical personnel from the intensive care nurseries of both the Royal Women's Hospital and the Mater Mother s Hospital, as well as scientific staff experienced in the use of this technology. If this technique is effective, it will enable babies to receive maximum benefit from new treatments and reduce long-term difficulties suffered by these children and their families.Read moreRead less
A Novel Approach To The Training Of Functional Standing Following Spinal Cord Injury
Funder
National Health and Medical Research Council
Funding Amount
$412,706.00
Summary
The study will employ a new type of functional electrical stimulation (FES), strength-endurance muscle conditioning and standing training to improve stance in SCI victims with incomplete paralysis. We will evaluate an innovative combination of muscle training and novel FES protocols which allow paralysed people to stand and perform upper limb functional tasks. The primary outcomes will be duration of standing, number of repetitions of standing and sitting and upper limb function while standing.
Improved Perception Of Temporal Information In Electrical Signals For Profoundly Deaf Users Of Cochlear Implants
Funder
National Health and Medical Research Council
Funding Amount
$170,440.00
Summary
The ultimate goal of this project is to improve the ability of cochlear implant users to understand speech. The way in which a speech signal varies in amplitude over time provides useful information to the listener about the content of the speech signal. Currently, the way that the acoustic signal amplitude is converted to electrical signal amplitude for cochlear implantees does not take into consideration the very significant loudness summation present in multiple-electrode electrical stimulati ....The ultimate goal of this project is to improve the ability of cochlear implant users to understand speech. The way in which a speech signal varies in amplitude over time provides useful information to the listener about the content of the speech signal. Currently, the way that the acoustic signal amplitude is converted to electrical signal amplitude for cochlear implantees does not take into consideration the very significant loudness summation present in multiple-electrode electrical stimulation. That is, when there are multiple sequential current pulses on different electrodes over a short time, the resultant loudness is greater than the loudness due to individual current pulses. The lack of consideration of loudness summation effects has led to the amplitude variations in the acoustic signal not being accurately represented in the loudness variation perceived by the cochlear implantee. This project aims to develop a practical way of more accurately representing speech signal amplitude fluctuations for cochlear implantees by studying the effects of loudness summation. A second aim of the project is to study the effects on perception of using differently-shaped current pulses from those currently used. There is evidence from physiology experiments that using different shapes might cause the electrical stimulation to activate a more narrowly-spaced set of auditory neurons for each electrode. The application of results of both these studies will lead directly to improved perception of speech and other sounds by cochlear implantees, thus improving their communication ability and quality of life.Read moreRead less
Orthostatic Tolerance During FES-evoked Stepping In Paraplegia: A Safety And Viability Study
Funder
National Health and Medical Research Council
Funding Amount
$244,900.00
Summary
In the past 30 years, there has been growing interest in the potential benefits of functional electrical stimulation (FES) of the paralysed leg muscles as a means of restoring movement in the lower limbs. FES uses electrical impulses generated by a stimulator to elicit purposeful muscle contractions via skin-surface electrodes placed over the muscles. Although traditionally limited to health-related activities such as stationary cycling exercise, recent bioengineering advances in the area of FES ....In the past 30 years, there has been growing interest in the potential benefits of functional electrical stimulation (FES) of the paralysed leg muscles as a means of restoring movement in the lower limbs. FES uses electrical impulses generated by a stimulator to elicit purposeful muscle contractions via skin-surface electrodes placed over the muscles. Although traditionally limited to health-related activities such as stationary cycling exercise, recent bioengineering advances in the area of FES present the SCI person with a means of restoring upright mobility and reinstating functional tasks. Yet, while this technological innovation remains promising for optimising functional outcomes after SCI, there remains a distinct lack of knowledge of the physiological stresses placed upon the individual. In this preliminary safety and viability study, the physiological implications central to enhanced upright mobility will be investigated during FES-evoked prolonged stepping. The responses during FES-stepping will be contrasted with the responses observed during stepping performed without FES. The study will investigate the blood pressure responses during FES-gait, but also address possible physiological mechanisms underlying those blood pressure responses. The findings from this study will identify whether there is a phsiological limitation to the performance of FES-evoked functional mobility. Current physiotherapy practice recognises blood pressure control and orthostatic hypotension as a significant barrier to functional standing and stepping, yet little is known about the physiology underpinning the condition. If FES does present a limitation to the performance of upright functional activities, this study will also assist in devising alternative physiotherapy gait training regimens.Read moreRead less
Non-invasive Electrical Nerve Stimulation To Improve Healing Of Chronic Venous Leg Ulcers
Funder
National Health and Medical Research Council
Funding Amount
$206,210.00
Summary
Chronic venous leg ulcers are common in the elderly. They often last for many months or years, causing much suffering and expense (currently around $600,000,000 per year in Australia). As more and more Australians live into advanced age, more and more people will be troubled by leg ulcers, particularly as the likelihood of having a leg ulcer increases markedly in the very old. We have developed a painless, cheap treatment that improves wound healing. The treatment consists of electrical stimulat ....Chronic venous leg ulcers are common in the elderly. They often last for many months or years, causing much suffering and expense (currently around $600,000,000 per year in Australia). As more and more Australians live into advanced age, more and more people will be troubled by leg ulcers, particularly as the likelihood of having a leg ulcer increases markedly in the very old. We have developed a painless, cheap treatment that improves wound healing. The treatment consists of electrical stimulation of nerves that supply the wound. Low frequency current is passed through the skin from small battery powered stimulators. We have tested this technique in laboratory animals and in just a few older people with diabetes and have shown it is remarkably effective. We now plan to test this technique properly in a large study in older adults. If successful, the electrical stimulation could result in healing of wounds in relatively few weeks that otherwise would not heal for many months. Much suffering and expense would be avoided. As people age, nerve function deteriotes. Another part of the project will explore whether electrical nerve stimulation can improve damaged nerves themselves. This will provide interesting scientific insight about nerve repair and could lead to treatments for peripheral neuropathy that occurs in diabetes and other medical conditions. Australia needs to act on this now because the number of people aged over 65 will increase from around 2.3 million at present to over 6 million in the next half century. The increase in those over 85 will be even more marked with numbers increasing four fold to over one million people. Many of these people will experience severe impairment of their quality of life from leg ulcers that could be avoided, or at least minimized if a successful treatment is developed and made available to them. Similarly, much unnecessary expense could be avoided.Read moreRead less
Periodontal disease is an inflammatory disorder leading to tooth loosening and, if untreated, tooth loss. Once bone destruction has occurred around teeth the treatment outcomes are severely compromised and are mainly focussed towards slowing the process of destruction rather than repairing the damage. Over the last decade, treatment of advanced periodontal disease has focussed on ways in which the damaged tissues may be regenerated. We now have gained considerable insight into the molecular and ....Periodontal disease is an inflammatory disorder leading to tooth loosening and, if untreated, tooth loss. Once bone destruction has occurred around teeth the treatment outcomes are severely compromised and are mainly focussed towards slowing the process of destruction rather than repairing the damage. Over the last decade, treatment of advanced periodontal disease has focussed on ways in which the damaged tissues may be regenerated. We now have gained considerable insight into the molecular and cellular events associated with periodontal regeneration. Despite efforts to induce regeneration through the selective use of growth and differentiation factors it is becoming obvious that the most significant factor in successful clinical outcomes is the recruitment of special cells to the site of damage which have the potential to repair tissue damage. Thus, we intend to engineer different types of periodontal matrices in the laboratory and then transplant these newly formed tissues into sites affected by periodontal disease in an attempt to repair the damage caused by the disease process.Read moreRead less
Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$82,450.00
Summary
1 in 300 children suffer from chronic constipation that is not fixed by changing their diet or taking laxatives. They continue to suffer the problem into adulthood. They also have fecal incontinence or soiling that causes problems with socialising and schooling. We are testing a method of electrical stimulation through the skin on the belly to increase the movement of the bowel. Initial results are encouraging, showing that the rate of movement of the bowel is increased and soiling is decreased.
Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$346,995.00
Summary
We have over 300 children with chronic treatment-resistant constipation at Royal Children's Hospital Melbourne. We have a new physiotherapy technique that may overcome constipation and stop soiling in many of these children. In 2003-4, we ran a pilot study to test a technique used by physiotherapists to treat urinary incontinence. We have called the method TESIC (transcutaneous electrical stimulation using interferential current). TESIC uses suction electrodes placed on the belly and back at the ....We have over 300 children with chronic treatment-resistant constipation at Royal Children's Hospital Melbourne. We have a new physiotherapy technique that may overcome constipation and stop soiling in many of these children. In 2003-4, we ran a pilot study to test a technique used by physiotherapists to treat urinary incontinence. We have called the method TESIC (transcutaneous electrical stimulation using interferential current). TESIC uses suction electrodes placed on the belly and back at the level of the belly button. The electrical stimulation is applied using a current (interferential current) that stimulates deep into the abdomen. We tested 8 children and had very encouraging results with improved constipatio in 5-8 and all with soiling stopped. Parents and children are keen to use this technique but first we need to establish that the results are reproducible in a larger group of 70 children. We also need to know if the effect was just a placebo response (due to time spent with the physiotherapists), and how long the effect lasts. We will also measure changes in soiling. Faecal soiling is smelly and antisocial. Relief of soiling has a big impact on a child's ability to fit in at school and to attend normal schooling. We will measure outcomes using daily diaries kept by children, questionnaires, how quickly food moves through the bowel and pressures within the bowel. We have a multidiciplinary team of experienced clinicians and scientists with expertise in these techniques and in constipation and incontinence in children (paediatric surgeon, gastroenterologist, manometry nurse, incontinence paediatrician and physiotherapist, expert in electrical stimulation and gut nervous system scientist). This technique could revolutionise treatment of chronic constipation. Most physiotherapists have TESIC machines, allowing delivery Australia wide. It is non-invasive and should also be able to be used by adults, including the elderly in nursing homes.Read moreRead less