A Randomised Trial Of Constraint Induced Movement Therapy And Botulinum Toxin A In Children With Congenital Hemiplegia.
Funder
National Health and Medical Research Council
Funding Amount
$399,995.00
Summary
Congenital hemiplegia occurs in over 1 million children under 21 years of age in the industrialized world. It is the most common type of cerebral palsy, accounting for 36 percent of children diagnosed with this lifelong condition. We intend to determine if a promising new treatment approach is effective in providing a superior and lasting benefit, compared to conventional techniques. Children with hemiplegia usually have the intellectual capacity to attend normal school; however the impaired arm ....Congenital hemiplegia occurs in over 1 million children under 21 years of age in the industrialized world. It is the most common type of cerebral palsy, accounting for 36 percent of children diagnosed with this lifelong condition. We intend to determine if a promising new treatment approach is effective in providing a superior and lasting benefit, compared to conventional techniques. Children with hemiplegia usually have the intellectual capacity to attend normal school; however the impaired arm reduces independence in activities of daily living and can compromise their ability to participate in educational, leisure and vocational roles. Previously we have shown that a program of upper limb rehabilitation in children with spasticity was effective in improving participation and quality of life. We have also shown that rehabilitation combined with Botulinum toxin A (Botox) can further improve functional activity. We believe that a new method of therapy, that has been used effectively in Adults with stroke, called Constraint Induced Movement Therapy (CIMT) may also be beneficial in the treatment of children with congenital hemiplegia. In CIMT, the unimpaired arm is constrained in a glove to promote use of the impaired arm (hemiplegic arm). We predict that, combined with the Botox treatment, CIMT will provide a superior and longer lasting benefit compared to standard rehabilitation combined with Botox. The primary aim of our study is to test this hypothesis in a controlled trial. A secondary aim is to further our understanding of the central neurovascular mechanisms underlying changes in upper limb function. To achieve this, we will use Functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS) to measure central activation in the parts of the brain controlling movement. Improving our understanding of the mechanisms involved in this condition is an essential next step towards providing a more effective and long lasting treatment.Read moreRead less
In Vitro And In Vivo Assessment Of The Funhaler -an Innovative Therapeutic Device For Children
Funder
National Health and Medical Research Council
Funding Amount
$472,750.00
Summary
Aerosol therapy is the most effective form of treatment for children with respiratory diseases such as asthma. While optimising aerosol delivery systems has an important role in increasing the efficacy of asthma therapy, ensuring patient compliance is often the most difficult part of the clinician's role, particularly in the paediatric age group. An innovative small volume spacer device (Funhaler) developed by a West Australian company (InfaMed, Ltd) may help overcome this problem. The Funhaler ....Aerosol therapy is the most effective form of treatment for children with respiratory diseases such as asthma. While optimising aerosol delivery systems has an important role in increasing the efficacy of asthma therapy, ensuring patient compliance is often the most difficult part of the clinician's role, particularly in the paediatric age group. An innovative small volume spacer device (Funhaler) developed by a West Australian company (InfaMed, Ltd) may help overcome this problem. The Funhaler incorporates a spinning toy attached to the outside of the spacer. The toy is activated when the patient breathes through the spacer. The device has been designed to encourage children to co-operate when their asthma therapy is being delivered. The Funhaler is currently in the late development stage. We propose, firstly, to carry out in vitro assessments of drug delivery from the Funhaler compared to the two most widely available small volume spacers: the Aerochamber Plus (Trudell, Canada) and the Breath-A-Tech (Scott-Dibben, Australia). These assessments will be carried out to meet the standards of regulatory bodies worldwide (including the FDA). Secondly, we propose to perform extensive in vivo studie: filter studies to assess drug delivery to the patient; deposition studies to measure drug deposition in the lungs; and a pilot clinical trial to assess the efficacy of the device during medium to long-term use in children aged 2-8 years.Read moreRead less
Understanding Typical And Atypical Development Of The Infant Brain
Funder
National Health and Medical Research Council
Funding Amount
$428,065.00
Summary
This project will apply advanced magnetic resonance imaging (MRI) techniques to understand how brain abnormalities in preterm infants relate to their functional impairments. It aims to: develop new software to easily and accurately measure infant brain structures and tissues; understand the neurobiological basis for adverse outcomes, enabling diagnosis of high risk preterm infants; and identify MRI biomarkers to assess interventions designed to give Australian babies a healthier start to life.
Improving Our Understanding Of Causal Pathways To Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
The type of brain injury in in children with cerebral palsy varies. In some children the brain developed abnormally in early pregnancy; others had a stroke or suffered from lack of oxygen around the time of birth. In many cases the exact cause remains unclear. This project will explore brain imaging, potential risk factors, and clinical outcomes for children with cerebral palsy to identify possible causes and prevention pathways.
The Burden Of Late Preterm Birth On Brain Development And 2 Year Outcomes – A Prospective, Longitudinal Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$838,690.00
Summary
80% of preterm babies are born from 32-36 weeks’ gestation, and are late preterm (LPT). LPT children have more learning problems, but why this occurs is unknown. This study aims to understand the effect of LPT birth on brain development. We will do brain scans at term and assess development at 2 years of age of 200 LPT and 200 full-term children. We expect LPT babies will have subtle alterations in brain development compared with term controls which will be associated with delayed development.
Executive Dysfunction And Brain Development In Very Preterm 13-year-olds - A Longitudinal MRI Study.
Funder
National Health and Medical Research Council
Funding Amount
$738,656.00
Summary
An area of concern for very preterm children is executive function (i.e. skills used for problem solving), which is related to educational problems, behavioural issues and social difficulties. In very preterm children this study will 1) determine if executive function problems remain stable, worsen, or improve with age; 2) look for markers for these problems from infant brain scans; and 3) examine how executive function difficulties are related to brain re-organisation.
Centre Of Research Excellence (CRE) In Newborn Medicine
Funder
National Health and Medical Research Council
Funding Amount
$2,622,320.00
Summary
Problems around birth are common and can have long-term implications, including into adulthood. Our goal is to improve health outcomes for all newborn babies and their families by determining factors that enhance outcome and assessing the benefits and consequences of new treatments for mothers and babies. We are world leaders in this field and are dedicated to training the next generation of health professionals in the care of newborn babies, in Australia and the rest of the world.
Neurobehaviour Between Birth And 40 Weeks In Infants Born
Funder
National Health and Medical Research Council
Funding Amount
$832,215.00
Summary
Very preterm infants (born at <30 weeks’ gestation) are at risk of long term developmental problems with 50% having cognitive, motor or behavioural problems. This study will examine, for the first time, neurobehavioral development of very preterm infants from birth so that we can describe neurobehaviour for a given gestation from birth to term equivalent age, and explore how it relates to brain growth or injury and to neurodevelopmental outcome at two years’ corrected age.
Long-term Effect On Offspring Of Low To Moderate Or Binge Drinking During Pregnancy.
Funder
National Health and Medical Research Council
Funding Amount
$1,688,992.00
Summary
Drinking during pregnancy is a major public health issue. The majority of pregnant women consume some alcohol during pregnancy or the peri-conception period, which is extremely concerning given the potential consequences associated with prenatal alcohol exposure. We will study the effects of low to moderate and binge drinking during pregnancy in early school-aged children by testing for subtle alterations in craniofacial shape, brain structure and function, and neurobehavioural functioning.