Experience drives changes in the connections between neurons in the brain. This neuroplasticity is a fundamental property of the nervous system, critical for learning and memory, but also important for recovery from injury and development of some nervous system disorders. This study will improve understanding of how, with practice, the human brain adapts to functional demands in the development of motor skill. Musicians are used as exemplars of fine motor skill who show long-term experience-driv ....Experience drives changes in the connections between neurons in the brain. This neuroplasticity is a fundamental property of the nervous system, critical for learning and memory, but also important for recovery from injury and development of some nervous system disorders. This study will improve understanding of how, with practice, the human brain adapts to functional demands in the development of motor skill. Musicians are used as exemplars of fine motor skill who show long-term experience-driven plasticity in the brain. This study will provide specific and detailed quantitative information about how motor cortex circuits important for control of the hand are altered in musicians. The study will also improve understanding of basic mechanisms involved in short-term neuroplasticity associated with motor learning in musicians and non-musicians, and hemispheric or training-related differences in these properties which may contribute to different abilities to use the hand for fine motor tasks.Read moreRead less
External Therapeutic Device To Support Rehabilitation Of The Hand Following Trauma Or Surgery
Funder
National Health and Medical Research Council
Funding Amount
$175,000.00
Summary
The loss of hand function will affect every aspect of an individual’s life. This includes the ability to feed and care for themselves and the ability to work and participate in family life. For people recovering from problems such as trauma, burns or surgery affecting the hand, careful management of hand rehabilitation can influence the outcome for the patient significantly. In order to reduce the possibility of mobility difficulties occurring, including loss of joint range of motion, muscle and ....The loss of hand function will affect every aspect of an individual’s life. This includes the ability to feed and care for themselves and the ability to work and participate in family life. For people recovering from problems such as trauma, burns or surgery affecting the hand, careful management of hand rehabilitation can influence the outcome for the patient significantly. In order to reduce the possibility of mobility difficulties occurring, including loss of joint range of motion, muscle and tendon sheath adhesions or non-functional scar tissue formation, continuous passive motion (CPM) is often indicated. Additionally, for people with reduced mobility of the hand due to upper limb paralysis, such as those with cervical spinal cord injury, stroke, cerebral palsy or peripheral nerve injury, disregard for management of the maintenance of the joint range of motion of the effected hand will result in contracture and limited joint range of motion. Such syndromes will reduce hand function, which is already limited by paralysis, and will negatively affect potential outcomes for aggressive rehabilitation techniques, such as tendon transfer surgery and functional neuromuscular stimulation. Therefore, in such cases, CPM is also indicated. Current devices applying CPM have shown to be effective in minimising the syndromes indicated above and these results are summarised in the Background and Research Plan attached to this proposal. Unfortunately, the use of such devices is not always prescribed by clinicians. This is due, mainly, to the limitations of these devices that are in the marketplace. These limitations include lack of secure finger placement, lack of portability, the inability to provide specialised therapy to specific joints and inflexible programming. This proposal introduces an improved device to be developed and these improvements form the proposal aims below. Given such an improved device, which can overcome many of the problems with current CPM machines, it is likely that that the clinical application of CPM will achieve the greater degree of prescription and application in hand rehabilitation. These improvements should overcome the clinical reticence to use these devices and restore a balance by increasing their use to the level that the scientific literature indicates they should have. The overall aim of the proposal is to take the device to a stage where it is ready for clinical trial.Read moreRead less
METHODS - A Randomised Controlled Trial Of METhotrexate To Treat Hand Osteoarthritis With Synovitis
Funder
National Health and Medical Research Council
Funding Amount
$770,014.00
Summary
Hand osteoarthritis (OA) is common, but has no treatment. Almost 50% of people with hand OA will have joint swelling (synovitis). The hand joint of people with synovitis are 3.5 times more likely to experience joint destruction within as little as 2 years. Drugs used to treat synovitis may reduce pain and joint destruction. We propose that treating patients with symptomatic hand OA and synovitis with the anti-synovitis drug, methotrexate, will be a major medical advance.
Novel Assessments Of The Central And Peripheral Control Of The Human Hand
Funder
National Health and Medical Research Council
Funding Amount
$365,105.00
Summary
This is a study of how the human hand works. The hand is supremely adapted for manual skills ranging from writing and playing a musical instrument to non-verbal communications via gesture and pointing. How is the range of hand skills achieved? We are motivated to study this because the ability of the hand to recovery from some neurological disorders, particularly stroke, is very poor. One important element in virtually all activities of the hand is precise movement of the thumb. The tip of the t ....This is a study of how the human hand works. The hand is supremely adapted for manual skills ranging from writing and playing a musical instrument to non-verbal communications via gesture and pointing. How is the range of hand skills achieved? We are motivated to study this because the ability of the hand to recovery from some neurological disorders, particularly stroke, is very poor. One important element in virtually all activities of the hand is precise movement of the thumb. The tip of the thumb is flexed by a single muscle, a muscle only present in humans. We want to determine how this muscle works, and how the force it produces affects the whole hand. We will use specialised neurophysiological techniques to do this in human volunteers. There is no comparable animal model for this type of work due to significant differences at both the level of the brain and the level of the muscle. Second, we want to understand better how the cells in the spinal cord which control the hand (and other) muscles work. We have two new ways to do this, including a novel technique which can activate these cells with a form of stimulation that may help us improve functional electrical stimulation. Finally, with 27 bones and more than 25 muscles which operate it, the hand is not simple to control. We will use a new apparatus to measure how well it is controlled, and we will directly stimulate the motor areas of the brain to evaluate the control. From this, we will come up with new understanding, as well as new stimulus and measurement techniques that can be applied to patients with impaired hand function, as occurs all too often after stroke.Read moreRead less
Understanding The Human Hand In Grasping And How This Changes After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$227,855.00
Summary
The hand allows remarkable feats of dexterity. But, paralysis of the hand severely limits daily activities and is common after stroke. We will determine key mechanisms that control the hand at the level of the brain and spinal cord. We will assess some limits that develop in the muscle itself. Stroke patients will be tested so that we can better understand the brain�s control of the hand and use this to enhance recovery of hand performance in those with impaired function.