Portable Motor Rehab Device To Improve Arm Movement After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$241,064.00
Summary
One in six people have a stroke at some time in their life. Half the people with upper limb problems after stroke do not recover useful function. New technologies are needed to improve outcomes. This project develops the portable Arm Movement Measurement device, which measures motor control of the arm and hand for clinicians and patients, to improve rehabilitation outcomes, and for researchers to use to measure motor control in clinical studies.
Investigation Of The Clinical Utility Of The Nintendo Wii_ Gaming System For Assessment And Rehabilitation Of Balance Post-stroke
Funder
National Health and Medical Research Council
Funding Amount
$75,660.00
Summary
The assessment and treatment of balance problems following stroke is a primary focus for physiotherapists working in this field. The Nintendo Wii_, a commercially available active gaming system, is a potentially useful tool for stroke rehabilitation. This research will investigate the effectiveness of this system to improve balance following stroke as well as examine the clinical utility of the Wii Balance Board_, with custom-designed software, for assessment of balance in stroke patients.
Improving Arm Function After Stroke Using Task Specific Training
Funder
National Health and Medical Research Council
Funding Amount
$832,597.00
Summary
85% of the 15 million people in the world annually who have a stroke cannot use their arm for basic tasks like eating and toileting. With usual health care services, 60% of stroke survivors still have non-functional arms 6 months after stroke. More effective treatments are needed. Task-specific training may improve arm and hand function more than usual care. We will conduct a multicentre randomised controlled trial to test whether task-specific training is more effective than usual care.
Improving Translation Of Intensity And Quality Of Upper Limb Rehabilitation Provided By Occupational Therapists To Children With Unilateral Cerebral Palsy: A Cluster Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$225,539.00
Summary
This study aims to increase occupational therapist's use of best available evidence of intensive upper limb therapy for children with unilateral cerebral palsy. The study will determine in a cluster randomised trial whether a multifaceted implementation program comprising: (a) audit & feedback, (b) identifying barriers to implementing best practice evidence, and (c) targeted interactive training is more effective than a single faceted program (audit & feedback alone) to increase evidence uptake.
InTOUCH: Tactile Assessment In Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$176,571.00
Summary
Recent research finds that over 70% of children with unilateral cerebral palsy have impairments in touch function that affect how well they can use their hands. Until now, the severity and extent of this deficit has been unknown, and so children with cerebral palsy have not been receiving touch assessments. This project aims to increase awareness of touch impairments and achieve integration of touch assessment into routine examaination.
The Efficacy Of Novel, Non-robotic Devices To Train Reaching Post Stroke
Funder
National Health and Medical Research Council
Funding Amount
$491,605.00
Summary
Up to 50% of stroke survivors are left with upper limb disability that limits their daily activities and their paralysis is so severe that it excludes them from training with the most effective methods. This study is a clinical trial of innovative new techniques to assist people with severe upper limb paralysis to reach following stroke. Positive results are likely to reduce disability in a large number of stroke survivors and has the potential to be used by other patients with paralysis.
I will use non-invasive brain stimulation to study the operation of the corticospinal pathway in humans while they perform tasks requiring precise control of fingers and thumb. This pathway from brain to spinal cord is important for independent finger movements, and these experiments will provide insight into the cortical mechanisms by which independent finger movements are produced. I will also investigate relationships between patterns of corticospinal activation (which I have shown differ bet ....I will use non-invasive brain stimulation to study the operation of the corticospinal pathway in humans while they perform tasks requiring precise control of fingers and thumb. This pathway from brain to spinal cord is important for independent finger movements, and these experiments will provide insight into the cortical mechanisms by which independent finger movements are produced. I will also investigate relationships between patterns of corticospinal activation (which I have shown differ between subjects and hands) and digital dexterity. While it seems reasonable to assume that digital dexterity is dependent on the operation of the corticospinal system, the relationship is obscure, even at a gross level. Digital dexterity can vary considerably between subjects, and even between hands in the same subject. Are people more skilled with their hands because they are better able to engage the corticospinal system in control of the digits? The present study will address this fundamental question. The brain stimulation techniques that I will use are the only techniques presently available which can answer these questions in humans. This information will assist us to understand how normal subjects perform skilled tasks with their hands, as well as helping us to understand how damage to the nervous system (e.g., stroke, multiple sclerosis, Parkinson's disease) produces deficits in movement control. The information gained may suggest training regimes for skill acquisition in normal subjects, and to promote recovery of function in patients with neurological damage or disease.Read moreRead less
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