Psychosocial Disability And Return To Work In Younger Stroke Survivors
Funder
National Health and Medical Research Council
Funding Amount
$511,216.00
Summary
Each year about 12,000 Australians of working age survive a stroke. These younger survivors have responsibility for generating an income or providing care for families and state that their main objective is to return to work for financial reasons and to help rebuild confidence and independence. This observational 3 year study will determine thefactors are associated with returning to work, improving the wellbeing of thousands of stroke survivors and their families using multivariate regression.
Most strokes are ischaemic due to occlusion of an artery producing rapid reduction in blood flow to the brain. Positioning a patient ‘lying flat’ (i.e. ‘head down’ to be level with the body, which increases the blood flow to the brain, may improve recovery and reduce disability. This study aims to determine whether ‘lying flat’ head positioning is beneficial in patients with acute stroke. The results could lead to a cheaper, safer and more effective stroke care in the world.
Supported Treadmill Training To Establish Walking In Non-ambulatory Patients Early After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$341,349.00
Summary
This project will improve the health and well being of people affected by stroke. Stroke is the most common disabling neurological condition in adults and consumes up to 5% of health care expenditure in developed countries, estimated by the National Stroke Foundation at $1-2 billion per year in Australia. Some 48,000 people suffer a stroke each year in Australia, with approximately one third of these people requiring inpatient rehabilitation and 70% of them are unable to walk on admission to reh ....This project will improve the health and well being of people affected by stroke. Stroke is the most common disabling neurological condition in adults and consumes up to 5% of health care expenditure in developed countries, estimated by the National Stroke Foundation at $1-2 billion per year in Australia. Some 48,000 people suffer a stroke each year in Australia, with approximately one third of these people requiring inpatient rehabilitation and 70% of them are unable to walk on admission to rehabilitation. This randomised controlled trial will investigate whether treadmill walking with partial weight support via an overhead harness is effective at establishing independent walking (i) more often, (ii) earlier and (iii) with a better quality of walking, than current treatment for stroke patients who cannot walk. We will measure (i) whether patients achieve independent walking and (ii) the time taken to achieve independent walking. We will also measure parameters of walking such as speed, step length and step width to evaluate the effect of treadmill training on the quality of walking. Furthermore, by measuring participation in the community at 6 months, we will evaluate the long-term effect of this innovative treatment. Given that independence in walking is a major factor in the decision to discharge patients from inpatient care, earlier independent walking should result in a reduction in length of hospital stay which will save about $800 per patient per day in a teaching hospital setting. Identifying rehabilitation strategies which enhance walking outcome will not only improve quality of life of both stroke patients and their carers by reducing disability and handicap but also reduce the cost of rehabilitation.Read moreRead less
THE NATURAL HISTORY OF COGNITIVE IMPAIRMENT AND DEMENTIA IN A STROKE COHORT
Funder
National Health and Medical Research Council
Funding Amount
$290,747.00
Summary
In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large ....In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large number also become depressed. These consequences of stroke are not given sufficient importance by clinicians. The fact that stroke is a common problem in the elderly, and our society is aging, makes this a problem of major public health significance. In the new proposal, we plan to study these subjects up to 3 years with repeat neuropsychiatric assessments and brain scans to investigate the natural history of stroke-related cognitive impairment. We will determine whether further new cases of dementia develop in the period 1-3 years, what happens to the brain lesions picked up on brain scans, and how these deficiencies affect the patients' living status and their longevity. We will be able to determine the factors that lead to a good outcome, and suggest strategies that may be applicable to improve the functioning of these individuals.Read moreRead less
An Australasian, Multi-centre, Randomized, Double-blind, Placebo-controlled Trial Of The Efficacy Of Fluoxetine In Improving Functional Recovery After Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$2,306,367.00
Summary
Stroke is one of the top three causes of disability. Treatments that improve recovery after stroke are lacking. We reviewed the world literature and found a number of very small studies which, together, suggest that the antidepressant drug, fluoxetine, may improve the recovery in stroke patients. AFFINITY is a large trial in 1600 Australians and New Zealanders with stroke which aims to find out whether taking fluoxetine for 6 months after a stroke improves recovery compared to a placebo.
An Extended Follow-up Of Stroke Patients For Cognitive Impairment And Neuropsychiatric Disorders: Sydney Stroke Study
Funder
National Health and Medical Research Council
Funding Amount
$321,800.00
Summary
Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not bee ....Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not been studied. There have been few studies of the progressive changes in MRI in patients with cerebrovascular disease. The overlap of VaD and Alzheimer's disease (AD) remains a problem for taxonomists and clinicians. One approach to the study of VaD is to examine a high risk group of subjects longitudinally to determine the early features, the risk factors and progressive changes. With this in mind, we began studying a cohort of stroke patients who are at high risk of VaD, in 1997-1999, and are following them longitudinally. The follow-up is now in its third year, and three neuropsychological assessments and two MRI-MRS scans have been performed. We propose to extend the follow-up to 5 years, with repeat neuropsychiatric, neuropsychological and MRI-MRS investigations, and wherever possible to necropsy, to determine the nature of vascular pathology that underlies cognitive impairment. Our cohort of stroke patients is arguably the most comprehensively assessed such cohorts internationally, and presents an excellent opportunity for a long-term follow-up study.Read moreRead less
Acute Vertigo In Emergency Departments: Distinguishing Between Central And Peripheral Causes By Objective Measure Of Oculomotor Examination (HINTS)
Funder
National Health and Medical Research Council
Funding Amount
$181,065.00
Summary
The goal of this work is to provide a quantitative objective measure of HINTS for developing an automatic diagnostic decision tool to differentiate vestibular neuritis (peripheral) and stroke (central) in patients presenting in emergency department for acute vestibular syndrome. Video oculography makes interpretation of the results more reliable. Video oculography goggles will be used as part of a systematic training program to enhance frontline clinician skills in eye movement examination.
Fracture Associated Premature Mortality; An International Consortium
Funder
National Health and Medical Research Council
Funding Amount
$579,807.00
Summary
Following an osteoporotic fracture there is an increased premature mortality compared with someone who has not fractured. There is also evidence that anti-osteoporosis medication reduces this premature mortality. This study will determine the size of the fracture-mortality relationship and the effect of treatment on this mortality for different fracture types and in different populations by integrating data from multiple international epidemiology studies of osteoporosis.
Improving The Identification, Management And Outcome Of People With Depression And Other Chronic Diseases
Funder
National Health and Medical Research Council
Funding Amount
$476,728.00
Summary
My research is designed to reduce depression and help people with chronic disease have a better quality of life. I will work with Aboriginal and/or Torres Strait Islander communities to improve how depression is identified, prevented and treated. I will work with the general community who have major depression, depression that is difficult to treat and people with depression and chronic disease to improve their outcomes. I will also aim to improve the recovery of people who have had a stroke.
Centre For Translational Neuroscience: A Modular Platform For Translating Discovery Into Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$2,623,735.00
Summary
Clinical Centre of Research Excellence in Translational Neuroscience will provide people, pathways and resources to create a novel platform to take the outputs of Neuroscience Discovery programs though to improved patient outcomes for common brain diseases. A critical role will be to train and equip the best and brightest of the next generation of researchers to undertake internationally competitive translational neuroscience research that makes a difference to the health of our community.