Can Real-time Biofeedback Of Foot Clearance Data Be Used To Assist With Gait Rehabilitation Following Stroke?
Funder
National Health and Medical Research Council
Funding Amount
$587,143.00
Summary
A new intervention for falls-risk minimization is proposed by providing additional visual sensory information to increase foot-ground clearance in order to walk more safely.A randomised controlled trial will be employed to assess the effects of biofeedback on foot-ground clearance during gait training. The outcome will be innovative biofeedback-based gait training that could significantly enhance existing stroke rehabilitation programs.
IMPROVING STROKE OUTCOMES: NEW TARGETS AND THERAPIES
Funder
National Health and Medical Research Council
Funding Amount
$7,212,064.00
Summary
Previously we established a unique collaboration of researchers from the basic and clinical sciences.. The main aim of this ' vertically integrated ' model was to develop new therapies to improve stroke outcomes. We developed a system to identify ' off-the-shelf ' compounds which protect the brain after stroke onset. This involves data assimilation (meta-analysis) in a unique way, an approach which has attracted attention internationally. We are also completing an important clinical trial using ....Previously we established a unique collaboration of researchers from the basic and clinical sciences.. The main aim of this ' vertically integrated ' model was to develop new therapies to improve stroke outcomes. We developed a system to identify ' off-the-shelf ' compounds which protect the brain after stroke onset. This involves data assimilation (meta-analysis) in a unique way, an approach which has attracted attention internationally. We are also completing an important clinical trial using the clot dissolving agent tPA to extend the time during which the drug may be effective beyond the three-hours currently used. In the next phase of our program we plan to expand the basic science component to identify parts of brain cells (axons and dendrites) which may yield important information about new drugs to protect the brain. We will use our novel summary data technique to test drugs in animal models more appropriate to the human stroke paradigm than have been used in the past In clinical studies we will follow our theme of identifying new targets for therapy using sophisticated PET and MRI imaging techniques, both in patients who are at great risk of stroke recurrence after a minor warning stroke and those with stroke caused by bleeding within the brain. These studies will provide information about predictors of recurrent and worsening stroke which may be modified by new therapies. The final stage in identifying new therapies is the Phase III clinical trial. We will complete one of these in which the most appropriate drug preventing further strokes in a major new stroke subtype will be identified. Toward the end of the program, we will commence phase 3 studies of drugs we have selected as being most likely to protect the brain based on our animal experiments. The main benefit of this unique collaborative research model is to efficiently identify new therapies to reduce the burden of stroke, currently the second most common cause of death globally.Read moreRead less
Improving Stroke Outcomes: Attenuating Progression And Recurrence
Funder
National Health and Medical Research Council
Funding Amount
$9,331,996.00
Summary
Stroke is the second most common cause of death and major cause disability. There are few proven interventions, so we need to introduce new ones. We developed a bench to bedside program to introduce new stroke therapies and its early secondary prevention. Our general goal is to provide evidence for their effectiveness and safety. We will use animal stroke models, markers in the blood to help diagnose and predict stroke outcome and imaging to help select patients for several clinical trials.
Randomised Double-blind Placebo-controlled Trial Of Aspirin In Primary Prevention Of CVD Events Or Dementia In The Aged.
Funder
National Health and Medical Research Council
Funding Amount
$3,532,500.00
Summary
The single most important risk factor for cardiovascular disease is age. All men aged 75 years have a 10-15% risk of having a stroke or heart attack in the next 5 years. Low dose aspirin has been shown to prevent further strokes and heart attacks in people who have already had one. It has been also shown to protect people who have not had a heart attack or stroke but who are at increased risk. Given that the elderly are at increased risk why do we need to do a trial in this particular group? The ....The single most important risk factor for cardiovascular disease is age. All men aged 75 years have a 10-15% risk of having a stroke or heart attack in the next 5 years. Low dose aspirin has been shown to prevent further strokes and heart attacks in people who have already had one. It has been also shown to protect people who have not had a heart attack or stroke but who are at increased risk. Given that the elderly are at increased risk why do we need to do a trial in this particular group? The reason is that relatively few elderly patients were included in the previous prevention trials. Also while the elderly may have the most to gain from treatment, they also have the most to lose because they are more likely to suffer from side-effects. Aspirin prevents heart attacks by stopping clots forming in blood vessels. This also means that people taking it have an increased tendency to bleed. Thus though it may prevent strokes due to clots it may also increase the risk of strokes caused by bleeding. Bleeding from the gut is another major problem as aspirin tends to erode the lining of the stomach. Minor bleeding from the gut can also lower blood oxygen carrying capacity which may exacerbate other diseases associated with ageing, e.g. heart failure. Dementia may be caused by repeated clots in small or large vessels. Dementia is a particular problem in the elderly affecting 10% of 85 year olds. It is a major cause of loss of quality of life and a significant cost to the community. Aspirin may reduce the progression of such a disease leading to a maintained quality of life (QOL) for individuals and their families. As our age increases our years of life remaining decreases. This is self-evident. Thus the potential to add years to life reduces and the potential of diseases to adversely affect quality of life becomes more important. Thus it may be more important to prevent a nonfatal stroke that leads to institutionalisation than a fatal stroke. Hence QOL will be assessed.Read moreRead less
Post-stroke Hyperglycaemia – Treatment With Exenatide In Acute Ischaemic Stroke (TEXAIS) Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,266,149.00
Summary
Raised blood glucose levels (hyperglycaemia) after a stroke is common. It reduces the efficacy of stroke treatments and results in worse outcomes. Insulin is not useful as a treatment for this as it causes frequent hypoglycaemia and does not improve clinical outcomes. Exenatide is a common diabetes drug that is simple to use and lowers blood glucose without hypoglycaemia. It will be tested in the Treatment with Exenatide in Acute Ischaemic Stroke (TEXAIS) trial.
Centre For Research Excellence In Stroke Rehabilitation And Brain Recovery
Funder
National Health and Medical Research Council
Funding Amount
$2,595,746.00
Summary
The Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery will transform the stroke research and practice landscape in Australia, and accelerate the development of new interventions strongly supported by neuroscience. This unique collaboration will improve patient selection and rehabilitation research methods, create a training culture for the next generation of rehabilitation researchers and effectively implement proven cost effective interventions for Australians.
Many new therapies are being developed to treat stroke and prevent its recurrence. While a number of these have been successfully introduced, there is a puzzling gap between evidence of efficacy in animal models and humans. One of the main reasons may be lack of an integrated approach between the basic sciences and clinical researchers. By assembling a team with skills in both areas and a structure to maximise communication between groups this team plan to incrementally introduce new therapies i ....Many new therapies are being developed to treat stroke and prevent its recurrence. While a number of these have been successfully introduced, there is a puzzling gap between evidence of efficacy in animal models and humans. One of the main reasons may be lack of an integrated approach between the basic sciences and clinical researchers. By assembling a team with skills in both areas and a structure to maximise communication between groups this team plan to incrementally introduce new therapies into clinical practice.Read moreRead less
Shared Team Approach Between Nurses And Doctors For Improved Risk Factor Management (STAND FIRM)
Funder
National Health and Medical Research Council
Funding Amount
$1,945,676.00
Summary
There are many proven treatments for preventing people with stroke from having a recurrent event, e.g. maintaining blood pressure at acceptable levels. However, uptake of therapies is poor. We will assess whether patients receiving individualised management plans, prepared and administered by both doctors and nurses will have risk factors controlled better than those receiving usual care. The plan includes education of patients to help them have more control over their own care.
The Role Of Interferon Signalling In The Regulation Of Stroke
Funder
National Health and Medical Research Council
Funding Amount
$620,381.00
Summary
This project focuses on the role that inflammation plays in the progression of the type of neural injury seen in stroke victims. This project targets a specific pathway that is thought to be involved in the regulation of general inflammation but has not been greatly investigated in terms of the neural injury seen in stroke. Understanding the actions of this pathway may lead to future therapies that can be used to prime the brain to react in a positive way to stroke.