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Brain Adaptation Associated With Spontaneous And Training-induced Recovery Of Touch Sensation Post-stroke.
Funder
National Health and Medical Research Council
Funding Amount
$339,950.00
Summary
Brain networks may reorganize to optimise stroke recovery. However, little is known about brain mechanisms underlying natural and training-induced recovery after stroke, particularly following loss of body sensations. Knowledge of the experiences that may facilitate brain reorganisation is a prerequisite for the development and evaluation of optimal stroke rehabilitation strategies. We aim to provide novel information on the potential benefits of specific training in facilitating reorganisation ....Brain networks may reorganize to optimise stroke recovery. However, little is known about brain mechanisms underlying natural and training-induced recovery after stroke, particularly following loss of body sensations. Knowledge of the experiences that may facilitate brain reorganisation is a prerequisite for the development and evaluation of optimal stroke rehabilitation strategies. We aim to provide novel information on the potential benefits of specific training in facilitating reorganisation of the brain after stroke. Specifically we will: (i) locate areas of brain activity associated with natural and training-induced recovery of touch sensation following stroke and (ii) investigate the relationship between brain activation, sensory recovery and intervening experience. Site and extent of brain activation associated with recovery of touch sensation will be investigated over time using serial functional magnetic resonance imaging (fMRI), a controlled sensory task and clinical measures of recovery. Thirty stroke patients with impaired touch sensation of the upper limb will be studied at 2-6 weeks and 6 months post-stroke to investigate changes in brain activation associated with natural recovery (Study 1). Ten healthy controls will also be studied over 6 months. Those patients who still have sensory loss at 6 months will then receive specific sensory training or placebo intervention to study the effect of training-induced recovery on brain activity (Study 2). The whole brain will be studied and activation sites will be interpreted relative to individual and standard brain maps. We expect that the findings will advance our knowledge of the relationship between clinical recovery, training and neural plastic changes in the brain. This information will provide direction for the development of scientifically based treatments designed to maximise recovery and help identify patients who are likely to show natural recovery and-or benefit from training.Read moreRead less
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
Falls Prevention For Stroke Patients Following Discharge Home: Contributory Factors And A Randomised Trial Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$549,440.00
Summary
Falls are common after stroke, with over 50% of people being discharged home from hospital after stroke experiencing one or more falls in the subsequent six months. Despite a large focus on falls prevention in the community generally, and increasing research that a range of activities (such as exercise, medication review, home hazard modification) are effective in reducing falls among older people generally, there have been no randomised trials evaluating the effectiveness of falls prevention ac ....Falls are common after stroke, with over 50% of people being discharged home from hospital after stroke experiencing one or more falls in the subsequent six months. Despite a large focus on falls prevention in the community generally, and increasing research that a range of activities (such as exercise, medication review, home hazard modification) are effective in reducing falls among older people generally, there have been no randomised trials evaluating the effectiveness of falls prevention activities for people with stroke. This research will evaluate whether a detailed assessment and program of falls prevention activities (exercise, falls prevention information, bone strength recommendations, and other activities based on the assessment findings) will reduce falls in stroke patients with increased risk of falling. Two additional issues associated with falls among people with stroke will also be investigated. Detailed analysis of walking and stepping over obstacles will be evaluated to determine long term problems which might increase the risk of falling, and the effect of the falls prevention program will also be evaluated on the walking and stepping over the obstacle tasks. A third study will investigate the development of fear of falling firstly as a result of the stroke and resultant walking difficulties, and then how this changes when a fall occurs. The interaction between falls, fear of falling, and reduced activity and walking will be explored. The outcomes of this project will improve the understanding by health professionals of key factors contributing to increased risk of falling following stroke, and provide clear direction and resources for general application of the program in other stroke rehabilitation programs nationally. The main anticipated outcome is 33% reduction in falls, and improved balance, walking, and confidence for people returning home after stroke.Read moreRead less
Client Centred Palliative Rehabilitation: An Evaluation Of Its Efficacy
Funder
National Health and Medical Research Council
Funding Amount
$90,570.00
Summary
�I don�t want to sit here waiting to die�. Many people towards end of life want their palliative care to continue to be rehabilitative as well as supportive, yet no study to formally evaluate the effectiveness of a patient-centred palliative rehabilitation program has been conducted in Australia. This study aims to identify patient and carer-centred rehabilitation goals such as independence in self care, and develop, trial and evaluate a rehabilitation program to address these goals. The program ....�I don�t want to sit here waiting to die�. Many people towards end of life want their palliative care to continue to be rehabilitative as well as supportive, yet no study to formally evaluate the effectiveness of a patient-centred palliative rehabilitation program has been conducted in Australia. This study aims to identify patient and carer-centred rehabilitation goals such as independence in self care, and develop, trial and evaluate a rehabilitation program to address these goals. The program would be transfer stage conditions such as cancer, cardiac or renal failure.Read moreRead less