A Network Of Sites And ‘up-skilled’ Therapists To Deliver Best Practice Stroke Rehabilitation Of The Upper Limb.
Funder
National Health and Medical Research Council
Funding Amount
$955,910.00
Summary
We aim, through our partnership, to bring better therapy to more stroke survivors. Effective therapies are available to improve hand function but survivors are not currently receiving these. We will systematically address this evidence-practice gap using knowledge-transfer methods to up-skill therapists and change practice behaviours. A network of sites and up-skilled therapists will deliver this therapy and sustain change. A template will guide future translational activities.
Randomised Controlled Trial Of Virtual Reality Therapy After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$452,264.00
Summary
Stroke is the second largest cause of disability in Australia. There is no cure, so patients must rely on therapy to restore movement. We want to make rehabilitation more effective. This study compares virtual reality game therapy (using the Nintendo Wii) to current best practice (constraint therapy). We anticipate patients will improve more with Wii therapy. Because it is fun, patients will enjoy therapy and spend longer training resulting in a greater recovery and better movement ability.
A-Prof Wheatley is a respiratory and sleep disorders physician investigating the pathogenesis, health consequences and management of sleep breathing disorders, including sleep apnoea and snoring.
Hedgehog Signalling In Limb And Craniofacial Development And Disease
Funder
National Health and Medical Research Council
Funding Amount
$494,544.00
Summary
Anomalies of the face and limbs are amongst the most common features of human birth defects, and their frequent association suggests that the same genes are involved in governing the development of the limbs and face during embryogenesis. We have used a genomics-based approach to identify genes involved in limb development based on their alteration in a mouse model which develops extra fingers and toes. Defects in this mouse result from changes in Gli3, a gene which is known to be important in b ....Anomalies of the face and limbs are amongst the most common features of human birth defects, and their frequent association suggests that the same genes are involved in governing the development of the limbs and face during embryogenesis. We have used a genomics-based approach to identify genes involved in limb development based on their alteration in a mouse model which develops extra fingers and toes. Defects in this mouse result from changes in Gli3, a gene which is known to be important in both limb and face development. Based on the organs in which our genes of interest are active, we believe that they will also play key roles in embryonic development of the limbs, face and other organs. We now plan to investigate the regulation of a subset of these genes based on analysis in mouse models of limb and face development. In addition, we have chosen to further analyse the function of a completely novel gene we have identified which our preliminary studies suggest may play a role in the normal development of the lip and palate. These studies have the potential to shed light on the processes governing how organs develop, as well as on the molecular basis of common birth defects such as polydactyly (extra fingers and toes) and cleft palate.Read moreRead less
Pressures Exerted On Upper Airway Walls By Surrounding Tissue Structures
Funder
National Health and Medical Research Council
Funding Amount
$426,500.00
Summary
The obstructive sleep apnoea syndrome (OSA) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSA effects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect of the pressure in the tissues surrounding the throat on the ability of the throat to stay open a ....The obstructive sleep apnoea syndrome (OSA) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSA effects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect of the pressure in the tissues surrounding the throat on the ability of the throat to stay open and allow breathing. The major outcome of the animal studies is increased knowledge concerning mechanisms whereby collapsing forces are applied to the upper airway. This will give insights into potential factors influencing upper airway collapse during sleep in OSA patients. Of particular importance will be our studies on the effects of jaw position on the pressure exerted on the walls of the throat since the use of an intra-oral device to hold the jaw forward during sleep is one of the treatments used to prevent throat blockage during sleep. The studies in humans will examine, for the first time, the notion that the mass (weight) of the neck has a direct effect on the severity of sleep disordered breathing. If neck mass has a substantive influence on sleep disordered breathing then strategies aimed at reducing neck mass (fat) may provide a new therapeutic approach to the management of OSA patients.Read moreRead less
The Role Of Snoring Vibrations In The Pathogenesis Of Early Carotid Artery Atherosclerosis
Funder
National Health and Medical Research Council
Funding Amount
$593,833.00
Summary
Habitual snoring is a very common problem in the adult population, with a prevalence of between 20-40%. Increasingly it is now recognised that snoring may be an independent risk factor for the development of stroke. In this proposal, we will explore the hypothesis that chronic snoring transmits a pressure wave through the tissues of the neck to the carotid artery which may damage the artery wall and subsequently lead to stroke. This may lead to new strategies to treat habitual snoring.
Hydrostatic Pressure Distributions In Peri-pharyngeal Tissues : Impact On Upper Airway Patency
Funder
National Health and Medical Research Council
Funding Amount
$508,935.00
Summary
The obstructive sleep apnoea hypopnoea syndrome (OSAHS) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSAHS affects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in ~4% of men over the age of 45 years. In the proposed studies we will develop a computer model of the function of the throat during breathing. A particular focus of our mo ....The obstructive sleep apnoea hypopnoea syndrome (OSAHS) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSAHS affects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in ~4% of men over the age of 45 years. In the proposed studies we will develop a computer model of the function of the throat during breathing. A particular focus of our model will be the influence of the properties of the tissue that form the walls of the throat. Our goal is to construct a computer model that will be useful in identifying specific features of throat function that make people susceptble to the development of OSAHS. In this manner we hope to provide a tool that can be used to develop new approaches to the treatment and prevention of OSAHS.Read moreRead less
Surface Tension Of Upper Airway Lining Liquid: Role In Obstructive Sleep Apnoea Hyponoea Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$494,833.00
Summary
The obstructive sleep apnoea hypopnoea syndrome (OSAHS) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSAHS affects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect that the liquid layer that lines the throat, has on the ability of the airway to st ....The obstructive sleep apnoea hypopnoea syndrome (OSAHS) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSAHS affects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect that the liquid layer that lines the throat, has on the ability of the airway to stay open during sleep. In particular we will examine whether coating the throat with a substance that decreases stickiness will help to prevent the occurrence of episodes of throat blockage during sleep in persons with OSAHS. We will also explore the role of saliva production and swallowing during sleep in maintaining a low stickiness of the throat and whether this liquid lining is abnormal in OSAHS patients. These studies will establish the potential usefulness of decreasing the stickiness of the liquid lining the throat as a treatment for OSAHS.Read moreRead less
The Role Of Respiratory And Upper Airway Neural Control In Sleep Disordered Breathing
Funder
National Health and Medical Research Council
Funding Amount
$346,018.00
Summary
Obstructive Sleep Apnea (OSA) is a disorder associated with snoring. It affects 4% of adult men and causes excessive daytime sleepiness leading to increased accidents, high blood pressure and premature cardiovascular disease eg. heart attacks and strokes. Patients with OSA obstruct the floppy portion of the upper airway (UA) during sleep and consequently experience frequent episodes of oxygen deprivation as well as sleep fragmentation. OSA is at least 2-3 times more common in men than women. Whi ....Obstructive Sleep Apnea (OSA) is a disorder associated with snoring. It affects 4% of adult men and causes excessive daytime sleepiness leading to increased accidents, high blood pressure and premature cardiovascular disease eg. heart attacks and strokes. Patients with OSA obstruct the floppy portion of the upper airway (UA) during sleep and consequently experience frequent episodes of oxygen deprivation as well as sleep fragmentation. OSA is at least 2-3 times more common in men than women. While OSA patients seem, on average, to have smaller upper airways than normal subjects, the cause of OSA cannot be attributed to this factor alone. For example, a small UA cannot explain the male tendency for OSA. Abnormalities in breathing control or the control of upper airway muscles that normally hold the airway open might also be important in OSA. Men have previously been shown to have a greater increase in UA resistance during sleep than women, consistent with the idea that a gender difference in UA muscle control partly explains why more men than women have OSA. We aim to investigate how changes in breathing and UA dilator muscle control might lead to unstable patterns of breathing and to OSA. We propose that protective UA muscle reflexes are reduced during sleep more in men than women, and are reduced by low blood oxygen levels and alcohol (a known aggravator of sleep apnea). We further propose that low blood oxygen levels not only result from OSA but may also aggravate OSA by preferentially reducing the activity of UA dilating muscles, by making breathing patterns overall less stable and by depressing the ability of subjects to arouse from sleep to an airway blockage. We believe that this tendency to decrease UA activity may be exaggerated in OSA patients. We also propose that men are more vulnerable to the deleterious effects of low oxygen than women. We will also examine if men and snorers have exaggerated breathing responses on arousal from sleep.Read moreRead less