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.
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 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
Prediction Of Oral Appliance Treatment Outcome In Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$280,200.00
Summary
Obstructive sleep apnoea (OSA) is a very common disorder, affecting approximately 2% of women and 4% of men in the middle-aged workforce . It is characterised by repetitive, complete or partial closure of the throat passage during sleep, resulting in sleep disturbance and low oxygen levels. OSA is recognised as a serious public health problem. There is growing evidence supporting the use of oral appliances to treat OSA. It is thought that these work by enlarging the throat passage, but this rema ....Obstructive sleep apnoea (OSA) is a very common disorder, affecting approximately 2% of women and 4% of men in the middle-aged workforce . It is characterised by repetitive, complete or partial closure of the throat passage during sleep, resulting in sleep disturbance and low oxygen levels. OSA is recognised as a serious public health problem. There is growing evidence supporting the use of oral appliances to treat OSA. It is thought that these work by enlarging the throat passage, but this remains uncertain. The aim of this project is to gain a better understanding of how such appliances work, so as to be able to predict which patients will particularly benefit from this form of treatment.Read moreRead less
Novel Neuromechanical Measurements Of The Human Upper Airway In Health And Disease
Funder
National Health and Medical Research Council
Funding Amount
$543,728.00
Summary
Obstructive sleep apnea (OSA) is a common condition, in which the upper airway repeatedly collapses during sleep, causing the oxygen concentration in the blood to drop, carbon dioxide to rise, and the person to arouse in order to re-establish adequate oxygen supply. Consequences of OSA include increased daytime sleepiness, increased risk of accidents, and increased risk of cardiovascular diseases. It most commonly affects middle-aged males, but is also seen in the broader population. OSA is asso ....Obstructive sleep apnea (OSA) is a common condition, in which the upper airway repeatedly collapses during sleep, causing the oxygen concentration in the blood to drop, carbon dioxide to rise, and the person to arouse in order to re-establish adequate oxygen supply. Consequences of OSA include increased daytime sleepiness, increased risk of accidents, and increased risk of cardiovascular diseases. It most commonly affects middle-aged males, but is also seen in the broader population. OSA is associated with obesity and specific shapes of the upper airway and facial structure. These anatomical factors can be compensated for while awake but inadequate activity of the muscles surrounding the upper airway during sleep contributes to an increased predisposition of the airway to collapse. Airway collapse occurs when the muscles are unable to withstand the low pressures in the airway and collapse, obstructing the airway. This project will measure the stiffness and motion of the muscles surrounding the airway, in healthy people and those with OSA, to determine how these influence airway collapsibility. We will use two novel non-invasive Magnetic Resonance Imaging (MRI) techniques, MR Elastography, and MR tagging which will allow us to quantify the airway stiffness, or elasticity, and its motion (deformation). These will be the first direct measurements of the upper airway elasticity and deformation in humans. We will also measure how various treatments, such as CPAP therapy and mandibular advancement affect airway elasticity and deformation, so that their mechanisms can be better understood. This may also explain why some patients do not benefit from these therapies. These studies may lead to new diagnostic and treatment modalities, as well as gaining important insights into the basic mechanisms of airway collapse in humans.Read moreRead less
The Role Of SOX14 In Limb Development And Human Limb Defects.
Funder
National Health and Medical Research Council
Funding Amount
$257,606.00
Summary
Little is known about the mechanisms that control limb development. We have discovered a new gene which is active in the developing limb of the embryo. This study will provide information on how this new gene controls the development of the limb. Limb defects occur in 1 in 1,000 new-born babies. We believe the absence of our newly discovered gene may be responsible for some of these limb defects. Ultimately, this fundamental knowledge may lead to improved pre-natal diagnosis and better treament ....Little is known about the mechanisms that control limb development. We have discovered a new gene which is active in the developing limb of the embryo. This study will provide information on how this new gene controls the development of the limb. Limb defects occur in 1 in 1,000 new-born babies. We believe the absence of our newly discovered gene may be responsible for some of these limb defects. Ultimately, this fundamental knowledge may lead to improved pre-natal diagnosis and better treament for limb abnormalities.Read moreRead less
Dissecting The Role Of Hedgehog Signalling In Chondrogenesis And Skeletal Disease
Funder
National Health and Medical Research Council
Funding Amount
$408,739.00
Summary
There are close to 400 inherited disorders that affect how the skeleton develops, as well as a range of injury and age-related skeletal defects. There is much interest in treating such abnormalities with artificial bone grown outside the body. In order to achieve this aim we must understand all of the processes involved in producing and maintaining bone within the body. We are using both mouse and cell culture models of skeletal development to increase our understanding of these processes.
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
Factors Determining Collapsibility Of The Human Upper Airway During Sleep And General Anaesthesia
Funder
National Health and Medical Research Council
Funding Amount
$259,625.00
Summary
Obstructive sleep apnoea (OSA) is common, affecting between 2-4% of middle-aged adults. It is characterised by repetitive partial or complete collapse of the upper airway during sleep. Each episode is accompanied by transient hypoxemia, hypertension and arousal. The repetitive arousals disrupt sleep resulting in excessive daytime tiredness and lethargy, which have major consequences for social well-being and productivity in our community. OSA is an independent risk factor for vascular disease. C ....Obstructive sleep apnoea (OSA) is common, affecting between 2-4% of middle-aged adults. It is characterised by repetitive partial or complete collapse of the upper airway during sleep. Each episode is accompanied by transient hypoxemia, hypertension and arousal. The repetitive arousals disrupt sleep resulting in excessive daytime tiredness and lethargy, which have major consequences for social well-being and productivity in our community. OSA is an independent risk factor for vascular disease. Central to understanding OSA is knowledge of the mechanisms responsible for vulnerability to upper airway collapse. It remains unclear to what extent this vulnerability relates to abnormalities in the underlying structure and passive physical characteristics of the upper airway, versus abnormalities in activity of upper airway muscles. Making this distinction has been problematic because current methods of testing upper airway collapsibility in sleeping humans tend to result in changes in muscle activity and-or sleep state, affecting the measurements. It is, however, possible to suppress upper airway muscle activity and eliminate measurement-related changes in muscle activity and state with general anaesthesia, while maintaining normal spontaneous breathing. We have developed and refined this method and propose to use it in novel investigations to (a) relate the behaviour of the flaccid airway (no muscle activity) under anaesthesia to its behaviour during sleep (when muscle activity is variable but quantifiable), and (b) determine the effect of changes in body habitus (posture and lung volume) on airway collapsibility. These studies will allow examination of the exciting possibility that measurements made under brief general anaesthesia could be used to define propensity to obstruction during sleep. They will also allow examination of the contribution of common changes in body habitus toward vulnerability to upper airway collapse.Read moreRead less
Mechanisms Of Pharyngeal Collapse In Obstructive Sleep Apnoea Defined By Optical Coherence Tomography
Funder
National Health and Medical Research Council
Funding Amount
$476,764.00
Summary
Obstructive sleep apnoea is characterised by intermittent collapse of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and sleep disruption. Obstructive sleep apnoea is common, affecting 5% of middle-aged adults, and is associated with worsening health, increased motor vehicle accidents and increased risk of heart disease. However the mechanisms responsible for obstructive sleep apnoea are not well understood. One reason for this lack of ....Obstructive sleep apnoea is characterised by intermittent collapse of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and sleep disruption. Obstructive sleep apnoea is common, affecting 5% of middle-aged adults, and is associated with worsening health, increased motor vehicle accidents and increased risk of heart disease. However the mechanisms responsible for obstructive sleep apnoea are not well understood. One reason for this lack of understanding is that current diagnostic techniques can not accurately measure changes in the size and shape of the upper airway during sleep. Such information is vital for the accurate diagnosis and treatment of obstructive sleep apnoea. This project proposes to use a technique called endoscopic optical coherence tomography (eOCT), recently developed by ourselves, to measure the changes in upper airway size and shape in patients with obstructive sleep apnoea during wakefulness and, importantly, during sleep. A prototype of the system has been developed. Preliminary in vivo studies have been performed in the human upper airway and the results from these preliminary trials have been published. To our knowledge, world-wide, this is the only such system capable of making these measurements. The studies proposed in this application will provide a better understanding of the mechanisms underlying obstructive sleep apnoea and may lead to the development of greatly improved and more specific treatments that are tailored to the exact needs of the individual patient.Read moreRead less