Stroke

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Recovery and rehabilitation following stroke

WHAT WE KNOW

Over 60,000 Australians suffer a stroke every year, making it the second most common cause of disability in Australia. More than half of those who survive a stroke require help with normal daily activities.

There is no cure for stroke, nor any forthcoming. Rehabilitation is the only method to recover movement of stroke-affected limbs.

Our research focuses on the recovery of movement after stroke. We are currently setting up a project to test the delivery of rehabilitation therapy via high speed broadband to people in regional and remote parts of Australia. We are also making detailed assessments of stroke patients before and after rehabilitation that will allow us to predict which patients will benefit most from therapy.

More information

OUR LATEST RESEARCH

Investigations into the firing behaviour of human motoneurones in health and after neurological inju


PROFESSOR JANE BUTLER, PROFESSOR SIMON GANDEVIA, DR ANNA HUDSON

This basic science project aims to examine the behaviour of human motoneurones during sustained activation to reveal their mechanisms of recovery after activation. We will take the fundamental findings from this study and compare the behaviour of motoneurones innervating muscles affected by neurological injury such as spinal cord injury and stroke.

The physiology of improved functional movement with Wii therapy


DR PENELOPE MCNULTY

Successful rehabilitation after stroke is limited by many factors including trained personnel, equipment, time and money.

One of the biggest impediments in rehabilitation is patient compliance and motivation. We have developed a novel rehabilitation strategy using the Nintendo Wii that is fun, cheap, and can be used in patients’ homes. This intense but flexible program can be adapted to individual patient’s needs and can be use for patients with good upper limb function and those with poor function.
Now that we know Wii therapy works, we need to understand how and why it works. This will allow us to further refine and develop Wii therapy so that more patients can benefit from post-stroke rehabilitation.

Improving rehabilitation after stroke


DR PENELOPE MCNULTY

Every year more than 60,000 Australians suffer a stroke and this number will only increase with the aging population the growing epidemics of obesity, physical inactivity and diabetes.

Because there is no cure for stroke, the only method to improve functional movement is through rehabilitation. But we need to understand how rehabilitation works, and which patients will benefit most.
We are studying patients who have weakness on one side of their body 3-12 months after a single stroke. We are comparing a new and promising strategy, Wii therapy, against the current best practice – constraint induced movement therapy in a randomised control trial.
Both therapies have been shown to improve upper limb functional movement after an intense 2 week program of rehabilitation.

Changes in muscle drive as a function of age


DR PENELOPE MCNULTY

Measuring how well people can drive their muscle to produce maximum forces tells us a lot about the voluntary control of movement. We know that muscle strength decreases as people get older, particularly after the age of 70. Despite the loss of strength, the ability to drive muscles in maximum efforts does not deteriorate with age.

This study investigated why this might be so. It also provides normative values in healthy older people that can be used when deciding rehabilitation goals after stroke.

Changes in motor control after stroke


DR PENELOPE MCNULTY

Very little is known about the way in which the body controls voluntary movement changes after stroke, or which neurophysiological structures cause such changes.

Our series of studies will investigate how stroke patients control low-level voluntary force; how well they can drive their muscles to produce force; and how the command signal from the brain to move the body is altered in the spinal cord.
We will also study muscle and nerve function in the upper limb. we will repeat these studies after rehabilitation so that we can determine how the body works to recover functional movement and if we can identify which patients will benefit most from rehabilitation.

Age related sensorimotor changes in the hand


DR PENELOPE MCNULTY

Skin sensation, or the ability to detect contact on the skin, declines with age. Manual dexterity and fine motor control of the hand also decline with age.

In this study we have made an extensive survey of the sensation in the hand using multiple tools and up to 10 testing sites in people aged from 20-90. We also looked at the properties of the skin, manual dexterity and strength, all in the same group of subjects.
Although sensation has been studied before, the detailed approach of this study has shown the pattern of changes is much more complex than previously thought.

Koori Growing Old Well Study


REBECCA MANN, DR KYLIE RADFORD, PROFESSOR G A (TONY) BROE AM, TERRY DONOVAN, ALISON TIMBERY, LOUISE LAVRENCIC, DR WENDY ALLAN, SHARON WALL, HANNAH DERRIG, MADELEINE NICHOLS, PROFESSOR KIM DELBAERE

The primary aim of a proposed longitudinal study is to find the reasons for the high dementia rates (three times non-Indigenous rates) in urban/regional Aboriginal people.

Somatotopic mismatch of hand representation following stroke


DR INGVARS BIRZNIEKS

We have developed a testing technique that enables us to identify various distortions of somatotopic representation after stroke that are not detected by routine clinical testing and remain unknown to patients themselves. This indicates the need to raise awareness about this pathological condition and identify patients who would potentially benefit from sensory rehabilitation. We suggest that new rehabilitation strategies need to be developed specifically for such patients.

TEAM LEADERS IN STROKE

DR PENELOPE MCNULTY Research Fellow & Group Leader OSMR Career Development Fellow Conjoint Lecturer, School of Medical Sciences, UNSW

PROFESSOR ROB HERBERT Senior Principal Research Fellow, NeuRA Principal Research Fellow, NHMRC Conjoint Professor, School of Medical Sciences, UNSW

PROFESSOR SIMON GANDEVIA Deputy Director and Foundation Scientist, NeuRA Senior Principal Research Fellow, NHMRC Conjoint Prof, UNSW

DR INGVARS BIRZNIEKS Senior Research Fellow, NeuRA Senior Lecturer, Physiology, School of Medical Sciences, UNSW Medicine Adjunct Fellow, School of Science and Health, UWS

What else is happening in Stroke research at NeuRA?

FEEL THE BUZZ IN THE AIR? US TOO.

Episode 11: Wii-based Movement Therapy is being used at NeuRA to aid stroke recovery

The new issue of the NeuRA Magazine (#18) will arrive in people’s letterboxes this week, but if you haven’t yet signed up for it, or would prefer to read the digital version, you can go here. The issue explores in further detail the new study from Assoc Prof Olivier Piguet’s group, which has confirmed what many anecdotal stories had previously […]

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NeuRA BLOG: New issue of NeuRA Magazine out now

You don’t expect a stroke to strike at age 35, but...

...on a long flight to visit family and with two toddlers by her side, this is exactly what happened to Dana Can you even begin to image how frightening it must have been for Dana and her two children? Around a third of stroke victims (20% of which are younger than 60 years) will die within a month. Another third will survive with mild to minor long-term effects, and the final third are like Dana - they survive, but with a moderate to serious disability and life is never the same again. Traditional rehabilitation is arduous, painstakingly slow and worst of all, improvement may be very small. NeuRA has pioneered a revolutionary new program that gives stroke victims control of their limbs again - and incredibly, it’s based on the use of a video game unit called a Nintendo Wii! But before we can roll out the incredible Wii-based Movement Therapy across Australia, we need your help to fund further research that will help us understand some of the more complex science (like what neurophysiological mechanisms make it work so well), so we can carefully tailor the program to each patient. Please donate today, to help someone like Dana hold their children's hands once more.
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NeuRA Announces 2018 International Motor Impairment Conference in Sydney, Australia

Investigations into the firing behaviour of human motoneurones in health and after neurological injury

This basic science project aims to examine the behaviour of human motoneurones during sustained activation to reveal their mechanisms of recovery after activation. We will take the fundamental findings from this study and compare the behaviour of motoneurones innervating muscles affected by neurological injury such as spinal cord injury and stroke.
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