Recovery and rehabilitation following stroke


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.


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

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

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

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

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

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

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

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

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.

What else is happening in Stroke research at NeuRA?