Effective Strength Training For Walking In Neurological Rehabilitation
Funder
National Health and Medical Research Council
Funding Amount
$175,303.00
Summary
Muscle weakness is the cause of walking problems following neurological problems such as stroke and brain injury. Many studies have used strengthening exercises but few have benefitted. It appears that clinicians have been strengthening the wrong muscle groups and have not used exercises that stimulate the muscles to work the way they do when walking. The aim of this project is to use well established biomechanical and strengthening guidelines to improve walking after neurological injury.
A Trial Of Prehospital Rapid Sequence Intubation In Patients With Severe Head Injury
Funder
National Health and Medical Research Council
Funding Amount
$311,000.00
Summary
In Australia, major trauma is a leading cause of death in people between the ages of one and 44 years. In addition to mortality, there is a high morbidity rate and quality adjusted life-years lost from injury is vast. In broad terms, major trauma is defined as those injuries with the highest severity, requiring time critical medical care. Over 10% of major trauma patients have a severe head injury and approximately 40% of these patients die and another 40% have significant long-term morbidity. F ....In Australia, major trauma is a leading cause of death in people between the ages of one and 44 years. In addition to mortality, there is a high morbidity rate and quality adjusted life-years lost from injury is vast. In broad terms, major trauma is defined as those injuries with the highest severity, requiring time critical medical care. Over 10% of major trauma patients have a severe head injury and approximately 40% of these patients die and another 40% have significant long-term morbidity. Following severe head injury, it is common for patients to have decreased oxygen levels and this is associated with a significant increase in brain damage. To prevent or treat this, patients with severe head injury require endotracheal intubation (a tube is placed in the airway to provide oxygen to the patient) as soon as possible following injury. However, in most patients with severe head injury, endotracheal intubation requires the use of drugs to facilitate placement of the endotracheal tube. The usual technique involves the administration of both a sedative drug and an appropriate muscle-relaxant. This technique is known as rapid sequence intubation (RSI). However, it is unknown whether RSI should be undertaken by paramedics early after injury or be delayed until arrival at the hospital. Since better evidence of improved outcome is required to justify the possible risk and considerable expense of training ambulance paramedics in the skill of RSI, it is proposed that a randomized, controlled trial of RSI in adults with severe head injury be conducted. This trial will compare rapid sequence intubation with standard airway management (no intubation) by ambulance paramedics for major trauma patients with severe head injury. This study will assess differences in patient outcome at 6-months post injury. The study will involve head injury patients treated by paramedics in Victoria.Read moreRead less
Changes In Motoneurone And Motor Axon Properties Distal To The Lesion In Stroke
Funder
National Health and Medical Research Council
Funding Amount
$367,530.00
Summary
Following a stroke, adaptive changes occur in spinal cord motoneurones below the level of the stroke, but these are poorly understood. Apart from the exaggeration of spinal reflexes, distal changes have largely been neglected by clinicians. Even the mechanisms responsible for the exaggeration of spinal reflexes are still debated, in part because no single process can account for it. Using novel experimental techniques originally developed to study biophysical properties of human peripheral nerve ....Following a stroke, adaptive changes occur in spinal cord motoneurones below the level of the stroke, but these are poorly understood. Apart from the exaggeration of spinal reflexes, distal changes have largely been neglected by clinicians. Even the mechanisms responsible for the exaggeration of spinal reflexes are still debated, in part because no single process can account for it. Using novel experimental techniques originally developed to study biophysical properties of human peripheral nerves, this project will quantify the changes in excitability that occur in motoneurones and their peripheral extension, the motor axon, and compare these with the findings on the non-paralysed side of the same patients and with healthy matched control subjects. The changes that occur over time will be documented in longitudinal studies. The findings will be correlated with the patient's clinical status, providing insight into the extent to which changes in motoneurone properties drive clinical manifestations such as spasticity. In addition, control studies will provide further insight into whether disturbed transmission in some specific spinal reflex pathways contributes significantly to spasticity. The project is important for understanding the nature of adaptive changes (plasticity) in neural structures following lesions in the central nervous system and will shed light on the remote changes that occur in stroke. The studies are relevant not only for understanding current deficits but also for understanding and perhaps altering outcomes using rehabilitation procedures.Read moreRead less
Studies On Induction Of Antigen Specific T Regulatory Cells To Control Autoimmunity
Funder
National Health and Medical Research Council
Funding Amount
$353,033.00
Summary
The immune system has natural control mechanisms, called regulatory cells. Our group was the first in the world to correctly identify these cells. There is now a world-wide interest in these cells as they can prevent unwanted immune mediated injury. In autoimmune diseases such as multiple sclerosis, regulatory cells can prevent relapse and progression. This project will identify ways of producing potent specific regulatory cells to control multiple sclerosis and other debilitating neurological d ....The immune system has natural control mechanisms, called regulatory cells. Our group was the first in the world to correctly identify these cells. There is now a world-wide interest in these cells as they can prevent unwanted immune mediated injury. In autoimmune diseases such as multiple sclerosis, regulatory cells can prevent relapse and progression. This project will identify ways of producing potent specific regulatory cells to control multiple sclerosis and other debilitating neurological diseases.Read moreRead less