Effectiveness Of Training Somatosensation In The Hand After Stroke: A Randomized Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$180,660.00
Summary
Stroke is a leading cause of death and disability, requiring provision of rehabilitation services to help minimize impairment and its impact on the ability to resume daily activities. The ability to feel textures and objects through touch and to know where one s limbs are in space are impaired in up to 85% of people who have suffered a stroke. People with this loss are handicapped by difficulties in exploring objects through touch and in performing everyday tasks that require grasp and manipulat ....Stroke is a leading cause of death and disability, requiring provision of rehabilitation services to help minimize impairment and its impact on the ability to resume daily activities. The ability to feel textures and objects through touch and to know where one s limbs are in space are impaired in up to 85% of people who have suffered a stroke. People with this loss are handicapped by difficulties in exploring objects through touch and in performing everyday tasks that require grasp and manipulation of objects. Yet clinicians are either not treating the problem or are using methods without a sound theoretical basis and controlled evidence to support their application. We have systematically investigated optimal methods of sensory training across different sensory abilities using a series of single-subject experiments. Marked improvement in the ability to discriminate trained and related untrained texture stimuli and limb positions was achieved and maintained in most participants. These findings have provided the foundation for development a scientifically based and clinically focused sensory retraining program that has apparently excellent therapeutic potential. The purpose of the proposed study is to test the effectiveness of this scientifically based, clinical sensory retraining program in a broad group of stroke clients using the internationally recommended randomized controlled group design. The program will train a range of functionally important sensory discrimination tasks, i.e. texture discrimination, limb position sense and tactual object recognition, in clinical and home environments. Demonstration of clinically important and statistically significant training effects will provide the evidence necessary to recommend the introduction of the program into routine health service delivery. Investigation of patient characteristics that may impact on the ability to benefit from training will assist in the targeting of services to appropriate individuals.Read moreRead less
Can unloading footwear improve clinical care of people with knee osteoarthritis? Osteoarthritis is a public health problem imposing major economic and personal burden. It is the fourth highest cause of morbidity in Australia and national health expenditure in 2007 was $2.03 billion. Footwear can reduce knee load which is linked to disease pathogenesis. Specially-designed unloading shoes will be evaluated in a clinical trial and biomechanical studies to determine their efficacy at reducing sympto ....Can unloading footwear improve clinical care of people with knee osteoarthritis? Osteoarthritis is a public health problem imposing major economic and personal burden. It is the fourth highest cause of morbidity in Australia and national health expenditure in 2007 was $2.03 billion. Footwear can reduce knee load which is linked to disease pathogenesis. Specially-designed unloading shoes will be evaluated in a clinical trial and biomechanical studies to determine their efficacy at reducing symptoms, mechanical mechanism of pain relief, patient sub-groups that best respond to treatment and whether combined treatment with medial arch supports changes knee biomechanics. Outcomes will impact clinical practice and relieve suffering of people with knee osteoarthritis. Findings will also guide future shoe developments for arthritis. Read moreRead less
HABIT-ILE: A Randomised Trial Of Hand Arm Bimanual Intensive Training Including Lower Extremity Training For Children With Bilateral Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$1,100,903.00
Summary
In Australia, 35,000 people have cerebral palsy, and between 60-70% experience difficulties with movement on both sides of their body. There are currently no effective interventions for children with bilateral CP to improve their ability to use their hands, walk and perform daily life tasks. We have promising data about a new intervention, called HABIT-ILE, which we will test in 80 children with cerebral palsy and compare results to usual care.
Affordable Technology To Improve Physical Activity Levels And Mobility Outcomes In Rehabilitation
Funder
National Health and Medical Research Council
Funding Amount
$1,465,653.00
Summary
Repetitive exercise is a crucial part of rehabilitation for people with impaired mobility but current exercise levels are insufficient for optimal outcomes. Affordable exercise-based video- and computer game technology could enable additional exercise for rehabilitation patients at a relatively low cost. We propose a randomised trial to establish the impact on physical activity and mobility of the addition of these technologies to usual care for people admitted to rehabilitation wards.
Many older people who fracture their hip do not recover to their previous level of function. This study will test whether it is possible to help recovery of function, particularly walking, after hip fracture by using different and more intensive physiotherapy treatment. The treatment will concentrate on exercise when standing, will be provided twice daily and will continue after the person with hip fracture has returned home. Four months after the hip fracture it is expected that walking ability ....Many older people who fracture their hip do not recover to their previous level of function. This study will test whether it is possible to help recovery of function, particularly walking, after hip fracture by using different and more intensive physiotherapy treatment. The treatment will concentrate on exercise when standing, will be provided twice daily and will continue after the person with hip fracture has returned home. Four months after the hip fracture it is expected that walking ability, strength and balance will be improved by the new treatment methods.Read moreRead less
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.
The flipside of noise: Does it benefit listening and learning? People with low attention capacity can experience improvements in cognitive function (eg memory) in the presence of external white noise. This project aims to determine the brain mechanisms for this improvement and how it affects oral language comprehension and verbal learning. In doing so, the research would change the prevailing view that noise is always detrimental to mental processes, and provide a theoretical framework for predi ....The flipside of noise: Does it benefit listening and learning? People with low attention capacity can experience improvements in cognitive function (eg memory) in the presence of external white noise. This project aims to determine the brain mechanisms for this improvement and how it affects oral language comprehension and verbal learning. In doing so, the research would change the prevailing view that noise is always detrimental to mental processes, and provide a theoretical framework for predicting how an individual’s cognitive capacity is affected by the presence of noise. It may support the development of methods to improve educational participation and outcomes for children, particularly those with lower attention, and for older adults.Read moreRead less
Stroke affects 1 in 6 Australians and often leads to lifelong disability. This Fellowship will support A/Prof Bernhardt to: 1) complete the world first, international clinical trial of very early rehabilitation for people with stroke (AVERT), which has the potential to reduce the global disability burden of this disease; 2) in a new acute exercise laboratory, complete studies that help refine existing early exercise interventions and 3) test new models of rehabilitation care that take advantage ....Stroke affects 1 in 6 Australians and often leads to lifelong disability. This Fellowship will support A/Prof Bernhardt to: 1) complete the world first, international clinical trial of very early rehabilitation for people with stroke (AVERT), which has the potential to reduce the global disability burden of this disease; 2) in a new acute exercise laboratory, complete studies that help refine existing early exercise interventions and 3) test new models of rehabilitation care that take advantage of advanced e-health capability.Read moreRead less
A sound start: innovative technology to promote speech and pre-literacy skills in at-risk preschoolers. One in five Australian preschoolers have speech impairment and without specialist services face an increased risk of reading difficulties and life-long consequences. Given that demand for services exceeds supply, this project will determine if a preschool computer-based service can promote speech development and reduce risk of reading difficulty.
Randomised Controlled Trial Of Stretching For Contracture After Ankle Fracture
Funder
National Health and Medical Research Council
Funding Amount
$55,220.00
Summary
Restricted ankle motion (contracture) commonly occurs after cast immobilisation following ankle fracture. The prevalence of contracture could be as high as 77% immediately following cast removal. This interferes with tasks such as walking and stair climbing, and can result in significant disability. While physiotherapists regularly treat contracture after ankle fracture, the efficacy of specific treatment programs has not been established. This project aims to determine the effectiveness of two ....Restricted ankle motion (contracture) commonly occurs after cast immobilisation following ankle fracture. The prevalence of contracture could be as high as 77% immediately following cast removal. This interferes with tasks such as walking and stair climbing, and can result in significant disability. While physiotherapists regularly treat contracture after ankle fracture, the efficacy of specific treatment programs has not been established. This project aims to determine the effectiveness of two commonly used stretching programs for contracture after ankle fracture initially treated with cast immobilisation. Stretches of short and long duration will be compared to a no stretch condition. The study will determine the effects of these interventions on ankle flexibility, ability to perform everyday tasks (eg, walking), self-ratings of disability and pain.Read moreRead less