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.
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.
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
Does Aerobic Or Resistance Training Improve Walking Ability In Chronic Stroke Patients?
Funder
National Health and Medical Research Council
Funding Amount
$152,036.00
Summary
The majority of stroke patients discharged from rehabilitation are often housebound. The criterion which most often limits individuals with stroke from achieving 'community ambulation' is the inability to walk long distances. Current views suggest that an exercise program aimed at improving lower limb strength and aerobic fitness will improve walking ability in those stroke patients with mild to moderate disability. However, there are no reported studies that have rigorously investigated whether ....The majority of stroke patients discharged from rehabilitation are often housebound. The criterion which most often limits individuals with stroke from achieving 'community ambulation' is the inability to walk long distances. Current views suggest that an exercise program aimed at improving lower limb strength and aerobic fitness will improve walking ability in those stroke patients with mild to moderate disability. However, there are no reported studies that have rigorously investigated whether either of these approaches, singularly or combined, is effective for augmenting walking ability in chronic stroke patients. We will use a randomised, double-blinded controlled trial to determine which of strength training, aerobic training or a combination of the two is the most effective approach for improving walking endurance, measured by the 6-minute walk test, in individuals with mild-to-moderate stroke. In addition, we will determine the benefits of each program to subjects' cardiorespiratory fitness, lower limb strength, mobility and psychological function. Subjects will be randomly allocated to one of 4 groups: 1) Aerobic exercise (and sham strength training); 2); Strength training (and sham aerobic training); 3) Combined strength and aerobic training; and 4) Control (sham strength and aerobic training. Sham treatment for strength training is stretching and calisthenics, and for aerobic exercise is passive motorised cycling. All subjects will attend small group sessions for 10 weeks, with 3 sessions per week, and each session about 1 hour duration. The findings from this study are critical in identifying the most effective and efficient approach to improving stroke patient's walking endurance. Improvement in walking endurance will enable many persons following stroke to achieve the level of 'community ambulation'. Last, it will contribute to the 'evidence-based' scientific framework for treatment of stroke patients.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