Research Grants 2009

The National Stroke Foundation has awarded four research grants to further research into rehabilitation or quality of life after stroke as the first step in its research program. The four grants were awarded from a field of high quality submissions, to the following people: 

Basic Science Grant

• Dr. Damien McLeod – University of Newcastle, NSW
  Establishing computed tomography perfusion (CTP) imaging in an animal stroke model.

CT perfusion imaging has huge potential to improve stroke patient selection for acute therapies such as thrombolysis (clot-dissolving). Our pilot studies have determined that our rat stroke model is suitable for CTP imaging – a world first. We aim to correlate CTP imaging findings with the degree of subsequent brain injury.

• Ms Christine Barry – University of Adelaide
  Novel therapeutic approaches to subarachnoid haemorrhage targeting substance P.

Subarachnoid haemorrhage is a stroke that results in a bleed into the space surrounding the brain.
The average age of victims is 49 and in over half of all cases death or severe disability will result.
This study will develop a new drug therapy that may limit the brain swelling and associated damage
that follows.

Quality of Life Grant

• Ms Yasmeen El Masry – University of Sydney, NSW
  
  
• Lin Perry – University of Newcastle, NSW
  What difference does a stroke nurse make? A feasibility study for investigation of relationships
  between nurse staffing and stroke patient outcomes.

Patients admitted to Stroke Units recover better than those treated elsewhere; specialist staffing may be part of the reason. Hospital studies have shown that generally people do better when wards are better staffed with nurses. There is no clear information to show how many nurses should be on duty each shift in Stroke Units but many international studies suggest ways to calculate patient benefit in terms of staffing levels.

This study will collect information about Stroke Units across Australia. It will test whether routinely collected information is adequate, or whether such a project will need dedicated data collection. We will test out methods for 3 months in two Stroke Units, in Newcastle and Maitland.

We will survey nursing staff and extract information from patient notes, and compare this to information that is routinely collected electronically for stroke patients. This will show us the best way to get the information we need for a full scale study to demonstrate relationships between nurse staffing and patient outcomes, with the ultimate aim of informing nurse staffing recommendations for Stroke Units.

• Mark McKay – Royal Children’s Hospital, and Murdoch Children’s Research Institute, Melbourne
  Developing strategies to decrease lag time to diagnosis in paediatric stroke.

Stroke is among the top ten causes of death in children and it a major cause of disability. There is good evidence that medications to dissolve clots improve outcome if given within 3 hours of stroke onset. Less than 10% of adults present within 3 hours but the situation is far worse in children because stroke symptoms are under-recognised. A recent study at the Royal Children’s Hospital (RCH) found that median time to stroke diagnosis was 29 hours.

Strategies need to be developed to reduce time to diagnosis by improving knowledge of stroke symptoms amongst parents, general practitioners and paediatricians. The purpose of this study is to identify reasons for delayed presentation to hospital and to identify useful signs or symptoms to discriminate stroke from other brain problems. Parents of children recruited to RCH Registry will be interviewed and medical charts will be reviewed. A 12 month audit of children presenting to RCH with brain attacks will be performed to define the scope of conditions mimicking stroke.

This project will inform development of a stroke clinical pathway to enable rapid triage, medical assessment and neuroimaging to increase likelihood of children receiving thrombolytic treatment to reduce long term disability.

• Dr. Maarten A. Immink – University of South Australia
  A yoga and meditation program to improve physical function, mood and quality of life in individuals with chronic stroke-related hemiparesis.

The aim of this study is to be an initial investigation into the effects of a 12 week yoga and meditation program on movement ability, improved mood and self-reported quality of life with individuals who have suffered a stroke. There are two previous studies which suggest yoga-based activity programs may be of benefit for stroke survivors but these studies have had quite small sample sizes, which prevent any firm conclusions.

Adapted physical activity programs, involving similar movements to yoga, have been shown to improve mobility and quality of life in post-stroke individuals. In addition, there is some indication that yoga and meditation may benefit depression. Movement function, mood and quality of life will be measured for 15 participants before and after a 12 week yoga and meditation program, involving both instructed group classes and home practice.

These results will be contrasted against a 15 participant wait listed control group. If findings are consistent with previous preliminary research support for yoga and stroke, then this study may be able to provide a stronger case for undertaking a larger scale collaborative project with support from an Australian research funding agency.

Clinical Research Development Grant

• Kylie Bower – Princess Alexandra Hospital, Queensland
  Teaching people to manage the ongoing recovery of their stroke-affected arm.

Honour Grants

• Joyce Chan – La Trobe University, VIC
  Are functional outcome measures sensitive to change following Botulinum Toxin injections in adults with lower limb spasticity?

The effect of botulinum toxin injection on walking ability following stroke is unclear. This study will investigate whether three commonly used tests can detect important changes in walking following botulinum toxin injection. Our results will help to identify the benefits of this important treatment in people who have had a stroke.

• Mr. Weili Chan - University of South Australia
  ‘Yoga and Meditation as an Adjunct to Stroke Exercise Rehabilitation’.

This project will investigate the outcomes of supplementing a stroke exercise rehabilitation program with yoga and meditation. As stroke is associated not only with physical impairments but also mood disorders, yoga and meditation may enhance exercise related benefits through education of methods to manage stress and promote positive mood states.

• Alison King – University of Sydney, NSW
  Low levels of patient activity can limit rehabilitation outcomes after stroke.

This project aims to describe the time use and activity levels of inpatients in a Sydney stroke rehabilitation unit. Using a behaviour map, allied health and nursing staff will observe participants over 4 days, between 07.00h and 19.00h, as the initial stage
in an ongoing quality improvement process.

• Tom Lillicrap - ANU
  Testing the efficacy of Intravascular Cooling for reducing the temperature of Penumbra tissue after acute ischaemic stroke.

There is extensive experimental evidence in animal models to suggest that moderate hypothermia (approximately 33 degrees C) can reduce the extent of neuronal damage after ischaemic stroke.  Hypothermia has been used for traumatic brain injury, and ischaem

• Katherine McGurth – Edith Cowan University
  Young Stroke Survivors' Experiences of Peer Support.

A young person who experiences a stroke is faced with a unique set of challenges related to factors such as a developing self concept, and employment, study and parenting commitments.  This study will investigate the experience of being a young stroke survivor, their perceptions of available peer support and preferences for potential services.

• Aisling Ryan – University of Queensland
  Measuring outcomes in people who have had a stroke: can the telephone be used?

There is little guidance in the literature as to whether the telephone administration of outcome measures for people who have had a stroke is as reliable as face-to-face administration. This study will determine the equivalence reliability of telephone and face-to-face administration for various outcome measures that can be used with people who have had a stroke and their carers.

• Jacinta Spitzer – La Trobe University, VIC
  Relationship between performance and participation measures post-stroke.

The aim of this project is to investigate the relationship between performance outcomes, quality of life, mood and participation in daily activities in chronic stroke survivors.  Performance outcomes will include measures of sensory, motor, planning and memory functions. Participation in household, social/educational and leisure domains will be quantified using the Activity Card Sort.

• Amelia Tomkins – University of Newcastle, NSW
  Brain allopregnanolone levels in response to stroke.

Allopregnanolone is made in brain from progesterone. Preliminary studies demonstrate that allopregnanolone may reduce damage within the brain caused by stroke. I aim to quantify allopregnanolone within stroke regions of brain using gas-chromatography mass-spectroscopy techniques. This will determine normal brain response to stroke and potential benefits of early treatment with synthetic allopregnanolone.

• Andrew Biviard – University of Newcastle, NSW
  Defining the extent of irreversible brain ischaemia in acute middle cerebral artery occlusion using perfusion computed tomography.

By defining the infarct core using both MRI and perfusion CT (CTP) imaging, a comparative analysis can be undertaken in order to appreciate whether CTP can reliably distinguish between reversible and irreversible ischemia.

• Isobel Hubbard
  A functional MRI study of upper limb therapy in community dwelling stroke survivors.

View Research Grants 2008