Clinical studies


Investigators: Dr AM Vallence, Prof KD Hill, A/Prof C Etherton-Beer 2016/17

Title: Strengthening functional connectivity in the motor system to reduce falls following stroke.

Area of Relevance: Brain injury; stroke

Stroke is associated with increased falls and fall-related injury. Functional connectivity between cortical motor areas is critical for the execution of appropriate motor responses, like walking and balance tasks, which ultimately enable successful interaction with the environment. We will use novel non-invasive brain stimulation to characterise and strengthen functionally relevant connections between brain areas important for movement control in chronic stroke patients, and test whether strengthening these cortical connections improves balance and gait. Identifying the mechanisms of movement deficits leading to falls in stroke patients will allow the development of targeted, evidence-based interventions to improve movement recovery in this population.

 

Investigators: Prof S Dunlop, Mr P Woodland, Dr P Batchelor, Ms L Goodes, Mr S Rao, Mr D Brink 2016/17

Title: CODE SPINE – Enabling the ‘ICED’ clinical trial for acute spinal cord injury in WA.

Area of Relevance: Traumatic spinal cord injury

Traumatic SCI in WA has recently doubled to around 80 pa and is twice the national average. Although early decompression is increasingly recognized as beneficial, it is difficult to achieve, but recent data suggest that hypothermia can “buy time”. Recent feasibility studies conducted by us prior to ‘ICED’ (a randomised controlled trial [RCT] of ‘Immediate Cooling & Early Decompression’) have revealed that ethical and governance processes are highly complex and time-consuming yet must be finalized prior to the trial itself. Here, we investigate barriers and facilitators to implementing ICED in WA so as to ensure successful progress to the full trial.


Investigators: A/Prof M Rosenberg, Dr A Vallence, A/Prof J Rodger, Dr A Shaykevich 2015/16

Title: A tailored music therapy and real-time bio feedback mobile phone app to promote motor rehabilitation following neurotrauma
Area of relevance: Traumatic brain injury

The use of music therapy to improve recovery of movement following neurological injury is gaining momentum; however, progress in the field is limited by the separation of music and feedback about movement in relation to the music. The investigators have developed a novel Mobile Software Application (App) that uses mobile phones and wireless wearable sensors to deliver music therapy to patients with real-time bio-feedback. In this study the investigators will test the effect of the App on motor performance and brain function in people with brain injuries from motor vehicle accidents. The App is simple, cheap, and self-administered, increasing motivation and compliance.

 

Investigators: A/Prof L Fitzgerald, Fatovich, Pestell

Title: Identification of biomarkers that correlate with clinical features and outcomes following concussion
Area of relevance: Traumatic brain injury, concussion

Following a mild traumatic brain injury (mTBI) or concussion, most patients symptoms resolve within a few days to weeks. However, a small but significant proportion develop debilitating post-concussion syndrome (PCS). Currently it is not possible to determine who will develop PCS. This study will use specialized imaging, neuropsychological tests and measurement of blood biomarkers at the time of presentation to hospital and again 28 days later. The aim is to identify indicators to predict if mTBI will develop into PCS. In future, patients showing these indicators would then be identified as likely to benefit from follow-up care and could be targeted for therapeutic interventions.

 

Investigators: Prof S Dunlop, Ms L Goodes, Ms A Watts, Ms C Hartshorn, Dr L D’Orsogna, A/Prof J Buchanan, A/Prof P Boan, A/Prof C Heath, Dr J Thavasselan, Dr D McLellan,  Dr P Bragge, Dr A Nunn, A/Prof J Brock, Dr J Middleton, Mr M Rawlins  2015/16

Title: Urinary tract management and infection control after spinal cord injury
Area of relevance: Spinal cord injury

Secondary urinary tract infection (UTI) is common following spinal cord injury (SCI). Early, frequent UTIs are debilitating, often leading to chronic bladder and renal problems. Protocols for urinary tract management differ at Australian Spinal Units and the association between protocols and infection incidence is unknown. This project is part of a national initiative to optimise bladder health following SCI, and involves three components: evidence review to determine best practice; an audit to determine current practices and urinary infection incidence in acute SCI in Western Australia; and an exploration of barriers and facilitators to improving practice. Findings will be incorporated into national guidelines for optimising post-SCI bladder management.


Investigators: Professor S Dunlop, Dr P Batchelor, Assoc Prof J Buchanan, Prof G Allison, Dr I Mosely, Ms E Eady 2013/14

Title: Determining the reliability and validity of a brief paramedic neurological assessment
Area of relevance: Spinal cord injury

Traumatic spinal cord injury involves bony fragments pressing on the spinal cord which cause damage due to pressure, swelling, oedema and biochemical events. This results in progressive destruction of tissue and life-long paralysis. Decompression surgery removes bony fragments, relieving the pressure and minimising tissue damage, and surgery within 4-24 hours can improve functional outcome. However, surgery can take 1-3 days to organize and tissue destruction continues unabated, this is particularly a problem for patients in rural and remote areas. Intravenous cooling is a way of cooling the spinal tissue to reduce the rate of damage to tissues and to buy time to implement treatment strategies. This project looks at a protocol for rapid assessment of neurological function that can be performed by paramedics at the time of injury. This will provide baseline data prior to cooling and surgery, and assessment of long term functional recovery.

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