Current Neurology Research Projects
See below for Recently completed Neurology Research Projects
Task-related training of arm and hand use following acute stroke:
a randomised controlled trial.
A randomised controlled trial comparing the effect of
a task-specific intervention on the upper limb compared to a
control intervention in patients within 6 weeks following stroke. Subjects
receive 15 treatment sessions over a 3-week period. Outcomes
include measures of dexterity, sensation, motor function and
quality of life.
Standardised measures of sensory discrimination and manual dexterity
in stroke survivors: test-retest reliability and construct validity.
This project encompasses a number of studies being undertaken
to establish both normative values and the intra- and inter-rater
reliability of two sensory discrimination tools, the nyloprint
and JVP domes, and the NK dexterity board in stroke patients. A
study evaluating the concurrent validity of the nyloprint and
Semmes-Weinstein monofilaments is also being undertaken.
Sensorimotor integration in the hand.
This project will exploresensorimotor integration in
the hand, i.e. the relationship between sensory feedback and
the development of appropriate muscle forces to manipulate objects
with different properties such as weight and slipperiness.Deficits
in sensorimotor integration experienced by patients with stroke
or peripheral neuropathy will be investigated by comparing their
performance on a grasp-and-lift task with that of healthy age-matched
subjects.
Task-related training of arm use in chronic stroke. A pilot study.
A repeated measures within-subject study to examine
the effect of a task-specific intervention on the upper limb
in patients who have had a stroke at least 12 months previously. Subjects
will receive 15 treatment sessions over a 8-week period. Outcomes
include measures of dexterity, sensation, motor funciton and
quality of life. Transcranial magnetic stimulation will
be performed to evaluate cortical reorganisation following the
intervention.
Assessment of cortical reorganisation following stroke using
transcranial magnetic stimulation.
Transcranial magnetic stimulation is used to determine
areas of representation in the motor cortex for specific muscles
in the upper limb. It is being used in the study of task-specific
training in chronic stroke patients. A study is also being
performed to obtain normative values in our laboratory.
A prospective study of gait parameters in patients recently diagnosed
with multiple sclerosis.
This study is investigating kinematic and electromyographic
parameters during gait and balance dysfunction in people recently
diagnosed with multiple sclerosis and who have minimal or no
impairment of motor function on clinical assessment. Comparison
will be made to matched healthy subjects, and the patients will
be followed longitudinally to assess change over time.
A pilot study of a dynamic balance intervention to improve gait
and balance in people recently diagnosed with multiple sclerosis.
This study aims to evaluate the effects of a dynamic
balance training program on walking and balance in people recently
diagnosed with multiple sclerosis who have no obvioius functional
limitations.
Postural control mechanisms during self-generated perturbation
in standing in both healthy subjects and subjects with stroke.
This project encompasses two studies being undertaken
to examine postural control mechanisms in standing tasks. In
healthy subjects, kinematic and electromyographic analysis has
been performed to investigate the normal activaiton patterns
of pelvic and lower limb musculature and movement kinematics
during single-leg stance and the Lateral Reach test. This
study is being replicated in patients who are at least 6 months
post-stroke, with the additional task of the Functional Reach
test, and including the use of force plates for kinetic analysis.
The response of axon guidance molecules to spinal lesions.
This project is concerned with the investigation of
motor pathways and their response to spinal injury in mice that
lack the receptor tyrosine kinase, EphA4. Our preliminary data
indicate that this molecule, which is important for guidance
of axons to their targets in the developing nervous system, is
a potent inhibitor of neural regeneration following spinal cord
injury.
Activity patterns of frail elderly people in an aged care ward
A Positional Activity Logger (PAL-1) is being used to
measure activity patterns in frail elderly people undergoing
rehabilitation in an aged care ward. The PAL-1, worn on the thigh,
measures uptime (i.e. time spent upright). It will be worn continuously
over a three-day period while patients undertake their usual
activities. Data obtained in this project will provide information
about the role of physiotherapy in improving activity levels
in elderly patients during their admission.
Recently completed Neurology Research Projects
The Melbourne Pusher Scale: reliability and validity.
This study developed an ordinal scale, the Melbourne
Pusher Scale, to assess the severity of pushing in acute stroke
patients. Excellent intra- and inter-rater reliability
of the Melbourne Pusher Scale was established, and a preliminary
investigation of validity of the scale was undertaken.
Neural and non-neural factors contributing to reorganization
followingperipheral nerve injury.
We described a novel and reliable method for examining changes in motor and
sensory neuron populations following sciatic nerve lesion in the rat using
two compatible fluorescent tracers (Fast Blue and Diamidino Yellow). We showed
that new axonal projections from motoneurons and DRG neurons that were not
part of the original projections extended into the neuroma We also showed that
the neuroma changed in shape and size over time and that mast cells migrated
into the neural component of the neuroma. These changes provide insight into
nervous system changes that may contribute to neuropathic pain following peripheral
nerve injury.
The role of EphA4 in the regulation of axon guidance in the motor
system.
The Eph family of receptor tyrosine kinases and their
ligands, the ephrins, are important regulators of axon guidance
and cell migration in the developing nervous system. Inactivation
of the EphA4 gene results in axon guidance defects of the corticospinal
tract, a major descending motor pathway that originates in the
cortex and terminates at all levels of the spinal cord. Moreover,
EphA4 appears to be important for the correct localization of
a motoneuron pool to a specific position in the spinal cord.
In the spinal cord of mice deficient in EphA4, the motoneuron
pool that innervates the tibialis anterior muscle of the hindlimb
is caudally displaced by approximately one vertebral segment.
However, despite the abnormal position of the tibialis anterior
motoneuron pool in the spinal cord of EphA4-deficient animals,
the motoneurons of this pool still project to the tibialis anterior
muscle of the hindlimb correctly.
Distribution of muscle spindles in cervical muscles
The distribution, morphology and density of muscle spindles
were examined in the longus colli and multifidus of the human
cervical spine between C5 and C7. These vertebral segments were
selected deliberately because they form the apex of the cervical
lordosis and the site at which the greatest age-related modification
occurs. The longus colli has a high density of muscle spindles,
which appear clustered and concentrated anterolaterally, away
from the vertebral body. The multifidus has a low density of
muscle spindles, which are found predominantly as single units
concentrated closely to the vertebral lamina. No change in spindle
distribution, morphology, and density were observed with age.
Spindle characteristics represent one of many factors that govern
proprioceptive regulation in skeletal muscle and remain unchanged
in these intrinsic muscles whose underlying segments are subject
to age-related osteoligamentous changes.