Our research focuses on movement control after stroke. Stroke is the second most common cause of disability in Australia. Over 60,000 Australians suffer a stroke every year. Our lab studies changes in the motor pathway after these devastating brain injuries, from changes in the brain itself to changes in the spinal cord, peripheral nerve, muscle and single motor units – the smallest functional units of muscle. We not only study changes in functional ability, or how well patients can perform activities of daily living but how the brain and nervous system control both simple and complex movements. We use a variety of techniques from common everyday objects and tasks to detailed neurophysiological techniques to understand the consequences of stroke and how patients recover functional movement.
We have shown how different levels of the motor pathway are affected after stroke. The brain cannot drive the muscles on the more affected side as well as those in healthy controls and the resulting force is not as steady. This lack of control makes holding objects or carrying items difficult, particularly when patients do not have vision to help control movement. We have also shown that when patients are distracted their control of movement on the more affected side becomes worse. This lack of movement control is compounded by the muscle weakness that characterises movement control after stroke.
Project 1. For the first time detailed neurophysiological and functional assessments are being made in each patient before and after therapy and then again 12 months later. These investigations also address the impact of stroke in everyday life, fatigue and depression. These comprehensive studies will allow us to predict which patients will benefit most from rehabilitation.
Project 2. We are implementing an intense but brief rehabilitation program using the Nintendo Wii as a therapy tool to improve hand function after stroke. Early data have shown significant improvements in multiple facets of motor control and greater independence in activities of daily living.