The Insurance Commission of Western Australia partners with the Neurotrauma Research Program (NRP) to find innovative solutions to rehabilitation and care challenges faced by people with catastrophic injuries from vehicle crashes and workplace accidents.
Pressure injuries develop in the buttocks of persons with spinal cord injury (SCI) due to the lack of norman sensory triggers to alter sitting postures that result in increased immobilisation. This trial is the first in the world to determine if the rate of re-positioning movements increases when using a behaviour change program that integrates real-time visual biofeedback from the new Healthy Chair © wheelchair system (Dynamic Control Inc, Christchurch, NZ). This state-of-the-art biofeedback system includes a data logger that continuously records seat-buttocks interface pressures and provides real-time algorithm-based risk feedback via an iPod Touch which prompts movement direction and duration.
Loss of neurons and networks after neurotrauma is considered irreversible, leading to significant functional impairment. Most therapies trialed for spinal cord injury (SCI) in humans have met with little or no success. The potential of generating new neurons to replace dead ones, and potentially initiate some form of circuit reconstruction, is a holy grail of restorative neurology, with obvious potential benefit to patients. In vivo reprogramming in the spinal cord is a new technology, but holds great promise. We are currently investigating this approach to treat spinal cord stroke. We will extend these studies to clinically relevant models of SCI.
Following spinal cord injury (SCI), urinary tract infection (UTI) is common and debilitating, often leading to long-term urological problems. Our recent WA inpatient cohort study showed that shorter time to first infection was the single predictor of higher UTI rates. There are currently no evidence-based interventions to prevent early UTI and antibiotic prophylaxis is not advisable. Methenamine hippurate has shown some promise, but has only been studied in chronic SCI. We propose testing the safety and feasibility of Methenamine hippurate in early acute SCI. Time to first UTI and UTI incidence will be assessed to indicate whether Methenamine hippurate improves outcomes.
Experimental studies aimed at recovery of motor function after spinal cord injury (SCI) often attempt to reduce injury effects and promote axonal plasticity by delivering agents at/into the injury site. Previously we have used repetitive transcranial magnetic stimulation (rTMS) to induce cortical plasticity in the brain resulting in moderate improvements in functional recovery of the affected forelimbs after cervical SCI in rats. Here we will reinforce or strengthen such plasticity related effects by using rTMS at the same time as specific and relevant training protocols to further enhance altered excitability in motor/sensorimotor cortex, producing even greater functional forelimb improvements.
Gait is the primary motor function that enables mobility and independent living amongst stroke patients and is a prioritized focus of many rehabilitation programs. Rhythmic auditory stimulation (RAS) is a clinically proven therapy that exploits music’s influence on motor control. Over the last 12 months, through NRP funding, we have developed a tailored music and real-time feedback system based on mobile technology (GotRhythm). The system has been adapted to include gait through the development of wireless plantar pressure sensors. Here, we aim to test the efficacy of the gait system within GotRhythm to improve stroke patients’ neurological and functional outcomes.
Using neuronal cultures we have recently demonstrated arginine-rich peptides are highly neuroprotective against excitotoxicity, which following neurotrauma (hereafter refers to global cerebral ischaemia, spinal cord injury, traumatic brain injury) is arguably the most important and profound secondary central nervous system damaging processes. Moreover, we have also demonstrated that arginine-rich peptides can reduce ischaemic brain injury following stroke in rats. Together our findings are highly significant as brain ischaemia shares many of the neuro-damaging events associated with neurotrauma including excitotoxicity. In this project, we aim to further assess the therapeutic potential of arginine-rich peptides to reduce brain damage in neurotrauma.
