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Right dose, right person, right time: Advancing stroke rehabilitation paradigms

Our goal is to find breakthrough treatments that achieve a meaningful shift in the upper limb recovery profile post-stroke.

Aims

This project will involve working with people with upper limb impairment throughout the first year post-stroke. We will use a range of biomarkers to grow our understanding of the ‘right person’, to understand ‘right time’ we will intervene at various timepoints that are linked to the neurobiology of recovery, and to understand ‘right dose’ we will explore dose-response to training.

The dose of upper limb training achieved clinically early post stroke is low (Hayward et al., 2015). Clinical trials testing higher doses of training compared to usual care have demonstrated that we can get our patients a little better, but our goal is to find breakthrough treatments that achieve a meaningful shift in the upper limb recovery profile post-stroke. Data from animal and human studies suggest that the failure of past rehabilitation efforts may be related to an incomplete understanding of the way recovery works. This underpins our focus to understand ‘right dose, right person, right time’ post-stroke. This project will involve working with people with upper limb impairment throughout the first year post-stroke. We will use a range of biomarkers (e.g., Hayward et al., 2017; Boyd et al., 2017) to grow our understanding of the ‘right person’, to understand ‘right time’ we will intervene at various timepoints that are linked to the neurobiology of recovery (e.g., Bernhardt et al., 2017), and to understand ‘right dose’ we will explore dose-response to training (e.g., Dite et al., 2015). This project will contribute to advancing individualised patient treatment post-stroke. 

Students will work within the Centre for Research Excellence in Stroke, based at the Florey Institute in Heidelberg.

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