Shared neural networks for arm and hand (upper limb) movement and language function are being put to the test in an innovative Australia-wide trial that could result in global implications in the recovery for community stroke survivors.
Losing arm, hand and language functions after stroke currently affects 1 in 6 survivors at three-months post-stroke and remains an unmet need long-term.
The multi-site trial, called UPLIFT (UPper limb and Language Impairment and Functional Training), will conduct interrelated rehabilitation processes with community living stroke survivors for both arm and hand movement and language neural centres, with Townsville the only regional centre taking part in the phase II trial. JCU Associate Professor of Rehabilitation Ruth Barker is chief investigator of the trial site in Townsville.
“Sites in the brain used for language function and for the arm and hand sit closely together, and so the hypothesis in a nutshell is if we train these areas of the brain together, we'll get a better recovery. But in saying that, we have to work out how much training to give to maximise recovery and how exactly to do that training, which is what the UPLIFT trial aims to do,” Associate Professor Ruth Barker said.
The trial site in Townsville is a collaboration between the Australian Institute of Tropical Health and Medicine and the Townsville University Hospital, with rehabilitation physician Dr Paul Chapman as site coordinator. Support for the trial is also being provided by JCU lecturer in Physiotherapy, Dr Moira Smith and JCU PhD student, Bridee Neibling.
“Having a regional centre involved in this innovative, national trial is important from both a clinical and research perspective. It reminds urban centres of the need to be testing for clinical efficacy of rehabilitation programs with people from regional areas, and also gives us the opportunity to keep our researchers engaged at a national level,” Associate Professor Ruth Barker said.
The UPLIFT trial will follow an ‘umbrella’ trial design and is the first of its kind to do so globally in regard to stroke recovery.
“The benefit of using an umbrella trial design is that we can evaluate multiple UPLIFT interventions based on dose (two hours or four hours) and mode of delivery (in-person or telehealth) within the one trial. This design allows the dropping of interventions not showing sufficient promise which in turn, enables us to fast track the establishment of evidence for UPLIFT as a new model of rehabilitation,” Associate Professor Ruth Barker said.
Recruitment of speech pathologists, physiotherapists and occupational therapists to deliver the trial’s integrated therapies in-person and/or via telehealth is currently underway. The trial will start in June 2022 and run for 18 months, utilising consult rooms and videoconferencing facilities at AITHM’s Translational Research Facility.
In addition to Townsville, The UPLIFT trial includes investigators in Melbourne (University of Melbourne, Florey Institute of Neuroscience and Mental Health, Royal Melbourne Hospital, Austin Hospital), Brisbane (University of Queensland, STARS, RBWH), Perth (Edith Cowan University and Sir Charles Gardiner Hospital), and Adelaide (Royal Adelaide Hospital). The nation-wide trial is being led by JCU College of Healthcare Science Alumni, Dr Kate Hayward, who is now based at the University of Melbourne.
If you are interested in participating, please email firstname.lastname@example.org.