Activity Based Therapy may prove key to spinal cord recovery
5 March 2009
The Faculty of Health Sciences' Clinical Exercise and Rehabilitation Unit (CERU) is integral to a recent grant of over $5 million from the Victorian Neurotrauma Initiative and the NSW Lifetime Care and Support Authority which seeks to uncover the effect of functional electrical stimulation (FES) and assistive technologies on individuals with spinal cord injury.
Under the direction of Associate Professor Glen Davis, CERU will play a key role in developing the technologies, equipment and methods that will be used in two sub-projects under the 'Spinal Cord Injury and Physical Activity' (SCIPA) grant.
'If exercise works not only to improve quality of life but to improve your medical condition that's an absolute breakthrough outcome,' said A/Prof Davis who originally began his work with spinally injured clients on bikes and treadmills with the sole aim of improving health, fitness and wellbeing. 'If it changes your neurological state and means you are less disabled, then that's a world breakthrough.'
Under the first subproject - SCIPA Switch On - the trial will start working with spinally-injured patients as soon as the spinal cord condition is stable, which could be as early as 3 days post injury. A treatment group using electrically-stimulated cycling exercise on paralyzed muscles will be compared to those that only receive the usual rehabilitation care of nursing and physiotherapy. At the normal discharge period of 4 - 6 months later patients will be accessed according to their neurological status and their level of discharge health and fitness.
'If this is the therapy that's going to give an improved outcome patients should demand it, but we don't know that yet because it's never been carried out in a real clinical trial,' commented Davis.
The second subproject in which the Faculty is involved - SCIPA Full On- will investigate the impact of upper body exercise only, in contrast to upper body exercise, cycling and treadmill walking with chronic patients at least 2 years following spinal injury. This project in particular will be looking for a change in neurological status and will aim to measure if, and indeed how the spinal cord is improving itself.
The Faculty's role in these projects is also set to reap benefits for undergraduate and postgraduate Health Sciences' students who are likely to have opportunities to undertake a proportion of their clinical hours working on this breakthrough national study.
The Clinical Exercise and Rehabilitation Unit work with technology, exercise and clinical populations has historically attracted a range of researchers, PhD candidates and clinical fieldwork students from areas as diverse as biomedical engineering, exercise and sport science, physiotherapy, and medicine. Research collaborator, Associate Professor James Middleton from the Faculty of Medicine's Rehabilitation Studies Unit says this boils down to the Unit's ability to, 'blend exercise science, spinal cord injury medicine, rehabilitation and biomedical engineering to develop and test assistive technologies to enhance a person's independence following spinal cord injury.' The Unit's high-profile international reputation has also meant that it has attracted a cultural mix of researchers from Brazil, Iran, Malaysia and Austria.
Rehabilitation Physician, Dr Nazirah Hasnan from the University of Malaya is currently in Australia working with the Centre. 'I'm here to look at technologies like electrical stimulation that can help my patients be motivated to exercise. There are over 500 spinally injured patients in my hospital; however this research isn't happening in Malaysia yet. There are so many possibilities with the work that is happening here.'
Aside from the dramatic implications of a study of this size and scope, Deputy Director of the Clinical Exercise and Rehabilitation Unit, Che Fornusek says the Unit's main aim is still to make exercise available to disabled clients in order to maintain their health, fitness and quality of life. 'Exercise is available to able bodied people and they make their choice whether or not to do it, but for spinally injured people that's not the case. It's not accessible because of cost or location or because of attitudes. We are trying to change that.'
Contact: Associate Professor Glen Davis
Phone: +61 2 9351 9466