Impacts of CIHR-funded research: Stroke
[ Table of Contents ]Targeting the right side of the brain
Helping stroke sufferers cope with communications disorders
Overview
New evidence over the past two decades has shown that communication disorders after stroke, including conveying emotion in speech, communicating appropriately in social situations, the capacity to be coherent and cohesive and the ability to treat words' meaning, can result from damage to the right brain. Drs. Yves Joanette and Bernadette Ska of Montreal have been working for nearly all of that time to understand the communication problems that follow damage to the right side of the brain. They have developed an evaluation tool, the Protocole Montréal d'Évaluation de la Communication (Protocole MEC) to assess communications ability in people who have suffered right brain damage in a stroke.
Impact
The Protocole MEC has been distributed to French-speaking clinicians in Quebec and to those in European French-speaking countries. Drs. Joanette and Ska have also developed a one-day continuing education workshop describing the latest scientific findings on communications disorders following right-brain damage and how to screen for, evaluate and deal with the disorders. The course has been given to more than 300 speech and language pathologists in Canada and France and the Protocole has been translated into Spanish, Portuguese, Italian and English. A 2007 survey found that 82% of 46 respondents had found that the Protocole or the course had a positive impact on their ability to evaluate communications disorders, 91% felt that their patients with these disorders following right brain damage were receiving better services and 80% felt that rehabilitation professionals in their workplaces were more sensitized to communications disorders after right brain damage due to stroke.
First Published
CIHR Institute of Circulatory and Respiratory Health, newsletter, summer 2008
"Time is brain"
Quick treatment can prevent disability from stroke
Overview
There's a saying in stroke medicine that "time is brain" – the faster treatment can be initiated, the better the outcome. In fact, quick treatment with clot-busting drugs can return patients to pre-stroke health – but only 1.4% of people who suffer a blood-clot-induced stroke, the most common form, actually receive the drug they need, according to research by Dr. Michael Hill of the University of Calgary. Emergency physicians can be reluctant to administer clot-busting drugs for fear of inducing bleeding in the brain, but this study demonstrated that such bleeding occurs in only five per cent of cases.
Impact
Dr. Hill's research is part of a larger body of stroke research highlighting the need to improve hospital performance when patients arrive with a suspected stroke. Treatment protocols have been developed to assist emergency rooms in recognizing, assessing and treating stroke and, as of 2009, stroke treatment will be measured by Accreditation Canada as part of the hospital accreditation process. Pilot testing in eight hospitals will take place in 2009 and the measurement process will be rolled out across Canada in 2010.
First Published
CIHR Health Research Results 2004-05; updated 2009
Exercising back to health post-stroke
Speeding up reflexes has multiple benefits
Overview
Stroke is a leading cause of disability among older adults. From her earlier research, Dr. Janice Eng of the University of British Columbia knew that people with stroke have much slower reflexes. So she set out to improve their reflexes, with a program that included stretching, weight-bearing exercises and walking – and, for part of the group, a series of challenging, quick-reflex exercises such as stepping quickly to one side or responding to a light push. After 10 weeks, the group that had these exercises added to their routine were about 30% faster than when they started, while the reflexes of remainder of the group were unchanged. In addition, the "agility" group, as they were known, made greater gains in muscle strength and cardiovascular fitness and had a reduction in falls. They also maintained bone density, which the control group did not.
Impact
The Fitness and Mobility Exercise (FAME) program is currently operating in at least 50 sites in seven countries, including the United States and Canada, where it is up and running in several cities, including Vancouver and Toronto.
First Published
Researcher profile, June 2008