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Very Early Start to Personalised Upper limb Rehabilitation after stroke (VESPUR): A Phase II trial of safety, feasible and efficacy
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Very Early Start to Personalised Upper limb Rehabilitation after stroke (VESPUR): A Phase II trial of safety, feasible and efficacy

Dr Kathryn Hayward, Institution: Florey Institute of Neuroscience and Mental Health

2017 Vanguard Grant

Years funded: 2018-2021


An early start to upper limb rehabilitation after stroke is critical to optimize functional outcomes.
Currently, people with more severe impairment receive little to no rehabilitation due to perceived futility.

Promising data suggest that this defeatist attitude is not warranted: the failure of past rehabilitation efforts is likely related to an incomplete understanding of the way recovery works.

According to insights from animal and human studies, time is key to motor recovery post-stroke. Thus, our hypothesis is that stroke survivors with more severe impairments may be able to recover if given the 'right training at the right time'.

Our unique project aims to test this theory by comparing early motor training (start ≤10 days post stroke) during the window of heightened plasticity (up to 3-months post-stroke), to late motor training (start 3-months post-stroke) when heightened plasticity has theoretically ended.
Motor training is based on biological and clinical evidence of what promotes best upper limb recovery.

This study will identify if early training is:
  • Safe (cardiac and stroke outcomes),
  • Feasible (cardiac and stroke outcomes), and
  • Leads to greater UL motor recovery (stroke outcome) at 6-months post-stroke compared to late training.
The design is an innovation in how we undertake rehabilitation trials in stroke, which may be a catalyst to achieve a recovery breakthrough. This study will provide pilot data to support a future, adequately powered trial.

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