14 December 2020

Researcher in bid to help patients stand tall

A WA Health researcher is hoping to boost the recovery prospects of patients who lose the ability to remain upright following a stroke.

Lateropulsion, often referred to as “pushing” is an impairment of postural control that causes patients to list to one side. It affects about 50 per cent of stroke survivors requiring rehabilitation, with the struggle to sit, stand or even roll over in bed, robbing many of their independence.

Osborne Park Hospital (OPH) physiotherapist Jess Nolan reveals that with the aid of inpatient rehabilitation 70 per cent of stroke patients with mild pushing recover fully but that figure drops to 50 per cent for patients with moderate pushing and just 20 per cent for those with severe pushing.

A further 35 per cent of patients with moderate pushing and 60 per cent with severe pushing, however, show some improvement following inpatient rehabilitation.

Ms Nolan is hopeful that her role in landmark WA-Health led research will change the outlook for these patients by determining whether increasing the length of inpatient rehabilitation could improve their prospects of making a complete – or close to complete – recovery.

Ms Nolan is one of three WA Health clinicians awarded a 2020 Department of Health Raine Medical Research Foundation Clinician Research Fellowship and will use the grant to pursue a multi-faceted project that will involve patients admitted to Osborne Park Hospital’s Stroke Rehabilitation Unit.

Patients with lateropulsion following a stroke feel compelled to “push” toward their hemiplegic side (the side of the body affected by the stroke) or resist taking weight on their non-hemiplegic side.

Ms Nolan said this compulsion was driven by the patient’s impaired perception of his or her midline, caused by the stroke.

In what will be one of the biggest studies of its kind in the world, Ms Nolan will provide the evidence needed to show how the severity of a stroke patient’s pushing impacts:

  • their recovery of everyday functioning
  • their time spent in hospital rehabilitation
  • the destination to which they are discharged following in-hospital rehabilitation.

The study will also draw on international expertise to develop a model of rehabilitation best-practice for patients with post-stroke lateropulsion.

Ms Nolan said boosting the evidence on the short and long-term outcomes of stroke survivors with lateropulsion could also strengthen the case for increased funding for stroke rehabilitation.

Ms Nolan’s research will also draw on data from OPH’s comprehensive stroke rehabilitation database which contains detailed information about more than 1000 patient admissions since 2005.

Ms Nolan is one of three local researchers who will share in just over $1 million awarded in round nine of the Department of Health Raine Medical Research Foundation Clinician Research Fellowship program.

The program is an initiative of the Department of Health and Raine Medical Research Foundation that enables clinicians to pursue research of relevance to the WA Health system.

Fellowships can be for up to three years depending on the extent of the research proposal.

Clinicians must continue some of their clinical duties during the period of their fellowship.

Assistant Director General Clinical Excellence Division, Dr James Williamson, said Ms Nolan’s project highlighted some of the valuable research being undertaken by clinician researchers working across Western Australia’s public health system, including within the allied health professions.

Applicant Project Title Institution Position Title
Ms Jessica Nolan Determining best-practice rehabilitation for lateropulsion after stroke Osborne Park Hospital Coordinator of Physiotherapy, Stroke and Inpatient Rehabilitation
Dr Stephen Macdonald Improving survival from sepsis: a translational research platform for the future East Metropolitan Health Service Staff Specialist
Dr Mon Ohn NIGHTOWL – Safety and quality in adenotonsillectomy for childhood obstructive sleep apnoea Perth Children's Hospital Consultant Respiratory and Sleep Paediatrician


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