A5077960316- Stroke Rehabilitation and Recovery
- Acute Ischemic Stroke Management
- Cerebral Palsy and Movement Disorders
- Traumatic Brain Injury and Neurovascular Disturbances
- Health Systems, Economic Evaluations, Quality of Life
- Dementia and Cognitive Impairment Research
- Balance, Gait, and Falls Prevention
- History and Developments in Astronomy
- Diabetic Foot Ulcer Assessment and Management
- Astronomy and Astrophysical Research
- Peripheral Artery Disease Management
- Medical Practices and Rehabilitation
- Musculoskeletal pain and rehabilitation
- Healthcare Systems and Practices
- Long-Term Effects of COVID-19
- Meta-analysis and systematic reviews
- Muscle activation and electromyography studies
- Dietary Effects on Health
- Venous Thromboembolism Diagnosis and Management
- Older Adults Driving Studies
- Neonatal and fetal brain pathology
- Advanced Optical Sensing Technologies
- Ocular Oncology and Treatments
- Intensive Care Unit Cognitive Disorders
- Motor Control and Adaptation
Florey Institute of Neuroscience and Mental Health
2009-2025
Emory University
2025
The University of Melbourne
2008-2022
Monash Health
2016-2020
Eastern Health
2016-2020
Austin Health
2006-2020
National Health and Medical Research Council
2020
The George Institute for Global Health
2016-2019
Deakin University
2016-2019
University of Glasgow
2009-2019
Early mobilisation after stroke is thought to contribute the effects of stroke-unit care; however, intervention poorly defined and not underpinned by strong evidence. We aimed compare effectiveness frequent, higher dose, very early with usual care stroke.We did this parallel-group, single-blind, randomised controlled trial at 56 acute units in five countries. Patients (aged ≥18 years) ischaemic or haemorrhagic stroke, first recurrent, who met physiological criteria were randomly assigned...
Very early rehabilitation, with an emphasis on mobilization, may contribute to improved outcomes after stroke. We hypothesized that a very rehabilitation protocol would be safe and feasible.We performed randomized, controlled trial blinded outcome assessment. Patients at <24 hours stroke were recruited from 2 Melbourne metropolitan units. randomly assigned receive standard care (SC) or SC plus mobilization (VEM) until discharge 14 days (whichever was sooner). The primary safety the number of...
Background and Purpose— Regaining functional independence is an important goal for people who have experienced stroke. We hypothesized that introducing earlier more intensive out-of-bed activity after stroke would reduce time to unassisted walking improve in activities of daily living. Methods— A Very Early Rehabilitation Trial (AVERT) was a phase II randomized controlled trial. Patients with confirmed (infarct or hemorrhage) admitted <24 hours met physiological safety criteria were...
<h3>Objective:</h3> Our prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount mobilization following acute stroke. <h3>Methods:</h3> Eligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, admitted a stroke unit within 24 hours onset. Patients randomized receive very early frequent mobilization, commencing hours, or usual care. We used regression...
To examine rehabilitation interventions and resulting physical activity patterns of patients managed in acute stroke units to help inform development a randomized controlled trial very early rehabilitation.An open observational study patient therapist report interventions. A survey unit resources.Patients less than 14 days post-stroke from 5 metropolitan were observed over 2 consecutive weekdays at 10-minute intervals between 08.00 h 17.00 h. Physical activity, location person(s) present...
Inthedevelopedworld,oneinfourmenandoneinfivewomencan expect to suffer a stroke if they live 85 years (1). Strokeresults in both premature death and disability however, incontrast tocoronaryheartdiseaseand cancer,its major burdenis chronicdisability rather than (2). We know that strokepatients who have received organised multidisciplinary care inaStrokeCareUnit(SCU)environmenthavereducedmortalityand dependency (3). However, it is uncertain which compo-nents of the SCU management strategies...
<i>Background:</i> Interventions that may reduce the number and severity of potentially harmful post-stroke complications are desirable. This study explored whether very early frequent mobilisation (VEM) affected complication type (immobility/stroke related), severity. <i>Methods:</i> Secondary analysis from phase II, randomised controlled trial. Patients admitted within 24 h stroke, whose physiological parameters fell set limits, were to either VEM, commencing <24...
<b>Objective</b> To report the number of participants needed to recruit per baby born trial staff during AVERT, a large international on acute stroke, and describe management consequences. <b>Design</b> Retrospective observational analysis. <b>Setting</b> 56 stroke hospitals in eight countries. <b>Participants</b> 1074 physiotherapists, nurses, other clinicians. <b>Outcome measures</b> Number babies recruitment participant recruited. <b>Results</b> With 198 site...
Background Past studies have inconsistently identified factors associated with independent walking post-stroke. We investigated the relationship between pre-stroke and collected acutely after stroke number of days to 50 m unassisted using data from A Very Early Rehabilitation Trial (AVERT). Methods The outcome was recovery walking, tested 24 hours 3 months set a priori defined (participant demographics: age, sex, handedness; pre-stroke: hypertension, ischaemic heart disease,...
Abstract Background To estimate the short term (5 years) and long (30 economic burden of stroke among younger adults (18–64 years), to calculate loss health-related quality life in these individuals, Australia. Methods A Markov microsimulation model was built simulate incidence Younger with commenced via health states defined by modified Rankin Scale at 12 months from AVERT study (A Very Early Rehabilitation Trial), transitioned through states. Costs Australian dollars (AUD) were measured a...
The immobility common to patients after acute stroke has the potential increase negative mood symptoms. We evaluated effect of very early mobilization on levels depression, anxiety and irritability.AVERT is a randomized controlled trial; in group receive earlier (within 24 h stroke) more frequently than standard care group.Seventy-one with confirmed were included.Patients assessed Irritability, Depression Anxiety (IDA) scale at multiple time-points.At 7 days, less depressed (z=2.51, p=0.012)...
<h3>Objective</h3> To determine whether early and more frequent mobilization after stroke affects health-related quality of life. <h3>Methods</h3> A Very Early Rehabilitation Trial (AVERT) was an international, multicenter (56 sites), phase 3 randomized controlled trial, spanning 2006–2015. People were included if they aged ≥18 years, presented within 24 hours a first or recurrent (ischemic hemorrhagic), satisfied preordained physiologic criteria. Participants to usual care alone very in...
Objectives Information about younger people of working age (≤65 years), their post stroke outcomes and rehabilitation pathways can highlight areas for further research service change. This paper describes: (1) baseline demographics; (2) acute pathways; (3) 12-month outcomes; disability, mobility, depression, quality life, informal care return to work across three geographic regions (Australasia (AUS), South East (SE) Asia UK). Design hoc descriptive exploration data from the large...
<i>Background/Purpose:</i> The effectiveness and costs of very early rehabilitation after stroke are unknown. This study assessed the cost mobilisation in addition to standard care (VEM) compared with alone (SC). <i>Methods:</i> Cost-effectiveness analysis alongside a phase II, multi-centre, randomised controlled trial (RCT) blinded outcome assessments. Less than 24 h stroke, patients were recruited from two units receive VEM or SC. intervention continued until...
Falls are common after stroke and can have serious consequences such as hip fracture. Prior research shows around half of individuals will fall within the 12 months post stroke, these falls more likely to cause injury compared people without stroke. However, there is limited on risk factors collected in immediate post-stroke period that may relate risk. Furthermore, circumstances surrounding resulting adverse events (serious falls) underexplored. Using longitudinal cohort data from A Very...
Introduction: Limiting the rate of unplanned emergency department (ED) revisits for patients with acute ischemic stroke is an important aspect secondary prevention. This influenced by patients’ demographics, comorbidities, severity, disposition destination, and may be impacted early outpatient follow-up where risk factors etiology continue to evaluated. Methods: We retrospectively identified all discharged from 11-hospital network, largest healthcare system in state Georgia, October 1, 2022...
<i>Background and Purpose:</i> The modified Rankin Scale (mRS), designed as a measure of disability in the community, has increasingly been administered acute stroke setting but poorly studied within hospital environment. We prospectively interrater reliability mRS acutely hospitalised patients examined effect prior experience with scale use decision tool on agreement trained raters. <i>Methods:</i> Patients <4 days after were recruited. Individuals from 3 rater...
The utility-weighted modified Rankin Scale, representing patient perspectives of quality life, is a newly proposed measure to improve the interpretability Scale. Despite obvious advantages, such weighting imperfectly reflects multidimensional patterns post-stroke burden.To investigate burden formed by individual domains Assessment Quality Life and Barthel Index for each Scale category.In A Very Early Rehabilitation Trial (n = 2104), scores Scale-stratified Self-care Mobility, Independent...