Ulrike is a research physiotherapist with an interest in upper limb recovery after stroke. She completed her PhD at University College London in 2015, during which she investigated the effect of movement speed during training on motor learning.
Description of research
This study will test arm training to encourage a functionally useful contribution to recovery from the side of the brain unaffected by stroke (the 'non-stroke hemisphere'), and whether this is only possible early after stroke.
Recovery of arm movements after stroke is possible due to the brain's ability to form new connections and this process underpins rehabilitation therapy. Animal experiments show that brain reorganisation occurs through powerful mechanisms that only occur for a short period after a stroke in the adult brain. We want to see if we can encourage the side of the brain unaffected by stroke to make new connections during this early period, since our work suggests that this is less likely at a later stage after stroke. This would lead to an improvement in arm function in the short and long term.
We will invite 40 patients with arm weakness to take part in a study within 3 weeks of their stroke. Half the patients will receive early (within the first 6 weeks after stroke) intensive training over 6 days to improve the movement in their arm. The remaining patients will receive training later (after 3 months) and will be used as a comparison. The selection of the groups will be random. We will measure how early reaching training affects the strength of new connections in the brain by using brain stimulation techniques. These are well established, safe and painless. To see if these changes are lasting, we will repeat the measure 3 months after the stroke.
The study will improve our understanding of the process of brain recovery early after stroke. If effective, it will lead to further clinical trials with greater numbers of participants to confirm this theory. Such a finding would reinforce the importance of intensive physiotherapy during an early window of opportunity after stroke, ultimately improving recovery for stroke patients.