University of Manchester
Scientific title
Strategies to COPE with cognitive difficulties after stroke (SCOPE)
Principal Investigator
Professor Audrey Bowen
Year awarded
Grant value
Research ID
TSA LECT 2015/01
Research area
Start date
Tuesday 1 September 2015
End date
Tuesday 1 September 2020
5 years

Why is this funding for research needed?

NHS services for people with stroke have improved greatly in recent decades due to research that has changed clinical practice. However, improvements have mostly been for hospital-based treatments at the emergency phase.

Many stroke survivors experience inadequate support for psychological difficulties such as the cognitive abilities of thinking, remembering and planning, and this can have a huge impact on their lives once leaving the hospital.

To help stroke survivors, their carers and loved ones cope, adapt and recover from stroke, the NHS and services in the community need research to find proven therapies and rehabilitation strategies for cognitive problems. National Clinical Guidelines for stroke have concluded that existing research is not adequate.

This award will allow Professor Audrey Bowen to speed up the development of research to help people affected by stroke cope with cognitive problems.

What will this funding do?

This funding will support two postgraduate research students (PhDs) to work with Audrey on training studentships. They will design and test therapies, in collaboration with a wider team of NHS and research experts, and people with lived experience of stroke.

The funding will allow Audrey to apply for additional funds to develop the field of cognitive rehabilitation research. She will use her time to apply for larger research grants that can fund the clinical trials needed to provide robust evidence for effectiveness and value for money of new interventions and to make significant changes to clinical practice.

Did Audrey achieve her aims?

Audrey achieved her aims that increase the likelihood, and bring forward hope, that research will find effective new treatments and therapies for psychological problems and improve the lives of people affected.

In total, Audrey supported 12 early career researchers to develop the skills and experience necessary to conduct high-quality research on new treatments for stroke. These awards had a value of over £529,000.

Audrey also secured funds for a number of research projects in stroke with a value of over £5.4million. The funders include UK-based National Institute for Health Research, Wellcome Trust and other European funders. Some of the funds are in the area of cognitive rehabilitation, others are for projects that include stroke patients with cognitive difficulties. This is because Audrey adapted her plans in response to new research and the opportunities available to work in the areas of greatest need.

A specific area of focus for Audrey was a cognitive disorder (called spatial neglect/inattention) that results in stroke patients not looking towards or moving on one side. As Chief Investigator on the SPATIAL trial, she led a team to find that it was possible and acceptable to conduct a large trial of therapy for stroke survivors with this cognitive problem that begins in the hospital, early after stroke. You can read the SPATIAL Easy Access report here.

The study found the particular therapy being trialled as part of occupational therapy, didn’t help to improve activities of daily living. However, they set a precedent for high-quality rehabilitation trials that can uncover effective treatments for the future.

Furthermore, Audrey established and led the International group on Spatial Attention and Neglect Disorders which aims to improve research and care for people with spatial neglect. Founding members come from across the world with a range of expertise. They are undertaking a range of activities including to build consensus and standardise definitions and taxonomy for neglect, and its screening in clinical practice.

How can this benefit patients?

Audrey has made significant progress in building the research workforce in the area of rehabilitation for stroke. She has also expanded the research methods that can be used to provide the robust evidence necessary for new treatments and therapies to be introduced into clinical practice. This has increased the likelihood, and bought forward the hope that research will find effective new treatments and therapies to improve the lives of people affected by stroke.

On completing this award Audrey said: “Thanks to generous donations to Stroke Association I have been able to work with stroke survivors and their families, health professionals and students. Together we have raised awareness of the impact of stroke on a person’s ability to think, concentrate, and interact. These are vital but vulnerable skills that many of us take for granted, until a stroke strikes and a brain fog descends affecting our relationships, work and play. There is much more research to do but thanks to donors there are many more of us now to speed up progress.”