NHMRC Career Development Fellowship (Clinical; Level 2): Neurorestorative rehabilitation in children with cerebral palsy (2012-2015)
Abstract
This research program supports a general theme uniquely combining neuroscience and restorative rehabilitation for infants and children with cerebral palsy. The functional limitations for children with CP can be progressive due to the motor disorder and associated muscle tone disturbances causing reduced functional activity and participation restrictions. In 2007, over 33,000 Australians had CP at a financial cost of $1.47 billion or 0.14% GDP. Cerebral palsy results from a deficit or lesion of the immature brain. There is no known cure, so that prevention, interrupting or mitigating the initial causative event holds hope for advancement in this field. There is significant interest and early evidence from our own randomised clinical trials that neurorehabilitation can modulate brain reorganisation and lead to improved functional outcome measures for children with CP. Current rehabilitation models are frequently not delivered at intensities sufficient to promote neuro-plastic changes. Non-invasive neuroimaging techniques provide quantitative information about the extent of injury and provide mechanisms for determining reorganisation of perturbed neural networks in the brain. Such technology that allows quantitative measurement of neuroplasticity plays a key role in measuring the efficacy of therapy and in the design of new neurorehabilitation strategies. The clinical trials test new training models in infants (Action Observation Training), studies of environmental enrichment and developing novel approaches to web based multimodal training. Outcomes will be comprehensively tested by investigating the relationships between brain structure and function to understand the mechanisms of response to those treatments using Advanced Brain Imaging techniques (functional MRI, Diffusion Imaging and Functional Connectivity). These studies will be conducted against the background of established population based cohorts and linked to Cerebral Palsy Registers.