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ResearchFeb 5, 2021

Stroke Association announces £215,000 award to fund Lisa Tedesco Triccas' physiotherapy rehab study

Lisa Tedesco Triccas has been awarded a £215,000 grant to investigate whether intensive physiotherapy helps stroke survivors with arm and hand weakness.

Dr Tedesco Triccas, a PhD who graduated in physiotherapy in Malta and has spent part of her research career in Belgium, will be the principal investigator in the project, to be based at University College London.

Dr Tedesco Triccas' career has spanned three countries: Malta, Belgium and the UK

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The study period starts next month, and is due for completion in March 2026. The scientific title is as follows: 'Is intensive upper limb rehabilitation effective in chronic stroke patients? A randomised controlled trial' [RCT].

In an interview published on the Stroke Association’s website, Dr Tedesco Triccas said: ‘After stroke, around three quarters of people have weakness of their arm and hand (sometimes called the “upper limb”). This can have a big impact on stroke survivors’ lives, affecting whether they’re able to prepare food, eat and drink, and put on the clothes they would like to wear.'

We don’t know how much rehabilitation is most helpful for stroke survivors. Some researchers think that 'high-dose, high-intensity' rehabilitation ...  can improve life after stroke [Dr Tedesco Triccas]

According to a 2016 National Clinical Guideline for Stroke, stroke survivors should receive therapy for as long as they are willing and capable of participating, and showing measurable benefit from treatment, she said. ‘However, the majority of stroke survivors don’t receive the support they need. Many also say they’ve been told that they’re unlikely to see any more improvement more than three to 12 months after their stroke.

‘We don’t know how much rehabilitation is most helpful for stroke survivors. Some researchers think that “high-dose, high-intensity” rehabilitation – where patients receive lots of rehabilitation in a short space of time – can improve life after stroke.'

Neurorehabilitation programme

Dr Tedesco Triccas referred to the Queen Square Upper Limb (QSUL) neurorehabilitation programme, which was set up at the National Hospital for Neurology and Neurosurgery in 2014. See: https://www.ucl.ac.uk/ion/research/departments/clinical-and-movement-neurosciences/people/ward-lab/queen-square-upper-limb

‘It’s an NHS service which gives stroke survivors high-intensity arm and hand physiotherapy: 90-hours of rehabilitation over three weeks, that’s six hours per day. 

The QSUL team found that patients’ arm and hand function can be better at the end of the treatment – even if they had their stroke many years ago, according to Dr Tedesco Triccas. ‘While these results are promising, we need to find out more about how effective this type of treatment is, and why, before it can be routinely offered on the NHS.’

Dr Tedesco Triccas' research project, which will involve an RCT, aims to discover how effective the QSUL rehabilitation is. ‘The researchers hope that this project will provide the evidence necessary to decide if intensive arm and hand rehabilitation is recommended in clinical guidelines and offered routinely on the NHS to stroke survivors.

‘The researchers also hope that this project will tell us whether some stroke survivors are more likely to benefit from this rehabilitation than others. This will help healthcare professionals to give stroke survivors better and more accurate information about the chances of improvement to their arm and hand function.’

Many stroke survivors 'feel abandoned'

Currently, 45 per cent of people with stroke feel abandoned after they leave hospital. ‘This type of work is important in rebuilding lives after stroke by providing hope to those who feel they have been abandoned.’

For more information, see: https://www.stroke.org.uk/research/can-more-intensive-physiotherapy-help-stroke-survivors-who-have-arm-and-hand-weakness

Author: Ian A McMillan
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