Why is this research important?

Stroke is the commonest cause of severe disability in England and affects over 110,000 people a year, 10,000 of whom are under the age of 50. One of the major problems that occurs as a result of a stroke is the inability to control movement and function in one side of the body. This affects the whole side of the body often making it difficult or even impossible to walk and therefore a lot of current rehabilitation is concentrated on improving walking to improve mobility. However the arm and hand are also affected and many people have little useful hand function after their stroke, having to rely more on carers. This greatly reduces independence and severely reduces the possibility of those of working age returning to work.

What are Assistive Technologies?

In the treatment of stroke, there has recently been a greater emphasis placed on rehabilitation of the hand and arm and a number of new techniques developed. These include a number of approaches, often involving technology such as the use of robots to move the arm, electrical impulses to activate muscles, botulinum toxin to reduce tightness in paralysed muscles and a variety of splints and supports (orthotics) to aid function. These are often known as Assistive Technologies, or ATs for short.

What will this research programme do?

This programme of research seeks to improve significantly the rehabilitation of the hand and arm following a stroke by investigating the use of assistive technologies to maximise function. To do this we will undertake a detailed survey of all Stroke Units in England to determine the current treatments undertaken. We will search the literature worldwide looking for evidence of these new treatments and determine which look the most promising. At the same time we will consult widely with people who have had a stroke, their carers, health professionals, commissioners and those purchasing health services, to see if there are any barriers to these technologies being used in the NHS.

The results of these first three tasks will lead us to identify the most promising treatment, or combinations of treatments, to maximise function. We will then undertake a clinical trial of these treatments to produce the  evidence needed before such treatments can be used in the NHS. Finally, based on the results of the whole programme, we will develop a standard package of treatment, known as a Care Pathway, suitable for use in Stroke Units throughout England, and run a series of meetings, conferences and training courses to disseminate, educate and train NHS staff..