Date: 17 May 2019
The second Pan London Kent, Surrey and Sussex Clinical Research Network Stroke Research Forum took place in Brighton on Friday 3 May 2019 and the four LCRNs came together to share learning around improving stroke outcomes across the care pathway. More than 100 delegates from the four LCRNs attended the stroke research forum.
Over the past decade there have been major developments in the management of stroke patients. The evidence base of this is from a number of large international and UK-based clinical trials. There has been an expansion in the clinical trials ranging from hyperacute treatment to rehabilitation post stroke. The conference focused on a number of these areas across the entire stroke care pathway and the speakers shared their insights and experience of research in stroke medicine.
Dr George Findlay, Medical Director and Deputy Chief Executive of Western Sussex Hospitals NHS Foundation Trust and Brighton and Sussex University Hospitals NHS Trust gave the inaugural speech. He spoke on the importance clinical research and its benefits to the patients and NHS. Prof C Rajkumar from Kent, Surrey and Sussex LCRN and Dr Omid Halse from North West London LCRN chaired the two morning sessions. Professor Tom Robinson, NIHR CRN National Specialty Lead for Stroke discussed the benefits of working with the network and how the network can help researchers. Between 2008/09 and 2018/19 NIHR CRN has supported recruitment of over 218,000 participants into 568 stroke studies. He also spoke on the four domains that are required for a Hyperacute Stroke Research Centre.
Professor Martin Dennis, Chair of Stroke Medicine from the University of Edinburgh joined the conference via video link. Together he and colleague Carol Williams, a coordinator in the Division of Clinical Neurosciences, who was in Brighton, presented their research study FOCUS and its implications. The FOCUS trial was a randomised controlled trial which aimed to find out whether fluoxetine given to people for six months after a stroke improves long-term recovery. Fluoxetine is an effective and safe drug that has been successfully used for many years to relieve depression. There is evidence from small trials that fluoxetine might have other effects on the brain for example generation of new brain cells, which might help patients make a better recovery from the physical effects of their stroke (http://www.isrctn.com/ISRCTN83290762)
Professor Valerie Pomeroy from the University of East Anglia talked about personalised stroke rehabilitation and its use in clinical practice. She talked through two studies SWIFT Cast and FAST INdICATE. SWIFT Cast looked at whether an individualised and rapidly produced ankle-foot cast (SWIFT CAST) used in addition to protocol-driven conventional physical therapy (CPT) early after stroke is more cost-effective than protocol-driven CPT alone for walking recovery. FAST INdICATE investigated two forms of conventional therapy (CPT). One called Functional Strength Training (FST), the other called Movement Performance Therapy (MPT). The study looked at which stroke survivors responded best to which therapy.
Professor Duncan Turner from the neurorehabilitation unit at the University of East London, discussed his research on vagal nerve stimulation in rehabilitation with the aim to improve upper limb function in stroke survivors. Professor Turner’s research is jointly funded by local and overseas industry funding streams.
The topics of the three breakout sessions in the afternoon related to the national objectives for the specialty. Delegates discussed issues on the benefits and barriers in getting involved in commercial studies, training the next generation of early career researchers (ECR); and Stroke research in non NHS settings.
The afternoon plenary sessions chaired by Professor David Werring from North Thames London LCRN included a presentation from Professor Keith Muir, Professor of Clinical Imaging and Consultant Neurologist at the University of Glasgow on the latest advances in the hyperacute management of stroke using thrombolysis. Professor Muir was Chief Investigator for the WAKE-UP trial which looked at MRI-selection in stroke of unknown onset time. Dr Alana Tooze a clinical psychologist at Brighton and Sussex University Hospitals NHS Trust presented two case studies on post stroke rehabilitation in neuropsychology.
Professor David Werring closed the conference with his presentation ‘Trials and Fibrillations’ on acute treatment of ischaemic stroke associated with atrial fibrillation and the OPTIMAS study. Delegates were encouraged to send their Expressions of Interest to participate in this study.
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