Karen Borschmann

The Florey Institute of Neuroscience and Mental Health · Stroke Division

Background and aim: In humans, inactivity after stroke is associated with accelerated bone loss. The aim of this study was to investigate skeletal effects of brain infarct, using a proven animal model. Hypothesis: post-stroke, skeletal parameters of left and right femurs would be compromised, but physical activity unaffected, to suggest a skeleta...

Background: Returning to work is an important outcome for stroke survivors. Objectives: This sub-study of a randomised controlled trial aimed to provide characteristics of working-age stroke participants and identify factors associated with return to work at 12 months. Methods: We used paid employment data collected as part of A Very Early Reh...

Purpose The context of implementation plays an important role in the delivery of optimal treatments in stroke recovery and rehabilitation. Considering that stroke systems of care vary widely across the globe, the goal of the present paper is to compare healthcare providers’ priority of key areas in translating stroke research to clinical practice a...

The impact of out-of-bed upright activity on outcomes in ischemic stroke patients with severe extra- and intracranial stenosis or occlusion is unknown. Using ultrasound findings from a cohort recruited to A Very Early Rehabilitation Trial (AVERT) which compared higher dose very early mobilisation (VEM) to usual care (UC), we aimed to explore the as...

Aims Pre-diabetes is a common condition that affects about 16.4% of Australian adults. Hyperglycaemia is a strong risk factor for the development of stroke. Metformin XR is an approved medication to treat type 2 diabetes in Australia but not pre-diabetes. Additionally, whether it is tolerated following a stroke is unclear. In this pilot study, we a...

Objective: To determine how young stroke survivors want their unmet needs to be addressed, we undertook an international online survey of people living with stroke. Methods: Participants self-selected to complete an online survey that included a questionnaire on demographics and stroke-related characteristics, the Young Stroke Needs Screening To...

Objective: This tertiary analysis from AVERT examined fatal and non-fatal Serious Adverse Events (SAEs) at 14 days. Method: AVERT was a prospective, parallel group, assessor blinded, randomized international clinical trial comparing mobility training commenced <24 hours post stroke, termed very early mobilization (VEM) to usual care (UC). Primar...

The effects of upright postures on the cerebral circulation early post-ischaemic stroke are not fully understood. We conducted a systematic review and meta-analysis to investigate the effects of head positioning on cerebral haemodynamics assessed by imaging methods post-ischaemic stroke. Of the 21 studies included ( n = 529), 15 used transcranial D...

Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty st...

Table S1 Prevalence of previously unrecognized diabetes, known diabetes and pre‐diabetes in stroke inpatients.

The Stroke Recovery and Rehabilitation Roundtable (SRRR) meetings bring together an international group of preclinical and clinical researchers along with statisticians, methodologists, funders and consumers, working to accelerate the development of effective treatments for stroke recovery and to support best-evidence uptake in rehabilitation pract...

Purpose: Bone fragility contributes to increased fracture risk, but little is known about the emergence of post-stroke bone loss. We investigated skeletal changes and relationships with physical activity, stroke severity, motor control and lean mass within 6 months of stroke. Methods: This is a prospective observational study. Participants were...

Background: The ineffectiveness of most complex stroke recovery trials may be explained by inadequate intervention design. The primary aim of this review was to explore the rationales given for interventions and dose in stroke rehabilitation randomised controlled trials (RCTs). Methods: We searched the Cochrane Stroke Group library for RCTs that...

Background Diabetes Mellitus is an established risk factor for stroke and maybe associated with poorer outcomes following stroke. Objective The aims of this literature review were to determine (i) the prevalence of diabetes in acute stroke patients through a meta‐analysis, (ii) the association between diabetes and outcomes after ischemic and hemor...

Background: Stroke is the third leading cause of disability worldwide. Physical activity is important for secondary stroke prevention and for promoting functional recovery. However, people with stroke are more inactive than healthy age-matched controls. Therefore, interventions to increase activity after stroke are vital to reduce stroke-related d...

Aim: To explore the use of a rehabilitation-focused behavioral mapping method to identify changes in patient physical activity, location, and social interaction following the relocation of a rehabilitation ward. Background: Rehabilitation wards are unique healthcare environments where patient activity is encouraged to improve recovery. Little is...

Finding, testing and demonstrating efficacy of new treatments for stroke recovery is a multifaceted challenge. We believe that to advance the field, neurorehabilitation trials need a conceptually rigorous starting framework. An essential first step is to agree on definitions of sensorimotor recovery and on measures consistent with these definitions...

The first Stroke Recovery and Rehabilitation Roundtable established a game changing set of new standards for stroke recovery research. Common language and definitions were required to develop an agreed framework spanning the four working groups: translation of basic science, biomarkers of stroke recovery, measurement in clinical trials and interven...

Stroke recovery is the next frontier in stroke medicine. While growth in rehabilitation and recovery research is exponential, a number of barriers hamper our ability to rapidly progress the field. Standardized terminology is absent in both animal and human research, methods are poorly described, recovery biomarkers are not well defined, and we lack...

The first Stroke Recovery and Rehabilitation Roundtable established a game changing set of new standards for stroke recovery research. Common language and definitions were required to develop an agreed framework spanning the four working groups: translation of basic science, biomarkers of stroke recovery, measurement in clinical trials and interven...

Finding, testing and demonstrating efficacy of new treatments for stroke recovery is a multifaceted challenge. We believe that to advance the field, neurorehabilitation trials need a conceptually rigorous starting framework. An essential first step is to agree on definitions of sensorimotor recovery and on measures consistent with these definitions...

Introduction: Deranged glycaemic control is common post-stroke, increasing risks of recurrent stroke and development of diabetes. The aim of the study is to examine glucose metabolism in relation to body composition, physical activity and sedentary time post-stroke. Patients and methods: Observational study: Non-diabetic adults, unable to walk i...

Background: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based...

Background Immobility and neural damage likely contribute to accelerated bone loss after stroke, and subsequent heightened fracture risk in humans. Objective To investigate the skeletal effect of middle cerebral artery occlusion (MCAo) stroke in rats and examine its utility as a model of human post-stroke bone loss. Methods Twenty 15-week old spo...

Raw data. This file contains data from animals? bone, behavior and activity measurements. (XLSX)

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To summarise the available evidence regarding the effectiveness of commercially available wearable devices and smart phone applications for increasing physical activity levels for people with stroke. © 2017 The Cochrane Collaboration. Published by John Wiley & S...

Stroke recovery is the next frontier in stroke medicine. While growth in rehabilitation and recovery research is exponential, a number of barriers hamper our ability to rapidly progress the field. Standardized terminology is absent in both animal and human research, methods are poorly described, recovery biomarkers are not well defined, and we lack...

Stroke survivors experience accelerated bone loss and increased fracture risk, particularly in paretic weight bearing limbs. Understanding how these changes unfold and their relationship to stroke severity and physical activity could help in the development of targeted interventions to prevent or reduce the severity of these outcomes. The primary a...

Background and aim: Deterioration of bone occurs rapidly after stroke, leading to increased risk of fracture and worsening outcomes for stroke survivors. Two complementary studies have been designed with aligned comorbidities and key outcomes, using humans and animal models. We aim to determine the timing and magnitude of bone loss after stroke and...

Subjective and Objective Sleep Measures in Older People with a History of Falls Study background: Falls are common in older people, with approximately 40% of those aged 80 and over falling each year. Sleep difficulties in older people have been recognized as a risk factor for falls. Most clinical and research information on sleep in older people, p...

Background and aims: Substantial bone loss and structural deterioration occurs, and risk of fracture increases 7-fold 12 months after stroke. However, acute changes to bone structure have not been described. The aim of this ongoing prospective study is to determine the timing and magnitude of loss of bone mass and structure soon after stroke. Met...

Background: One-third of stroke patients develop hyperglycaemia soon after hospitalisation. Of these patients, up to two-thirds experience impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or diabetes by three months after stroke1. Muscle loss and immobility after stroke may contribute to development of IFG and IGT. Aims: To investi...

Background and Aims: Losses of muscle mass and increased fat mass after stroke are thought to contribute to detrimental bone loss and insulin resistance. This study aims to determine the skeletal, body composition and metabolic changes which occur in the first six months after stroke. Method: Patients with hemispheric stroke from Austin Hospital,...

Previous research has mainly targeted older people with high risk of falling. The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored. This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematically screened as having mild balan...

Physical inactivity contributes to accelerated bone loss after stroke, leading to heightened fracture risk, increased mortality, and reduced independence. This paper sought to summarise the evidence for the use of physical activity to protect bone in healthy adults and adults with stroke, and to identify international recommendations regarding any...

Background/Purpose Older people commonly have concerns about their balance and mobility. This study aimed to identify the prevalence of mild balance dysfunction in community-dwelling older people with self-expressed concerns about balance and to determine factors associated with the presence of mild balance dysfunction. Methods This was a cross-sec...

Background: Poststroke bone loss is pronounced, contributing to increased fracture risk. Many stroke patients also experience insulin resistance. The emergence of these health issues are unknown but physical activity can maintain or improve bone mineral density (BMD) and insulin sensitivity in chronic stroke patients, and may be of benefit in the a...

Bone loss after stroke is pronounced, and contributes to increased fracture risk. People who fracture after stroke experience reduced mobility and increased mortality. Physical activity can maintain or improve bone mineral density and structure in healthy older adults, likely reducing fracture risk. The purpose of this systematic review was to inve...

Background: While recruitment of participants to trials is often discussed, there is little attention given to the time and costs associated with the selection of recruiting hospitals to clinical trials. Aims: to describe the time required to reach important milestones between first contact with a potential hospital, to recruitment of their first p...

To investigate by randomised trial, health professional facilitated sessions aiming to overcome barriers to physical activity (PA), improve readiness to undertake PA, increase PA participation and improve fitness among older Australian adults from Macedonian and Polish backgrounds. One hundred and twenty-one participants (mean age 70 years, 63% fem...

To determine the relationship between the severity of distance and near-vision impairment on vision-specific quality of life (QoL) and depression in residential care residents. Residents from three low-level residential care facilities in Victoria (Australia) were recruited. All participants were assessed for cognitive impairment, distance and near...

Introduction The ENvironment and Vision Optimisation in Residential Care (EnVORC) project was a collaborative project between the National Ageing Research Institute, the Centre for Eye Research Australia and three low-level residential aged care facilities in Victoria. Method Participating residents underwent a comprehensive assessment of vision,...

Aim: Balance dysfunction is an important risk factor for falls in older people but little research has been conducted in early identification of older people’s balance impairment. This study aimed to assess the prevalence of early balance ysfunction and associated risk factors in a sample of community-dwelling older people in Melbourne, Australia....

ObjectivesFollowing hip fracture, the amount of time an individual spends on their feet (‘uptime’) may be an important marker of recovery. Using an automated device that measured uptime (Uptimer), we aimed to: (1) compare hip fracture patients’ uptime with age- and gender-matched community dwelling older people; (2) identify whether uptime changed...