Natasha A. Lannin

• PhD
• Professor (Associate) at La Trobe University

Objective To determine the effectiveness of government policies supporting coordinated multidisciplinary primary care (MDC) in improving long-term survival following stroke or Transient Ischaemic Attack (TIA). ApproachWe used the target trial framework for observational data to assess the average population effect of primary care MDC policies. The...

Background Unplanned hospital presentations may occur post-stroke due to inadequate preparation for transitioning from hospital to home. The Re covery-focused C ommunity support to A void readmissions and improve P articipation after S troke (ReCAPS) trial was designed to test the effectiveness of receiving a 12-week, self-management intervention,...

Introduction Following lung transplantation, it is unknown how children/adolescents self-assess their performance in everyday activities, importance of these activities, and whether resumption of everyday activities influences self-reported quality of life. The aim was to examine the effect of bilateral lung transplantation on children’s/adolescent...

Research Objectives Although recommendations are for vocational rehabilitation to commence soon after injury, there are acknowledged challenges to commencing this activity during hospitalisation, when clinical goals are more often centred on basic activities (such as self-care and mobility). This study aimed to develop a vocational rehabilitation i...

Research Objectives To investigate the profile of self-awareness for patients with traumatic brain injury and to make recommendations for practice in rehabilitation. Design Non-interventional cohort study with clinical audit of self-awareness interview applying thematic analysis. Setting A large public acquired brain injury rehabilitation unit in...

Research Objectives To propose an evidence-based, best-practice framework for lived experience and community engagement in clinical trials testing rehabilitation interventions. Design This project applied a mixed-method and iterative process. Commencing first with a scoping review of available policies and processes, we then undertook a consultati...

Research Objectives To investigate the impact of brain injury (TBI) on grocery shopping performance from the viewpoint of those who have suffered a moderate or severe TBI. Design Exploratory and descriptive qualitative approach. Setting Specialised acquired brain injury rehabilitation service (inpatient and community rehabilitation services). Pa...

Objective(s) To establish (1) the theoretical models and frameworks of self-awareness in adults with acquired brain injury; and (2) how self-awareness is conceptualized within those models. Data Sources Medline, CINAHL, EMBASE, PsycINFO, and Cochrane databases were searched, references were screened and expert recommendations were included. Search...

Background Evidence for digital health programmes to support people living with stroke is growing. We assessed the feasibility of a protocol and procedures for the Re covery-focused C ommunity support to A void readmissions and improve P articipation after S troke (ReCAPS) trial. Methods We conducted a mixed-method feasibility study. Participants...

Objectives Data linkage can provide sufficient breadth and size of data, to draw reliable estimates of effectiveness, at a population level using real-world data. We compared differences in survival and hospital presentations following stroke or transient ischaemic attack (TIA), based on whether a Medicare funded chronic disease management plan was...

This systematic review aimed to investigate timing, dose, and efficacy of upper limb intervention during the first 6 months poststroke. Three online databases were searched up to July 2020. Titles/abstracts/full-text were reviewed independently by 2 authors. Randomized and nonrandomized studies that enrolled people within the first 6 months poststr...

Rationale: People with stroke experience falls at more than twice the rate of the general older population resulting in high fall-related injuries. However, there are currently no effective interventions that prevent falls after stroke. Aims: To determine the effect and cost-benefit of an innovative, home-based, tailored intervention to reduce f...

Objective: Evidence is accumulating for the potential benefits of technology use in stroke rehabilitation. However, few studies have examined ways in which technology can be used to increase adherence to programs after discharge from rehabilitation. The aim of this study was to determine if the addition of concurrent visual feedback, via a tablet...

Background: We examined sex differences in cause of death and cause-specific excess mortality after stroke. Methods: First-ever strokes (2010-2013; 35 hospitals) participating in the Australian Stroke Clinical Registry were linked to national death registrations and other administrative datasets. One-year cause-specific mortality were categorised a...

Background: Women may receive stroke care less often than men. We examined the contribution of clinical care on sex differences and health-related quality of life (HRQoL) after stroke. Methods: We included first-ever strokes registered in the Australian Stroke Clinical Registry (2010-2014) with HRQoL assessed between 90-180 days after onset (EQ-5D-...

Introduction Intervention studies to date have shown limited evidence of fall reduction in community-dwelling stroke survivors. This study aims to test the acceptability and feasibility of the Stepping On after Stroke (SOAS) program in Singapore. Methods Pre-post intervention study design was used. The SOAS program consisted of 7 weekly group ses...

Background Oral care is important to prevent buccal and systemic infections after an acquired brain injury (ABI). Despite recent advancements in the development of ABI clinical practice guidelines, recommendations for specific clinical processes and actions to attain adequate oral care often lack information. Objective This systematic review will...

Introduction: Neuroplasticity is harnessed through high-intensity or high-dose training. Given the costs and time burden for families of children with cerebral palsy (CP), it is important to quantify which rehabilitation training approaches and doses confer the largest clinical gain. The main objective of this systematic review was to determine an...

Objective Evidence is accumulating for the potential benefits of technology use in stroke rehabilitation. However, few studies have examined ways in which technology can be used to increase adherence to programs after discharge from rehabilitation. The aim of this study was to determine if the addition of concurrent visual feedback, via a tablet co...

Objective Evidence is accumulating for the benefits of technology use in stroke rehabilitation. Few studies have examined ways in which technology can be used to increase adherence to programs after discharge from rehabilitation. The aim of this study was to determine if the addition of concurrent visual feedback, via a tablet computer, increased a...

BACKGROUND Oral care is important to prevent buccal and systemic infections after an acquired brain injury (ABI). Despite recent advancements in the development of ABI clinical practice guidelines, recommendations for specific clinical processes and actions to attain adequate oral care often lack information. OBJECTIVE This systematic review will...

Aims: To evaluate the feasibility of using a tablet computer to monitor the amount of upper limb practice completed by stroke patients prescribed with a home program and to explore factors that influence adherence. Method: Ten consecutive participants randomized to the intervention arm of a randomized controlled trial investigating therapy after sp...

Introduction: There is some evidence that women receive evidence-based care less often than men, but how this influences long-term mortality after stroke is unclear. We explored this issue using data from a national stroke registry. Methods: Data are first-ever hospitalized strokes (2010–2014) in the Australian Stroke Clinical Registry from 39 hosp...

Supplemental material for A systematic review of measures of adherence to physical exercise recommendations in people with stroke

Objectives To determine the feasibility of linking data from the Australian Stroke Clinical Registry (AuSCR), the National Death Index (NDI), and state‐managed databases for hospital admissions and emergency presentations; to evaluate data completeness and concordance between datasets for common variables. Design, setting, participants Cohort desi...

Objective To review methods for measuring adherence to exercise or physical activity practice recommendations in the stroke population and evaluate measurement properties of identified tools. Data sources Two systematic searches were conducted in eight databases (MEDLINE, CINAHL, PsycINFO, Cochrane Library of Systematic Reviews, Sports Discus, PED...

Background: Uncertainty exists over attributable causes for the excess mortality after stroke, and of any differences by sex. Methods: First-ever strokes (2010-2013) admitted to 35 hospitals enrolled in the Australian Stroke Clinical Registry (AuSCR) were linked to national death registrations. For this analysis, one-year causes of death due to st...

Introduction Survivors of stroke have complex needs from ongoing disabilities and have increased risk of cardiovascular diseases. The societal costs are therefore substantial. Person-level longitudinal data on the longer-term hospital utilizations of patients with stroke in Australia, and the factors that may influence usage in this setting, are ra...

Introduction Recent advances in data linkage infrastructure in Australia mean that data can be linked based on various identifiers across datasets. In a first for Australia, we tested the feasibility of linking data between a clinical quality disease registry with Australian and state government health data across multiple jurisdictions. Objective...

Background: Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functional hand splinting, and in combination with splinting, fo...

Introduction Home assessments conducted by occupational therapists can identify hazards and prevent falls. However, they may not be conducted because of limited time or long distances between the therapist’s workplace and the person’s home. Developments in technologies may overcome such barriers and could improve the quality of the home assessment...

Purpose Worldwide, stroke is a leading cause of disease burden. Many survivors have unmet needs after discharge from hospital. Electronic communication technology to support post-discharge care has not been used for patients with stroke. In this paper, we describe the development of a novel electronic messaging system designed for survivors of stro...

Objective: The aim of this review was to critically appraise the quality of evidence-based clinical practice guidelines (CPGs) for the rehabilitation of children with moderate or severe acquired brain injury (ABI). Data sources: A systematic search of MEDLINE, PsycINFO, Embase, CINAHL, and the Cochrane Library was conducted and an extensive webs...

Background/aim Functional electrical stimulation (FES) improves active movement of the hemiplegic upper and lower limbs following stroke. The use of FES by Australian allied health clinicians in stroke rehabilitation is, however, unknown. The purpose of this study was to understand the use of FES in clinical practice. Reasons for the use of FES and...

Background Botulinum toxin-A is provided for adults with post-stroke spasticity. Following injection, there is a variation in the rehabilitation therapy type and amount provided. The purpose of this study was to determine if it is feasible to add intensive therapy to botulinum toxin-A injections for adults with spasticity and whether it is likely t...

Purpose: This study investigates the perspectives of rehabilitation therapists on the implementation of fall prevention programmes with community-dwelling stroke survivors in the Singapore context, and elicits recommendations to adapt the Stepping On programme with stroke survivors. Method: Qualitative data were elicited during 4 focus groups with...

Background and Aims All-cause mortality after stroke is greater in women than men. Our aim was to examine whether there are sex differences in the causes of death (COD) or the potential contributing factors. Method 1-year COD were obtained by linking first-ever strokes (2010-2013) admitted to 35 hospitals participating in the Australian Stroke Cli...

Objective To identify research priorities of consumers and other stakeholders to inform Cochrane Reviews in ‘health communication and participation’ (including such concepts as patient experience, shared decision-making and health literacy). Setting International. Participants We included anyone with an interest in health communication and partic...

Background: Identifying the characteristics of individuals who are most likely to respond to a certain rehabilitation intervention is advantageous for the child, family, clinicians and the healthcare system. Aim: To investigate the individual characteristics of children with cerebral palsy or brain injury who responded best to the Cognitive Orie...

Background Health‐care expenditure is rapidly increasing in Australia with increasing pressure on health‐care services to review processes, improve efficiency and ensure equity in service delivery. The nursing profession have improved efficiency and patient care by investigating time‐use to describe current practice and support development of workf...

Objective To compare the cost effectiveness of two occupational therapy–led discharge planning interventions from the HOME trial. Design An economic evaluation was conducted within the superiority randomized HOME trial to assess the difference in costs and health-related outcomes associated with the enhanced program and the in-hospital consultatio...

Rationale Although clinical practice guidelines recommend that management of moderate to severe spasticity include the use of botulinum toxin-A in conjunction with therapy, there is currently no evidence to support the addition of therapy. Aims To determine the effect and cost-benefit of adding evidence-based movement training to botulinum toxin-A...

Purpose: To examine in people with neurological disorders, which method/s of providing external cues to improve task performance are most effective. Methods: Medline, EMBASE, and PsycINFO were systematically searched. Two reviewers independently screened, extracted data, and assessed the quality of the evidence using the Grading of Recommendations...

Introduction: It is difficult to determine if, or when, individuals with stroke are ready to undergo on-road fitness-to-drive assessment. The Occupational Therapy – Driver Off Road Assessment Battery was developed to determine client suitability to resume driving. The predictive validity of the Battery needs to be verified for people with stroke. A...

Background and purpose: In multicultural Australia, some patients with stroke cannot fully understand, or speak, English. Language barriers may reduce quality of care and consequent outcomes after stroke, yet little has been reported empirically. Methods: An observational study of patients with stroke or transient ischemic attack (2010-2015) cap...

Introduction: Women appear to experience worse HRQoL after stroke than men. However, women without stroke also report poorer health status than men in all ages. Therefore, it is uncertain whether the sex disparity in HRQoL is caused by stroke or other differences between men and women. Methods: First-ever strokes admitted to 39 hospitals participat...

Objectives Rehabilitation clinical practice guidelines (CPGs) contain recommendation statements aimed at optimising care for adults with stroke and other brain injury. The aim of this study was to determine the quality, scope and consistency of CPG recommendations for rehabilitation covering the acquired brain injury populations. Design Systematic...

Objective: To investigate the risk of death from cardiovascular disease between patients who were and were not prescribed antihypertensive medication following stroke or TIA. Methods: This was a large cohort study using routinely collected prospective data from the Australian Stroke Clinical Registry. Patients registered between 2009 and 2013 wh...

Background: The treatment of somatosensory loss in the upper limb after stroke has been historically overshadowed by therapy focused on motor recovery. A double-blind randomized controlled trial has demonstrated the effectiveness of SENSe (Study of the Effectiveness of Neurorehabilitation on Sensation) therapy to retrain somatosensory discriminati...

Objective To explore the ways clinicians engage rehabilitation patients in patient-centered goal setting and identify factors influencing the goal-setting process. Design Ethnographic study utilizing observed practice—thematic analysis. Setting Four rehabilitation wards of a large metropolitan hospital in Melbourne, Australia. Subjects Participa...

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Purpose: Drawing on the perspectives of stroke survivors, family members and domestic helpers, this study explores participants’ experiences of self-perceived fall risk factors after stroke, common fall prevention strategies used, and challenges to community participation after a fall. Methods: Semi-structured interviews were conducted in Singapore...

Background/aim: Allied health professionals frequently use surveys to collect data for clinical practice and service improvement projects. Careful development and piloting of purpose-designed surveys is important to ensure intended measuring (that respondents correctly interpret survey items when responding). Cognitive interviewing is a specific t...

Background/aim: Scientific conferences provide a forum for clinicians, educators, students and researchers to share research findings. To be selected to present at a scientific conference, authors must submit a short abstract which is then rated on its scientific quality and professional merit and is accepted or rejected based on these ratings. Pr...

Background: Given the potential differences in etiology and impact, the treatment and outcome of younger patients (aged 18-64 years) require examination separately to older adults (aged ≥65 years) who experience acute stroke. Methods: Data from the Australian Stroke Clinical Registry (2010-2015) including demographic and clinical characteristics...

This paper obtains the views and priorities of both international and Singapore experts in falls and stroke rehabilitation using a modified Delphi method to determine the key elements of the Stepping On after Stroke program for community-living stroke survivors in Singapore.

Study design: Two-group randomized controlled trial. Introduction: Upper limb orthoses worn during functional tasks are commonly used in pediatric neurologic rehabilitation, despite a paucity of high-level evidence. Purpose of the study: The purpose of this study was to investigate if a customized functional wrist orthosis, when placed on the...

Background: Comprehensive discharge planning is important for successful transitions from hospital to home after stroke. The aim of this study was to describe the quality of discharge planning received by patients discharged home from acute care, identify factors associated with a positive discharge experience, and assess the influence of discharg...

Secondary outcomes: change in individual indicators, change in composite score comparing hospitals that did or did not develop action plans (per-protocol analysis), impact on 90-180-day health outcomes. Sensitivity analyses: hospital self-rated status, alternate cross-sectional audit data (Stroke Foundation). To account for temporal effects, compa...

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...

Objective: To identify the risk factors for falls in community stroke survivors. Data sources: A comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, Cochrane Library, and Web of Science databases was conducted. Study selection: Prospective studies investigating fall risk factors in community stroke survivors were i...

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...

Transitional living service (TLS) programmes for adults with an acquired brain injury are considered an important part of rehabilitation. However, considerable variability exists in the design and structure of these services, with limited research to guide the development of a programme based on best evidence. A scoping literature review was comple...

Purpose: To examine the internal consistency, construct validity and responsiveness of functional assessments tools when used with hospitalized older adults. Materials and methods: The functional ability of 66 patients was assessed using a semi-structured interview scale (n = 16 tools). The assessment of motor and process skills was administered du...

Objectives: Hospital data used to assess regional variability in disease management and outcomes, including mortality, lack information on disease severity. We describe variance between hospitals in 30-day risk-adjusted mortality rates (RAMRs) for stroke, comparing models that include or exclude stroke severity as a covariate. Design: Cohort des...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The primary objective of this Cochrane Review is to assess the effects of implementation interventions to promote the uptake of evidence-based practices (including clinical assessments and treatments recommended in evidence-based guidelines) in stroke rehabilita...

Background and purpose: Uncertainty exists over whether quality improvement strategies translate into better health-related quality of life (HRQoL) and survival after acute stroke. We aimed to determine the association of best practice recommended interventions and outcomes after stroke. Methods: Data are from the Australian Stroke Clinical Regi...

Question: Is stretch effective for the treatment and prevention of contractures in people with neurological and non-neurological conditions? Design: A Cochrane Systematic Review with meta-analyses of randomised trials. Participants: People with or at risk of contractures. Intervention: Trials were considered for inclusion if they compared stretch t...

Background: Contractures are a common complication of neurological and non-neurological conditions, and are characterised by a reduction in joint mobility. Stretch is widely used for the treatment and prevention of contractures. However, it is not clear whether stretch is effective. This review is an update of the original 2010 version of this rev...

Purpose: The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire is a patient reported outcome measure for evaluating upper limb function in people with musculoskeletal conditions. While the DASH has good psychometric properties when used with people with musculoskeletal conditions, it has not been tested with adults after stroke. Methods:...

To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1) characterize brain biomarkers; 2) determine relationship(s) between biomarkers and motor outcome; and 3) establish relationship(s) between biomarkers and motor rec...

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Objectives: To determine whether an enhanced occupational therapy discharge planning intervention that involved pre- and postdischarge home visits, goal setting, and follow-up (the HOME program) would be superior to a usual care intervention in which an occupational therapy in-hospital consultation for planning and supporting discharge to home is...

Objective: To describe the challenges of obtaining state and nationally held data for linkage to a non-government national clinical registry. Methods: We reviewed processes negotiated to achieve linkage between the Australian Stroke Clinical Registry (AuSCR), the National Death Index, and state held hospital data. Minutes from working group meet...

Background/aim: Assistive technologies have the potential to increase the amount of movement practice provided during inpatient stroke rehabilitation. The primary aim of this study was to investigate the feasibility of using the Saebo-Flex(™) device in a subacute stroke setting to increase task-specific practice for people with little or no active...

Purpose: Understanding the relationship between health-related quality of life (HRQoL) and long-term unmet needs is important for guiding services to optimise life following stroke. We investigated whether HRQoL between 90 and 180 days following stroke was associated with long-term unmet needs. Methods: Data from Australian Stroke Clinical Regis...

Questions: In people receiving rehabilitation aimed at reducing activity limitations of the lower and/or upper limb after stroke, does adding extra rehabilitation (of the same content as the usual rehabilitation) improve activity? What is the amount of extra rehabilitation that needs to be provided to achieve a beneficial effect? Design: Systema...

Purpose: The purpose of this study was to explore the experience of parents of children with cerebral palsy (CP) who participated in an intensive cognitive orientation to daily occupational performance (CO-OP) group program addressing child chosen goals. Method: Participants were six parents of children with CP who participated in a CO-OP upper...

Background: The advanced hand activities item of the Motor Assessment Scale (Upper Limb items, UL-MAS) includes the ‘lines’ and ‘dots’ tasks, which require skilful pencil use. Prior Rasch analysis studies identify these two tasks as the most difficult to achieve for stroke survivors compared with the other advanced hand activities. Yet it is unknow...

Objective: The aim of the present study was to investigate the perceptions of consultant surgeons, allied health clinicians and rehabilitation consultants regarding discharge destination decision making from the acute hospital following trauma.Methods: A qualitative study was performed using individual in-depth interviews of clinicians in Victoria...

Objectives: To investigate differences in management and outcomes for patients admitted to the hospital with TIA according to care on a stroke unit (SU) or alternate ward setting up to 180 days post event. Methods: TIA admissions from 40 hospitals participating in the Australian Stroke Clinical Registry during 2010-2013 were assessed. Propensity...

Background: Discharge planning for patients with an acquired brain injury (ABI) is considered best practice for assisting the patient and caregiver to successfully transition from hospital to home and is complex because of the long-term care and support needs of the patient. This review aimed to describe and synthesize the perspectives of patients...