A post by Dr Brendon Haslam, Noigroup Instructor
This Sunday, October 29, is World Stroke Day, a day dedicated to raising awareness. The theme for this year’s World Stroke Day is “Together we are greater than stroke”. With this in mind, we hope you’ll read on to learn about the work that we’ve done here at Noigroup in stroke around chronic pain post-stroke and identifying potential treatment targets, plus some exciting new initiatives that we’d like to share with you.
First, some not-so-fun facts about stroke:
- Stroke is the second leading cause of death worldwide.
- Stroke is the third leading cause of disability worldwide.
- Approximately 1.8 million people experience a stroke each year.
- In some low- and middle-income countries (including India), there has been a staggering 100% increase in stroke cases.
But there’s also some good news:
- With improved education about early detection, resulting in earlier access to improved healthcare services, the mortality rate in developed countries is decreasing (that is, more people are surviving after stroke)
It doesn’t read so well, does it? Even the good news comes with a concern for us in healthcare. There are now more people than ever living in the community with ongoing difficulties following stroke, and stroke care places a significant burden on healthcare services, the workplace and community services, as individuals with stroke experience more difficulties participating in work and leisure activities than those without.
A significant contribution to the burden of stroke is chronic pain, affecting between 40-65% of all stroke survivors. Currently, the management (and treatment) of chronic pain post-stroke is sadly lacking, with little research out there in this important field.
What are we doing?
To help address this gap, a few years ago, Noigroup teamed with researchers at the Florey Institute of Neuroscience and Mental Health, to build knowledge of chronic pain post-stroke, with the aim of ultimately identifying potential treatment targets. Publications are now coming out with our findings. We’ve found that:
- stroke survivors hold very firm beliefs about a very fixed cause of their pain (making for great educational targets; for links to the paper, go to https://pubmed.ncbi.nlm.nih.gov/31821126/)
- working body schema (left/right judgement ability) is affected post-stroke (https://pubmed.ncbi.nlm.nih.gov/36534017/)
- stroke survivors with chronic pain often perceive their affected body part to be a different size (https://www.mdpi.com/2076-3425/12/10/1331)
- there is a remarkably strong association with sensory discrimination and chronic pain post-stroke (https://www.mdpi.com/1660-4601/20/2/906)
As you can see, there are treatment targets galore here, that all fit with Noigroup’s thinking – approaching the individual as a whole, opportunities for reducing threat, and building perceived robustness! There are also a few more in the pipeline, which we’ll gladly share as they hit the press.
New developments
Recently, our friends at the Florey Institute have launched the Young Stroke Initiative, based in Melbourne, Australia. They aim to link people with stroke with existing services or refer them to their bespoke services that are being developed to support diagnostics, neuropsychological needs, return to work and driving, and advice for NDIS applications (the National Disability Insurance Scheme in Australia).
They are now accepting patients from across Victoria and South Australia, with a goal to expand to all of Australia. Referrals are accepted from GPs and other allied health professionals. For more details on the service, and how to make referrals, please contact youngstrokeadmin@florey.edu.au
For additional background information, see their main website or the project website.
Thank you for reading, your comments are welcome below.
– Dr Brendon Haslam
B App Sc (Physio) M Physio (Neurological) PhD MACP
Pain Physiotherapist (as awarded by the APA)
Neurological Physiotherapist (as awarded by the APA)
Noigroup instructor profile and course schedule
Explain Pain / Graded Motor Imagery / Explain Pain: Stroke and NeuroRehab
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