Seeking answers for a common disease

Picture caption: Matt Wingfield with two of his PhD supervisors from University of Melbourne Dr Nat Fini and A/Prof Kate Hayward.

Research to identify the most effective combination of treatments for stroke recovery has netted Epworth Camberwell physiotherapist Matt Wingfield the New Investigator in Recovery Award from the Stroke Society of Australasia.

Matt’s research was undertaken as part of his PhD and he was also supported through an Epworth scholarship.

“This project has focused on working out what makes treatments effective and what treatments support brain recovery from stroke. Our brains are not straight forward. There is massive variability within this single disease, so it is hard to tackle and unfortunately stroke is not going away,” Matt said.

“One in four people in their lifetime will have a stroke. In 2020, 500,000 people were living with stroke and this will grow to 820,000 by 2050.”

Matt’s qualitative research brought together nine neuroscientists who specialise in stroke recovery plus nine clinical researchers, nine clinicians and 10 stroke survivors, asking them what is important to include in a treatment package.

“We think it is the combination and connection between treatments that makes it effective. This a paradigm shift on how we have undertaken research before,” Matt added.

From this research, Matt came up with four therapy elements:

1. engagement in the intervention; looking at aspects like a patient’s motivation, support and hope in recovery
2. dose of intervention
3. content of therapy involved
4. therapist – who delivers the care.

“We know something like hope is essential for recovery and for people who don’t have hope, we must try to facilitate a shift in their thinking.

“Neuroscientists helped us understand how we can motivate people in their therapy. It goes beyond a pat on the back, you must try to leverage an inbuilt reward system to get the best results. Some people are good at accessing that and some are not.”

The team has also been discussing new approaches to therapy.

“We’re thinking about what makes things like TikTok addictive. How can we get patients, who are lacking in motivation, ‘addicted’ to their therapy? If we can understand how to do that, we can get patients engaged and they will seek more treatment, which will help them get better. With animal studies, food is used as a motivator. With humans, perhaps it’s access to a mobile phone to view videos (on TikTok) while a patient resets between therapy. Anything to make them feel good.

For Matt, the next steps are to encapsulate multiple therapy elements for trial with patients over the next couple of years.

“It will mean personalised care. One patient will want to achieve X and the way you treat them will be different to someone who wants to achieve Y.

“Stroke is still prevalent; it is not going away. About 60% of stroke patients are older than 60 years old, so this disease will only increase as the population ages.”

Congratulations to Matt on receiving the Recovery Award from the Stroke Society of Australasia and we wish him well for the remainder of his important research.