OSN Funded Research

Below is a list of Ontario Stroke Network Funded Research:

Project Title Principal Investigator Year Description of Project
Directed Research #1
Optimizing Care for Transient Ischemic Attack in Ontario
Dr. Moira Kapral / Dr. Ruth Hall 2012-2014 This project will provide key information on areas for improvement in current TIA management practices, and will evaluate the impact of Ontario’s stroke secondary prevention clinics on the care and outcomes of patients with TIAGoals and Objectives: 1) Identify predictors of hospitalization in patients with TIA; 2) Evaluate the impact of SPC care on processes of care and outcomes after TIA. We will evaluate processes of care for pts with TIA using quality indicators from the Canadian BP recommendations 2010.
Directed Research #2
Stroke units in Ontario: characteristics and costs associated with effectiveness
Dr. Murray Krahn 2012-2014 The primary objective is  to use a survey of hospitals in Ontario  and data available from the Ontario Stroke Audit (OSA) to identify which specific characteristics of Ontario Stroke Units (SUs) appear to be (cost-) effective and are associated with improved patient outcomes, in comparison to non-specialized general medical wards (GWs).
The research questions to be investigated comparing acute stroke care received at SUs to care received in GWs (i.e. care not received at SUs) include:
1. What are the characteristics of SUs in Ontario (i.e. frequently occurring, common characteristics)?
2. Are SUs effective, as currently structured in Ontario?
3. Are SUs cost-effective, as currently implemented in Ontario (i.e. what are the resources used and associated costs)?
4. Which SU characteristics are associated with improved patient- and system-level outcomes?
Investigator Driven Research
Effects of an Adapted Cardiac Rehabilitation Program of Combined Aerobic and Resistance Training Versus Aerobic Training Alone in People Following Stroke Dr. Dina Brooks / Susan Marzolini 2012-2014 The primary objective is to examine the effects of a 6 month program of combined aerobic and resistance training (AT+RT) compared to that of aerobic training alone (AT) on cardiovascular fitness (VO2peak) and mobility (6 minute walk distance) in people ≥3 months following stroke with motor impairments, participating in an adapted cardiac rehabilitation program.
The secondary objectives are to evaluate the effects of AT+RT compared to AT alone on the following:
a) Cognition and health-related quality-of-life (HRQOL)
b) Muscle mass and muscular strength
Community Reintegration of Stroke Survivors in Northeastern Ontario: The effect of a Community Navigation Intervention Darren Jermyn / Phyllis Montgomery 2012-2014 The project goals are knowledge creation, knowledge translation, and research capacity development.
Knowledge creation: A mixed methods approach drawing from both quantitative and qualitative traditions will be used to explore the phenomenon of community reintegration. Knowledge translation: Researchers and stakeholders will be engaged in various knowledge exchange and translation strategies. Creative and traditional knowledge translation activities will be implemented across Northeastern Ontario to promote understanding and dialogue about the applicability of the results to practice. Research capacity development: The use of various knowledge translation processes will foster a research-community alliance capable of advocating for change and sustaining the momentum required.
Enhancing Stroke Survivor Community Re-Integration  by Supporting their Family Caregiver Dr. Jill Cameron 2012-2014 The study extends a previous study to determine whether caregivers’ receipt of the TIRSFSP intervention resulted in enhanced community re-integration for stroke survivors. In addition, research will determine if caregivers who are better supported, have a greater sense of mastery, participate in more valued activities, and have better mental health is related to better community re-integration for stroke survivors.
Effectiveness of iPAD technology for HOME rehabilitation after Stroke (iHOME) Dr. Gustavo Saposnik / Dr. Chi-Ming Chow 2012-2014 The goal of iHOME is to examine the feasibility of an interactive software application, using a tablet PC (the iPad), to enhance attention and fine motor function of the upper extremity in stroke patients, relative to the standard of care.
Development and Evaluation of An Integrated Knowledge Translation Initiative to Train Physical and Occupational Therapists in a Motor Learning-based Virtual Reality Intervention Program Ms. Danielle Levac 2012-2014 Using a KT framework to guide a KT strategy designed to increase therapists’ uptake of motor learning-based VR interventions.
Development and Preliminary Evaluation of an Enhanced Fitness Program to Promote Long Term Engagement in Physical Activity after Stroke Dr. Avril Mansfield 2012-2014 The researchers propose that structured fitness programming could provide a supportive therapeutic environment to facilitate long-term changes in exercise behaviour. The components of the program are: supervised aerobic exercise with increased self-monitoring of patients’ progress, education regarding the benefits of physical activity, and development of plans to incorporate physical activity into everyday life.
Evaluation of the Effectiveness of Inpatient Rehabilitation for Mild Stroke Patients – A Functional Recovery Analysis of Inpatient Rehabilitation for Mild Stroke Patients Nicole Pageau 2011-2013 According to the Stroke Evaluation and Quality Committee report (2010), there are still a high number of stroke patients with a FIM™ score > 80 being admitted to the inpatient rehabilitation setting.  This project will follow (retrospectively) stroke patients over a two year period from two Regional Stroke Centre’s acute stroke units through rehabilitation.  The patients will be categorized within the three stroke severity bands (as per FIM™ score and RPG) and their functional gain and functional efficiency will be analyzed.
The impact of a Community Re-engagement Cue to Action Trigger Tool on the re-engagement in valued activities post stroke Jocelyne McKellar 2011-2013 The Community Re-engagement Cue to Action Trigger Tool (CR CATT) is a new question prompt list and patient-mediated intervention (PMI.) This study intends to inform about the usefulness of the question prompt list and PMI in the re-engagement of valued activities post stroke and its suitability for persons living with stroke and their caregivers.  The primary objective of this randomized controlled trial is to determine if persons with stroke will report higher participation in valued activities and report more positive experiences in their re-engagement process than those who are not exposed to the CR CATT.  A secondary objective is to explore, through qualitative interviews, the use of the tool by persons with stroke and their family caregiver.
Older Women Living with Stroke: A Missing Perspective in Emergency Management Tracey O’Sullivan 2011-2013 Stroke can precipitate changes in participation in daily life activities and roles. Older women with stroke have complex personal and situational contexts which increase their vulnerability every day and place them at higher risk during an emergency or community disaster, as they may be unable to access essential resources needed to protect themselves and participate in recovery activities. The proposed research employs a community-based approach and a gendered perspective to identify risk and capability among a specific group of Ontarians with disabilities: older women who have survived a stroke.
Peer support for stroke survivors: a pilot evaluation Dorothy Kessler 2011-2013 Innovative and sustainable programs are required to support the well-being and community reintegration of stroke survivors. Peer support is a potentially cost effective way to enhance survivors’ well-being and reintegration. Since 2008, the Stroke Survivors Association of Ottawa (SSAO) has been operating a volunteer peer support program (PSP).  This pilot evaluation will be instrumental in demonstrating the benefit of peer support. It will become a stepping stone for the development of best practices in this under researched area.  It will also provide information necessary for the establishment of a more extensive program of research on peer support for stroke survivors.
Improving safety and preventing falls in stroke survivors through the continuum of care Aleksandra Zecevic 2011-2013 Injuries and fractures due to falls are common complications after stroke. Greater focus on prevention of post-stroke fall related injuries is warranted and acutely required. This project proposes implementation and evaluation of an innovative method capable of identifying systemic causes of falls among stroke survivors as they transition from an acute care stroke unit, to stroke rehabilitation, community re-integration and/or long-term care.
Assessing the Impact of the South West LHIN’s Community Stroke Rehabilitation Teams: An Economic Analysis Robert Teasell 2011-2013 The proposed project seeks to evaluate the clinical and economic impact of the South West LHIN’s Community Stroke Rehabilitation Teams (CSRTs) in order to help improve this best-practice initiative and ensure that it is having the intended impact along the continuum of care.
Using wireless technology in clinical practice: does feedback of daily walking activity improve walking outcomes of individuals receiving rehabilitation post-stroke? Avril Mansfield 2011-2013 Regaining independent ambulation is the top priority for individuals recovering from stroke. Thus, physical rehabilitation post‐stroke should focus on improving walking function and endurance. The purpose of this study is to determine the effect of accelerometer‐based feedback of daily walking activity during rehabilitation on the frequency and duration of walking post‐stroke. Increased walking activity during rehabilitation is expected to improve walking function and community re‐integration following discharge. In addition, a focus on altering walking behaviour within the rehabilitation setting may lead to altered behaviour and increased activity patterns after discharge.
The SPOTLIGHT Study: A Multicentre Image-Guided Emergency Treatment Protocol for Patients with Intracerebral Hemorrhage David Gladstone 2011-2013 The overall goal of this work is to reduce death and disability from intracerebral hemorrhage, which accounts for 10-30% of all strokes worldwide and is the deadliest and most disabling type of stroke. With no approved hyperacute medical treatments for intracerebral hemorrhage, development of safe and effective therapy is urgently needed.
Communicative Access Measures for Stroke: Evaluation of reliability and usefulness Aura Kagan 2011-2013 This project will establish the validity and reliability of three communicative accessibility evaluation tools previously developed as part of an OSN grant. The entire purpose of this set of communicative access tools (Communicative Access Measures for Stroke (CAMS)) is to evaluate the level of communicative access across the spectrum of care at facilities that provide service to clients suffering the sequelae of stroke, in particular aphasia.
The Potential for Personal Support Workers to Support Stroke Survivors and Family Caregivers in Home-based Rehabilitation and Community Re-integration Wendy Gifford and Paul Holyoke (original applicant Catherine Brookman) 2011-2013 Mechanisms for realizing the potential of the Canadian best practices guidelines for stroke survivors who leave acute care to enter long-term care homes have been developed, but the continuum of care is relatively underdeveloped for survivors who return to their home in the community. This project will investigate the potential for Personal Support Workers (PSWs), where they are already providing personal care (home care) to clients, to be more active coaches and supporters of stroke survivors and their family caregivers in home-based rehabilitation and community re-integration. It will also identify additional supports and training that PSWs may need to increase their contribution in this area.

Project Title Principal Investigator Year Description of Project
The ‘Weight Times’ Strategy: A simple, low cost intervention to improve safety in patients receiving thrombolysis for acute stroke Dr. Richard Swartz 2010-2012 To demonstrate the feasibility and utility of introducing a ramp scale into the work flow of the acute stroke setting. We aim to show that this simple intervention can be implemented routinely for all acute stroke patients, without impeding speed of patient care and with positive impact on patient outcomes.
FIT for FUNCTION: A Community Wellness Program for Persons with Stroke Julie Richardson / Rebecca Fleck 2010-2012 (1) To assess the feasibility of a community partnership between 3 institutions (health (HHS),  community (YMCA) and academic (McMaster University)) to deliver a community based wellness program for persons with stroke. (2) To evaluate the community based wellness program for persons with stroke to improve the physical functioning, the self management skills and self efficacy around living with the sequelae of stroke. (3) To increase the capacity of a community institution (YMCA) to deliver a wellness program for community dwelling persons post stroke.
Exploring the influence of the adult daughter to stroke survivor relationship on caregiver wellbeing Jill Cameron 2010-2012 This study aims to understand how the interaction between the relationship and caregiver wellbeing impacts the needs of the ADC in order to inform future interventionalresearch aimed at supporting this unique caregiving population.
Linkage of the ‘Assessment for Living with Aphasia’ to an economic Quality of Life Measure Dr. Aura Kagan 2010-2012 (1) To assess the feasibility of using a pictographic, communicatively accessible version of the standard methodology for QALY calculation, the TTO (subsequently referred to as the picTTO). (2) To establish the reliability and validity of the picTTO (3) To establish QOL weights for the ALA
Effectiveness of Virtual Reality Exercises in STroke Rehabilitation (EVREST) Dr. Gustavo Saposnik 2010-2012 To examine the efficacy of virtual reality technology using the Wii Gaming system in the promotion of upper extremity functional recovery post stroke in a multi-centre trial. We hypothesize those stroke patients who receive virtual reality based therapy using the Wii gaming system (VRWii) up to 3 months following stroke will improve upper extremity function for activities of daily living greater than patients who receive recreational activities with identical inclusion and exclusion criteria.
Current State of Community Stroke Support Services in Ontario Dr. Mark Bayley 2010-2012 To understand the current state of community based programs and resources for persons with stroke in some of Ontario’s most populated cities. Specifically the objectives are: (1) To identify the neighbourhoods within each of the municipalities that have the highest prevalence of stroke survivors. (2) To identify the existing community stroke resources in these urban centres (3) To examine the extent to which existing stroke resources are located in areas of highest stroke survivor prevalence.  (4) To evaluate the visibility and accessibility of available community stroke resources by addressing questions such as; (i) How potential users are made aware of the availability of existing resources? (ii) How aware are health professionals of the existing programs? (iii)  Do the potential users have to have transportation means to access the resource? (iv) What are some successful communication strategies used by academic, healthcare, community planning and community member stakeholders to ensure linkages with these resources? (5) To determine to what extent do the existing community programs adhere to  best practices guidelines  by comparing program content to the interventions supported by available evidence and the Canadian Stroke Strategy Best practice recommendations for Community Reintegration?
Adherence to Canadian stroke rehabilitation guidelines regarding the assessment and treatment of post-stroke depression: a quality assurance initiative Dr. Robert Teasell 2010-2012 To estimate, based on data from a number of Ontario facilities providing inpatient stroke rehabilitation services, what proportion of patients are being screened for depression using a validated screening tool, receive additional detailed assessment by an appropriately trained mental healthcare professional and/or are treated for post-stroke depression.
Hemorrhage in Children with Cerebrovascular Malformations Dr. Gabrielle deVeber 2010-2012 (1) To determine the etiological contribution of cerebrovascular malformations to hemorrhagic stroke among children at a large Ontario Tertiary care centre (2) To determine the predictors of hemorrhage in children who harbour cerebrovascular malformations (3) Assemble a cohort of children with cerebrovascular malformations to determine frequency of hemorrhagic presentation and relative proportion of malformation subtypes.
A pilot study of the evaluation of the Family/Informal Caregiver Stroke Self Management Project (FICSS): Impact on Caregiver Psychosocial, Emotional and Health needs. Gail Mores 2010-2012 The primary outcome of this pilot project is to evaluate the impact of the FICSS project on the positive and negative effects of caregiving for informal family stroke caregivers, as defined by Bakas Caregiving Outcome Scale.Secondary outcomes of the research project:1) Evaluate the ability of the project to: (i)Decrease stroke caregiver stress, strain and burden (ii) Improve stroke caregivers’ problem solving ability by increasing their knowledge of strategies and community services (iii)Increase role satisfaction of the stroke caregiver and their satisfaction in their relationship with the stroke survivor (iv)Increase perceived quality of life of the caregiver; (2) 2) Develop a preliminary understanding of the optimal time to provide the intervention in order to optimize caregiver outcomes.
The Ontario Stroke Prevention Registry for aTrial Fibrillation Dr. David Gladstone 2010-2012 The primary objective of this project is to assess “real-world” antithrombotic management for secondary stroke prevention in patients with atrial fibrillation and a recent diagnosis of stroke or TIA, and to monitor the anticipated practice changes following Health Canada approval of dabigatran and other novel anticoagulants over the next 2 years.
Do measures of reactive balance control predict falls in people with stroke returning to
the community?
Elizabeth Iness / Avril Mansfield 2010-2012 The primary objective of this research is to create a novel model of falls risk for stroke survivors returning to community living, with a specific focus on the predictive capacity of measures of reactive balance control. These reactions are assessed using ‘advanced’ technological measures as part of a unique Balance Mobility and Falls Clinic at Toronto Rehab. We anticipate that a model that identifies those who are most likely toexperience a loss of balance, and least likely to be able to recover from instability, will be highly predictive of falls in the community. We hypothesize that indices of reactive balance control will explain a larger proportion of variability in fall rates than conventional clinical indices largely based on voluntary movement.
Impact of physical guidance schedule on learning of a challenging walking task in adults with a history of stroke: a pilot project Vincent DePaul 2010-2012 The overall purpose of this pilot study is to inform a series of future studies that will examine the impact of physical guidance during walking retraining after stroke.  A novel narrow base of support walking task paradigm will be used to evaluate the impact of physical guidance on relearning walking after stroke.
Project Title Principal Investigator Year Description of Project
Investigating the relationships between clinical and laboratory-based measures of exercise capacity and measures of physical activity in daily life in individuals post stroke Dina Brooks 2009-2011 This study will (i) measure how well a walking test reflects physical activity during daily life among individuals post-stroke, and (ii) compare whether laboratory and walking tests of exercise capacity result in similar responses. These findings will help guide clinicians to the most valid and cost effective means for measuring physical activity in the community.
Measuring engagement in valued activities and its health benefits among stroke survivors living in long term care facilities Mary Egan 2009-2011 In our research program we are addressing how community dwelling stroke survivors re-engage in their valued activities. The objective of the first phase is to develop a protocol combining quantitative and qualitative measures to examine, longitudinally, engagement in valued occupations and its health effects among stroke survivors who live in long-term care.
Exploring client centred care experiences of patients, families and health professionals in in-patient stroke rehabilitation settings: A mixed methods design Dr. Peter Rosenbaum 2009-2011 The objectives of this study are to 1) complete the development of a measurement tool that will capture the extent to which this partnership is experienced by patients, families, and health professionals; 2) understand the needs of patients and families in terms of ways in which this partnership can be improved; and 3) explore potential barriers to partnership experienced by health professionals. The mixed-methods study will be carried out in District Stroke Rehabilitation Centres in Southwestern Ontario. The results of this study will provide tools to enhance coordination and continuity of health care, in turn improving health care-related quality of life of Canadian families living with stroke
SOS Stroke Care: Evaluating gaps along the continuum in stroke care Dr. Gustavo Saposnik 2009-2011 To determine the continuity of evidence-based stroke care with antihypertensive and lipid-lowering agents between hospital and community care.
Mapping resource availability and patient needsView more hereClick here for webcast Dr. Robert Teasell 2009-2011 Building on the OSS funded “Blueprint for Transforming Stroke Rehabilitation in Ontario: Research Synthesis of Effectiveness and Cost-Benefits”, this project will establish a working economic model for stroke rehabilitation in Ontario by identifying the annual demand for rehabilitation resources and evaluating current resource availability.  The results will be built into an economic model to identify strategies to optimize use of currently available resources and to determine areas where future cost-effective investments should be made.
Tailored Interventions to Improve Hypertension Management after Stroke or TIA Study-Phase ll (TIMS ll) Gail MacKenzie 2009-2011 To determine the effectiveness of an inter-professional case management approach in reducing blood pressure and improving medication self-efficacy and adherence, and reducing stroke recurrence in SPC patients with confirmed stroke or probable Transient Ischemic Attack (TIA), and uncontrolled hypertension, and deficits in cognition, medication self-efficacy, and/or medication adherence. This study builds on the objectives of two previous studies that identified predictors of achievement of blood pressure targets and the feasibility of a Secondary Stroke Prevention Clinic (SPC) case management model.
Effect of Implementation of an Inpatient Code Stroke Protocol on Outcomes and Staff Knowledge Krystyna Skrabka 2009-2011 This study evaluates a quality improvement initiative and knowledge acquired from the implementation process and particularly the knowledge translation aspect may be broadly disseminated. Objectives: 1) To evaluate change in process indicators related to the rapid assessment and intervention for acute stroke pre and post implementation of the inpatient code stroke protocol. 2) To evaluate staff knowledge and retention pre and post intervention with respect to the signs and symptoms of acute stroke, key assessment criteria and, protocol for activation a code stroke.
Teach Our Children: Stroke Awareness for Aboriginal Youth Dr. Bruce Minore 2009-2011 This participatory research project will assess what Aboriginal youth understand about stroke, what they need to know about stroke and how to deliver this information in a cultural and age-appropriate manner. Using research results, the team will develop and evaluate a multimodal web and DVD based educational tool and assess its usefulness in assisting First Nations youth to understand stroke better.
The effect of a three dimensional scapular-humeral mobilization Technique and protocol on the reduction of hemiplegic shoulder pain Dr. Denyse Richardson 2009-2011 This double-blind randomized-controlled multi-centre study will investigate a novel three dimensional scapular-humeral mobilization treatment technique and protocol for decreasing HSP, and compare it to the current standard. The protocol includes scapular mobilizations in upward/downward rotation, anterior/posterior tilt about a horizontal axis, and medial/lateral tilt about a vertical axis, all of which are synchronized in alignment with humeral flexion, abduction and external rotation
Medical, rehabilitation, and educational needs after stroke: a study of ethnic subgroups in Toronto Dr. Leanne Casuabon 2009-2011 We plan to evaluate the needs of three major ethnic groups in the Toronto West Stroke Region: Chinese, Portuguese, and Caucasian, using a structured needs assessment questionnaire. Our objectives are to identify the needs of patients after stroke and to assess for possible factors such as age, gender, education, language, social supports, stroke type, and neurological deficits that may potentially affect these needs. Our goal is to address the needs of major ethnic groups in our entire region. Our study will address key questions regarding our patients’ needs in their recovery after stroke and what factors influence these needs. It is planned that after this study, the study protocol and questionnaire can be developed and translated as a tool to evaluate the needs of stroke patients representing the multiple other cultural groups in our region.

Project Title Principal Investigator Year Description of Project
Evaluation of blood pressure self monitoring in inpatient stroke rehabilitation: does it improve self management practices and blood pressure control in hypertensive patients after discharge Anna Bluvol 2008-2010 Determine whether the introduction of blood pressure self monitoring on the stroke rehab inpatient unit will have an impact on self management practices and on blood pressure control among hypertensive individuals after discharge. A randomized control trial. Anticipated clinical impact is improved self-management practices and improved BP control following rehabilitation, with potential reduction in stroke recurrence and cost savings to the health care system.
Collaborative Interprofessional Stroke Care in Community Re-engagement ( CISCCoR) Donna Cheung, Jocelyne McKellar 2008-2010 Assess the impact of education intervention on patient centred care and patient satisfaction. Study includes focus groups, interviews and questionnaires pre- and post-intervention
A point of care quality assurance project evaluating rapid access to carotid ultrasound in patients experiencing recent symptoms of transient ischemic attack Dr. Demetrios Sahlas 2008-2010 A quality assurance project to determine the time it takes for patients with TIA to have carotid ultrasound performed. Participating sites include ultrasound laboratories in three Regional Stroke Centres and three-to-six hospital and community-based laboratories.
Tele-Rehab: Improving access to quality stroke rehabilitation in rural and remote communities Esme French 2008-2010 Examine the impact of using telemedicine to conduct reassessments of the rehabilitation needs of persons with stroke in their come community post-discharge from hospital.
Evaluating an online self-learning portal supporting the implementation of stroke care clinical practice guidelines Andrea Fisher 2008-2010 Explores the feasibility of online self-learning to support the implementation of best practice guidelines for the urinary continence care of stroke survivors.
Effectiveness of Virtual Reality Exercised in Stroke Rehabilitation (EVREST) Dr. Gustavo Saposnik 2008-2010 A pilot randomized, two parallel group study comparing Wii Gaming vs. Recreational activity in patients receiving standard rehabilitation after stroke.
Enhancing the community reintegration of chines stroke survivors and their family caregivers: Phase 1- determining their experiences and needs Jill Cameron 2008-2010 Qualitative study to understand the experiences and needs of stroke survivors and family caregivers of Chinese origin.
Rehabilitation in the home environment: A knowledge transfer project to implement best practice and ensure continuity of care with stroke Julie Richardson 2008-2010 Implement an explicit framework for stroke rehabilitation within the home environment adapting task-oriented therapy to the home environment.
Psychometric evaluation of the assessment for living with aphasia: a tool to support data driven treatment and policy decisions in the area of stroke Aura Kagan 2008-2010 Build on pilot development and evaluation of the psychometric properties of the Assessment for Living with Aphasia (ALA) using a larger sample of 75 individuals with aphasia.  Objectives include a method of documenting and evaluating elusive but critical quality of life outcomes directly related to living with aphasia; a means of evaluating the efficacy of various aphasia interventions based on ratings by the person with aphasia him or herself; and finally, support for clinical decisions as well as for decisions regarding allocation of funds to aphasia treatments that reduce the negative life consequences of aphasia.
Primary Care Stroke Algorithm Kathryn Lockington 2008-2010 Researching and developing Primary Care stroke tools for: High risk stroke population identification and management, and Post-stroke management, recovery and community re-integration
Evaluation of the Implementation of the Revised Acute Stroke Medical Redirect Protocol in Urban and Rural Settings in Eastern Ontario Dr. Ian Stiell 2008-2010 We propose to conduct a rigorous evaluation of the revised Acute Stroke Medical Redirect Paramedic Protocol (ASMRPP). We expect to prospectively evaluate the ASMRPP on a prospective cohort of 2,400 patients with possible stroke, including 800 who are redirected from remote, rural, and urban communities to the three stroke centres. We will compare outcomes to those of a 2009 retrospective cohort obtained from the Canadian Stroke Registry.

Project Title Principal Investigator Year Description of Project
Blueprint for Transforming Stroke Rehabilitation in Canada: Research Synthesis of Effectiveness and Cost-Benefits Robert Teasell 2007-2009 Project evaluated the benefits of applying evidence-based processes of care to stroke rehabilitation in Ontario. Processes were incorporated into a cost-effectiveness model to evaluate their potential as cost-saving measures in Ontario.
The weekend home visit program during inpatient rehabilitation: how can we optimize the benefits to stroke survivors and family caregivers Jill Cameron 2007-2009 Little is known of stroke survivors’ and family caregivers’ experiences with weekend home visits. The objectives of this qualitative study were to understand their experiences and to determine the education and support needed to optimize the weekend home experience.
Integrated NeuroCognitive Assessment System (INCAS) for Stroke (Infrastructure revision of the collaborative affect, cognition and behavior database tool (ABC’C)) Jon Ween 2007-2009 The Integrated Neurocognitive Assessment System for stroke is an innovative, point-of-care tool that seeks to integrate clinical and cognitive data gathering and reporting for clinical, quality assurance and research purposes
Aboriginal Stroke Educational Strategy Dr. Bruce Minore 2007-2009 This participatory research project, conducted in partnership with six First Nations in Northwestern Ontario (1 urban, 3 rural and 2 remote), was designed to gain and understanding of how Aboriginal people understand stroke.
Evaluation of the impact of an eight week stroke specific exercise programme developed by physiotherapists and delivered in the community by trained fitness facilitators Esme French 2007-2009 Provide a safe and effective community exercise programme accessible to people with stroke, and focused on improving or maintaining mobility and health related quality of life, while providing an opportunity for community reintegration.
Clients perceptions on factors influencing their participation in a group stroke self-management program using videoconference technology: a qualitative study Denyse Taylor 2007-2009 This study explored the experiences of rural participants of the Moving on after Stroke Telehealth Remote program (MOST-TR). MOST® is an 18-session psycho-social program based on principles of self-management for people with stroke and their care partners in order to facilitate community reintegration.
Participation in valued activities post stroke Mary Egan 2007-2009 This project initiated a longitudinal cohort study of engagement in valued activities at 6, 9 and 12 months post stroke. This cohort will allow in-depth study of the trajectory of engagement in valued activities post stroke, the impact of this engagement on health and well-being, and barriers and facilitators of engagement in the post stroke period.
Premature Stroke Associated with Regency of Immigration to Ontario (PRESARIO) Dr Gustavo Saposnik 2007-2009 The PRESARIO project is a low-cost, potentially high-impact effort aimed to enhance stroke prevention among new immigrants to Ontario.
Navigating Community: Charting the Course Mary Egan 2007-2009 Due to the often complex nature of their health issues, stroke survivors must obtain, remember and synthesize information from various health providers. As well, they often have complex and on-going needs for support services and issues with private and public insurance providers. This project evaluated stroke survivors and their care partners in the areas of community re-integration, and physical and emotional well-being prior to and 4 months following initiation of Community Stroke Navigation services.
Communicative Access Measures for Health Systems: Development and Evaluation Aura Kagan 2007-2009 This project produced practical and simple means to support health care providers/administrators or researchers in evaluating and rating the degree to which their facility is communicatively accessible for people with aphasia. Three questionnaires and a guide explaining Communicative Access and tools to create an accessibility plan were also developed.
Tailored interventions to improve management after stroke or TIA Pilot Study (TIMS) Sandra Ireland 2007-2009 This pilot study demonstrated the feasibility and effectiveness of a case management model designed to improve medication adherence and blood pressure outcomes in 20 patients attending a Stroke Prevention Clinic (SPC) who were identified as having probable transient ischemic attack (TIA) and/or confirmed stroke and hypertension and one or more deficits in cognition, self-efficacy and self-reported non adherence.

Project Title Principal Investigator Year Description of Project
Survey of Physician Care Practices in Ontario for the Treatment of Hyperglycemia in the early stages of Stroke Care Frank Silver 2006-2008 Examined current care practices of physicians in Ontario for the management of hypoglycemia after early stroke.
Measure Best Practices and Quality of Care through Telestroke in Ontario Cheryl Jaigobin 2006-2008 Development of a web-based data collection system to enable information gathering on all stroke patients at Telestroke sites across Ontario.
Development of a web based course to maintain skills in nurses trained to screen for dysphagia Rosemary Martino 2006-2008 Facilitated the successful implementation of the new HSFO dysphagia screening model. Objectives were to: 1) Determine the natural history of dysphagia screening skill decay, and 2) Assess the benefit of independent web-based practice and periodic feedback on screening skill maintenance
Ontario Stroke Strategy- A Patient Centred Circle of Stroke Support Jan Kasperski 2006-2008 Development of “Saving the Brain Collaborative Stroke Care Network,” an educational mentoring program of the Ontario College of Family Physicians. The program links stroke specialist and family physician mentors with family physician mentees in their region.
Triage and Referral Toolkit for Stroke Prevention Clinic Project Dan Selchen 2006-2008 Created and piloted a comprehensive triage tool based on the “ABCD” scoring system.
Strategic Processes for Establishing Stroke Best Practice Guidelines in Diverse Central South Long Term Care Homes Kim Young 2006-2008 Partnered with senior administrative networks and a number of long-term care homes, including staff, residents and family caregivers, to develop, implement and evaluate strategies to create a stroke friendly culture of care
A motor learning based walking program versus body weight supported treadmill training in community dwelling adults within 6 months of stroke onset: a randomized controlled trial Vince De Paul 2006-2008 Randomized controlled trial to compare the efficacy of two different approaches to walking retraining, in community dwelling individuals within six months of stroke onset.
Evaluation of post stroke transition programs Donna Quiggan 2006-2008 Development and implementation of a shared evaluation framework of 3 transition programs available in the Champlain region, to ensure the appropriate, timely and integrated provision of care/supports along the continuum of care
Examination of the differences of rates of t-PA delivery via the Telestroke Neurologists Local Physician Group Kasia Luebke 2006-2008 Examining the rates of t-PA delivery in two physician groups and the factors which may contribute to rate differences.

Project Title Principal Investigator Year Description of Project
Ontario Secondary Stroke Prevention Data Registry Frank Silver 2005-2007 Development and implementation of a province-wide Registry for Secondary Prevention Clinics. Part of an ongoing research and evaluation agenda for stroke care by the research team.
The Childhood Stroke Pilot Project Gabrielle deVeber 2005-2007 The project involved conducting a needs assessment for childhood stroke at the 5 acute care pediatric Ontario hospitals. The project funded a Stroke Coordinator to facilitate the ongoing development and dissemination of guidelines and protocols for evidence-based stroke care for children.
The Stroke Rehabilitation Consensus Panel HSFO/
Caroline Ganji
2005-2007 Convened a Stroke Rehabilitation System Consensus Panel in order to: Describe and define components of the stroke rehabilitation system in Ontario, including key patient and system-level indicators for each component and common stroke rehabilitation definitions; Select common assessment tools; Identify components of a triage system; Determine and implement the initial steps in the development of a province-wide data system.
Canadian Stroke Quality of Care Study Phase V: Identification, Selection and Measurement of Quality of Care Indicators for Secondary Prevention Patrice Lindsay,
David Gladstone
Oxford Blood Pressure Education Project Judy Winter 2005-2007 Best-practice evidence-based education program for newly diagnosed clients with hypertension. A multi-disciplinary community education program is provided for the client and family, focusing on lifestyle modification and blood pressure medications.

 Project Title Principal Investigator Year Description of Project
Collaborative Development of an Affect – Behavior- Cognition Assessment Battery & Point of Care Case Record for Implementation with Wireless Device Technology in the Local Stroke Care Continuum. Jon Ween 2004-2006 The Integrated Neurocognitive Assessment System for stroke is an innovative, point-of-care tool that seeks to integrate clinical and cognitive data gathering and reporting for clinical, quality assurance and research purposes.
The Canadian Stroke Network Registry Frank Silver 2004-2006 Data collection to evaluate the characteristics of stroke patients in Ontario, assess the type of stroke care they receive, and assist in the evaluation of the Ontario Stroke Strategy.
Converting Stroke Best Practices Into a Province Wide Tele-Education Module Ellen Rukholme 2004-2006 Develop, produce, pilot and evaluate a technology-enabled stroke education program targeted for nurses. Technologies used included videoconferencing, web casting, and a web-based learning site.