WFNR Franz Gerstenbrand Award
The WFNR Franz Gerstenbrand Award, worth £3000, recognises and rewards a neurorehabilitation project that has benefitted patients.
Named after Professor Franz Gerstenbrand in recognition of his contribution to neurorehabilitation, the Award is open to WFNR members and non-members worldwide.
Entries for the WFNR Award are welcome from clinicians, researchers and allied health professionals who are currently working in neurorehabilitation. Special consideration is given to applications from those under 35 years of age.
Entries can involve any aspect of neurorehabilitation, e.g.:
- Patient or clinic management initiative
- Research project
- Best practice development
- Use of a new technological development
The entries must demonstrate a difference to patient outcome.
The work described must be completed and yielded results, or published in the last 12 months.
There is a single prize of £3000.
This will be awarded for a:
- Travel bursary to a clinical/scientific conference
- Professional development course
- Research project
WINNER OF THE 6th WFNR FRANZ GERSTENBRAND AWARD
PROFESSOR MARY GALEA AND HER TEAM WIN THE 6TH WFNR FRANZ GERSTENBRAND AWARD.
Professor Mary Galea, Professorial Fellow from the University of Melbourne in Australia and her team have won the 2019 World Federation for NeuroRehabilitation (WFNR) Franz Gerstenbrand Award. Their research project, recently published in the Lancet, showed how hand function can be restored in people with spinal cord injury (SCI) using nerve transfer surgery1.
Professor Mary Galea led a research group from the Department of Medicine at the Royal Melbourne Hospital and the Victorian Spinal Cord Service at Austin Health, together with Dr Natasha van Zyl, a plastic and reconstructive surgeon at Austin Health, in the largest prospective, consecutive case series of nerve transfers undertaken to date at a single centre in the tetraplegic population.
The study involved 16 participants (13 male, 3 female) with an average age of 27 years, and within 18 months of traumatic SCI affecting the mid-cervical region. Most of the injuries were the result of motor vehicle accidents or sports injuries. Participants underwent single or multiple nerve transfers in one or both upper limbs to restore elbow extension, grasp, pinch, and hand opening (59 nerve transfer procedures in 27 limbs). After immobilisation, intensive therapy was provided to maintain joint mobility and to practise activation of the donor muscle function paired with passive recipient muscle movement. When reanimation of the recipient muscle(s) was first detected, recipient muscle strengthening was commenced through the patient activating donor muscle movement against resistance.
At the two-year time-point, significant improvements were observed in the participants’ ability to pick up and release objects of different sizes within a specified time and also in their independence. Prior to surgery, none of the participants were able to perform the grasp or pinch strength tests, however two years later, pinch and grasp strength were sufficiently high to enable performance of most activities of daily living. The outcomes in hands, where grasp and pinch had been reconstructed with nerve transfers, were similar to those reconstructed with tendon transfers. However, a hand reconstructed with a nerve transfer for grasp and pinch had a more natural appearance and feel for social interactions and extended (opened) more easily for use of electronic devices. Participants were satisfied with outcomes, would have the surgery again and would recommend it to others.
Professor David Good, WFNR President Elect said: “Congratulations - Mary and her team are well-deserved winners of the WFNR Franz Gerstenbrand Award. This is a high quality project showing how nerve transplantation can improve spinal cord injury causing weakness of the upper extremity – it’s unique. Great science in SCI patients.”
Commenting on winning the Award, worth £3000, Mary said: “Our team is delighted to win the Award. Nerve transfer surgery offers an exciting new option for the reanimation of upper limb function in tetraplegia and we’ll be using the prize for further research.”
1. Van Zyl N, Hill B, Cooper C, Hahn J, Galea MP. Expanding traditional tendon-based techniques with nerve transfers for the restoration of upper limb function in tetraplegia: a prospective case series. Lancet 2019;394(10198):565-575.
WINNER OF THE 5TH WFNR FRANZ GERSTENBRAND AWARD
Dr Jessica Trevena-Peters, a Clinical Neuropsychologist at Australia’s Monash-Epworth Rehabilitation Research Centre has won the 2018 World Federation for NeuroRehabilitation (WFNR) Franz Gerstenbrand Award. The findings of her study ‘Commencing rehabilitation early: activities of daily living retraining during post-traumatic amnesia’ challenge current thinking about the timing of rehabilitation in individuals with post-traumatic amnesia (PTA).
The assessment and management of individuals in PTA varies greatly, with limited evidence guiding clinical practice. In Australia, rehabilitation requiring active participation is often delayed until the individual emerges from PTA due to impaired learning ability and the perceived risk of increasing agitation. This approach is not universal.
The randomised controlled clinical trial took place over a three-year period and involved 104 participants. It evaluated the impact of the provision of activities of daily living (ADL) retraining during PTA following Traumatic Brain Injury (TBI), with treatment as usual (TAU), compared with TAU alone (daily physiotherapy, speech therapy for swallowing and communication) during PTA in improving functional independence. The primary outcome measure was the Functional Independence Measure (FIM) with assessments at baseline, PTA emergence, discharge from inpatient rehabilitation and two-month follow-up by a research assistant independent of treatment delivery and blinded by group membership. Secondary outcomes included rehabilitation inpatient length of stay, PTA duration, agitation levels during PTA, goal attainment, and community re-integration. Qualitative interviews regarding the experience of delivering therapy were conducted with therapists.
Commencing ADL retraining during PTA produced greater improvements in functional independence for individuals than when the training began after PTA emergence. Despite being amnesic, individuals in PTA were able to benefit from skill retraining when it was provided in a procedural and errorless framework. Agitation was not increased by delivery of the intervention and did not limit participation.
WINNER OF THE 4TH WFNR FRANZ GERSTENBRAND AWARD
Dr Charlotte Stagg, Associate Professor and Sir Henry Dale Fellow who is based at the John Radcliffe Hospital in Oxford, UK is the winner of the 2016 WFNR Franz Gerstenbrand Award.
Chronic stroke is one of the most common causes of long-term neurological disability. The recovery of hand function is extremely important for stroke survivors but intensive physiotherapy, the current ‘gold’ standard intervention is expensive, in short supply and inherently limited by the activity of the residual cortex.
One potential adjunct therapy is transcranial Direct Current Stimulation (tDCS) to the ipsilesional primary motor cortex (M1). Anodal transcranial Direct Current Stimulation (A-tDCS) is a non-invasive brain stimulation technique that involves passing a 1mA current through the brain via two scalp electrodes, with one centred over the ipsilesional M1.
Dr Stagg reported on a randomised, double-blind placebo controlled trial using A-tDCS as an adjunct to physiotherapy in patients with chronic stroke. Patients received a one-hour long standardised upper limb training intervention across nine consecutive working days, with tDCS applied during the first 20 minutes each day. They were then assessed before, one day, one week, one month and three months after the intervention. Patients also had an MRI scan where a range of sequences were acquired, including functional MRI and measures of grey matter volume.
Overall the improvements in function seen in the A-tDCS group reflected meaningful long-lasting functional benefits. As A-tDCS is a relatively cheap, well-tolerated and easy-to-use approach, the results of this study suggest that it could rapidly become part of clinical practice and guide therapy developments.
WINNER OF THE 3rd WFNR FRANZ GERSTENBRAND AWARD
Dr Wuwei Feng, Assistant Professor of Neurology at the University of South Carolina, USA is the winner of the 3rd WFNR Franz Gerstenbrand Award.
Motor impairment is the most common complication after stroke and making accurate predictions about motor outcome and recovery potential continues to challenge stroke clinicians. Dr Feng used the Upper-Extremity Fugl-Meyer (UE-FM) Scale to measure the motor impairment in the acute phase and at three months, in 76 patients in a two-cohort study. A weighted CST lesion load (wCST-LL) was calculated by overlaying the patient’s lesion map on MRI with a probabilistic CST constructed from age-matched healthy control subjects. Dr Feng found that the wCST-LL could effectively predict post-stroke motor outcomes at three months in both cohorts, especially in patients with severe impairment at baseline. This tool only requires a clinical MRI scan which gives it an advantage over other methods and its use will mean that patients and their families can be better informed about motor recovery prognosis.
Dr Feng will use part of the prize to attend the 9th World Congress for NeuroRehabilitation to be held in Philadelphia in May 2016. The rest, he will donate to the Stroke Reseasrch Foundation.