S+SLAM-TIA is a research project evaluating the effect of translation of an evidence based stroke prevention education and exercise program into the Hunter New England Local Health District (HNE LHD) health service.

Dr Heidi Janssen
Conjoint Lecturer
School of Health Sciences
- Email:heidi.janssen@newcastle.edu.au
- Phone:0240420417
Career Summary
Biography
Dr Janssen (PhD, MHSC, BPhysio) is an experienced physiotherapist and researcher fully immersed clinically and academically in the field of stroke recovery and rehabilitation research. Dr Janssen is well respected amongst her clinical and research peers locally, and nationally. Currently she is employed with Hunter New England Local Health District (HNE LHD) as a senior physiotherapist with Community and Aged Care Services Community Stroke Team and with Hunter Stroke Service. She holds a conjoint position in the School of Health Sciences (Physiotherapy), University of Newcastle (UoN), is a member of the Priority Research Centre for Stroke and Brain Injury and a Research Affiliate of the NHMRC Centre for Excellence in Stroke (Hunter Medical Research Institute and The Florey) Rehabilitation and Brain Recovery.
Dr Janssen is one of very few senior allied health clinicians who has a doctorate and is actively leading clinical trials and does so whilst working with stroke survivors and carers within the health system. This clinical role gives her invaluable insights into the needs of the two biggest stakeholders in stroke care; the stroke survivor and the health care provider.
Through the completion of her PhD, Dr Janssen was the first to translate the use of environmental enrichment into the clinical setting. Dr Janssen is committed to making significant contributions to her discipline. In addition to the professional development days she presents to her fellow clinicians, she regularly talks with community groups including at HMRI functions. She reviews for journals and funding bodies and supervises Higher Degree Research students including PhD and honours studnets, and mentors fellow clinicians on research method. She is a member of the Agency for Clinical Innovation’s Stroke and Rehabilitation Network and Stroke Society of Australasia, is on the physiotherapy working party for the Stroke Clinical Guidelines (2017 update and now Living Guidelines project) and is an active member of the ACtivity To Improve Outcome after Stroke (ACTIOnS) Group. She is a member of the organizing and scientific committee for the Australian Cardiovascular Disease and Health and Rehabilitation Association (ACRA).
Dr Janssen is an active participant in all her research collaborations. She is passionate about designing and testing interventions which are clinically relevant and feasible. She was integral in the development and testing of the first human equivalent (patient driven) model of environmental enrichment and is highly regarded in the field for work in this space to date. Output related to her clinical research demonstrates that Dr Janssen is a major leader in the field of health research translation.
Future Focus
My hope is that people living with stroke and their families will have a space in the community where they can come together, socialise, support and encourage each other, exercise and do other enjoyable activities which are beneficial for their brain, body and well-being. To create a model of rehabilitation that is ‘owned’ by the community and which has the support of community members, many local groups, and council and health services. That this model of rehabilitation may be of benefit for many different people who have had significant life changing events and or diagnoses affecting the brain, and that this model is available for such people to use for as long as they need.
Specialised/Technical Skills
I am a physiotherapist experienced in stroke rehabilitation, exercise prescription and health behavior change to prevent cardiovascular events. She is a clinical trialist capable of leading large research teams, designing clinical studies from proof of concept through to determination of effectiveness. Dr Janssen is a health translational researcher.
Affiliations
- University of Newcastle, School of Health Science
- Priority Research Centre for Stroke and Brain Injury
- Hunter New England Local Health District
- Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery
- The Florey Institute of Neuroscience and Mental Health
Memberships
- ACtivity to Improve Outcome After Stroke (ACTIOnS)
- Australian Cardiovascular Health and Rehabilitation Association (ACRA)
- Stroke Society of Australasia (SSA)
- Stroke Foundation of Australia Living Guidelines Project
Source: HMRI Researcher Profile - Dr Heidi Janssen https://hmri.org.au/researchers/heidi-janssen HMRI Researcher Profile - Dr Heidi Janssen
Qualifications
- Doctor of Philosophy, University of Newcastle
- Bachelor of Physiotherapy, Charles Sturt University
- Master of Health Science (Neurological Physiothera, University of Sydney
Keywords
- environmental enrichment
- exercise
- secondary stroke prevention
Fields of Research
Code | Description | Percentage |
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110201 | Cardiology (incl. Cardiovascular Diseases) | 20 |
110317 | Physiotherapy | 30 |
110321 | Rehabilitation and Therapy (excl. Physiotherapy) | 50 |
Professional Experience
Professional appointment
Dates | Title | Organisation / Department |
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1/6/2017 - |
NSW Early Career Research Fellow, NSW Health and Hunter New England Local Health District Clinical Research Fellow (honorary) |
Hunter New England Local Health District Australia |
7/1/2007 - | Health Services Manager (Research Associate) | Hunter Stroke Service (Hunter New England Local Health District) Australia |
7/1/2016 - | Senior Physiotherapist | Community Stroke Team, Hunter New England Local Health District Australia |
1/1/2014 - 31/12/2016 | Casual Physiotherapist | Westlakes Community Rehabiltation Unit, Hunter New England Local Health District Australia |
Teaching appointment
Dates | Title | Organisation / Department |
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31/1/2014 - | Conjoint Lecturer | School of Health Sciences, Faculty of Health and Medicine, University of Newcastle Australia |
31/1/2012 - 31/12/2014 | Casual lecturer/Tutor (Neurological Physiotherapy) | School of Health Science, Faculty of Health & Medicine, The University of Newcastle Australia |
Awards
Award
Year | Award |
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2019 |
Vice Chancellor's Early Career Research and Innovation Excellence Award, Faculty of Health and Medicine University of Newcastle, Australia |
Research Award
Year | Award |
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2019 |
Women in Medical Research Fellowship (WIMRF) Hunter Medical Research Institute |
2017 |
Honorary 2017 Clinical Research Fellowship Hunter New England Local Health District NSW Health |
Publications
For publications that are currently unpublished or in-press, details are shown in italics.
Chapter (1 outputs)
Year | Citation | Altmetrics | Link | ||
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2018 |
Janssen H, Nilsson M, Spratt N, Walker FR, Pollack M, 'Environmental enrichment:neurophysiological responses and consequences for health', The Oxford Textbook of Nature and Public Health - The role of nature in improving the health of a population, Oxford University Press, Great Britain 71-78 (2018)
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Journal article (26 outputs)
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2020 |
English C, Weerasekara I, Carlos A, Chastin S, Crowfoot G, Fitzsimons C, et al., 'Investigating the rigour of research findings in experimental studies assessing the effects of breaking up prolonged sitting extended scoping review', Brazilian Journal of Physical Therapy, (2020) © 2020 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia Objectives: Sedentary behaviour research is a relatively new field, much of which has emerged since the wi... [more] © 2020 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia Objectives: Sedentary behaviour research is a relatively new field, much of which has emerged since the widespread acceptance of clinical trial registration. The aim of this study was to investigate the trial registration and related issues in studies investigating the effect of frequent activity interruptions to prolonged sitting-time. Methods: Secondary analysis of a scoping review including systematic searches of databases and trial registries. We included experimental studies investigating the effects of frequent activity interruptions to prolonged sitting-time. Results: We identified 32 trials published in 45 papers. Only 16 (50%) trials were registered, with all 16 trials being completed and published. Of the unregistered trials, we identified three (19%) for which similarities in the sample size and participant demographics across papers was suggestive of duplicate publication. Identification of potential duplicate publications was difficult for the remaining 13 (81%). Results from 53 (76%) of the 70 registered outcomes were published, but 11 (69%) registered trials reported results from additional outcomes not prospectively registered. A total of 46 different outcomes (out of 53 reported outcome measures, similar measures were collated) were reported across all trials, 31 (67%) of which were collected in =2 trials. Conclusions: We found direct evidence of trial registration issues in experimental trials of breaking up sitting-time. The lack of prospective registration of all trials, and the large number of outcomes measured per trial are key considerations for future research in this field. These issues are unlikely to be confined to the field of sedentary behaviour research.
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2020 |
Sammut M, Fini N, Haracz K, Nilsson M, English C, Janssen H, 'Increasing time spent engaging in moderate-to-vigorous physical activity by community-dwelling adults following a transient ischemic attack or non-disabling stroke: a systematic review.', Disabil Rehabil, 1-16 (2020)
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2019 |
Geldens N, Crowfoot G, Sweetapple A, Vyslysel G, Mason G, English C, Janssen H, 'Patient readiness for risk-reduction education and lifestyle change following transient ischemic attack', DISABILITY AND REHABILITATION, (2019)
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2019 |
Mackie P, Weerasekara I, Crowfoot G, Janssen H, Holliday E, Dunstan D, English C, 'What is the effect of interrupting prolonged sitting with frequent bouts of physical activity or standing on first or recurrent stroke risk factors? A scoping review', PLoS ONE, 14 1-24 (2019) [C1]
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2019 |
Hanna E, Janssen H, Crowfoot G, Mason G, Vyslysel G, Sweetapple A, et al., 'Participation, Fear of Falling, and Upper Limb Impairment are Associated with High Sitting Time in People with Stroke.', Occupational therapy in health care, 33 181-196 (2019) [C1]
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2019 |
Denham AMJ, Wynne O, Baker AL, Spratt NJ, Turner A, Magin P, et al., '"This is our life now. Our new normal": A qualitative study of the unmet needs of carers of stroke survivors', PLOS ONE, 14 (2019) [C1]
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2018 |
Kenah K, Bernhardt J, Cumming T, Spratt N, Luker J, Janssen H, 'Boredom in patients with acquired brain injuries during inpatient rehabilitation: a scoping review', Disability and Rehabilitation, 40 2713-2722 (2018) [C1] © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group. Purpose: Boredom may impede engagement in inpatient rehabilitation following an acquired brain injury. ... [more] © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group. Purpose: Boredom may impede engagement in inpatient rehabilitation following an acquired brain injury. This review aimed to: (1) describe the experience and (2) quantify the incidence of boredom; (3) identify measurement tools used to quantify boredom; (4) summarize factors contributing to boredom, and (5) outline evidence-based interventions shown to reduce boredom during inpatient rehabilitation. Methods: Two researchers independently screened publications retrieved from electronic database searches. Publications presenting patient, carer or staff data relating to boredom in inpatients with acquired brain injuries were included. Results: Two thousand four hundred and ninety-nine references were retrieved, 88 full texts were reviewed, with 24 studies included. The majority of studies reported qualitative data indicating boredom to be a common experience of patients with acquired brain injuries (n = 14 studies +1 review). The incidence of boredom post acquired brain injury is unknown. Personal and organizational factors and the physical environment may contribute to boredom (n = 11 studies +2 reviews). Qualitative work (n = 9 studies) indicates that use of the creative-arts or exposure to environmental enrichment may help alleviate boredom in patients with acquired brain injuries during inpatient rehabilitation. Conclusion: Further mixed-methods research is required to establish the incidence of and contributing factors to boredom in patients with acquired brain injuries undergoing rehabilitation. Understanding this will help inform future research aimed at improving patient engagement in inpatient rehabilitation.Implications for rehabilitation Boredom is commonly reported by hospitalised patients with ABI to negatively affect their rehabilitation yet the scope of the problem has not been measured. Boredom is a complex phenomenon, likely influenced by a number of personal and environmental factors that are not fully understood in this population. Through a better understanding of boredom, interventions may be developed to improve patient engagement in inpatient rehabilitation programs.
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2018 |
Lynch EA, Jones TM, Simpson DB, Fini NA, Kuys SS, Borschmann K, et al., 'Activity monitors for increasing physical activity in adult stroke survivors', Cochrane Database of Systematic Reviews, 2018 (2018) [C1]
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2018 |
English C, Janssen H, Crowfoot G, Bourne J, Callister R, Dunn A, et al., 'Frequent, short bouts of light-intensity exercises while standing decreases systolic blood pressure: Breaking Up Sitting Time after Stroke (BUST-Stroke) trial', International Journal of Stroke, 13 932-940 (2018) [C1] © 2018 World Stroke Organization. Background: Stroke survivors sit for long periods each day. Uninterrupted sitting is associated with increased risk of cardiovascular disease. Br... [more] © 2018 World Stroke Organization. Background: Stroke survivors sit for long periods each day. Uninterrupted sitting is associated with increased risk of cardiovascular disease. Breaking up uninterrupted sitting with frequent, short bouts of light-intensity physical activity has an immediate positive effect on blood pressure and plasma clotting factors in healthy, overweight, and type 2 diabetic populations. Aim: We examined the effect of frequent, short bouts of light-intensity physical activity on blood pressure and plasma fibrinogen in stroke survivors. Methods: Prespecified secondary analyses from a three-armed randomized, within-participant, crossover trial. Participants were 19 stroke survivors (nine female, aged 68 years old, 90% able to walk independently). The experimental conditions were sitting for 8 h uninterrupted, sitting with 3 min bouts of light-intensity exercise while standing every 30 min, or sitting with 3 min of walking every 30 min. Blood pressure was measured every 30 min over 8 h and plasma fibrinogen at the beginning, middle, and end of each day. Intention-to-treat analyses were performed using linear mixed models including fixed effects for condition, period, and order, and a random intercept for participant to account for repeated measures and missing data. Results: Sitting with 3 min bouts of light-intensity exercise while standing every 30 min decreased systolic blood pressure by 3.5 mmHg (95% CI 1.7¿5.4) compared with sitting for 8 h uninterrupted. For participants not taking antihypertensive medications, sitting with 3 min of walking every 30 min decreased systolic blood pressure by 5.0 mmHg (95% CI -7.9 to 2.0) and sitting with 3 min bouts light-intensity exercise while standing every 30 min decreased systolic blood pressure by 4.2 mmHg (95% CI -7.2 to -1.3) compared with sitting for 8 h uninterrupted. There was no effect of condition on diastolic blood pressure (p = 0.45) or plasma fibrinogen levels (p = 0.91). Conclusion: Frequent, short bouts of light-intensity physical activity decreases systolic blood pressure in stroke survivors. However, before translation into clinical practice, the optimal duration and timing of physical activity bouts needs to be determined. Clinical trial registration: Australian and New Zealand Clinical Trials Registry http://www.anzctr.org.au ANZTR12615001189516.
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2018 |
English C, Janssen H, Crowfoot G, Callister R, Dunn A, Mackie P, et al., 'Breaking up sitting time after stroke (BUST-stroke)', International Journal of Stroke, 13 921-931 (2018) [C1] © 2018 World Stroke Organization. Objectives: People with stroke sit for long periods each day, which may compromise blood glucose control and increase risk of recurrent stroke. S... [more] © 2018 World Stroke Organization. Objectives: People with stroke sit for long periods each day, which may compromise blood glucose control and increase risk of recurrent stroke. Studies in other populations have found regular activity breaks have a significant immediate (within-day) positive effect on glucose metabolism. We examined the effects of breaking up uninterrupted sitting with frequent, short bouts of light-intensity physical activity in people with stroke on post-prandial plasma glucose and insulin. Methods: Randomized within-participant crossover trial. We included people between 3 months and 10 years post-stroke, ambulant with minimal assistance and not taking diabetic medication other than metformin. The three experimental conditions (completed in random order) were: sitting for 8 h uninterrupted, sitting with 3 min bouts of light-intensity exercise while standing every 30 min, or sitting with 3 min of walking every 30 min. Meals were standardized and bloods were collected half- to one-hourly via an intravenous cannula. Results: A total of 19 participants (9 female, mean [SD] age 68.2 [10.2]) completed the trial. The majority (n = 12, 63%) had mild stroke symptoms (National Institutes of Stroke Scale score 0¿13). There was no significant effect of experimental condition on glucose (mean [SD] positive incremental area [+iAUC] mmol·L·h-1 under the curve during sitting 42.3 [29.5], standing 47.4 [23.1], walking 44.6 [26.5], p = 0.563) or insulin (mean + iAUC pmol·L·h-1 sitting 14,161 [7,560], standing 14,043 [8,312], walking 14,008 [8,269], p = 0.987). Conclusion: Frequent, short bouts of light-intensity physical activity did not have a significant effect on post-prandial plasma glucose and insulin in this sample of people with stroke. Further studies are needed to identify strategies that improve inactivity-related glucose metabolism after stroke.
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2017 |
Lynch EA, Cumming T, Janssen H, Bernhardt J, 'Early Mobilization after Stroke: Changes in Clinical Opinion Despite an Unchanging Evidence Base', Journal of Stroke and Cerebrovascular Diseases, 26 1-6 (2017) [C1] © 2017 National Stroke Association Background We sought to determine whether Australasian health professionals' opinions regarding early mobilization after stroke changed bet... [more] © 2017 National Stroke Association Background We sought to determine whether Australasian health professionals' opinions regarding early mobilization after stroke changed between 2008 and 2014, when a large international trial of early mobilization (A Very Early Rehabilitation Trial, AVERT) was underway. Methods Attendees at the two major Australasian stroke conferences in 2008 and 2014 were surveyed. Participants rated their agreement with statements about the risks and benefits of commencing mobilization within 24 hours of hemorrhagic and ischemic stroke using a 5-point Likert scale. Participants in 2014 were asked about their awareness of AVERT. Logistic regressions were performed to determine whether the time point (2008 versus 2014) or awareness of AVERT influenced opinions about early mobilization. Results Surveys were completed by 443 health professionals (2008: N¿=¿202; 2014: N¿=¿241). Most respondents in 2014 reported that early mobilization was beneficial and not harmful to people with ischemic and hemorrhagic stroke. Opinions regarding mobilization after ischemic stroke did not change significantly between 2008 and 2014. In 2014, a significantly greater proportion of respondents believed that early mobilization after hemorrhagic stroke was helpful (2008: n¿=¿98 of 202 [49%] versus 2014: n¿=¿170 of 241 [71%], P¿<¿.01). Awareness of AVERT was significantly associated with the opinion that early mobilization was beneficial and not harmful to patients with stroke (P¿<¿.05). Conclusions Australasian health professionals' opinions of early mobilization after hemorrhagic stroke changed between 2008 and 2014, prior to reporting of the AVERT trial. Our results suggest that awareness of an ongoing research trial can lead to changes in opinions before the efficacy of the experimental intervention is known.
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2017 |
Rosbergen ICM, Grimley RS, Hayward KS, Walker KC, Rowley D, Campbell AM, et al., 'Embedding an enriched environment in an acute stroke unit increases activity in people with stroke: a controlled before-after pilot study', CLINICAL REHABILITATION, 31 1516-1528 (2017) [C1]
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2015 |
White JH, Bartley E, Janssen H, Jordan LA, Spratt N, 'Exploring stroke survivor experience of participation in an enriched environment: A qualitative study', Disability and Rehabilitation, 37 593-600 (2015) [C1] © 2014 Informa UK Ltd. All rights reserved. Background: Data highlight the importance of undertaking intense and frequent repetition of activities within stroke rehabilitation to ... [more] © 2014 Informa UK Ltd. All rights reserved. Background: Data highlight the importance of undertaking intense and frequent repetition of activities within stroke rehabilitation to maximise recovery. An enriched environment (EE) provides a medium in which these activities can be performed and enhanced recovery achieved. An EE has been shown to promote neuroplasticity in animal models of stroke, facilitating enhanced recovery of motor and cognitive function. However, the benefit of enriching the environment of stroke survivors remains unknown. Aim: To qualitatively explore stroke survivors' experience of implementation of exposure to an EE within a typical stroke rehabilitation setting, in order to identify facilitators and barriers to participation. Methods: Semi-structured interviews with 10 stroke survivors (7 females and 3 males, mean age of 70.5 years) exposed to an EE for a 2-week period following exposure to routine rehabilitation within a stroke rehabilitation ward. An inductive thematic approach was utilised to collect and analyse data. Results: Qualitative themes emerged concerning the environmental enrichment paradigm including: (1) "It got me moving"-perceived benefits of participation in an EE; (2) "You can be bored or you can be busy."-Attenuating factors influencing participation in an EE; (3) "I don't like to make the staff busier"-limitations to use of the EE. Conclusions: This study provides preliminary support for the implementation of an EE within a typical stroke rehabilitation setting from a patient perspective. Reported benefits included (1) increased motor, cognitive and sensory stimulation, (2) increased social interaction, (3) alleviation of degree of boredom and (4) increased feelings of personal control. However, participants also identified a number of barriers affecting implementation of the EE. We have previously published findings on perceptions of nursing staff working with stroke survivors in this enriched rehabilitation environment who identified that patients benefited from having better access to physical, cognitive and social activities. Together, results contribute to valuable evidence for future implementation of an EE in stroke rehabilitation settings.Implications for RehabilitationStroke survivor access to an enriched environment (EE):Results identified that participation in both individual and communal forms of environment enrichment within the stroke rehabilitation ward resulted in increased access to activities providing increased opportunities for enhanced motor, cognitive and sensory stimulation.Increased access to and participation in activities of the environmental enrichment (individual and communal) interrupted the ongoing cycle of boredom and inactivity experienced by many participants.This study provides preliminary support for the implementation of an EE within a typical stroke rehabilitation setting from a patient perspective.
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2015 |
White JH, Janssen H, Jordan L, Pollack M, 'Tablet technology during stroke recovery: A survivor's perspective', Disability and Rehabilitation, 37 1186-1192 (2015) [C1] © 2014 Informa UK Ltd. All rights reserved. Background: Clinician interest in the role of tablet technology in commercially available tablet devices (i.e. iPads) following stroke ... [more] © 2014 Informa UK Ltd. All rights reserved. Background: Clinician interest in the role of tablet technology in commercially available tablet devices (i.e. iPads) following stroke is rising. Tablets have the potential to encourage engagement in therapeutic activities. We aimed to explore stroke survivor acceptability of and experience of tablet use during the first three months of stroke recovery. Design: A qualitative study using an inductive thematic approach incorporating the process of constant comparison was utilized to collect and analyse data. Setting: Community dwelling stroke survivors in metropolitan Newcastle, New South Wales, Australia. Participants: Twelve stroke survivors (8 male, 4 female; median age of 73 (IQR 58-83) years). Main outcome measures: Qualitative outcomes were participants' perceptions using in-depth, semi-structured interviews. Results: Participants' found tablets easy to use and beneficial. Most stroke survivors used the tablet to engage in therapeutic and leisure activities on most days during the three months. Three key themes emerged: (1) Getting established on the iPad: "It just became easier and easier", (2) Technology as a means for increased stimulation: "Something to keep me interested", and (3) Personal experiences of access to an iPad: "It's been very helpful". Conclusions: Incorporating tablet technology into the delivery of stroke rehabilitation appears to be feasible and acceptable at a patient level. This process has the potential to improve participation in therapeutic and or leisure; however further evaluation towards the impact of tablet technology on patient outcome and quality of life is required.
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2014 |
Janssen H, Ada L, Bernhardt J, McElduff P, Pollack M, Nilsson M, Spratt N, 'Physical, cognitive and social activity levels of stroke patients undergoing rehabilitation within a mixed rehabilitation unit', Clinical Rehabilitation, 28 91-101 (2014) [C1] Objective: To determine physical, cognitive and social activity levels of stroke patients undergoing rehabilitation, and whether these changed over time. Design: Observational stu... [more] Objective: To determine physical, cognitive and social activity levels of stroke patients undergoing rehabilitation, and whether these changed over time. Design: Observational study using behavioural mapping techniques to record patient activity over 12 hours on one weekday and one weekend day at baseline (week 1) and again two weeks later (week 2). Setting: A 20-bed mixed rehabilitation unit. Subjects: Fourteen stroke patients. Interventions: None. Main measures: Percentage of day spent in any activity or physical, cognitive and social activities. Level of independence using the Functional Independence Measure (FIM) and mood using the Patient Health Questionniare-9 (PHQ-9). Results: The stroke patients performed any activity for 49%, social activity for 32%, physical activity for 23% and cognitive activity for 4% of the day. Two weeks later, physical activity levels had increased by 4% (95% confidence interval (CI) 1 to 8), but levels of any activity or social and cognitive activities had not changed significantly. There was a significant: (i) positive correlation between change in physical activity and change in FIM score (r = 0.80), and (ii) negative correlation between change in social activity and change in PHQ-9 score (r = -0.72). The majority of activity was performed by the bedside (37%), and most physical (47%) and cognitive (54%) activities performed when alone. Patients undertook 5% (95% CI 2 to 9) less physical activity on the weekends compared with the weekdays. Conclusions: Levels of physical, cognitive and social activity of stroke patients were low and remained so even though level of independence and mood improved. These findings suggest the need to explore strategies to stimulate activity within rehabilitation environments. © The Author(s) 2013.
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2014 |
Janssen H, Ada L, Bernhardt J, McElduff P, Pollack M, Nilsson M, Spratt NJ, 'An enriched environment increases activity in stroke patients undergoing rehabilitation in a mixed rehabilitation unit: a pilot non-randomized controlled trial', DISABILITY AND REHABILITATION, 36 255-262 (2014) [C1]
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2014 |
Egan KJ, Janssen H, Sena ES, Longley L, Speare S, Howells DW, et al., 'Exercise reduces infarct volume and facilitates neurobehavioral recovery: Results from a systematic review and meta-analysis of exercise in experimental models of focal ischemia', Neurorehabilitation and Neural Repair, 28 800-812 (2014) [C1] © The Author(s) 2014. Background. Regular exercise reduces the risk of a first-ever stroke and is associated with smaller infarcts. Although evidence has suggested that therapeuti... [more] © The Author(s) 2014. Background. Regular exercise reduces the risk of a first-ever stroke and is associated with smaller infarcts. Although evidence has suggested that therapeutic exercise following stroke is beneficial, we do not yet know whether exercise reduces stroke severity and improves functional recovery. The mechanisms underlying any benefit remain unclear.Objective. To conduct a systematic review and meta-analysis of studies testing exercise in animal models of ischemic stroke where outcomes were measured as infarct volume, neurobehavioral score, neurogenesis, or a combination of these. We also sought evidence of publication bias.Methods. We searched 3 online databases for publications reporting the use of exercise in focal cerebral ischemia. We used DerSimonian and Laird normalized random-effects meta-analysis and meta-regression to determine the impact of study quality and design on the efficacy of exercise.Results. Overall, exercise reduced infarct volume by 25.2% (95% confidence interval [CI] = 19.0%-31.3%; 65 experiments and 986 animals) and improved neurobehavioral score by 38.2% (95% CI = 29.1%-47.3%; 42 experiments; n = 771). For both outcomes, larger effects were seen when exercise preceded ischemia rather than came after it. For neurobehavioral scores, we found evidence of publication bias. Reported study quality was moderate (median score 5/10). Both model-specific (eg, type of ischemia) and exercise-specific characteristics influenced reported outcome.Conclusion. Exercise, either before or after ischemia, reduced infarct volume and improved neurobehavioral score. However, overall estimates of efficacy were higher in studies at risk of bias, and for neurobehavioral outcomes, there was evidence of a substantial publication bias.
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2014 |
White JH, Alborough K, Janssen H, Spratt N, Jordan L, Pollack M, 'Exploring staff experience of an "enriched environment" within stroke rehabilitation: a qualitative sub-study.', Disabil Rehabil, 36 1783-1789 (2014) [C1]
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2013 |
Janssen H, Speare S, Spratt NJ, Sena ES, Ada L, Hannan AJ, et al., 'Exploring the Efficacy of Constraint in Animal Models of Stroke: Meta-analysis and Systematic Review of the Current Evidence', NEUROREHABILITATION AND NEURAL REPAIR, 27 3-12 (2013) [C1]
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2012 |
Janssen H, Ada L, Karayanidis F, Drysdale K, McElduff P, Pollack MR, et al., 'Translating the use of an enriched environment poststroke from bench to bedside: study design and protocol used to test the feasibility of environmental enrichment on stroke patients in rehabilitation', International Journal of Stroke, 7 521-526 (2012) [C3]
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2010 |
Janssen H, Bernhardt J, Collier JM, Sena ES, McElduff P, Attia JR, et al., 'An enriched environment improves sensorimotor function post-ischemic stroke', Neurorehabilitation and Neural Repair, 24 802-813 (2010) [C1]
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Show 23 more journal articles |
Conference (40 outputs)
Year | Citation | Altmetrics | Link | ||||
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2019 |
Denham A, Wynne O, Baker AL, Spratt NJ, Turner A, Magin P, et al., '"This is our life now. Our new normal'': A qualitative study of the unmet needs of carers of stroke survivors', INTERNATIONAL JOURNAL OF STROKE (2019)
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2019 |
Janssen H, Shakespeare D, Luker J, Denham A, McCluskey A, Bernhardt J, et al., 'Altering the rehabilitation environment to improve stroke survivor activity (AREISSA): Patient perception of activity during environmental enrichment', INTERNATIONAL JOURNAL OF STROKE (2019)
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2019 |
Janssen H, Shakespeare D, Luker J, Denham A, McCluskey A, Bernhardt J, et al., 'Altering the rehabilitation environment to improve stroke survivor activity (AREISSA trial): Staff experience of implementing environmental enrichment', INTERNATIONAL JOURNAL OF STROKE (2019)
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2015 | Rosbergen ICM, Grimley RS, Hayward KS, Walker K, Rowley D, Campbell A, et al., 'Stroke patients in an acute stroke unit show little physical, social and cognitive activity', INTERNATIONAL JOURNAL OF STROKE (2015) [E3] | ||||||
2015 |
D'Souza S, Janssen H, Ciccone N, Hersh D, Armstrong E, Godecke E, 'Communication enhanced environments to increase communication activity early after stroke: Design and protocol', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
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2015 |
Smith H, Marquez J, Ada L, Spratt NJ, Nilsson M, Pollack M, et al., 'Quantifying physical, cognitive and social activity early after stroke: How enriched is the acute stroke environment?', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
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2013 |
Egan KJ, Janssen H, Sena ES, Bernhardt J, Longley L, Speare S, et al., 'Exercise reduces infarct volume and facilitates neurobehavioural recovery: systematic review and meta-analysis of exercise in animal models of stroke', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
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2013 |
Janssen H, Speare S, Spratt NJ, Sena ES, Ada L, Hannan AJ, et al., 'Exploring the efficacy of constraint in animal models of stroke: meta-analysis and systematic review of the current evidence', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
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2012 |
Janssen H, Ada L, Bernhardt J, Karayanidis F, Drysdale K, McElduff P, et al., 'The use of an enriched environment post stroke: Translating from bench to bedside', Neurorehabilitation & Neural Repair: WCNR 2012 Oral Abstracts, Melbourne, VIC (2012) [E3]
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2012 |
Bartley E, White JH, Janssen H, Spratt NJ, Pollack M, 'Exploring the experience of stroke rehabilitation following exposure to an enriched environment', International Journal of Stroke, Darling Harbour, Sydney (2012) [E3]
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2012 |
Alborough K, White JH, Janssen H, Spratt NJ, Jordan L, Pollack MR, 'Exploring staff experience of an 'Enriched Environment' within stroke rehabilitation: A qualitative sub-study', International Journal of Stroke, Darling Harbour, Sydney (2012) [E3]
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2012 |
Bernhardt J, Janssen H, Ada L, McElduff P, Pollack M, Spratt NJ, 'Exposure to an enriched environment increases post stroke activity and decreases time spent alone', Abstract E-book. 2012 European Stroke Conference, Lisbon, Portugal (2012) [E3]
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2011 |
Janssen H, Ada L, Bernhardt J, McElduff P, Pollack MR, Spratt NJ, 'Levels of physical, cognitive and social activity are low and stable during a two week period of stroke rehabilitation', APA Physiotherapy Conference 2011 Abstract Presentations, Brisbane (2011) [E3]
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Show 37 more conferences |
Grants and Funding
Summary
Number of grants | 19 |
---|---|
Total funding | $776,109 |
Click on a grant title below to expand the full details for that specific grant.
20201 grants / $96,000
FoCCuS4HEART: Female Carers Co-produce Support 4 Heart and Emotional health to Address Risk facTors$96,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Ms Alexandra Denham, Doctor Heidi Janssen, Professor Billie Bonevski, Professor Neil Spratt, Doctor Kirsti Haracz, Dr Marie-Louise Bird |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2020 |
Funding Finish | 2022 |
GNo | G2000972 |
Type Of Funding | C3120 - Aust Philanthropy |
Category | 3120 |
UON | Y |
20193 grants / $297,340
Exercising, Socialising and Thinking after Stroke (ESTEEM After Stroke)$275,220
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Doctor Heidi Janssen |
Scheme | Women in Medical Research Fellowship |
Role | Lead |
Funding Start | 2019 |
Funding Finish | 2022 |
GNo | G1901101 |
Type Of Funding | C3120 - Aust Philanthropy |
Category | 3120 |
UON | Y |
Exercising, Socialising and Thinking: Environmental Enrichment Model in the Community After Stroke$20,120
Funding body: Priority Research Centre for Stroke and Brain Injury, University of Newcastle
Funding body | Priority Research Centre for Stroke and Brain Injury, University of Newcastle |
---|---|
Scheme | Research Support Funding |
Role | Lead |
Funding Start | 2019 |
Funding Finish | 2020 |
GNo | |
Type Of Funding | C4000 - CRC UON Participant |
Category | 4000 |
UON | N |
Vice-Chancellor's Award for Early Career Research and Innovation Excellence$2,000
Funding body: University of Newcastle
Funding body | University of Newcastle |
---|---|
Project Team | Doctor Heidi Janssen |
Scheme | Vice-Chancellor's Award for Early Career Research and Innovation Excellence |
Role | Lead |
Funding Start | 2019 |
Funding Finish | 2019 |
GNo | G1900139 |
Type Of Funding | Internal |
Category | INTE |
UON | Y |
20185 grants / $126,104
Service change and Supporting Lifestyle and Activity Modification after TIA (S+SLAM-TIA)$83,909
Funding body: The Nancy and Vic Allen Stroke Prevention Fund
Funding body | The Nancy and Vic Allen Stroke Prevention Fund |
---|---|
Project Team | Doctor Heidi Janssen, Conjoint Professor Chris Levi, Ms Gillian Mason, Doctor Gary Crowfoot, Professor Coralie English, Professor John Attia |
Scheme | Stroke Prevention Grant |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2020 |
GNo | G1801093 |
Type Of Funding | C3112 - Aust Not for profit |
Category | 3112 |
UON | Y |
Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial$20,000
Funding body: NHMRC (National Health & Medical Research Council)
Funding body | NHMRC (National Health & Medical Research Council) |
---|---|
Scheme | Centre for Research Excellence |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | C1100 - Aust Competitive - NHMRC |
Category | 1100 |
UON | N |
Service change and Supporting Lifestyle and Activity Modification after TIA (S+SLAM-TIA)$17,182
Funding body: Priority Research Centre for Stroke and Brain Injury, University of Newcastle
Funding body | Priority Research Centre for Stroke and Brain Injury, University of Newcastle |
---|---|
Scheme | Research Support Funding |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2020 |
GNo | |
Type Of Funding | C4000 - CRC UON Participant |
Category | 4000 |
UON | N |
Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial$3,683
Funding body: Priority Research Centre for Stroke and Brain Injury, University of Newcastle
Funding body | Priority Research Centre for Stroke and Brain Injury, University of Newcastle |
---|---|
Scheme | Research Support Funding |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | C4000 - CRC UON Participant |
Category | 4000 |
UON | N |
Service change and Supporting Lifestyle and Activity Modification after TIA (S+SLAM-TIA)$1,330
Funding body: Priority Research Centre for Stroke and Brain Injury, University of Newcastle
Funding body | Priority Research Centre for Stroke and Brain Injury, University of Newcastle |
---|---|
Scheme | Research Support Funding |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | C4000 - CRC UON Participant |
Category | 4000 |
UON | N |
20174 grants / $54,896
BUST-Stroke: 'Breaking up sitting time after stroke' a new paradigm for reducing recurrent stroke risk$20,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Professor Coralie English, Doctor Heidi Janssen, Professor Rohan Walker, Professor Neil Spratt, Conjoint Professor Robin Callister, Doctor Amanda Patterson, Associate Professor Julie Bernhardt, Professor David Dunstan |
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | G1700572 |
Type Of Funding | C3120 - Aust Philanthropy |
Category | 3120 |
UON | Y |
Hunter New England Health Local Health District Clinical Research Fellowship (Honorary) for Service change and Supporting Lifestyle and Activity Modification after TIA (S+SLAM-TIA)$15,000
Funding body: Hunter New England Local Health District
Funding body | Hunter New England Local Health District |
---|---|
Scheme | Clinical Research Fellowship |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Other Public Sector - Local |
Category | 2OPL |
UON | N |
Service change and Supporting Lifestyle and Activity Modification after TIA (S+SLAM-TIA)$10,000
Funding body: Priority Research Centre for Stroke and Brain Injury, University of Newcastle
Funding body | Priority Research Centre for Stroke and Brain Injury, University of Newcastle |
---|---|
Scheme | Research Support Funding |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | C4000 - CRC UON Participant |
Category | 4000 |
UON | N |
Assessment for stroke recovery$9,896
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
---|---|
Project Team | Doctor Lin Kooi Ong, Doctor Gary Crowfoot, Doctor Heidi Janssen, Doctor Dianne Marsden, Doctor Jodie Marquez, Professor Coralie English, Professor Rohan Walker |
Scheme | Medical Research Support Program (MRSP) |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | G1701224 |
Type Of Funding | C2220 - Aust StateTerritoryLocal - Other |
Category | 2220 |
UON | Y |
20162 grants / $38,845
BUST-Stroke “Breaking Up Sitting Time after Stroke. A new paradigm for reducing recurrent stroke risk”$21,745
Funding body: John Hunter Hospital Charitable Trust
Funding body | John Hunter Hospital Charitable Trust |
---|---|
Project Team | Professor Coralie English, Doctor Heidi Janssen, Professor Neil Spratt |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2016 |
GNo | G1600566 |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | Y |
Service change and Supporting Lifestyle and Activity Modification after TIA (S+SLAM-TIA)$17,100
Funding body: The University of Newcastle
Funding body | The University of Newcastle |
---|---|
Scheme | Research Advantage Early Career Researcher Equipment Grant Funding |
Role | Lead |
Funding Start | 2016 |
Funding Finish | 2016 |
GNo | |
Type Of Funding | C4000 - CRC UON Participant |
Category | 4000 |
UON | N |
20143 grants / $52,924
Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA): A Phase II Trial$30,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Scheme | Bridging Grant |
Role | Lead |
Funding Start | 2014 |
Funding Finish | 2014 |
GNo | |
Type Of Funding | C1700 - Aust Competitive - Other |
Category | 1700 |
UON | N |
Tablets and Technology During Stroke Recovery (TNT)$19,924
Funding body: National Stroke Foundation
Funding body | National Stroke Foundation |
---|---|
Project Team | Doctor Heidi Janssen, Professor Neil Spratt, Ms Louise-Anne Jordan, Doctor Patrick McElduff |
Scheme | Research Grant |
Role | Lead |
Funding Start | 2014 |
Funding Finish | 2014 |
GNo | G1301138 |
Type Of Funding | Grant - Aust Non Government |
Category | 3AFG |
UON | Y |
Quantifying Physical, Cognitive and Social Activity Early After Stroke$3,000
Funding body: National Stroke Foundation
Funding body | National Stroke Foundation |
---|---|
Project Team | Doctor Jodie Marquez, Doctor Heidi Janssen, Miss Hannah Smith, Professor Neil Spratt, Doctor Patrick McElduff, Associate Professor Louise Ada |
Scheme | Honours Grant |
Role | Investigator |
Funding Start | 2014 |
Funding Finish | 2014 |
GNo | G1301144 |
Type Of Funding | Grant - Aust Non Government |
Category | 3AFG |
UON | Y |
20131 grants / $110,000
Enriched Environment in Rehabilitation - A Phase II Trial$110,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Doctor Heidi Janssen, Professor Neil Spratt, Professor Michael Nilsson |
Scheme | Project Grant |
Role | Lead |
Funding Start | 2013 |
Funding Finish | 2014 |
GNo | G1300569 |
Type Of Funding | C3120 - Aust Philanthropy |
Category | 3120 |
UON | Y |
Research Supervision
Number of supervisions
Current Supervision
Commenced | Level of Study | Research Title | Program | Supervisor Type |
---|---|---|---|---|
2015 | PhD | Investigating Communication Enhanced Environments after Stroke | Speech Pathology, Edith Cowan University, Western Australia | Co-Supervisor |
Research Projects
Exercising, Socialising and Thinking: an Environmental Enrichment Model in the Community After Stroke (ESTEEM) 2019 -
Service Change and Supporting Lifestyle and Activity Modification after Transient Ischemic Attack (TIA) [S+SLAM-TIA] 2016 -
The program under investigation targets patients who have had a transient ischemic attack (TIA). A TIA is a major warning sign for stroke; it is a short disruption in blood supply to the brain resulting in signs and symptoms similar to that of a stroke (eg. loss of speech, arm weakness etc). A TIA resolves in 24 hours but there is a 15% risk that the person will go on to have a stroke within the next 3 months, and the risk of having another cardiovascular event (eg. stroke, heart attack or TIA), remains high for the following 10-15 years.
The SLAM-TIA program involves 6 weeks of face to face education (30min) and exercise (60min) at a community based gym. Education sessions outline the signs and symptoms of a stroke, risk factors for and consequences of a stroke, and focus on individual stroke risk identification and goal setting. After this 6 weeks, patients are provided 12 weeks of fortnightly telehealth health coaching to support them to reduce their stroke risk by changing their health behaviours. Patients are given support and strategies to reduce individual stroke risk factors. Particular focus is given to increasing regular physical activity, reducing high blood pressure, improving diet (increasing fruit and vegetables and reducing salt), reducing psychological distress and adhering to guidelines on alcohol consumption.
Analysis of patient results collected in the pilot project which informed S+ SLAM-TIA reveals significant and clinically meaningful improvements in the leading risk factor for stroke, blood pressure. Patient systolic blood pressure reduced on average by 14mmg [95% CI 9-18] and a 8mmg [95%CI 4-12] reduction in diastolic blood pressure (p<0.001). Furthermore, patients had a 12% [95% CI 6-25] (p=0.02) improvement in quality of life, and reported that (i) they were highly satisfied with the program, (ii) “I can exercise” and (iii) “I am doing more exercise than what I was before the program”.
S+SLAM-TIA has to date recruited >30 patients, has employed two clinicians to work as research assistants (giving them the opportunity to actively engage in research for the first time), and is supported by NSW Health and HNE LHD through a Early to Mid-Career Fellowship and Honorary Clinical Research Fellowship for CI Janssen. Amount sought - $34 245.12
Altering the Environments to Improve Stroke Survivor Activity (AREISSA) 2015 -
BUST-Stroke "Breaking Up Sitting Time after Stroke. A new paradigm for reducing recurrent stroke risk” 2016 -
Sitting for long periods of time each day increases the risk of cardiovascular disease. Stroke survivors living at home spend 75% of their waking hours sitting down, which is much higher than healthy people of a similar age, making them at particularly high risk.
The study seeks to assess the immediate effects of either sitting all day, or breaking up sitting time with regular short bursts of physical activity. This study is the first important step in understanding how a particular intervention (reducing sitting time) might affect the health of stroke survivors.
Edit
News
Fellowship to help reconnect stroke survivors with community
June 21, 2019
World-first stroke trial led by University of Newcastle researchers underway in the Hunter
February 15, 2016
Dr Heidi Janssen
Position
Conjoint Lecturer
Stroke Recovery Research Group
School of Health Sciences
Faculty of Health and Medicine
Contact Details
heidi.janssen@newcastle.edu.au | |
Phone | 0240420417 |
Links |
Twitter Research and Innovation Cluster Personal webpage |
Office
Room | Enter Building code/room eg. CH123 |
---|---|
Building | Hunter Medical Research Institute |
Location | Level 3 East HMRI Kookaburra Circuit New Lambton Heights , |