Dr Isobel Hubbard

Dr Isobel Hubbard

Lecturer

School of Medicine and Public Health (Public Health)

Career Summary

Biography

Isobel is an academic researcher in the School of Medicine and Public Health at the University of Newcastle. She convenes the Master of Health Science and has sole responsibility for the post-graduate, stroke-specific courses. Her primary research is investigating the association between upper limb recovery and brain activation patterns in the first month post-stroke. She is also involved in research investigating return-to-driving post-stroke; the incidence, prevalence and lived experiences of stroke in older Australian women and early upper limb intervention and assessment post-stroke.

Isobel has published in peer reviewed journals and presented at national and international conferences. Her aim is to champion a multi-professional and evidence-based approach in the healthcare we prescribe and apply to people at risk of, recovering from and/or living with, stroke. She is a registered Occupational Therapist.

Research Expertise
Upper limb stroke recovery, brain activation patterns and neuroplasticity.

Teaching Expertise
Design of inter professional courses and program Stroke Education - postgraduate and undergraduate Occupational Therapy

Administrative Expertise
Setting up of on-line courses in blackboard On-line, inter professional courses in health related issues



Qualifications

  • Doctor of Philosophy, University of Newcastle
  • Diploma of Applied Science (Occupational Therapy), Cumberland College of Health Sciences
  • Master of Occupational Therapy, University of South Australia

Keywords

  • Acute Stroke
  • Flexible delivery
  • Functional Magnetic Resonance Imaging
  • Health
  • Interprofessional
  • Interprofessional practice
  • Postgraduate
  • Stroke Rehabilitation
  • Stroke management
  • Upper limb therapy

Fields of Research

Code Description Percentage
111799 Public Health and Health Services not elsewhere classified 20
110399 Clinical Sciences not elsewhere classified 80

Professional Experience

UON Appointment

Title Organisation / Department
Casual Academic University of Newcastle
School of Health Sciences
Australia
Lecturer University of Newcastle
School of Medicine and Public Health
Australia

Academic appointment

Dates Title Organisation / Department
Peer Reviewer - Australian Occupational Therapy Journal Australian Occupational Therapy Journal
Australia
1/07/2005 -  Allied Health Researcher - Health Manager Hunter New England Health
Acute Stroke Research Unit, Neurology, John Hunter Hospital
Australia
1/01/2001 - 1/01/2004 Associate Lecturer

Occupational Therapy

University of Newcastle
School of Health Sciences
Australia

Membership

Dates Title Organisation / Department
Committee Member - National Stroke Foundation, Post-Acute Stroke Audit - National Advisory Body National Stroke Foundation
Stroke Coordinating Committee - Stroke Services NSW Stroke Services NSW
Australia
Stroke Nursing and Allied Health Education and Professional Development Sub-committee Member Stroke Services NSW
Australia
Member - Australian Occupational Therapy Association Australian Occupational Therapy Association
Australia
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (1 outputs)

Year Citation Altmetrics Link
2012 Stinear C, Hubbard IJ, 'Movement', Stroke Rehabilitation: Insights from Neuroscience and Imaging, Oxford University Press, Oxford 143-153 (2012) [B1]

Journal article (15 outputs)

Year Citation Altmetrics Link
2016 Hubbard IJ, Vo K, Forder PM, Byles JE, 'Stroke, physical function, and death over a 15-year period in older Australian women', Stroke, 47 1060-1067 (2016)

© 2016 American Heart Association, Inc.Background and Purpose-As populations age, an increasing number of older women are living with stroke. This study looks at long-term outcom... [more]

© 2016 American Heart Association, Inc.Background and Purpose-As populations age, an increasing number of older women are living with stroke. This study looks at long-term outcomes for women with stroke, comparing mortality rates for women with poor physical function (PF) and those with higher levels of function. The purpose is to understand not only how long women might live after a stroke, but also how long they live with physical disability. Methods-The study uses 15 years of data on women from the Australian Longitudinal Study on Women's Health 1921 to 1926 cohort. The risk of stroke and the risk of stroke and poor PF were estimated using Cox proportional hazard model. Among women who reported a stroke during the study period, mortality risk was compared according to their physical functioning level after that stroke. Results-Almost half of the women who had a stroke and poor PF survived past 10 years. The 10-year mortality rate was 37% for women with stroke and adequate PF and 51% for women with stroke and poor PF at the time of the stroke (hazard rate ratio, 1.52; 95% CI, 1.18-1.95; P=0.0015 adjusting for demographic and health covariates). Conclusions-This study provides evidence of the long-term outcomes of stroke among older women, with women living for many years with poor PF. This outcome has important implications for the women's quality of life during their later years and in understanding the burden of disability associated with stroke.

DOI 10.1161/STROKEAHA.115.011456
Co-authors Julie Byles, Peta Forder
2015 Frith J, Hubbard IJ, James CL, Warren-Forward H, 'Returning to driving after stroke: A systematic review of adherence to guidelines and legislation', British Journal of Occupational Therapy, 78 349-355 (2015) [C1]

© The Author(s) 2015.Introduction: This systematic review aimed to determine whether stroke survivors routinely received return-to-driving education in the acute hospital setting... [more]

© The Author(s) 2015.Introduction: This systematic review aimed to determine whether stroke survivors routinely received return-to-driving education in the acute hospital setting prior to discharge home; and if education was provided, were the restrictions in driving guidelines adhered to. Method: A systematic search was conducted of PubMed, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Web of Science, Scopus, Pedro and OTseeker databases for original research reporting findings on the adherence to return-to-driving legislation and clinical guidelines after stroke, and return-to-driving behaviours in stroke survivors up to 1 month post stroke. Results: Three studies met the inclusion criteria and reported on a combined total of 252 stroke survivors living in the United Kingdom. Forty-eight per cent of stroke survivors received education on the 1 month driving restriction. A total of 61.4% of participants waited 1 month prior to returning to driving. Conclusion: This review found that there is limited literature available on the management of return to driving following acute stroke but there is evidence that education may not be routinely provided in the acute hospital setting and that many stroke survivors could be returning to driving within the 1 month restriction.

DOI 10.1177/0308022614562795
Citations Scopus - 1Web of Science - 2
Co-authors Carole James, Helen Warren-Forward
2015 Hubbard IJ, Carey LM, Budd TW, Parsons MW, 'Reorganizing therapy: Changing the clinical approach to upper limb recovery post-stroke', Occupational Therapy International, 22 28-35 (2015) [C1]

© 2014 John Wiley & Sons, Ltd.Stroke is the leading cause of adult disability, and as a consequence, most therapists will provide health care to patients with stroke during their... [more]

© 2014 John Wiley & Sons, Ltd.Stroke is the leading cause of adult disability, and as a consequence, most therapists will provide health care to patients with stroke during their professional careers. An increasing number of studies are investigating the association between upper limb recovery and changes in brain activation patterns following stroke. In this review, we explore the translational implications of this research for health professionals working in stroke recovery. We argue that in light of the most recent evidence, therapists should consider how best to take full advantage of the brain's natural ability to reorganize, when prescribing and applying interventions to those with a stroke-affected upper limb. The authors propose that stroke is a brain-based problem that needs a brain-based solution. This review addresses two topics, anticipating recovery and maximizing recovery. It proposes five practice-ready recommendations that are based on the evidence reviewed. The over-riding aim of this review and discussion is to challenge therapists to reconsider the health care they prescribe and apply to people with a stroke-affected upper limb.

DOI 10.1002/oti.1381
Co-authors Mark Parsons, Bill Budd
2015 Tavener M, Thijsen A, Hubbard IJ, Francis JL, Grennall C, Levi C, Byles J, 'Acknowledging How Older Australian Women Experience Life After Stroke: How Does the WHO 18-Item Brief ICF Core Set for Stroke Compare?', Health Care Women Int, 36 1311-1326 (2015) [C1]
DOI 10.1080/07399332.2015.1055747
Co-authors Chris Levi, Julie Byles, Meredith Tavener
2015 Byles JE, Francis JL, Chojenta CL, Hubbard IJ, 'Long-term survival of older australian women with a history of stroke', Journal of Stroke and Cerebrovascular Diseases, 24 53-60 (2015) [C1]

© 2015 National Stroke Association.Background Although many people survive an initial stroke, little is known about long-term impacts of stroke on survival. Methods Data from the... [more]

© 2015 National Stroke Association.Background Although many people survive an initial stroke, little is known about long-term impacts of stroke on survival. Methods Data from the Australian Longitudinal Study on Women's Health were used to compare 12-year survival rates in older women with prevalent stroke, incident stroke, and no stroke. Cox regression models were fitted to assess the effect of lifestyle and demographic characteristics on the relationship between stroke and all-cause mortality. The "no stroke" group was used as the reference category in all statistical models. Results At baseline, 4% of the women reported a previous stroke (prevalent stroke). At survey 2 in 1999, a further 3% reported having a stroke between 1996 and 1999 (incident stroke). Stroke was significantly associated with reduced long-term survival. Age-Adjusted hazards ratios (HRs) were: 1.64 (1.43-1.89) for the "prevalent stroke" group and 2.29 (1.97-2.66) for the "incident stroke" group. Adjusting for comorbidities reduced the HRs, but the risk of death was still significantly higher in the 2 stroke groups. Adjusting for demographic and lifestyle factors did not make any further difference to the relationship between stroke and survival. However, obesity and past smoking were also risk factors for mortality. Conclusions This study highlights the long-term impacts of stroke on life expectancy and the importance of comorbidities and other lifestyle factors in affecting poststroke survival.

DOI 10.1016/j.jstrokecerebrovasdis.2014.07.040
Citations Scopus - 3Web of Science - 3
Co-authors Julie Byles, Catherine Chojenta
2015 Hubbard IJ, Carey LM, Budd TW, Levi C, McElduff P, Hudson S, et al., 'A Randomized Controlled Trial of the Effect of Early Upper-Limb Training on Stroke Recovery and Brain Activation', Neurorehabilitation and Neural Repair, 29 703-713 (2015) [C1]

© 2015 American Society of Neurorehabilitation.Background. Upper-limb (UL) dysfunction is experienced by up to 75% of patients poststroke. The greatest potential for functional i... [more]

© 2015 American Society of Neurorehabilitation.Background. Upper-limb (UL) dysfunction is experienced by up to 75% of patients poststroke. The greatest potential for functional improvement is in the first month. Following reperfusion, evidence indicates that neuroplasticity is the mechanism that supports this recovery. Objective. This preliminary study hypothesized increased activation of putative motor areas in those receiving intensive, task-specific UL training in the first month poststroke compared with those receiving standard care. Methods. This was a single-blinded, longitudinal, randomized controlled trial in adult patients with an acute, first-ever ischemic stroke; 23 participants were randomized to standard care (n = 12) or an additional 30 hours of task-specific UL training in the first month poststroke beginning week 1. Patients were assessed at 1 week, 1 month, and 3 months poststroke. The primary outcome was change in brain activation as measured by functional magnetic resonance imaging. Results. When compared with the standard-care group, the intensive-training group had increased brain activation in the anterior cingulate and ipsilesional supplementary motor areas and a greater reduction in the extent of activation (P =.02) in the contralesional cerebellum. Intensive training was associated with a smaller deviation from mean recovery at 1 month (Pr>F0 = 0.017) and 3 months (Pr>F = 0.006), indicating more consistent and predictable improvement in motor outcomes. Conclusion. Early, more-intensive, UL training was associated with greater changes in activation in putative motor (supplementary motor area and cerebellum) and attention (anterior cingulate) regions, providing support for the role of these regions and functions in early recovery poststroke.

DOI 10.1177/1545968314562647
Citations Scopus - 2Web of Science - 2
Co-authors Bill Budd, Mark Parsons, Chris Levi
2014 Hubbard IJ, Evans M, McMullen-Roach S, Marquez J, Parsons MW, 'Five years of acute stroke unit care: Comparing ASU and non-ASU admissions and allied health involvement', Stroke Research and Treatment, (2014) [C1]

Background. Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU) provides specialised, hyperacute care and thrombolysis. John Hunter H... [more]

Background. Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU) provides specialised, hyperacute care and thrombolysis. John Hunter Hospital, Australia, admits 500 stroke patients each year and has a 4-bed ASU. Aims. This study investigated hospital admissions over a 5-year period of all strokes patients and of all patients admitted to the 4-bed ASU and the involvement of allied health professionals. Methods. The study retrospectively audited 5-year data from all stroke patients admitted to John Hunter Hospital (n=2525) and from nonstroke patients admitted to the ASU (n=826). The study's primary outcomes were admission rates, length of stay (days), and allied health involvement. Results. Over 5 years, 47% of stroke patients were admitted to the ASU. More male stroke patients were admitted to the ASU (chi2=5.81; P=0.016). There was a trend over time towards parity between the number of stroke and nonstroke patients admitted to the ASU. When compared to those admitted elsewhere, ASU stroke patients had a longer length of stay (z=-8.233; P=0.0000) and were more likely to receive allied healthcare. Conclusion. This is the first study to report 5 years of ASU admissions. Acute Stroke Units may benefit from a review of the healthcare provided to all stroke patients. The trends over time with respect to the utilisation of the John Hunter Hospitall's ASU have resulted in a review of the hospitall's Stroke Unit and allied healthcare. © 2014 Isobel J. Hubbard et al.

DOI 10.1155/2014/798258
Co-authors Mark Parsons
2013 Kitsos GH, Hubbard IJ, Kitsos AR, Parsons MW, 'The Ipsilesional Upper Limb Can Be Affected following Stroke', SCIENTIFIC WORLD JOURNAL, (2013) [C1]
DOI 10.1155/2013/684860
Citations Scopus - 4Web of Science - 3
Co-authors Mark Parsons
2012 Hubbard IJ, Harris D, Kilkenny MF, Faux SG, Pollack MR, Cadilhac DA, 'Adherence to clinical guidelines improves patient outcomes in Australian audit of stroke rehabilitation practice', Archives of Physical Medicine and Rehabilitation, 93 965-971 (2012) [C1]
Citations Scopus - 21Web of Science - 13
2011 Kitsos G, Harris D, Pollack M, Hubbard IJ, 'Assessments in Australian stroke rehabilitation units: A systematic review of the post-stroke validity of the most frequently used', Disability and Rehabilitation, 33 2620-2632 (2011) [C1]
DOI 10.3109/09638288.2011.575526
Citations Scopus - 8Web of Science - 9
2010 Pickering RL, Hubbard IJ, Baker KG, Parsons MW, 'Assessment of the upper limb in acute stroke: The validity of hierarchal scoring for the Motor Assessment Scale', Australian Occupational Therapy Journal, 57 174-182 (2010) [C1]
DOI 10.1111/j.1440-1630.2009.00810.x
Citations Scopus - 6Web of Science - 4
Co-authors Mark Parsons
2009 Hubbard IJ, Vyslysel G, Parsons MW, 'Interprofessional, practice-driven research: Reflections of one 'community of inquiry' based in acute stroke', Journal of Allied Health, 38 E69-E74 (2009) [C1]
Co-authors Mark Parsons
2009 Hubbard IJ, Parsons MW, Neilson C, Carey LM, 'Task-specific training: Evidence for and translation to clinical practice', Occupational Therapy International, 16 175-189 (2009) [C1]
DOI 10.1002/oti.275
Citations Scopus - 90Web of Science - 71
Co-authors Mark Parsons
2007 Hubbard IJ, Parsons MW, 'The conventional care of therapists as acute stroke specialists: A case study', International Journal of Therapy and Rehabilitation, 14 357-362 (2007) [C1]
Citations Scopus - 5
Co-authors Mark Parsons
2006 Hubbard IJ, 'Stroke: The silent Cinderella!', Australian Occupational Therapy Journal, 53 337-340 (2006) [C1]
DOI 10.1111/j.1440-1630.2006.00616.x
Citations Scopus - 1
Show 12 more journal articles

Conference (18 outputs)

Year Citation Altmetrics Link
2015 Frith J, Hubbard IJ, James C, Warren-Forward H, 'Doctors in the driving seat: Proposal to translate return-to-driving evidence into clinical practice after acute stroke.' (2015)
Co-authors Helen Warren-Forward, Carole James
2015 Hubbard IJ, Tavener M, Thijsen A, Francis L, Grennall C, Levi C, Byles J, 'How do older Australian women experience life after stroke, and how does the WHO 18-item ICF core Set for Stroke compare?', INTERNATIONAL JOURNAL OF STROKE (2015) [E3]
Co-authors Meredith Tavener, Julie Byles, Chris Levi
2014 Kitsos GH, Hubbard I, Kitsos AR, Parsons M, '2Up: A longitudinal study of upper limb recovery', INTERNATIONAL JOURNAL OF STROKE (2014) [E3]
Co-authors Mark Parsons
2014 Byles J, Francis JL, Chojenta CL, Hubbard I, 'Long-term survival of older Australian women with a history of stroke', International Journal of Stroke (2014) [E3]
Co-authors Catherine Chojenta, Julie Byles
2013 James C, Frith J, Warren-Forward H, Hubbard I, 'Driving after Stroke: Knowledge and use of legislation and guidelines by Australian Health Practitioners', Australian Occupational Therapy Journal, (2013) [E3]
Co-authors Carole James, Helen Warren-Forward
2013 James CL, Frith JLT, Warren-Forward H, Hubbard IJ, 'Return to driving post stroke: What should be happening and who should be doing it?', International Journal of Stroke (2013) [E3]
Co-authors Helen Warren-Forward, Carole James
2013 Kitsos G, Hubbard IJ, Kitsos A, Parsons MW, 'Non-affected or less affected: What is the ipsilesional upper limb following stroke? A systematic literature review', INTERNATIONAL JOURNAL OF STROKE (2013) [E3]
Co-authors Mark Parsons
2012 Hubbard IJ, Carey LM, Budd TW, Parsons MW, 'An RCT of differing intensities of early upper limb training post stroke: Evidence of neuroplastic changes in the ipsilesional SMA', Congress Handbook. 7th World Congress for Neurorehabilitation (2012) [E3]
Co-authors Bill Budd, Mark Parsons
2012 Frith J, Hubbard IJ, James CL, Warren-Forward H, 'Returning to driving after stroke: A systematic review investigating adherence to legislation and guidelines', International Journal of Stroke (2012) [E3]
Co-authors Helen Warren-Forward, Carole James
2012 Hubbard IJ, Carey L, Budd TW, Parsons MW, 'Brain activation and upper limb recovery post stroke: A systematic literature review', International Journal of Stroke (2012) [E3]
Citations Web of Science - 2
Co-authors Mark Parsons, Bill Budd
2011 Hubbard IJ, Harris D, Kilkenny MF, Faux SG, Pollack MR, Cadilhac DA, 'Australian clinical practice of inpatient stroke rehabilitation and its relationship to patient outcomes', International Journal of Stroke (2011) [E3]
2011 Frith JLT, Hubbard IJ, Parsons MW, Vyslysel G, Burgman I, James CL, 'Shifting Gears: Resuming driving after stroke', Proceedings of the 24th Occupational Therapy Australia National Conference (2011) [E3]
Co-authors Mark Parsons, Carole James
2010 Hubbard IJ, Parsons MW, Carey LM, 'Translating task-specific, upper limb evidence into stroke recovery intervention and clinical practice', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Mark Parsons
2010 Hubbard IJ, Budd TW, Carey LM, McElduff P, Levi CR, Parsons MW, 'Intensive behavioural upper limb training in acute stroke: an RCT of functional outcomes and brain reorganisation', Cerebrovascular Diseases: European Stroke Conference (2010) [E3]
Co-authors Bill Budd, Chris Levi, Mark Parsons
2008 Budd TW, Parsons MW, Hubbard IJ, Carey L, Levi CR, 'A longitudinal fMRI study of cortical sensorimotor reorganization in stroke recovery', NeuroImage (2008) [E3]
Co-authors Mark Parsons, Bill Budd, Chris Levi
2008 Hubbard IJ, Budd TW, Parsons MW, 'Arm function, fMRI and early reorganisation mapping in stroke (AFfERMS): Findings from the pilot phase', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01755_7.x
Co-authors Mark Parsons, Bill Budd
2008 Hubbard IJ, Carey L, Parsons MW, 'The evidence concerning task-specific therapy for upper limb function: A literature review', Internal Medicine Journal (2008) [E3]
DOI 10.1111/j.1445-5994.2008.01756.x
Co-authors Mark Parsons
2006 James CL, Hubbard IJ, 'Inter-professional practice development: A challenge in knowledge transfer', ANZAME: Setting the Standards of Medical Education: Conference Proceedings: Abstracts & Program (2006) [E3]
Co-authors Carole James
Show 15 more conferences
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Grants and Funding

Summary

Number of grants 3
Total funding $188,282

Click on a grant title below to expand the full details for that specific grant.


20111 grants / $23,980

Using functional MRI, this project explores brain activation patterns and upper limb recovery in stroke survivors$23,980

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Doctor Isobel Hubbard
Scheme Equity Research Fellowship
Role Lead
Funding Start 2011
Funding Finish 2011
GNo G1000911
Type Of Funding Internal
Category INTE
UON Y

20091 grants / $41,828

A functional MRI study of upper limb therapy in community dwelling stroke survivors$41,828

Funding body: National Stroke Foundation

Funding body National Stroke Foundation
Project Team Professor Mark Parsons, Dr Leeanne Carey, Doctor Isobel Hubbard
Scheme Research Grant
Role Investigator
Funding Start 2009
Funding Finish 2011
GNo G0189945
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

20061 grants / $122,474

A functional MRI study of upper limb therapy in acute stroke$122,474

Funding body: National Heart Foundation of Australia

Funding body National Heart Foundation of Australia
Project Team Professor Mark Parsons, Doctor Bill Budd, Conjoint Professor Chris Levi, Doctor Isobel Hubbard
Scheme Grant-In-Aid
Role Investigator
Funding Start 2006
Funding Finish 2007
GNo G0186201
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON Y
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Research Supervision

Number of supervisions

Completed0
Current3

Total current UON EFTSL

PhD0.53

Current Supervision

Commenced Level of Study Research Title / Program / Supervisor Type
2016 PhD Evaluating the Effectiveness of Thrombolysis Implementation in Stroke (TIPS): A Cluster Randomized Controlled Trial in Acute Stroke
PhD (CommunityMed & ClinEpid), Faculty of Health and Medicine, The University of Newcastle
Co-Supervisor
2014 PhD Predicting recovery after stroke using neuroimaging
PhD (Physiotherapy), Faculty of Health and Medicine, The University of Newcastle
Co-Supervisor
2014 PhD Shifting Gears: Returning to Driving After Stroke
PhD (Occupational Therapy), Faculty of Health and Medicine, The University of Newcastle
Co-Supervisor
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News

Dr Isobel Hubbard

Australian women challenge stroke survival assumptions

March 8, 2016

New research from UON has challenged assumptions on how long women will live after stroke, even with significant physical impairment.

Dr Isobel Hubbard

Positions

Lecturer
Convener of the Master of Health Science program; Coordinator of the Stroke Management Specialisation
School of Medicine and Public Health
Faculty of Health and Medicine

Casual Academic
Convener of the Master of Health Science program; Coordinator of the Stroke Management Specialisation
School of Health Sciences
Faculty of Health and Medicine

Focus area

Public Health

Contact Details

Email isobel.hubbard@newcastle.edu.au
Phone (02) 40420533

Office

Room Desk 18; Level 4; HMRI Building, Rankin Park Campus
Building HMRI Building Rankin Park Campus
Location Desk 18; Level 4; HMRI Building; Rankin Park Campus

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