A stroke is a neurological disease where the brain is deprived of oxygen and without it cells are deprived of the fuel they need to survive. Because cells die rapidly from oxygen deprivation, one of the key things about stroke is that time is of the essence. The deprivation of oxygen and resulting tissue damage is what leads to motor, sensory, cognitive impairment or a combination of these things.
Studying the impact of stroke on the human body, Dr. Tyler Cluff, PhD, Associate Professor in the Faculty of Kinesiology and Hotchkiss Brain Institute at the University of Calgary, spoke to THE EQUITY about a new project he is co-leading and the research he does.
Cluff grew up in Clarendon and went to post-secondary school in the city.
He did his undergraduate degree in health sciences at the University of Ottawa and then went on to do a master’s there as well. He then did his PhD at McMaster University and postdoctoral training at Queen’s University in neuroscience.
In his graduate training and postdoc, he worked on developing an understanding of the nervous system and the role that it plays in how we learn to move and also maintain skilled movements throughout our lifespan. That is what attracted him to accept a job at the University of Calgary in 2016.
“The thing I like about science, in general, is asking and answering questions, testing hypotheses and developing new knowledge. For a short period of time before you write things up and publish it, knowing things that currently nobody else in the world does, it’s part of the excitement of the discovery process,” said Cluff. The hardest part about research is that sometimes things do not work out, but when they do it’s very rewarding, he added.
Cluff was an inquisitive kid growing up, maybe even asking too many questions but that’s what has kept him going in his field, he’s always been curious in the way things work, learning new things and in the long run hoping to improve on them.
The Calgary Stroke Program was one thing he was interested in because of how it allowed him to take the basic studies and use that information as a foundation to understand what can go wrong after somebody has a stroke.
When he first started, he was teaching, doing research, and giving back to the university and the community in his field of work. His skill set is around understanding motor learning. The issue is most of the information that they use in helping to design and plan therapy comes from healthy people and that’s where the disconnect lay.
“The gap that we hope to address with the work that we’re doing is to develop a better understanding of why some people, despite investing the time and energy into therapy, don’t seem to fully recover after a stroke. We’re trying to understand how motor learning fits into the bigger picture of recovery,” he said.
Focusing on motor learning impairments, they work with people a week after a stroke and design tests to try to understand impairments and why many individuals do not recover and regain full mobility after stroke.
Through the research they have been doing at the university, they have made headway into developing a preliminary understanding of some factors that might influence an individual’s ability to learn motor skills after stroke, he explained. They are trying to understand what motor learning looks like for each individual.
He defines motor learning as the processes that enable people to improve their skill at movement through practice, which is the basis of what therapy is. But the disconnect is scientists do not know what motor learning looks like in the timeframe that most people will participate in therapy.
“We call that precision medicine or the ability to make decisions to alter therapy or treatment plans based on an individual’s capabilities. In the long run, we hope to work towards better individualizing what stroke care/stroke therapy looks like,” said Cluff.
In 2021, Cluff was awarded the Heart and Stroke Foundation of Canada National New Investigator Award. The award has allowed him to focus more of his time on advancing the research and work that they are doing in stroke, he added.
“I didn’t expect the award, but I was thrilled to get it. I think it recognizes some of the work that we’ve been doing here at Calgary with my students. I’ve been fortunate to work with some really talented and also dedicated graduate students, postdoctoral scholars and the bigger team that I’m a part of here at Calgary,” he said.
In the past four years, Cluff put together a mentorship team to study and understand impairments after stroke. In March 2021, they were awarded a five-year grant to explore this project in more depth from the Canadian Institutes of Health Research.
“The long-term plan would be to use this information to try to develop new therapies and interventions to help improve recovery from stroke,” he said.
An interesting device they use to profile impairments after a stroke is a robotic exoskeleton called the Kinarm. It is a shell that interfaces with and supports the participant’s arm(s) against gravity. It allows them to pair it with a virtual reality system to provide visual feedback to the participant. They can use the robot to assist movement, add resistance, and simulate different mechanical environments. “The robot is the technological foundation of the project. It gives us the ability to study movements and the ability to learn from them in a very precise and detailed way,” he said.
The UCalgary study aims to recruit healthy people to serve as the control group, and participants with stroke. “We follow participants from what is called the early subacute phase, quite early after a stroke, until the chronic phase of stroke recovery at six months. We have them come back in the lab so that we can quantify how these things change throughout the time course of stroke recovery,” he said.
One of the most eye-opening findings so far is that these impairments are more common than they thought. They also vary quite a lot between people which has lead to the long-term goal of being able to individualize therapy plans for stroke patients.
What he believes makes their research at UCalgary unique is their approach to recruiting people very early after stroke and studying these processes within the timeframe that people are recovering from a stroke. “We’re excited about first developing this understanding and then seeing where we can take it. Ultimately, the hope is to try to advance stroke care, in particular, rehabilitation,” he said.
One of the things he highlighted was the importance of inspiring the next generation of scientists. If anyone is interested to reach out and ask questions because neuroscience is a relatively young field and with new technology, so many discoveries are happening and it needs fresh new ideas and minds at the table, Cluff offered to help anyone interested if they had questions.
“I think for me one of the most rewarding things is seeing the people that you train start to make their impact, I think that has been the most rewarding for me,” he said.
His long-term goals include helping advance stroke care for Canadians and one day internationally so that they can help expedite and improve the level of recovery that people are able to attain. “It’s a lofty goal, but it’s something that keeps us motivated to do the day-to-day things,” he said.
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