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21st Century technology: A care provider’s guide

The team at the Elysium Neurocare facility at Badby Park, Daventry, share how they are exploring the use of technology for the benefit of patients.

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Robot pets

We have robot pet dogs and cats, and even a monkey and a horse. They respond to touch/voice commands, carry out movements and vocalise. They are primarily used to promote engagement by the patient, encourage pleasant feelings which helps set them in a good mood to participate in therapy, promote positive bonds with staff, and as a source of distraction should the patient start engaging in disruptive behaviours. For selected patients who have favourite smells, we can spray specific odours on the pets, so that all of the sensory modalities are engaged for a pleasant experience.

Voice-activated intelligent agents
We’re using Google Assistant with a patient who had quadriplegia following a gunshot injury. It enables him to control his television and lights, retrieve his schedule for the day, play his favourite music and sports clips, and make both voice and video calls to family and friends. Measures of wellbeing, behaviour and mood are monitored to see if they change as a result of this intervention.

Exergames
We’ve built up an exergame resource using the Nintendo Wii. This includes both hardware and a range of software games. In collaboration with colleagues in physiotherapy and speech and language therapy, and a er carefully documenting the past habits and leisure activities of a patient, games are selected to help promote engagement in these therapies, and generally give the patient a sense of both enjoyment and achievement.

Neuro-rehab apps
We’re using neuro-rehab apps to help with the needs of specific patients. Thus, we are using a scanning app, Visual Attention produced by Tactus Therapy, to help improve scanning in patients who show visual neglect following a condition such as stroke.

Intelligent clock displays
We are trialling clock displays which, in addition to day, date & time, have reminder features to help patients remember items such as scheduled activities, and via wifi can also be linked remotely to family and friends so that messages or pictures can be sent directly to the patient. We are also trialling a clock display which gives audio output of display information to touch, so as to benefit the visually impaired who may not be able to read the clock display.

Virtual reality apps
We have a Google Cardboard-based virtual reality app, WayBack, which features a video from the coronation in 1952, and which enables the patient to immerse themselves in scenes from the video. We will be introducing other VR apps, including geography-based ones. As with the aforementioned robot pets intervention, their primary purpose is to encourage pleasant feelings which help to set the patient in a goodmood, as a form of reminiscence therapy, and as a source of distraction should the patient start engaging in disruptive behaviours.

Odours, music, images and light for relaxation classes
Relaxation classes have generally been unimodal, with either verbal instructions or music. We are trying to use multiple modalities, ideally in synchrony, to enhance feelings of wellbeing in relaxation classes.

Using the latest technologies, we configure the setting where relaxation classes take place, so that selected room lighting can be generated, relaxing music or sounds are played, a pleasant odour is released and relaxing images such as sunset on a beach are displayed.

Regular feedback from patients, families and sta is obtained during implementation of all the interventions mentioned. And, as far as possible, practical outcome measures are included to evaluate the effectiveness of the interventions. The 21st Century has given us new technologies which can potentially broaden the independence and wellbeing horizons of neurological patients. As healthcare professionals, we need to respond to the challenges associated with their implementation, and this requires both commitment and creativity.

This article was co-written by Elysium’s Narinder Kapur, Callum Watson, Heena Parmar and Amy Watts.

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Brain injury

Olympic champion Tom Daley appeals for funding for ‘groundbreaking’ brain tumour drug

Olympic champion diver, Tom Daley joins Brain Charity to appeal for funding for a groundbreaking cannabis drug trial for brain cancer

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Olympic champion Tom Daley in a black tuxedo promoting a new trial into cannabis based drugs for brain cancer

Tom Daley has joined The Brain Tumour Charity appeal to call for more funding for a ‘groundbreaking’ trial of a cannabis-based drug that could help to treat an aggressive form of cancer.

The Olympic champion lost his father, Robert who died from a brain tumour aged 40 in 2011.

The appeal by the Brain Tumour Charity hopes to raise the £450,000 which is needed to fund the three-year trial. It will begin recruiting 232 patients at 15 hospitals across the UK early next year.

Olympic champion support

In a video, Tom said: “We are reaching out to all you individual heroes and supporters, to help fund this groundbreaking trial. When you donate, you’ll receive a link for your social media badge of honour. Join our community, spread the word and help us pave the way to beating brain tumours”.

Tom has been advocating and campaigning for charity since the loss of his father. He recently raffled off a jumper he made helping to raise £5,787 in 14 days. The Olympic champion diver was seen knitting a dog sweater at one of the recent swimming events. He took up knitting to help with his mental health and stress during lockdown.

Read more about the study here

The study

The study led by the University of Leeds and coordinated by the Cancer Research UK Clinical Trials Unit at the University of Birmingham will examine if adding Sativex to chemotherapy could extend life for people diagnosed with recurrent glioblastoma or delay the progression of the disease. Sativex is a cannabis-based drug normally prescribed to MS patients.

If the trial is successful, it could be one of the first additions to NHS treatment for glioblastoma patients in more than a decade.

The condition is one of the most common and aggressive forms of brain cancer. There are currently 2,200 people diagnosed in England each year.

Read more: Study suggests long-term Covid symptoms could be rare in school-age children

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Dementia

Could our driving help to diagnose Alzheimer’s Disease?

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A person driving while holding the steering wheel with both hands

Researchers have combined Global Positioning System-based (GPS) with AI to detect early-onset Alzheimer’s in drivers, revealing a high level of accuracy in diagnosis.

The DRIVES Study at Washington University in St. Louis, led by Catherine Roe and Ganesh Babulal and funded by the National Institute on Aging.

They proposed that those who had been diagnosed would make different decisions when driving in comparison to those without the disease. Alzheimer drivers may drive for shorter periods of time, stick to commonly used routes, travel less at night and make abrupt changes to their driving.

AI has the advantage of being able to read from large amounts of cases and diagnoses without bias or judgement. It is thought that this could lead to more correct diagnosis.

Read more: Supercomputer enables new levels of brain insight

The study

Researchers selected 139 people in Missouri US to have a GPS unit installed in their cars for one year. The data collected was fed into a custom AI system designed using Python to assess patterns in driving.

Half of the selected individuals had already been diagnosed with Alzheimer’s while the other half were healthy. Those in the positive group had been tested using medical methods such as spinal fluid tests and PET scans.

Driving results

The results of the experiment showed a detection accuracy of 82 per cent. The model was more accurate still (90%) when it also added in the results of a genetic test for Alzheimer’s known as apolipoprotein E (APOE) genotyping that indicates whether you may have an inherited risk for the disease.s. It was noted that all participants were over the age of 65 which means the study may not work on younger people who do not have symptoms.

Larger, randomised studies are needed to show a definitive link between the detected driving behaviours and preclinical Alzheimer’s disease.

The US National Institute on Aging says family members might eventually notice that their loved one is taking longer to complete a simple trip, has been driving more erratically, or gets muddled over which pedal is which, for example.

Read more: Maximum of 10 headers a week in football training, the new guidance recommends

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More headlines

More retired rugby players report concussion than any other injury

Concussion is the most common injury among retired rugby athletes, according to new research.

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Researchers from Durham University and Auckland University of Technology compared the injuries of retired rugby athletes with retired non-contact athletes.

They found that retired elite rugby athletes reported up to seven times the number of injuries than those who played amateur rugby and non-contact sports, and concussion was the most commonly reported injury, and had the most common recurrence, for both groups of rugby players compared to non-contact athletes.

Among retired rugby athletes, 81 per cent of elite and 76 per cent of amateur players reported at least one concussion, and concussion injury had the highest recurrence.

The rugby athletes, who were all code athletes, which means they played rugby union or rugby league, were also up to 10 times more likely to report experiencing a lasting impact of previous concussion, among other injuries, including back and joint pain.

The researchers concluded that past participation in rugby union and rugby league, particularly at elite level, is linked to a higher risk of cumulative injuries and a continued impact of previous injuries after retiring from the game.

Retired elite rugby code players reported that previous concussions had a negative impact on their current health, the researchers found.

They urge that there should be more efforts to reduce injuries in rugby codes at all levels, given such a high number of concussions.

“The monitoring of injuries at the player level rather than at club level could be one approach to improving the management of injury for individualised player welfare,” the paper, published today in the journal Sports Medicine, states.

“This could include a system by which the individual player’s injury history can be followed as they move across professional club contracts, and specific strength and conditioning and sports therapy strategies prescribed to help prevent recurrence of injury.”

This is the first study to examine total injuries across entire careers of contact sport athletes, according to the researchers, and the reported effects on physical wellbeing post-retirement.

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