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A 20-year adventure in rehab robotics

Tech pioneer Hocoma has long been pushing the boundaries of innovation in rehab. Now marking its 20th anniversary, it plans to step up its ability to drive better patient outcomes, as Deborah Johnson reports.

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Back in 2000, the world was a very different place, particularly in terms of technology.

Many of the high-tech innovations we now accept as standard were not yet launched and healthcare remained one of the most traditional markets around.

Yet into this climate, Hocoma launched the prototype of its pioneering Lokomat, a robotic medical device which provides repetitive and highly physiological gait training to patients, enabling even some of the most impaired to learn to walk again.

While it has gone on to become one of the world’s leading robotic medical devices, in 2000, it was a significant and controversial disruption into a long- established and relatively low-tech rehab scene.

Clemens Muller, global head of clinical and scientific affairs at Hocoma, says: “Twenty years ago, gait rehabilitation was completely different.

Therapists had to physically move patients’ legs – a manual task that can be very tiring and requires huge effort, particularly when you are doing it many times a day.”

Gery Colombo, a trained electrical engineer with an interest in neural rehabilitation, founded Hocoma alongside Peter Hostettler, an economist, and Matthias Jörg, a biomedical engineer.

“The founders realised the need for a change to this way of doing things and to find a better solution,” says Clemens.

“They wanted to establish a venture which could use their specialist knowledge and go in a particular direction, with a purpose and intention.

“The goal was to change rehab as it was known. This was absolutely new; in fact so new and innovative that the world of healthcare rehabilitation wasn’t really ready for it.

“This was a challenging phase but one in which Hocoma needed to be really entrepreneurial with a very clear vision and focus and to keep on going.

“It did take a little while until it was accepted and it was a long journey for the founders.”

Despite the initial challenges of launching such a high- tech product, over the past two decades, the Lokomat has become one of the most widely used gait rehabilitation devices in the world.

It has helped to set an industry standard in rehab products for people with brain injury, stroke and other neurological disorders.

Hocoma recently installed its 1,000th Lokomat.

But it has also built on the success of its flagship product by launching an array of other devices.

Among its product portfolio is the Erigo, which assists with patient mobilisation in the earliest stages of rehabilitation; its Armeo range, which supports the recovery of arm and hand function; and its Valedo products that targets back pain.

The business is headquartered in Switzerland but works in 27 countries worldwide – and believes it is changing the lives of people in clinics across the globe.

Clemens says: “I think there are three drivers behind innovation in healthcare – social aspect, which includes demographic changes and the shift from using products which are based on evidence rather than just experience; the technology changes in the world as a whole; and the clinical changes, which are moving on quickly and have changed dramatically to encompass robotics and exploit the previously unused potential of this way of therapy.

“These drivers have changed, and continue to change, the landscape of the world in which we work. Hocoma has always been at the front pushing the boundaries and helping to change the resistance there was at the beginning of our journey.

“When you went to a rehab conference 15 or 20 years ago, there was only one tech provider there, which was us.

“But if you compare that to now, there can be anything up to 20 companies at an event, including start-ups that are working in technology fields like robotics or sensor-based equipment, offering products for inpatients and outpatients, for acute needs. So there is a huge selection now available.

“There is also the demand from the market to integrate technology. The key for us has always been how to integrate this technology into a routine of therapy to use it to its full potential.

“It is about not only being engineering-driven but understanding how to use that to make a bridge to the rehab world and understand the link to the human world – bringing the know-how and capability and opening that up for the needs of patients.

“As a market, we do need to do more homework in that area.

“Lots of clinics already have integrated the technology they are using very successfully, and with our products it makes us proud to see how the patient is being supported to the highest level.

“I have seen this happening in many clinics around the world and it gives me goosebumps to see how happy patients are with how it is working for them. It also makes a huge difference to the work and demands placed on the therapist, and that is something that also makes us so proud.”

Now celebrating its 20th anniversary, Hocoma’s ambition for the future is to continue changing lives and reaching out to millions more around the world.

A strategic move in achieving this came in 2017 when Hocoma joined its now-parent company DIH – bringing it under the same roof as other rehab technology developers including Motek.

“We have always been a pioneer since we were established so we will continue this with new and better solutions to benefit people’s lives.

“Our focus is on bringing solutions which are innovative, high quality, effective and efficient.

“The future for us will of course be affected by the healthcare market in general. We are seeing a rapid demographic change around the world and this will mean a change in the healthcare approach.

“There will be a search for solutions.

“With the huge move towards digitalisation through the Industrial Revolution 4.0, there will be a greater role played by artificial intelligence and virtual reality.

We will continue to develop as a business so we can continue to be at the front of what is happening.

“Traditionally, we have come up with a new innovation every year, which could be a new product launch, or else new features or a new version of an existing product, but we are always developing what we have to make it the best it can be.

“We are always learning by doing and have a network of research and academic partners all over the world and this enables us to come up with great products which deliver solutions.

“We are planning heavily in our development team and are continuing to develop our launch plan and product road map.

“We hope the global coronavirus outbreak and the shutdown we are seeing around the world does not affect our plans too much in the short-term, but we will have to see how that develops and adapt to that as we need to.”

As a business which has helped to change traditional practices and approaches in rehab globally, one area in which Hocoma would like to push for further change is in widening patient access to its own products, and other high-tech solutions.

“At the moment, it is not a given that all patients and all clinics will have access to our products. Of course technology has its price, but we need to address that at some point.

“We need to work with clinics and insurance companies to try and find a solution here and to shape the future of rehabilitation.

“It is important to find optimal solutions which increase access to technology, to improve the quality of rehab, while looking at the cost effectiveness of such products.

“Over the next five to 10 years, there are going to be more stroke, cerebral palsy and traumatic brain injury patients who are needing innovative solutions and our goal is to develop more solutions which will benefit them and the therapists.

“When money and costs are involved it can often be a long journey, but we believe if all stakeholders got together to find a way of best dealing with this, together we could deliver the best rehab to patients, and this is something we would like to be involved in delivering.”

www.hocoma.com

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Learn more about virtual reality in rehab

Event is an opportunity to hear from expert Dr Katherine Dawson, Consultant Clinical Neuropsychologist.

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An event later this month will give neuro-rehab professionals an opportunity to learn more about the use of virtual reality in the field. 

The virtual webinar, on 26th January at 1.20pm to 2.30pm, features an in-depth talk by Dr Katherine Dawson, Consultant Clinical Neuropsychologist.

A Guide to Virtual Reality, which can be booked by emailing training@thinktherapy1st.co.uk, will cover:

– Growth of digital health

– Virtual Reality(VR) / Telerehabilitation evidence base

– Virtual tour of the Brain Recovery Zone VR platform

– Where does the Brain Recovery Zone sit in a clinical pathway

– Clinical outcomes, case studies, and research trial

Dr. Katherine Dawson has over 15 years experience working in various rehabilitation settings (both within the NHS and private sector) with individuals who have a wide range of neurological conditions.

She has a particular interest in cognitive rehabilitation, and working with individuals and families to manage emotional and behavioural changes following Acquired Brain Injury (ABI).

She is currently involved in research with the NHS regarding ABI and telerehabilitation, and has recently published a book exploring adjustment to brain injury from the perspectives of clients, family members and clinicians. 

In December 2017, Katherine set up a local neuro-rehab service (Sphere Rehab) with her business partner, focusing on community integration post ABI. She also co-founded the Brain Recovery Zone neuro rehab Virtual Reality platform in the summer of 2019. The team are commissioned by several local CCGs and also work within the private sector.

Ahead of the event, she said: “I just wanted to say a massive thank you to Think Therapy 1st for inviting me to talk about VR and the Brain Recovery Zone. Virtual Reality has great potential in neuro rehab – both to ‘up’ the dosage of rehab, in addition to promoting ongoing engagement and self management.

“I am really looking forward to delivering this webinar and discussing some of the clinical outcomes including the work completed together with Think Therapy 1st and other clients.”

Helen Merfield, Managing Director, Think Therapy 1st, which is organising the event, said: “I am really excited about our VR event we have used Dr Dawson on a number of cases with amazing results and her VR really has changed lives.

“So much so that we are partnering with her company Sphere as a preferred provider for both VR through Brain Recovery Zone and Clinical and Neuro psychology. Close working ties can only improve outcomes which for both our companies are already impressive.”

To register for the event email training@thinktherapy1st.co.uk.

 

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Neuropsychology

Sport and exercise ‘have key role in mental health and wellbeing’

The Moving for Mental Health report highlights the role of physical activity in supporting mental resilience and recovery

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Physical activity and sport can play a key role in supporting mental health and wellbeing and helping people to recover from the ongoing impact of the COVID-19 pandemic, a new report has concluded. 

The Moving for Mental Health report includes better training for health professionals to prescribe movement as a means of effectively tackling the vast growth in people experiencing mental health issues. 

Produced following the onset of the pandemic, the report sets out evidence that developing a healthy relationship with physical activity and being involved in linked programmatic interventions and social networks is beneficial, can improve people’s mental health and wellbeing, and help tackle social isolation.

The project, by the Sport for Development Coalition and Mind, highlights how COVID-19 has exposed the weaknesses of single-sector responses to addressing complex mental health problems and tackling growing health inequalities. 

The report recommends physical activity and community sport be further embedded in health policy and integrated care systems while calling for an enhanced role for experts by experience and diverse communities leading in the design, implementation and evaluation of future strategy and programming.

Launched at an online meeting of the All-Party Parliamentary Group for Sport, it is also designed to support and inspire public bodies, funders, commissioners and policy-makers as well as community-based programme providers aiming to enhance the impact of movement for mental health.

Paul Farmer, chief executive of Mind, said: “While Mind’s research suggests that half of adults and young people have relied on physical activity to cope during the pandemic, we also know that physical activity levels for people with long-term health conditions, including mental health problems, have declined. 

“Considering how vital physical activity is for many people’s mental health, it is clear that we need a collective effort to reach those who need support the most.”

Andy Reed, chair of the Sport for Development Coalition, said: “This report is aimed at supporting and informing policy-makers about how we can maximise the contribution of targeted sport and physical activity-based interventions at this crucial time.”

The research was led by a team of academic researchers from Edge Hill University and Loughborough University, and draws on evidence and submissions from over 70 organisations including sport and mental health organisations, public bodies and Government departments.

Andy Smith, professor of sport and physical activity at Edge Hill University, said: “The impact of Covid-19 on people’s mental health and wellbeing cannot be overstated. 

“It has brought to light the significant mental health inequalities which existed prior to COVID-19, but which have since worsened further, especially among those living in under-served and low-income communities. 

“Our research is calling on the Government and other public bodies to invest in the provision of movement opportunities for mental health across multiple policy sectors, and to use the evidence presented as a basis for making more effective policy decisions which benefit everyone’s mental health and which tackle deep-seated inequalities.”

Moving for Mental Health is the first policy report in a series being published throughout 2022 by the Coalition and relevant partners. The reports are aimed at maximising the contribution of targeted sport-based interventions to helping ‘level up’ communities facing disadvantage and deprivation and tackling deep-seated health and societal inequalities which have been exacerbated by COVID-19.

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Calvert Trust announces new trustees

Louise Dunn, Judith Gate, Emily Flynn and Victoria Notman bring their expertise to the Trust, which also runs Calvert Reconnections

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The Lake District Calvert Trust (LDCT), which runs brain injury rehabilitation centre Calvert Reconnections, has started 2022 by announcing the appointment of four new trustees.

Louise Dunn, Judith Gate, Emily Flynn and Victoria Notman will bring their respective expertise to supporting the further development of the charity and its vital services.

Louise Dunn

Louise Dunn is a communications consultant and academic with over 25 years’ experience of management and leadership roles in the pharmaceutical industry and at Alder Hey Children’s NHS Foundation Trust and Charity.

Commenting on her appointment, Louise said: “As a Keswick resident, I’m delighted to be able to get involved with this extraordinary organisation, that has such a positive impact for people living with disabilities in our community and all over the UK.

“I am looking forward to learning more about how I can help the team and contributing to their exciting plans for the future.”

Judith Gate has extensive experience in the charity and public sectors including leading the volunteering and customer care functions for a national charity.

She currently leads a continuous improvement programme with a focus on delivering efficiency and improved customer experience through business process improvement and digital transformation.

Judith Gate

Judith said: “I applied to be trustee because I wanted to use my skills to deliver as much positive impact as possible. As an outdoor enthusiast I feel a genuine connection to the Calvert Trust‘s mission of making outdoor activity accessible to everyone

“I am really excited to join the board and look forward to using my knowledge and experience to help support the Trust achieve its ambitions over the coming years.”

Emily Flynn has over 21 years’ experience as a military officer and communications-electronics engineer across a wide spectrum of business areas including: senior leadership/board-level management; digital optimisation; resource planning; engineering, operations and risk management; trusteeship; and mountaineering leadership.

Commenting on her appointment, Emily said: “I am delighted to become a trustee of the Lake District Calvert Trust.

“The military introduced me to the benefits of outdoor education as a means of expanding personal confidence and stretching comfort zones in a controlled environment. It also led me to become a mountaineer.

“I hope to be able to bring my previous experience as a leader, mountaineer, engineer and trustee to help the Calvert Trust

Emily Flynn

continue to deliver amazing outdoor education to its participants and to help it grow over the next few years.”

Victoria Notman is legal director at the employment team at Burnetts Solicitors in Carlisle and has over 20 years’ experience as an employment lawyer.

She also has a first-class honours degree in physiotherapy and experience in the rehabilitation and development of adults and young people with mild to severe physical and mental impairments and learning needs.

Victoria said: “I am looking forward to applying my knowledge and skills to become integrated into the fabric of the Trust to such a degree that all the experience I have to offer can really make a difference to the lives and happiness of those accessing Calvert Lakes and Calvert Reconnections.”

Welcoming the charity’s new trustees, Giles Mounsey-Heysham, chairman of the LDCT Trustees, said: “After a detailed recruitment process, we are delighted to welcome our new Trustees.

Victoria Notman

“Together they bring a wealth of skills, experience and shared passion to the Lake District Calvert Trust. We welcome their contributions moving forward.”

The Lake District Calvert Trust has been supporting people with disabilities from its specialist Calvert Lakes residential centre and accessible riding centre near Keswick in the Lake District for almost 45 years.

Calvert Lakes has grown from being the UK’s first dedicated activity centre for people with disabilities, to welcoming around 3,500 visitors to stay each year.

These include individuals, family groups, specialist schools, accessible sports clubs, disability charity groups, supported living organisations and care homes across the UK.

Last year, the charity also opened Calvert Reconnections, the UK’s first residential brain injury rehabilitation programme combining traditional clinical therapies with physical activity in the outdoors.

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