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Building confidence and learning new skills – how vocational work supports rehab

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St Andrew's

“Being at Workbridge gives the person a sense of purpose. It provides them with an aim to achieve. They can stand back and be proud of what they’ve done,” says Tom, a service user accessing Workbridge at St Andrew’s. 

Based within the St Andrew’s Northampton hospital site, and integrating public facing retail offerings, Workbridge provides a vocational pathway for people living with brain injuries, mental illness, learning disabilities or autism. 

The centre operates to provide training and social opportunities for people living in the community and within the inpatient setting of St Andrew’s and here people can learn new skills through the array of activities on offer, supported by vocational skills instructors. 

Departments ranging from ceramics to woodwork, horticulture to catering, allow service users to learn both life and work skills, building confidence and social capability in the process.

The products made in the workshop sessions are sold in the public-facing garden centre, charity and coffee shop where service users can also work, meeting the public and learning retail skills.

Workbridge has helped hundreds of people to gain or regain skills and build their confidence and independence over the 41 years since it was established. 

Tom, who accesses the centre as a community based service user is a regular and an enthusiastic advocate of the service. 

“I’m sure everyone benefits from being here, but that’s quite subjective and down to the individual, but for me the consistency it gives me has been really important,” he says. 

Having sustained two brain injuries – the first in 2001 as the result of an assault and another in 2008 while cycling – Tom is now rebuilding his life with the support of Workbridge, where he attends textiles sessions and volunteers in the charity shop. 

“I know I need structure as a result of my head injury and Workbridge gives that. It is an incredible community and there is a real family vibe. It has also helped with my patience… Ive developed more patience over the years. This is a non-intrusive environment but friendly and that has helped.”

For Neelam too – a young mother who needs ongoing care and who is currently a patient in St Andrew’s Brain Injury services after a tumour on her pituitary gland left her with a range of needs – her participation in ceramics sessions at Workbridge are an important aspect of her recovery. 

“In ceramics, at first they had a jar already made and to start with I just had to clean and tidy it up. But slowly they gave me more jobs and responsibilities because I was capable,” she says. 

“Now, I feel I am confident in meeting new people. I am working and have an important job to do and I feel more responsible; because what I am making is going to be sold to the public I have to be really careful. I try to give 100 per cent with any painting or modelling, I go there and I always try my best.”

For both Tom and Neelam, their positive experiences at Workbridge mean they now hope that one day they can find paid employment.

“Before my brain surgery, I was working in a multi-national company as a quality assurance officer. However, after my surgery, I was literally doing nothing and was just in hospital,” says Neelam.

“Now I feel my life has totally changed. I have hope that I can work again.”

Tom continues: “I need an employer with good understanding of head injury and my strengths and weaknesses. I think Workbridge would be an incredible employer for that and I could be a pathway example for other service users. 

“I am quite engaged and sociable so would love to be a service users’ representative and a voice for other people.” 

For the multi-disciplinary team that support patients on St Andrew’s brain injury wards and the vocational skills instructors based at Workbridge who work with service users from the community and hospital patients, they see first-hand the significant benefits that vocational opportunities bring.

“Everyone has different levels and abilities and things they are able to progress towards, but Workbridge offers opportunities for everyone. It’s an amazing example of what our service can provide,” says Gemma Thornton, an occupational therapist in the St Andrew’s Brain Injury service who works closely in supporting Neelam. 

“With Neelam, she is a very creative person, and I know she puts a great deal of effort into making something which will go on sale, in her mind it has to be perfect. 

“She has made some great progress with her skills and confidence through ceramics, in addition to the excellent progress we’ve made with her moods and frustration in our wider therapy work. 

Louise, a senior vocational skills instructor who works closely with Tom, adds: “Tom really enjoys the structure of attending Workbridge as he feels it gives him a purpose for the day. He’s given most things a try from upcycling, making bags for the mors bag project – morsbags.com –  to sanding and painting. All of these projects help with fine motor skills and Tom is certainly an asset within the department.”

Incorporating work back into their lives following their brain injury has certainly been an important part of Tom and Naleem’s recovery. 

As Tom says: “Vocational activities provide an individual with more meaning in their life, that distract from more troubling elements they may be living with, and they will also provide transferable skills which people can deploy in other areas of their life.”

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Neurokinex unveils winning Christmas card design

Eight-year-old Jasper’s creation will be this year’s festive fundraiser for the specialist neurophysio

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Over the past four years, the team at Neurokinex and some of its young clients at Neurokinex Kids have taken part in a fun and festive Christmas card charity design competition.

All the children’s designs are put forward to a public vote with the winner’s design then made up into a Christmas card that is sold to help raise awareness and vital funds for the charity. 

This year’s winning design

This year’s winning Neurokinex Kids Christmas card was designed by Jasper, eight, who also drew the winning design of the very first Neurokinex Christmas Card in 2018 when he was just four years old.

Jasper was the first paediatric client to attend Neurokinex aged just two in March 2016. Born fit and well, he contracted Hand, Foot & Mouth disease at a children’s party. A rare complication resulted in an enlarged heart and Jasper was admitted to hospital and put on life support. However, when the doctors brought him round, Jasper couldn’t move his legs: a blood clot had damaged his lower spinal cord and he was paralysed from the waist down.

After Jasper was discharged from Stoke Mandeville spinal care hospital in March 2016, his mum Kate started to look for specialist rehabilitation to give Jasper his best chance of recovery. She was initially recommended to visit the NeuroRecovery Network facility in Louisville and the family flew to the US in May 2015. At that time, the ground-breaking work being done in Louisville was only available at a select few NRN affiliated sites in America.

Luckily for Jasper, the NRN had just named the Neurokinex rehabilitation centre in Crawley as its first and only affiliate outside of the US, bringing this amazing treatment much closer to home. Kate flew the family home and Jasper started at Neurokinex. Two years later, in March 2018, Neurokinex opened Neurokinex Kids, a purpose-built activity gym upstairs at the main Neurokinex rehab centre to fully cater for their younger clients. 

Not just for fun, but providing therapy too 

Whilst designing the Christmas card is great festive fun for the kids, it’s also another opportunity to provide important therapy. 

Neurokinex Kids delivers ground-breaking work and defies diagnoses, focusing above and below the child’s point of injury in a bid to stimulate sensation and rehabilitation. It looks more like a play centre than a therapy suite with its bright and cheerful set-up. Here, children aged six months to 12 years engage in specialist rehab therapy through play, largely unaware how hard they are working because they’re having so much fun.

Designing the Christmas cards works many different muscle groups for the children as part of their vital therapy and gives the opportunity to focus on something different. It builds engagement, strengthens their relationship with their trainers and helps their families ‘give back’ to Neurokinex Kids. 

Last year, Ryan, eight, wowed everyone by using only his mouth and a paintbrush to create his design of a snowman. He did this at Neurokinex Kids as part of his ongoing therapy and was placed into a standing position to paint it, which made keeping his head in control even more challenging. 

In 2019, aged just two, Ralph’s design of snowmen using his footprints was chosen as the winning picture. A charming card, it was poignant because when Ralph first arrived at Neurokinex his hips were out of alignment and his feet were twisted backwards – meaning his ‘side by side’ snowmen wouldn’t have been possible. This was because when Ralph was just two weeks old he suffered a spinal stroke which had caused damage to his spinal cord and left him paralysed from the waist down. 

Raising vital funds 

Each year the Neurokinex Christmas card raises awareness and vital funds for the charity. A pack of 10 cards costs £6.50 and you can buy them here https://neurokinex.org/christmas-cards/

 

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Brain injury

Saliva test to diagnose concussion set to trial in football

Through a new joint action plan on brain health, education and research are identified as being at the heart of understanding concussion

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A breakthrough saliva test to diagnose concussion is set to be trialled in the Premier League, with a series of research projects also given backing, as efforts to protect players from the impact of head injury are stepped up within English football. 

In a new joint action plan on brain health, the need for research, education, awareness and support for players has been recognised, with a series of steps identified to better manage head injuries and to further understand the links between football and neurodegenerative disease.

The plan – from The FA, Premier League, EFL and PFA – includes a raft of measures, including the funding of an academic study to validate a diagnostic tool that uses salivary biomarkers, with reports that a trial could begin in the sport later this season.

It follows the publication of the SCRUM study findings in March, which showed a saliva biomarker tool was able to accurately detect concussion in elite male rugby players.

SCRUM, led by academics at the University of Birmingham, successfully predicted the outcome of head injury assessments in 94 per cent of cases during testing in the 2018-19 Premiership and Championship season. 

Furthermore, The FA is supporting the new BrainHOPE study, part of the wider Prevent Dementia study, which starts in 2022 at Glasgow University. 

The study will give an analysis of deterioration of cognitive function in the mid-life of ex-professional footballers to understand potential early interventions which could help reduce risk or speed of developing dementia. Its £1.2m investment will run until the 2024/25 season.

It is also partnering with the RFU and Premiership Rugby to expand the Advanced BRAIN Health Clinic, a new specialist clinical service and associated research programme for retired elite rugby players. The expansion to retired football players is due to start operating in 2022.

Trials of a new revolutionary mouthguard which includes a sensor that can relay real-time information to the sidelines – launched with players from Liverpool and Manchester City last season – is being expanded to include additional teams across the Premier League, EFL and The Barclays FA Women’s Super League (WSL).

Education is also highlighted as being of significant importance, and an expert working group formed by the Premier League is devising neck strengthening guidance. This will provide clubs with an introductory programme which is recommended to be implemented by strength and conditioning coaches.

In the grassroots game, authorities are working with brain injury charity Headway on a campaign – set to launch later this season – that will seek to improve awareness of concussion and ensure existing guidance is understood and accepted as standard practice. Referees will also be given greater support in dealing with concussion. 

“Understanding the risk factors of neurodegenerative disease in football is an incredibly complex area of medical science which requires exploration of many different lines of research,” said FA chief executive Mark Bullingham. 

“Football is working together to try to build a more complete picture by supporting a variety of projects.  Until we have a greater level of understanding, we are also reducing the potential risk factors. 

“This new joint action plan will further help to build our understanding across English football of this complex area.”

Richard Masters, Premier League chief executive, said: “It is important that football has come together to work collaboratively on this issue. With the help of experts, and alongside other sports with similar challenges, we want to ensure we have the right approach in place to protect the welfare of players.”

Trevor Birch, CEO of the EFL, said: “English football has a collective responsibility to understand and act upon the risk factors of neurodegenerative disease and therefore the EFL is pleased to support the game’s new joint action plan on brain health. 

“By working together in this collaborative approach, we will acquire the information to be better equipped to improve safeguarding measures for those who play football at all levels of competition.”

Maheta Molango, PFA Chief Executive – who has pledged to donate his brain to research to increase understanding of neurodegenerative illness – added: “A joined-up approach is essential to improve the health and safety of our current and future members. 

“A co-ordinated response is also required to provide comprehensive and dedicated support to our former players, and their families, currently living with dementia and other neurodegenerative diseases.

“This is a vital and complex area. It has to be the top priority for all involved in football.”

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Non-invasive technique ‘could replace need for brain surgery’

The new PING approach could help treat some of the most challenging and complex neurological diseases

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A new non-invasive technique has been developed to remove faulty brain circuits that could allow medics to treat debilitating neurological diseases without the need for conventional brain surgery.

If successfully translated into operating theatres, the breakthrough has been hailed as potentially revolutionary in the treatment of some of the most challenging and complex neurological diseases, including epilepsy, movement disorders and others. 

The PING approach, developed by the University of Virginia and Stanford University, uses low intensity focused ultrasound waves combined with micro-bubbles to briefly penetrate the brain’s natural defences and allow the targeted delivery of a neurotoxin. 

This neurotoxin kills the culprit brain cells while sparing other healthy cells and preserving the surrounding brain architecture.

“This novel surgical strategy has the potential to supplant existing neurosurgical procedures used for the treatment of neurological disorders that don’t respond to medication,” said researcher Dr Kevin S. Lee, of UVA’s departments of neuroscience and neurosurgery and the Center for Brain Immunology and Glia (BIG). 

“This unique approach eliminates the diseased brain cells, spares adjacent healthy cells and achieves these outcomes without even having to cut into the scalp.”

PING has already demonstrated exciting potential in laboratory studies. For instance, one of the promising applications for PING could be for the surgical treatment of epilepsies that do not respond to medication. 

Around a third of patients with epilepsy do not respond to anti-seizure drugs, and surgery can reduce or eliminate seizures for some of them. 

Dr Lee and his team, along with their collaborators at Stanford, have shown that PING can reduce or eliminate seizures in two research models of epilepsy. 

Dr Kevin S. Lee

The findings raise the possibility of treating epilepsy in a carefully-targeted and non-invasive manner without the need for traditional brain surgery.

Another important potential advantage of PING is that it could encourage the surgical treatment of appropriate patients with epilepsy who are reluctant to undergo conventional invasive or ablative surgery.

A key advantage of the approach is its incredible precision. PING harnesses the power of magnetic-resonance imaging (MRI) to let scientists peer inside the skull so that they can precisely guide sound waves to open the body’s natural blood-brain barrier exactly where needed. 

“If this strategy translates to the clinic,” the researchers write in their new paper, “the noninvasive nature and specificity of the procedure could positively influence both physician referrals for and patient confidence in surgery for medically intractable neurological disorders.”

“Our hope is that the PING strategy will become a key element in the next generation of very precise, noninvasive, neurosurgical approaches to treat major neurological disorders,” said Dr Lee, who is part of the UVA Brain Institute.

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