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Specialist Neuro Speech and Language Therapist

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Askham Rehab are looking for a full-time experienced (equivalent to Band 6/7) specialist neuro speech and language therapist to join the growing multi-disciplinary team, to provide advanced neuro assessments and treatments within our specialist units.  The candidate will have proven experience in assessing and treating neurological patients with tracheostomies, Dysphagia and communication difficulties, ideally with experience in communication aids and assistive technology.  The candidate will work closely with the MDT to provide guidance and treatment plans to our nursing, care and facilities colleagues to ensure that the patient-led rehabilitation goals are met.

 

Askham Rehab, part of Askham Village Community, is set in seven acres of beautiful countryside in Cambridgeshire, focusing on neurorehabilitation.  Askham Rehab is driven by a family orientated ethos, to ensure patient-centred care is facilitated with an innovative approach to rehabilitation.  Askham Rehab is made up of three multi-disciplinary focused units, with each unit specialising in an area of neuro rehab, including but not exclusive to; spinal cord injuries, acquired brain injuries, traumatic brain injuries, complex care potentially involving respiratory and tracheostomy care, Guillain-Barre syndrome, Multiple Sclerosis and Motor Neurone Disease.

The onsite provisions include a main gym, two satellite gyms, a robotic suite, functional training suites, hydrotherapy pool, daily rehab-led activities and other rehabilitation adjuncts such as functional electrical stimulation, Saebo, orthotics, splinting and serial casting being just a highlight.

 

Askham Rehab prides itself on providing excellent neuro therapy and fully supports staff with further professional development, training and benefit packages, such a contributory pension scheme, annual attendance bonus, loyalty bonus on selected work anniversaries, discounts at all national supermarkets, discounts at over 3000 companies including restaurants, insurance companies, travel agents and many more, cycle to work scheme, salary sacrifice scheme on gym membership and childcare, wellness app to support mental health and wellbeing plus free access to legal, medical and other forms of support.

If you wish to meet the team, experience our residents, facilities and outcomes, you will find us on our website, or on our own YouTube channel.

This role will be line managed by the Clinical Lead, for further information please liaise with Sara Neaves, 07990717625.

Please apply via sara.neaves@askhamvillagecommunity.com

To apply for this job please visit askhamrehab.com.

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Spinal

Clinical trial gives hope to spinal cord injury patients

If successful animal studies translate into patients, NVG-291 could be set to redefine the treatment of spinal cord injury

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A revolutionary treatment designed to help redefine the future of people with spinal cord injury (SCI) is to embark on a clinical trial. 

The NVG-291 treatment has previously indicated its huge potential through two independent studies, which resulted in significant recovery in mobility and/or bladder function in animals with spinal cord injury. 

Now, NervGen Pharma, the biotech company behind NVG-291, has announced a Memorandum of Understanding the Shirley Ryan AbilityLab, with the intention of progressing the first clinical trial of the treatment. 

The single site trial is expected to start in the second half of this year and will assess the safety and effect of NVG-291 in treating acute and subacute, as well as chronic SCI, patients. 

NVG-291 is based on the by Dr Jerry Silver at Case Western Reserve University of a class of molecules (chondroitin sulphate proteoglycans, or CSPGs) that are up-regulated in response to nervous system damage and that inhibit repair. 

NVG-291 was designed to bypass this inhibition by CSPGs, thereby enhancing the body’s natural repair mechanisms, including plasticity, regeneration and remyelination.

“We have been following Dr Silver’s work for years and are very excited to be the first centre working with NervGen on this important spinal cord injury study,” said Dr Monica A. Perez, scientific chair of the Arms + Hands Lab at Shirley Ryan AbilityLab.

“One of the important aspects of this single-centre, placebo-controlled trial is the use of advanced electrophysiology to assess transmission in cortical and subcortical neuronal pathways as well as behavioural outcomes. 

“The ability of NVG-291 to demonstrate meaningful recovery in motor function, sensory function and bladder control in animal models is exceptional. 

“If these results translate to patients, NVG-291 could redefine the treatment of spinal cord injury.”

“NervGen and Shirley Ryan AbilityLab are planning a very unique and intriguing trial design, into which I have been fortunate to provide input,” stated Dr James Guest, professor of neurological surgery at the University of Miami and member of NervGen’s Spinal Cord Injury Clinical Advisory Board.

“The rationale to include acute and chronic patients in a study underscores the broad potential of the mechanism of NVG-291 in SCI. 

“Using Shirley Ryan AbilityLab in a single-centre study that implements advanced electrophysiological techniques to monitor connectivity across the site of injury will allow reproducible testing to explore NVG-291’s effects on motor recovery, possibly shaping the impact of subsequent studies.

“Partnering with Shirley Ryan AbilityLab, a leading institution in spinal cord injury research and management of patients with spinal cord injury, is an exceptional opportunity for NervGen.”

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Neuropsychology

COVID cognitive symptoms linked to cerebrospinal fluid

The study could help increase understanding of ‘brain fog’ among people recovering from COVID and those with Long COVID

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Cognitive symptoms experienced by people recovering from COVID-19 may be linked to abnormalities found in cerebrospinal fluid, new research has revealed. 

The new findings around the role of cerebrospinal fluid, which saw similar changes in those recovering from a mild bout of COVID as people with other infectious diseases, may provide new insight into how the SARS-CoV-2 virus impacts the brain.

‘Brain fog’ has become recognised as a common after effect of COVID and symptom of Long COVID, which can cause varying degrees of cognitive issues.

In a small study with 32 adults, comprising 22 with cognitive symptoms and ten control participants without, researchers from UC San Francisco and Weill Cornell Medicine, New York, analysed the cerebrospinal fluid of 17 of the participants who consented to lumbar puncture. 

All participants had had COVID but had not required hospitalisation.

They found that ten of 13 participants with cognitive symptoms had anomalies in their cerebrospinal fluid – but all four of the cerebrospinal samples from participants with no post-COVID cognitive symptoms were normal. 

Participants with these symptoms presented with executive functioning issues, said senior author Dr Joanna Hellmuth, of the UCSF Memory and Aging Center. 

“They manifest as problems remembering recent events, coming up with names or words, staying focused, and issues with holding onto and manipulating information, as well as slowed processing speed,” she said.

Examinations of the cerebrospinal fluid revealed elevated levels of protein, suggesting inflammation, and the presence of unexpected antibodies found in an activated immune system. 

Some were found in the blood and cerebrospinal fluid, implying a systemic inflammatory response, or were unique to the cerebrospinal fluid, suggesting brain inflammation. 

While the targets of these antibodies are unknown, it is possible that these could be “turncoat” antibodies that attack the body itself.

“It’s possible that the immune system, stimulated by the virus, may be functioning in an unintended pathological way,” said Dr Hellmuth, who is principal investigator of the UCSF Coronavirus Neurocognitive Study and is also affiliated with the UCSF Weill Institute for Neurosciences. 

“This would be the case even though the individuals did not have the virus in their bodies,” she said, noting that the lumbar punctures took place on average ten months after the participants’ first COVID symptom.

The researchers also found that the participants with cognitive symptoms had an average of 2.5 cognitive risk-factors, compared with an average of less than one risk factor for participants without the symptoms. 

These risk-factors included diabetes and hypertension, which can increase the risk of stroke, mild cognitive impairment and vascular dementia; and a history of ADHD, which may make the brain more vulnerable to executive functioning issues. Other risk factors included anxiety, depression, a history of  heavy alcohol or repeated stimulant use, and learning disabilities.

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Interviews

Cognitive Rehab Coach – harnessing the power of remote therapy

Inspired by seeing the impact digital could make in rehab, Natalie Mackenzie has gone on to build an internationally-successful business

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Out of the necessity to pivot to digital during the early days of the pandemic, an international online business – The Cognitive Rehab Coach – has been created to support people living with the impact of concussion and brain injury around the world. 

The Cognitive Rehab Coach was born from seeing how effective remote support could be for clients who are eager and able to embrace it, with people from the United States to New Zealand now benefitting from therapy delivered from the UK. 

Founder Natalie Mackenzie, a highly-esteemed cognitive rehab therapist and also director of BIS Services, runs both individual and group sessions across the globe – something she admits she embarked on from the greater acceptance of the quality and impact of virtual therapy which has come from COVID-19. 

“I still do client work and love doing client work, but the challenges of running a business often mean you can’t do as much as you’d like. You can get very lost in the running of a business when you’re a clinician. So this has been very interesting and led by the changes in digital offering we’ve seen from COVID,” she says. 

“Through delivering therapy this way, I can do a large amount of client work with much less travel time and greater reach.

“With the BIS, we can spend anywhere between two and eight hours with a client. I’ve got clients who are two hours away, so I can spend six hours of my day only seeing a client for two hours. 

“But with the Cognitive Rehab Coach, I can spend six hours online with six different different groups or six different clients. It’s kind of brought back the reason why I love the work that I do.

“Clients can be a bit more autonomous and self-led with the learning and assignments I give them, so they can be shorter packages, but with the same level of information they’re being given. 

“That also led on to me doing group programmes. That kind of one-to-many offering through small groups, in addition to the one-to-one sessions, are proving to be really effective. 

“But it was through what we did with BIS that showed me what was and wasn’t possible. The virtual timetable was a huge learning curve for me in terms of what clients will tolerate right in a group online setting – which at BIS is not a lot – whereas the concussion and post-concussion syndrome demographic find that slightly easier. There have been a lot of lessons.”

And the lessons in what was possible also extended into what was essentially a ‘needs must’. 

For many clients at BIS Services – which delivers innovative in-person cognitive rehabilitation to clients living with brain injury and neurological problems across the country – the experience of digital adoption into therapy was rather more challenging. 

“We did take our virtual timetable online for a period of time, we did pivot to adapt to the challenges of staffing and keeping clients and staff safe,” she says. 

“But now, the only time we go digitally is if someone is in isolation and we can flip back into the online support. We do face the same challenges with engagement and being able to functionally practice things with clients, but at least we know it will be for a short period of time. And the transition is much easier now, too. 

“But for BIS and our team of RAs (rehab assistants), all of whom have been specifically matched to each client, wherever possible, we’ll do face to face. But although that’s from a therapy point of view, that’s not to say digital hasn’t been really important in many other ways.”

But while Kent-based BIS has not adopted digital as a core part of its therapy offering to clients, it has proven to be effective in other ways. Through the creation of online events and opportunities, clients continued to be challenged and stimulated. 

“Our weekly quiz night became a therapeutic activity, as well as a bit of fun,” says Natalie. 

“We had a group of people who really got on well, but you’d probably never have put those people in a room together. It was the one it was the one activity that we kept going for the longest because clients were so engaged in it. 

“We rotated themes and gave clients the opportunity to write a quiz themselves, and we know hours of work went into that 45-minute quiz. It was a lovely thing to see.

“We also did a couple of comedy nights where the clients did comedy for us, and we would record it for them. I thought that was really brave to do that in front of your peers. Then the following week, the client would then review it as part of their learning to see what they wanted to improve on.

“These were ways in which Zoom did really deliver some great benefits to us.”

And in terms of its impact on how BIS operates, technology has also delivered benefits in terms of staff training and supervision. 

With 45 rehab assistants across the South of England, and extending as far north as Manchester, the opportunity to unite the team online rather than in person has been a very welcome opportunity. 

“They’re all so busy with clients that to even find one day a quarter where we bring everyone in for training can be really prohibitive,” says Natalie. 

“But now, I’ll deliver it live for any staff who can’t be here in person, and then it’s made available on our virtual library. For supervisions too, you don’t want to have people coming down from Manchester, spending all those hours travelling, when you can do it online now.”

Online training and learning has been a key area of development and acceptance, within BIS and for countless other organisations around the world. For Natalie too, she has embarked on her own digital learning experience, securing qualification as an ADHD coach. 

“I have a lot of brain injured clients with ADHD, but there isn’t an ADHD coaching course in the UK. I ended up doing a year-long course in America and the ability to train digitally has been amazing,” she says. 

“While the opportunity would have been available before COVID, I guess it wasn’t as accepted, my preference would probably have been face to face. But now, there is much greater awareness and acceptance, because it works and we’re all seeing that.”

Going forward, digital will continue to be a key part in the administration role of BIS, and of course will be fundamental to the continued growth of the Cognitive Rehab Coach – although the early experiences of COVID showed Natalie and her team the need to avoid becoming over-reliant on its use for some very human reasons. 

“In clinical work, we’re not used to being on computers for six or seven hours a day, let alone the challenges of talking pretty continuously for that long,” says Natalie. 

“We had really bad headaches and were just so tired, we even started having problems with our vision. I remember losing my voice for a couple of days too. 

“But now, we have got into what I think is a good working pattern, where we can flip to digital for our clients if we need, but we’ve learnt what works and what doesn’t. We are now using that to our advantage and making it work best for everyone.”

  • Natalie will be speaking at the Virtually Successful conference next week, organised by Remote Rehab in association with NR Times. For more information and to sign up, visit here

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