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Inpatient rehab

Redefining rehab: first-of-its kind ward gets set to open

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As the new Castle Hill Hospital rehab ward gets set to open, NR Times speaks to Dr Abayomi Salawu, whose dedication to achieving goals through rehab, and passion for using VR and AR within it, is putting Hull at the forefront of the UK

 

A new NHS rehabilitation centre, which will be the first in the UK to incorporate digital technology and virtual reality into its rehab offering, is set to open its doors. 

The purpose-built ward at Castle Hill Hospital in Hull will have 12 beds and has a range of facilities, including a gym, therapy room and garden area, to enable a comprehensive rehab offering to be delivered. 

It also becomes the first NHS inpatient rehabilitation unit to incorporate digital technology, including virtual and augmented reality into its rehabilitation programme, after Hull hosted the UK’s first successful clinical trial of the GEO robotic gait trainer in 2017.

Patients are expected to move into the new building – the first purpose-built NHS specialist rehabilitation centre across the Humber, Coast and Vale area and neighbouring Lincolnshire – in the coming weeks. 

“This new building brings rehab into modern life. Previously to this, we had our rehab unit as part of the cardiac ward, and more recently in the oncology section, but the limitations of not having a dedication rehab ward became obvious,” says Dr Abayomi Salawu, consultant in rehabilitation medicine at Hull University Teaching Hospitals NHS Trust. 

“Our role in rehabilitation is to help restore function and enhance quality of life for people with complex health needs so that they may go on to live fully and meaningfully, not just exist.

“Normal hospital ward environments aren’t generally suited for this purpose, especially in the case of patients with acquired brain injury or physical and cognitive deficits.

“This new ward will give us the space and the facilities we need to provide specialist rehabilitation input to the highest level, and will also deliver an environment which is more conducive to patient recovery. 

“We have 12 beds, we do need more, but while acute clinical care and public health have both received significant investment for many years, rehabilitation – the third pillar upon which the NHS is built – has sadly lagged behind. 

“So our new rehabilitation ward is a really significant development and definitely a step in the right direction.”

On site during construction (l-r) Madeleine Leetham, senior occupational therapist, Dr Abayomi Salawu, consultant in rehabilitation medicine, and Lisa Cunningham, ward sister

Redefining the traditional definition and practices of rehab is something Dr Salawu has long been committed to, and that extends into the ethos of the Castle Hill ward. 

“We offer complex rehab, if the nurses or staff on any ward think they have a patient who could benefit, then they can come to the new ward,” he says. 

“Life has to be about more than going to the toilet and the whole ethos of being able to conquer that starts by conquering your first environment, which is hospital.

“The approach that has always been taken often makes a patient more poorly, in a way. I’m not underplaying physical injury, but in an NHS hospital, the first thing we do is give someone a bed, even if they walked in. A lot of people become de-conditioned when they are hospitalised, and that’s making patients worse. 

“If you can get a patient as physically fit before surgery, through ‘pre-hab’, then that can make things so much better before and after. With our amputation patients, we do the ‘pre-hab’ work with them and it’s so successful we can then pick them up after surgery as an outpatient. We haven’t used our rehab beds for amputation patients for four or five years now.   

“Another thing in rehab is that there isn’t always a cure, but that doesn’t say you can’t live life well and meaningfully. If, for example, you have a child with Cerebral Palsy, then that condition isn’t going to be reversed – so let’s move on and find out what we can do. How can we enable them to do things and how can we support them in that?”

One key way of engaging patients is through technology, believes Dr Salawu. In addition to the therapy work of the MDT, Dr Salawu is a firm believer in the power of virtual and augmented reality, and is so invested he is even leading the development of new apps.

“I’m a firm advocate and believer in technology, I’m totally sold that this helps rehab. I always look for whatever low hanging fruits we can use, and technology is something we can use. It’s easy, quick, achievable and doesn’t cost a massive amount,” he says. 

“We use virtual reality and augmented reality and we have linked in with Hull University to develop a virtual kitchen app, which patients can interact with virtually and then use their skills to replicate the tasks with their OT in the real-life kitchen. 

“It’s all about practice, practice, practice. That’s what helps recovery and that’s what rehab is about. But practice is boring, for a lot of people rehab isn’t exciting, and that’s the problem. 

“If you want someone with a paralysed limb to practice moving it, if they try a few times and their limb doesn’t respond, even the most motivated patient will give up. But if you translate that into a virtual environment, where you can move your virtual limb in a virtual world, then that might give the opportunity for some recovery – and psychologically can be very important. 

“The more opportunities you give to the patient to practice rehab, so they can maintain or recover their function, the better. That’s why VR works so well, because it’s fun it makes rehab more engaging. 

“That’s where we should be pushing, to empower patients to take over their own rehab. 

“I said to the computer scientists that I hear video games are addictive, could they please create some addictive rehab for my patients so they would become addicted to their practice!

“But we also have a quiet room in the new unit, where patients can use the immersive environment of a VR headset to be calm, de-escalate, become less agitated. We have developed the Brain Recovery Zone app, which is very calming and soothing, and can be used by patients in their own homes as well. 

“Through putting on a headset and being in that calm environment, that can also be very important in rehab.

“For my patients, I’ll say ‘Whatever floats your boat. Try things in rehab, see what you enjoy and what works’ and we’ll see what we can achieve. I want to empower patients to take control of their rehab however they can, and by using these pieces of technology, we’re seeing great results.” 

Brain injury

Groundbreaking neurorehab centre opens today

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A groundbreaking neurorehabilitation centre is today opening its doors, bringing a new dimension to brain injury rehabilitation in the UK. 

Calvert Reconnections, the UK’s first intensive acquired brain injury (ABI) rehabilitation centre which offers a unique approach to rehab for its residents, is now open after having to previously delay plans due to the COVID-19 pandemic. 

The centre, on the outskirts of Keswick in the Lake District, offers the first residential programme of its kind, combining traditional clinical therapies with physical activity in the outdoors.

“The opening of our new centre is the culmination of years of meticulous planning by the Lake District Calvert Trust. It is a landmark moment for the ABI rehab market and for us,” said Giles Mounsey-Heysham, chairman of the Lake District Calvert Trust (LDCT) trustees.

Working with leading clinicians and academics, our new rehabilitation centre will provide a groundbreaking, world-class rehabilitation programme tailored to support individuals in their recovery.”

Calvert Reconnections will actively seek to incorporate a wide range of outdoor activities into each participant’s rehabilitation programme, depending on their unique needs and interests.  

This may range from reflective activities such as fishing, bird watching or a nature walk, to higher adventure activities such as horse riding, canoeing, rock-climbing and abseiling – all closely assessed and graded to a person’s interests and functional abilities.

It is launching its new service with three confirmed participants and a strong pipeline of referrals, having seen significant interest from across the country since announcing its creation.

“After many challenges along the way, not least the COVID-19 pandemic, we are thrilled to open Calvert Reconnections. We are hugely excited about what the future holds,” says centre director, Sean Day. 

Rob White, activity lead at Calvert Reconnections, explains how the use of outdoor activities makes the new service unique.

“At Reconnections, participants are involved in every aspect of the activities they undertake,” he says.  

“They complete meaningful tasks, from concept to completion, in a real-world setting. Extensive research shows that outdoor activities can help individuals in their recovery from brain injury.”

Meanwhile, Calvert Reconnections’ long-established sister organisation Calvert Lakes is also reopening its doors today to people with a range of disabilities, from mild to profound, for much-needed holidays in the beautiful Lake District.

“Reopening Calvert Lakes is a welcome return to business as usual. We are so pleased to be able to welcome our visitors back,” says Sean. 

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Inpatient rehab

Father-and-son bond supports RAF veteran’s recovery

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A Royal Air Force veteran who sustained a significant brain injury and overcame “testing hurdles” on the road to recovery is now making strong progress with the unwavering support of his son.

Herbert Martin, an 85-year-old from Littleport, near Ely, sustained a brain injury following a fall in October 2020 and went on to make a remarkable recovery – highlighting the rapid progression specialist rehab therapy can offer.

A former RAF serviceman of 12 years, which included deployments to Cyprus, Australia, Pakistan and Singapore, Herbert was admitted to Askham Rehab on New Year’s Eve 2020 after suffering a subarachnoid haemorrhage that caused a bleed between his brain and skull.

The severity of the injury left Herbert extremely fatigued and resulted in muscle weakness that restricted his mobility. His condition upon arrival at Askham was so critical it was initially feared he wouldn’t recover enough to return home and live independently.

However, due to his extraordinary response to treatment from Askham’s multidisciplinary team of therapists, and the inspiring support from his son, Paul, and two grandchildren, Herbert is almost at a stage where he can return home.

Sara Neaves, clinical lead and outpatients service manager at Askham Rehab, says: “When Herbert first came to us, he was incredibly weak. This made any initial progress extremely challenging.

“He was assessed by our teams of clinical psychologists, physiotherapists, occupational therapists, and speech and language therapists, before SMART (Specific, Measurable, Achievable, Realistic, Time-based) goals were set to aid his recovery.

“To begin getting Herbert back on his feet, we began to build his strength and stamina up through various therapy exercises and activities, such as baking and cooking. Eventually, he progressed enough to be able to use our hydrotherapy pool where he could benefit from the many qualities of exercising in water.

“In a short space of time, he was then able to push himself further in our state-of-the-art robotic suite, where he used Tyromotion’s MYRO table, a sensor-based surface with interactive applications, to work on his standing balance and weight transference, whilst challenging his upper limb coordination. He also used the OMEGO Plus, a multifunctional chair enabling specific training of functional therapy goals, to build on his range of movement and strength.”

With the initial belief that it was unlikely Herbert would be able to return home and that another setting would be more suitable for him due to the severity of his condition, he surpassed everyone’s expectations during the early stages of his rehabilitation, maintaining an outstanding level of engagement in his therapy sessions.

One key driver for this was the support of his son, who has been motivating him every day throughout his stay at Askham, playing an integral role in his father’s recovery.

Paul’s encouragement enabled Herbert to push himself to perform functional tasks and overcome challenges to slowly regain his independence. Herbert went from standing at a work surface to standing with parallel bars, and finally taking independent steps with a rollator walking frame, which he was determined to achieve.

Sara continues: “Herbert’s main goal is to get back home. To facilitate this, our occupational therapy team completed a home assessment where they have been making adaptations to enable him to be as fully independent as possible.

“Today, he can now mobilise completely independently with a rollator. It was only a few months ago we feared informing his son that he wouldn’t be able to return home, so to see Herbert nearing a point where he can live a completely independent and happy life is nothing short of amazing.

“His remarkable progress is also due to the wonderful relationship he has with his son. The bond they have is really special and has been monumental in Herbert overcoming so many testing hurdles. It’s enabled him to maintain motivation to progress whilst allowing us to establish an effective working relationship with his family, which has allowed us to facilitate Herbert as coherently and effectively as possible.”

Herbert says: “I have a lovely relationship with my son, Paul. Every night we talk to each other without fail and he has been looking after my bungalow during my rehabilitation. The Askham Rehab team have been excellent. Everyone is so friendly and helpful, and I can’t thank them enough.”

Aliyyah-Begum Nasser, director at Askham, adds: “Our ethos is all about maintaining a person-centred approach. We put the patient at the core of our practices and empower them with the tools to oversee their journey with us their own way. We’re delighted Herbert has reached a stage where he can almost return home and live independently.”

 

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Inpatient rehab

Day One Trauma Support rolling out nationally

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A charity which supports seriously injured people from the earliest stages of their recovery is rolling out its services in new regions following its national launch last month. 

Day One Trauma Support offers financial, emotional and legal support to patients and their families, and was originally based at Leeds Teaching Hospitals NHS Trust.

Its support will now also be offered in the Major Trauma Centre at Aintree University Hospital, with rollout into more of the country’s 27 Major Trauma Centres also planned. 

The charity is launching a fundraising drive during July to help raise vital funds for the expansion of its services, with over 100 people committing to each cover 75 miles to raise money – the distance marking the journey between Leeds and Aintree. 

Day One’s support ranges from emergency funding for accommodation for families of patients being treated far from home, longer-term funding for mobility equipment, and legal advice with personal injury claims. 

The charity helps arrange counselling, welfare benefits and peer support volunteers, who offer a sounding board to patients still coming to terms with their injuries.

Day One has already supported more than 1,000 patients across Yorkshire since its local inception in 2014. Recently granted independent charitable status, Day One can now work beyond Yorkshire. 

Among those taking part are 40 medical professionals including surgeons, physiotherapists and nurses, from Leeds Teaching Hospitals NHS Trust and Aintree Major Trauma Centre, who will cover the distance as two competing relay teams on 31st July along the canal between Leeds and Liverpool.

Also participating is former Day One patient, Gary Brennan, who in 2010 made a remarkable recovery from a motorbike accident in which paramedics initially declared him dead at the scene. 

In spite of his long-term injuries, Gary has committed to cover the 75 miles by Segway for the benefit of others like him.

“Before Day One, patients had to figure things out on their own. We weren’t aware of any benefits we may have been entitled to,” says Gary. 

“I’ll do everything I can to make sure others going through what I went through have better support and advice as they recover.

“I’m hoping to cover the 75 Miles on a Segway, which isn’t as easy as it sounds – especially not with my spinal osteoporosis arthritis!”

Additionally, more than 20 lawyers and associates from Leigh Day, Sintons and Irwin Mitchell will join forces to raise as much money as possible for the injured patients they work with as members of Day One’s legal panel.

Lucy Nickson, CEO of Day One Trauma Support, says: “We are so grateful to everyone who has taken up the 75 Miles in July challenge to help us provide more trauma support. 

“This is a chance for us all to stand together with those recovering from injuries that test their physical limits every day, and push our bodies a little harder to help raise vital funds on their behalf. 

“We believe a supported recovery should not come down to luck or post code. With the help of this fundraiser we’re taking a step closer to making that a reality.”

Professor Peter Giannoudis, trauma surgeon at Leeds Teaching Hospitals NHS Trust and Day One founder, says: “The 75 miles from Leeds to Aintree is more than distance; it’s about the journey of collaboration, expansion and hope as these two Major Trauma Centres lead the way in mapping out the future care provision for patients recovering from serious traumatic injuries.”

“We’ve seen first-hand how vital the work of Day One is to families whose loved ones are in Leeds Major Trauma Centre, and for whom the support and guidance of the Day One team, during some of the most difficult and traumatic times they have probably ever faced, is absolutely invaluable,” adds Phil Davison, head of general personal injury at Sintons. 

“It is simply fantastic news that this is now being expanded into Aintree Major Trauma Centre, for the benefit of patients and families there, too – but their work comes at a cost, and fundraising plays a major role in helping to sustain this.”

To participate in #75Miles register at https://dayonetrauma.org/get-involved/75miles, or to donate to the cause, visit https://dayonetraumasupport.enthuse.com/profile.

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