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‘Seek early assistance for support with Long COVID’

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Neuro Physio Wales suggest telerehab could aid in Long Covid recovery

The toll Long COVID can have is still being researched, its symptoms have much in common with a number of neurological conditions. Here, specialists from Neuro Physio Wales share their thoughts on why early intervention could be crucial.

Early intervention with symptoms of Long COVID can be vital in mitigating long-term effects, specialist neurophysiotherapists have said.

While the effects of Long COVID are still being realised, with the condition only recently being recognised as a lasting impact of COVID-19, accepted symptoms include fatigue, brain fog, joint or muscle pain, dizziness, depression or anxiety and pins and needles.

Such symptoms are very commonly associated with many neurological conditions, such as multiple sclerosis (MS), and while they will be new to the thousands of people experiencing Long COVID, they can be amplified for those who have lived with them through pre-existing conditions.

For neurophysiotherapists, they are symptoms that are regularly dealt with through their work with neuro patients, and by tackling them at the earliest point, that could help alleviate further problems down the line.

And while many people are shielding or self-isolating and may not wish to seek in-person support, the access to virtual resources including telerehab is proving popular among many who are living with Long COVID.

“We’re well used to treating all of these symptoms but as part of different conditions, they go hand in hand with so many other things we help people with, so I think neurophysiotherapists are well equipped to support people with Long COVID,” says Sara Davis, clinical director at Neuro Physio Wales.

“For many people who have had COVID and have been really poorly with it, they will have lost strength and muscle mass, and may have to work on their general strength and balance as they recover. This is a condition which we continue to learn more about all the time, so there is no set formula in what to do.

“But getting the support they need is really so important because – as with neurophysio in general – many people are losing out on their best chance of recovery through a lack of access to the physio services they need, or else not recognising they need it, so we would urge anyone struggling with symptoms of Long COVID to seek some support.”

While several clients continue to attend Neuro Physio Wales’s base near Bridgend in person, others have opted to stay at home and seek support using telerehab – but reaching out when needed is the main thing, says Helena Cook, a specialist neurological physiotherapist.

“We are still getting new calls and referrals, such as from people who have had a stroke and have just been discharged from hospital, but we have quite a few clients who are happy without in-person appointments and to have us just monitoring their progress,” says Helena.

“I think people are thinking twice about coming out, particularly with much being said about this current lockdown potentially lasting until Easter, but we’re happy to work with our clients based on the decisions they’ve made.

“In ordinary circumstances, more people would come to us when they leave hospital, but they’re definitely more hesitant now. We understand that and can support them from afar, using video or telephone call, if that’s what they prefer.

“I have one client who I haven’t seen for a year now, but I do hear from his wife, who gives us a call to ask advice. It’s nice that people know we’re here for them in whatever form they need us.”

Having opted to close completely in the early stages of the pandemic last year, Neuro Physio Wales is again operating both clinic and home visits, but with some changes to its usual way of operation in the centre.

“We closed down until the point we could be absolutely confident in our clients’ safety in coming in to the centre, and we now welcome them back knowing we are operating in a very safe environment. I don’t think it could be any cleaner and we have very stringent protocols in place, although we have had to change our working practices so that we have up to 30 minutes between appointments to ensure proper cleaning,” says Sara.

“We’re really pleased that many of our clients are coming back into the clinic, but we know they miss the social contact,” adds Helena.

“We used to have a ‘Friday morning club’ where we would have two therapists in, some clients would come at the same time, the next person would come a bit early for a chat, and it was a lovely environment.

“We have lost that for now, but we appreciate that for many of our clients this is a vital social opportunity, often the only one they will have, so as soon as it is safe and possible for us to bring that back, we will do so.”

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Spinal cord patients see improvement in motor functions in new trial

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After being injected with stem cells, patients reported an improvement with their motor skills

Intravenous injection of bone marrow derived stem cells (MSCs) in patients with spinal cord injuries led to significant improvement in motor functions, new research has found.

For more than half of the patients, substantial improvements in key functions — such as ability to walk, or to use their hands — were observed within weeks of stem cell injection, the study from Yale University reports.

No substantial side effects were observed, they added.

The patients had sustained non-penetrating spinal cord injuries, in many cases from falls or minor trauma, several weeks prior to implantation of the stem cells.

Their symptoms involved loss of motor function and co-ordination, sensory loss, as well as bowel and bladder dysfunction.

The stem cells were prepared from the patients’ own bone marrow, via a culture protocol that took several weeks in a specialised cell processing centre.

The cells were injected intravenously in this series, with each patient serving as their own control. Results were not blinded and there were no placebo controls.

Yale scientists Jeffery D. Kocsis, professor of neurology and neuroscience, and Stephen G. Waxman, professor of neurology, neuroscience and pharmacology, were senior authors of the study, which was carried out with investigators at Sapporo Medical University in Japan.

Key investigators of the Sapporo team, Osamu Honmou and Masanori Sasaki, both hold adjunct professor positions in neurology at Yale.

Professor Kocsis and Professor Waxman stress that additional studies will be needed to confirm the results of this preliminary, unblinded trial.

They also stress that this could take years, but despite the challenges, remain optimistic.

“Similar results with stem cells in patients with stroke increases our confidence that this approach may be clinically useful,” notes Professor Kocsis.

“This clinical study is the culmination of extensive preclinical laboratory work using MSCs between Yale and Sapporo colleagues over many years.”

“The idea that we may be able to restore function after injury to the brain and spinal cord using the patient’s own stem cells has intrigued us for years,” adds Professor Waxman.

“Now we have a hint, in humans, that it may be possible.”

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Inpatient rehab

Family hail ‘amazing’ care at neurorehab centre

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Fraser Millar and his family

A family whose beloved husband and father had a stroke are fundraising for the neurological centre where he currently resident, after being impressed by the “amazing” standards of care.

Fraser Millar needed life-saving brain surgery in November last year and is now in Woodlands Neurological Care Centre in York, receiving intensive rehabilitation to aid his recovery.

Woodlands, a level two neurorehabilitation centre which is part of Active Care Group, specialises in maximising recovery and independence and sets patients rehabilitation goals that promote re-enablement and enhance quality of life.

Now, Fraser’s family – wife Debs and children Alex and Ryan – are fundraising on behalf of Woodlands, to purchase therapy equipment which will benefit people who are undergoing rehabilitation at the centre.

To remember the long walks Fraser and Debs used to enjoy so much, Debs and daughter Alex are walking the equivalent 230 mile distance from York to Perth in Scotland, where Fraser is from.

Having set a target of £500, the total now stands at over ten times that amount, with over £5,680 being raised at the time of writing.

Family, friends and work colleague donations have come from as far afield as Canada and Australia, from people inspired by the Millar family’s story, which has been widely shared on social media and is touchingly accompanied by the hashtag #comeondad.

“We feel the team at Woodlands have become extended members of our family, they’ve been amazing,” says Alex.

“One of dad’s hobbies is cooking, he’s an amazing chef and loves to watch cookery programmes on TV in the kitchen at home. Woodlands staff noted this on his arrival day and within 20 minutes dad was watching The Hairy Bikers in his room and he continues to watch various culinary programmes!

“Staff there make a huge effort to make dad comfortable, take great care of his needs and interact with us brilliantly, we’re so thankful and extremely happy he’s having the best care.

“We’re raising money to say a huge thank you and while we’re doing it for dad, it’s great that it will benefit other patients too.”

Debs and Alex initially set a target of completing their walk by March 7, which is Debs’ birthday, but typical of their determination, they had already finished by February 24. Their fundraising target has also been vastly exceeded, with donations continuing to come in by the day.

“We initially thought our family and close friends would help with our fundraising cause, but the charity page was quickly circulated and within hours are target was met and the figure kept rising, we couldn’t believe it! We are incredibly thankful for every donation,” says Alex.

“We feel so touched and overwhelmed to have had such amazing support for dad. We walked the long miles but the generous donations kept us going and without them we wouldn’t be in the position to present Woodlands with the equipment they deserve.”

To add support to the Millar family’s fundraising on behalf of Woodlands Neurological Care Centre, visit https://www.gofundme.com/f/woodlands-neurological-rehabilitation-centre

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Could sesame seeds help protect against Parkinson’s?

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There is currently no cure of Parkinson's, but research like this could help change that

A chemical commonly found in discarded waste from the sesame seed oil manufacturing process could have protective effects against Parkinson’s disease, new groundbreaking research has found.

Sesaminol, abundant in the empty shells of sesame seeds which are discarded after the fatty oils are extracted, could have a role to play in protecting against neuron damage in the brain, researchers from Osaka City University have revealed.

“Currently there is no preventive medicine for Parkinson’s disease, we only have coping treatments,” says OCU Associate Professor Akiko Kojima-Yuasa.

Professor Kojima-Yuasa led her research group through a series of experiments to understand the effects of sesaminol on in vitro and in vivo Parkinson’s disease models.

Parkinson’s disease is caused when certain neurons in the brain involved with movement break down or die due in part to a situation called oxidative stress – neurons in the brain come under extreme pressure from an imbalance between antioxidants and reactive oxygen species (ROS).

The team found in cell-based in vitro experiments that sesaminol protected against neuronal damage by promoting the translocation of Nrf2, a protein involved in the response to oxidative stress, and by reducing the production of intracellular ROS.

In vivo experiments brought Professor Kojima-Yuasa’s team what the University have hailed as equally promising results.

The impairment of movement due to Parkinson’s disease is the result of damaged neurons producing less dopamine than is naturally needed.

The team showed that mice with Parkinson’s disease models show this lack of dopamine production. However, after feeding the mice a diet containing sesaminol for 36 days, the research team saw an increase in dopamine levels.

Alongside this, a rotarod performance test revealed a significant increase in motor performance and intestinal motor function.

With the first-ever medicine for Parkinson’s disease potentially being the naturally occurring food ingredient sesaminol, and this ingredient being found in the naturally occurring waste of the sesame seed industry, Professor Kojima-Yuasa and her team are ready to take their work to the clinical trial phase and connect the consumption/production chain in a way that, as she puts it, “prevents diseases with natural foods to greatly promote societal health.”

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