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Therapies

Spinning back to normality

Through a shared love of cycling, Dave Buchan is helping to transform the lives and outcomes for people with brain injuries. Deborah Johnson speaks to him about the crucial role he sees for cycling in neuro-rehab.

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Martin was particularly hard to reach.

Aggressive and unpredictable in his behaviour after a brain injury, those tasked with working with him were at a loss as to how to help. Nothing seemed to work.

But a chance remark that he used to enjoy cycling when he was younger changed his life trajectory and got the gears of his meaningful recovery into motion.

He was introduced to Dave Buchan, a specialist cycling coach and mentor, and began to engage in ways the people around him had never imagined possible.

From the full-of-anger man he had become after his injury, through the medium of cycling, his behaviour began to change.

“That’s not to say he was really keen on the idea from the start,” recalls Dave. “I distinctly remember when he first came to us with his case worker, he refused to get out of the car.

“But since then, what we have done together has been amazing. His progress has been fantastic and helps to show the power of the positivity of cycling.

“I firmly believe cycling is fundamental to rehabilitation of all kinds, but Martin’s case shows the positive effect it can have on someone recovering from a brain injury which has had such a devastating impact on their life and behaviour.”

​For Martin, his life has been changed by getting back on a bike, something he had not done since he was young.

“I think for many people the case is the same, where they cycled when they were at school or university, but gave it up once they could get a car, started to work or had a family – but even though Martin’s brain had been injured, it obviously retained those special memories of how much he used to love cycling. That was a starting point and an ‘in’ for me to be able to help and to build that relationship with him.”

Dave is founder of Bike4Health, an organisation which promotes the health, wellbeing and sustainability benefits of cycling in the North of England.

“We started talking about bikes, about rides we could do, and we have a workshop on site which Martin was very interested in. When I first suggested some of the things we could do, he would instantly say ‘I don’t like that’ or ‘I’m not doing that’ and become defensive.

“But we usually did get round to doing these things and he loved them. The feeling of being outdoors, exploring the world, the exhilaration, made him want to do more.

“We would get out and about in the van, go to cafes and local bike shops, and he began to rediscover the world and things in it he enjoyed doing.

“We would have a great time, laughing and joking, singing and chatting, it was fantastic to see how he was progressing through his love of cycling.

“There is something so powerful for anyone about being out in the forest or countryside, riding down a path that snakes this way then that, going over all its lumps and bumps, exploring the world around us and discovering new things all the time.

“And that sense of excitement really did capture Martin. He loved the freedom it gave him.”

After engaging with cycling and building trust with Dave, Martin began to interact with some of Dave’s other more challenging clients, to great success on both sides.

“I do some work with patients in a secure hospital and they built a relationship with Martin, who came along to some of the sessions.

“They’d ask about him when he wasn’t there, and likewise he would ask about them. For these patients, they are under 24/7 supervision and my cycling sessions are possibly the only time they get off their ward. We push and challenge them in the same way we do with Martin.

“One patient recently was really struggling so I brought an electric bike with me to help. We did an eight kilometre course and he walked up one hill, but he completed it. Again, this person did have an interest in bikes as a young person, and that was the means of engaging him.

“That kind of impact can be life-changing for someone for whom things seemed so bleak.”

Dave Buchan

Martin is now a regular at the Bike4Health headquarters in Kirkley, Northumberland. He helps out two days a week with a multitude of tasks, and has become an unofficial part of the team.

“He is a fantastic worker and loves coming here, and it gives us all great pride to see how much he has overcome.

“He is certainly a different Martin now to the one we first met – rather than not wanting to get out of the car, he now texts me to say what time he wants to be picked up.”

Dave’s own love of cycling began as a young boy living in a tough community in Tyneside, when the opportunity came up to ride to picturesque Northumberland with his school.

“That was the catalyst for my love of bikes and cycling, and I became quite obsessed from that point. I loved being outdoors and being able to escape to somewhere and see the beauty of the countryside and the world.

“There is always so much more to do and explore, and I wanted to help people discover that sense of awe that I did as a young boy,” he says.

After becoming an amateur cyclist and competing across Europe, Dave then moved into a role as a mechanic, then managed a cycling shop.

But it was Dave’s own experience of recovering from a head injury which made him want to share his love of cycling more widely.

“I was cycling home from the shop and I was on a quiet side road, cycling around 4 or 5mph, and a little girl ran out into my front wheel. I went straight over the handle bars and landed on my head.

“I went to hospital for X-rays and they were all fine, but I wasn’t assessed for my head. However, that night I woke up laughing, then started crying, for no apparent reason, so I knew something wasn’t right.

“I went back to hospital the next day and I was told I had post concussion syndrome. It can cause mood swings and, if you don’t have calmness and positivity around you to help your recovery, you can go to some dark places in the longer term.”

Dave used cycling to aid his recovery and then set about helping others to do the same.

“I’ve always known the power of cycling and the positivity it can bring, and that experience made me realise I wanted to help other people realise that too, whether as part of recovery, or just for general wellbeing.”

Bike4Health was established in 2014 and has grown from just Dave to a three-strong senior team, two full-time bike mechanics and 12 freelance guides and coaches.

The organisation has also invested in specialist facilities and a workshop. Its core activities are working with schools across the North, with more than 4,000 children benefitting from sessions, in addition to its more specialist and bespoke rehabilitation work with patients.

“The positivity cycling generates is huge – as well as the endorphins are released by being outdoors and exercising anyway, there is also the sense of achievement.

“Managing to get up that hill and come down the other side is a big accomplishment for many people.

“You can see the growth in confidence and the fact they’re loving what they’re doing, like we saw with Martin, and it’s just great to help people discover that.

“That endorphin rush is priceless and can change someone’s whole outlook on life. In society today we’re very materialistic and seem to get pleasure from buying things, and we spend so much time on technology.

“This is going back to the basics. We are designed as humans to move, to think, to be active, and cycling is helping the body to achieve that.

“Cycling can play an important role in mental health in general, not just for patients as part of rehabilitation, but for everyone.

“It’s important in tackling obesity, promoting wellbeing, and cycling can be a very social activity which can engage even the hardest to reach people, as we have seen in a number of cases, but particularly that of Martin.”

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Therapies

Music therapy strikes a chord with traumatised emergency workers

The UK’s first pilot of its kind has delivered strong outcomes for participants as a way to deal with trauma

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The Blue Light Symphony Orchestra (BLSO), in collaboration with Chroma, has successfully completed a UK-first pilot project delivering group Music Therapy to emergency service workers to help them recover from traumatic experiences.

Working with Surrey and Sussex Police, Surrey and East Sussex Fire and Rescue and Southeast Coast Ambulance Service, the project delivered a bespoke music therapy program for emergency workers. It drew inspiration from the USA where music therapy is widely used to treat PTSD and trauma-related issues in army veterans.

The BLSO was awarded £10,000 funding from the Coronavirus Community Support Fund, distributed by The National Lottery Community Fund, recognising that emergency workers have been exposed to increased levels of trauma while responding to the COVID-19 pandemic.

Over 12 weeks, using a combination of psychodynamic music therapy, neurologic music therapy and dialectical behaviour techniques, emergency service personnel were able to experience, reflect, learn, and then transfer coping strategies into everyday life.

The group incorporated free improvisation, the learning of simple drumming techniques, blended with health and wellness education and interactive improvised music-making. Throughout the programme, the sense of camaraderie increased, alongside the enjoyment and playfulness that developed.

Seb Valentine, founder of the BLSO and serving Detective Sergeant with Surrey Police said: “We are extremely happy with the success of this project, bringing music therapy to emergency workers who develop mental health issues relating to the trauma they experience daily.

“Positive feedback from participants has meant we are planning to run another project in the Surrey Sussex area. I hope that when my colleagues see how successful this pilot was, it will reduce scepticism and encourage more to take advantage and benefit from the healing power of music.

“I would love to hear from any other emergency services organisations in England or Wales that would like to host a Music Therapy project. We are actively seeking funding opportunities and know that music therapy can help support the mental wellbeing of emergency service workers, so please do get in touch.”

Chroma will also be expanding the support, with the West Midlands Ambulance Service starting a similar project in May 2022.

Daniel Thomas, managing director at Chroma, added: “This was a wonderful project to be a part of. By the end of the 12 weeks, 71 per cent of the participants’ recorded reduced levels of distress compared to their CORE-OM scores when they signed up for the program.

“As a result of this success, we are pleased to be able to expand the project to offer more emergency service personnel vital support to support their physical, emotional and mental wellbeing.”

For more information regarding hosting a music therapy project, contact: Seb Valentine on 0777 337 2575 or via email Seb@bluelightsymphony.org.

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Therapies

How song writing can support brain injury recovery

Arts therapy provider Chroma looks at how music therapy is helping people with psychological issues post-trauma

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Music therapy has once again proven itself effective in helping to support people with cognitive issues after brain injury, with song writing proving a powerful tool.

Sarah Morgan, a qualified music therapist at Chroma, uses song writing as a means to help those living with a brain injury, overcome cognitive issues such as trouble remembering, planning tasks, learning new information, sustaining attention, or dealing with emotions.

Loss of identity is a common emotion following a traumatic or acquired brain injury. Song writing lends itself to emotional expression when the victim has a decline in speech and language skills or has trouble discussing difficult memories.

For brain injury survivors, the process of song writing enables them to explore, question, and connect with their new sense of self and challenge the perception of how they see themselves versus how the world sees them.

A loss of identity following a brain injury ultimately negatively affects wellbeing. The transition from loss to acceptance takes time. Song writing offers a creative, identity-based exploration, which effectively helps to reveal issues in order to explore and make sense of them.

Sarah is currently supporting a young rapper who sustained a brain injury due to a road traffic accident (RTA), through song writing, improvisation and the use of music recording software. Her aim, and his own personal goal, is to help him begin to identify as himself once again.

Cognitively, song writing helps develop attention, concentration and task-planning and prioritisation skills. It also utilises working memory by allowing the client to repeat and manipulate phrases.

Engaging in making music focuses attention on a positive creative expression, and stimulates and induces the release of brain chemicals such as dopamine and serotonin.  

Music plays an important role in providing a creative and emotional outlet and provides the client a positive focus. Song writing provides the client with a vessel to process trauma – by writing about the traumatic event or feelings surrounding it. 

In this particular case, creating new music enabled the client to re-connect with an integral part of himself – the rapper, which was a significant goal of his rehabilitation.

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Therapies

Paving the way for a digital future in neuro-rehab

The Virtually Successful conference is uniting therapists from around the world to promote the power of remote rehab

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An event which brings together therapists from across the world to analyse how the use of neuro-rehab innovation and digital therapy can benefit patients’ lives is being held next week.  

The first-of-its-kind Virtually Successful: Rehab in the New Normal event will reflect on the huge changes seen across neuro-rehab and healthcare since early 2020, and assess what the future now looks like for professionals and patients. 

Bringing together professionals from across the world, Virtually Successful has a five-day online programme – beginning on Monday – of insight from speakers who have helped to inspire, and have themselves been inspired by, the adoption of technology. 

The COVID-19 pandemic has seen a digital approach to rehab adopted like never before, and has introduced many new ways of working into the sector. 

Many therapists now incorporate some form of technology in their work with patients – be it an app or gamified rehab programme, or use of remote monitoring – which they combine with traditional hands-on rehab, in a way that enables patients to play a greater role in their own recovery than ever before. 

Virtually Successful – supported by NR Times – is organised by Remote Rehab, a global community of therapists created during the pandemic to share best practice and experiences for the good of their patients, in what was an unknown new world of digital adoption for many. 

It has since grown into a thriving global platform for the sharing of knowledge, with a host of online resources, support groups, masterclasses, courses, techniques, tools and tips, designed to enable outstanding rehabilitation globally. 

Leanna Luxton, a neurophysiotherapist and co-founder of Remote Rehab, says the event will be of significant value both for those who are keen tech adopters, as well as those who are more sceptical. 

“I think we’re now at a time where we could put our heads in the sand and say ‘I’m done with this, I’m not doing it anymore, I’m going back to face to face’,” she says. 

“But as therapists, as much as we may want to do that personally, we have to consider the opportunities we may be missing for our clients in doing that.

“This conference is a call to action for all therapists to be at the forefront of the digital revolution. There are many possibilities in the blended approach to rehabilitation and many opportunities for ourselves, our patients and our services.”

Deborah Johnson, editor of NR Times, added: “Technology has played an absolutely crucial role in neuro-rehab over the past two years in enabling people to continue to rehabilitation remotely, and has helped therapists and patients alike to discover new-found possibilities in what could be achieved using digital tech. 

“Virtually Successful helps to showcase the amazing work that is being done in helping to continue to maximise the impact of remote rehab, with five days of insight and inspiration from some true leaders in their field from across the world. 

“The team at Remote Rehab have created a fantastic line-up and so much hard work has gone into organising this event, which is the first of its kind, and we at NR Times are delighted to lend our support.”

To sign up for Virtually Successful, at an NR Times reader discount rate, visit here

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