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Stroke concern rising amid COVID-19 crisis

Concerns are mounting that people across the UK who have a stroke or TIA/mini-stroke (transient ischemic attack) are not calling 999 amid the coronavirus pandemic.



Stroke charity the Stroke Association fears that thousands of people could be at risk of severe disability, or even stroke-related death, if they don’t respond to stroke symptoms.

And Dr Deb Lowe, NHS national clinical director for stroke and consultant stroke physician at Wirral University Teaching Hospital, warns: “We’re beginning to see some quite striking reductions in the number of people coming into hospital with the symptoms of stroke.

“It appears that people aren’t seeking emergency help or going to hospital when they suspect a stroke, possibly due to fear of the virus or not wanting to be a burden on the NHS.

“Stroke is a medical emergency and it’s essential that you call 999 straight away if you suspect you or someone around you is having a stroke. Our hospitals are equipped and ready to treat stroke patients. Given the emergency changes being made across the NHS, it’s possible that a patient’s treatment or journey might be a bit different while we put measures in place to deal with coronavirus safely.

“But these are to keep patients and NHS workers safe and the most important thing to remember is to dial 999 if you suspect a stroke.”

Latest figures from Public Health England showed attendance to Emergency Departments in England has dropped by over a third (34.5%) on the same week last year, from 136,669 to 89,584(i).

Public Health Scotland figures report attendance to emergency departments has dropped by over a third (40.1%)on the same week last year(ii). While figures for emergency admissions aren’t available yet, the charity and senior stroke professionals expect similar declines.

In 2019, there were almost 90,000 strokes in England alone. Meanwhile, almost 21,000 patients were admitted to hospital with a TIA/mini-stroke. The charity warns that any delay in getting help will jeopardise your ability to rebuild your life after stroke.

Juliet Bouverie, chief executive of the Stroke Association, says: “The fear of contracting the virus or feeling like a burden on the NHS might be the main reasons putting people off seeking treatment. But I am reassured that the NHS is well equipped to treat both stroke and coronavirus.

“The best thing for you and the NHS, is to call 999 and say you, or the person in front of you, is having a stroke. Assume stroke until told otherwise.

“Equally concerning is people who experience mini-stroke and then dismiss it as ‘just a funny-turn’. A mini-stroke is a warning that major stroke is on its way, so you shouldn’t ignore the signs; and you need to seek help.

The stroke charity is highlighting the world-famous stroke acronym, FAST, urging the public to familiarise themselves with the signs and symptoms of a stroke: Face, Arms, Speech and Time (to call an ambulance) – Act FAST.

Bouverie says: “By acting FAST and getting access to world-class treatments, you can help save lives.  Acting FAST can also reduce the misery for thousands of stroke survivors and their families and the impact on the NHS associated with stroke, as the UK’s leading cause of adult disability. Now more than ever, during this pandemic we must remain focused on making and keeping stroke a priority for the UK.”

Professor Rustam Al-Shahi Salman, president of the British Association of Stroke Physicians (BASP) and honorary consultant neurologist in Edinburgh, says: “Strokes and mini-strokes are medical emergencies. The quicker many stroke treatments are given, the better.

“As we say, ‘time is brain.’ So it’s important to recognise the signs of a mini-stroke or stroke and act immediately. In this phase of social distancing during the COVID-19 pandemic, family and friends can do the FAST test on the phone or via video chat.

“Many stroke services have also adapted to the pandemic rapidly: rather than calling patients with mini-stroke up to a hospital outpatient appointment, they are using phone or video chat to diagnose and recommend treatment for patients.”

Dr David Hargroves, consultant stroke physician at East Kent University Hospitals, adds: “There may be many different ways in which the excellent stroke care we have in the UK will be delivered in the coming months. This may include different environments patients are cared for in, virtual assessments, therapy advice or interventions delivered by telephone or video link.

“Members of the public should be reassured that these changes will help reduce the transmission of the virus, whilst continuing to provide the care that will save lives and reduce disability. It is so vitally important that they continue seek help when they first spot the symptoms or signs of a stroke.”

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Video: everyday vs specialist tech

Assistive technology Expert Andy Fell joins Irwin Mitchell law firm for an in-depth exploration of the very latest independence-boosting devices and platforms.



Technology plays a day to day role in our lives and mobile phones, tablets, Alexa and Siri are common place.

Imagine the impact on your life if you were no longer able to interact with a touch screen or keyboard or give voice commands….

In this virtual event, Assistive Technology expert Andy Fell gives practical demonstrations of how everyday technology and specialist technology can be used to help give independence to those who need it most and why specialist technology may be needed.

During the event hosted by Lauren Haas, personal injury solicitor at Irwin Mitchell LLP, Andy goes into detail about what apps and gadgets are on the market, how everyday technology can be optimised such as the Amazon Alexa, and answered a number of questions ranging from touch screen sensitivity to smart watch reminders.

Case managers, ancillary medical professionals, as well as interested members in healthcare, social care, parents and clients may find this recording useful, as well as anyone caring for, working or living with people such as dementia sufferers or sufferers of other conditions which restrict their mobility.

Andy Fell is an independent disability and assistive technology (AT) consultant with almost twenty years’ experience working with all disabilities and age groups.

He is a qualified Rehabilitation Officer for the Visually Impaired and, since qualification, has lectured on the use of assistive technology and role of AT in the life of disabled people.

He has worked with a wide range of charitable organisations including British Dyslexia Association, was head of assistive technology for Guide Dogs for the Blind and National Disability Advisor for the Royal Yacht Association.

He has also worked for blue chip companies, the emergency services and various government departments including Department for Work and Pensions.

Andy is a fellow of the Royal Society of Arts, chairman and founding trustee of the Wetwheels Foundation and sat on the British Dyslexia Association – Workplace Assessors Professional Review Panel.

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The relationship between music and running

By Daniel Thomas, joint managing director of Chroma Therapies.



By Daniel Thomas, joint managing director of Chroma Therapies

With its ability to produce new neural pathways, Neurologic Music Therapy is able to encourage movement, co-ordination, improve speech and language, and improve the ability to read/feel emotions, reactions and more, in people living with catastrophic injuries.

This is because music automatically connects to the brain. And this automaticity is what makes music so powerful.

Music also has to ability to push your training capabilities farther and faster especially in running.

This is why a running playlist is the ideal accompaniment to any runner.

Each songs tempo stimulates the brain, evoking a running response of either a faster pace or a steady rhythm depending on what you want to achieve.

For a faster pace, a good running playlist should contain songs with 150-180bpm.

Unfortunately, with not many songs out there using that speed (unless you enjoy rock, metal or speed garage for running) than the other option is to choose songs with 75-90bpm, as this tempo is perfect for a steady rhythm and maximising efficiency.

Do you recall an earlier blog where we discussed cadence and stride length using NMT for preventing falls in the elderly?

We suggested music with a high bpm count promotes movement, good cadence and walking speed, so songs like Nancy Sinatra’s ‘These Boots are Made for Walkin’, which has 85 bpm, is ideal.

BPM strongly correlates to step cadence.

Rhythmic Auditory Stimulation (RAS) is an important aspect of NMT.

Predictable rhythmic structure allows the sensori-motor system to move in sync with the beat.

This is, in essence, why music is important to runners, as it has the ability to communicate with the brain in order to help maintain a steady pace or increase speed depending on the bpm.

When it comes to mental wellbeing, we will always discuss music’s ability to improve mental wellbeing, and its effect can also be attributed to runners.

Music’s ability to improve stride, cadence and style, to produce better and better runs, and enable runners to achieve personal goals also have a positive effect upon mental wellbeing.

A sense of accomplishment. And with the right playlist, runners can end each run on a high.

We also like to discuss how NMT is more effective when it is personalised to that individual.

The same can be said in the case of a runner. A playlist that includes, not only songs with the ideal tempo for them, but also have some personal meaning, have the greatest positive effect upon runners.

The more enjoyable the run, the less fatigue is experienced. This may be due to the fact that music is able to interfere with the parts of the brain that communicate fatigue, essentially causing a distraction, so less fatigue is experienced.

For runners, the relationship between music and running can be seen to be just as effective and important as the relationship between music and recovering from a brain injury.

Its ability to improve running capability, speed, motivation, and promote mental wellbeing is what makes the difference between a run just being a run and reaching ‘Flow State’ – the mental state where the runner is in the moment of running – no distractions, and the run becomes…euphoric.

Read more: Running in the name of mental health

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Concussion could lead to depression, ADHD, dementia and Parkinson’s – study



A new study has revealed a link between concussion and the risk of being diagnosed with attention-deficit hyperactivity disorder, mood and anxiety disorders, dementia and Parkinson’s disease later in life.

Despite ‘clinical recovery’ from concussion typically lasting one week, a team of researchers from the University of Manitoba suspected there may be longer term effects. They used 25 years of population-based health data between 1990 and 2015, involving almost 50,000 cases of concussion from people living in Manitoba, Canada.

They found that concussion was associated with an increased risk of being diagnosed with attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders (MADs), dementia and Parkinson’s disease.

After analysing the population data, they found that concussion was linked to an increased risk of diagnosis of ADHD, dementia and Parkinson’s.

Women who had a concussion were at greater risk of developing ADHD and MADs, but there were no differences between men and women for the risk of developing dementia or Parkinson’s.

Multiple concussions didn’t affect the risk of later being diagnosed with ADHD, but a second concussion increased the risk of dementia, while exposure to more than three concussions increased the risk of being diagnosed with MADs.

While previous studies have found links between concussion and ADHD, dementia, Parkinson’s and MADs, most have relied on patients self-reporting their symptoms, the researchers write.

However, this study can only show an association, not cause and effect.

The mechanism behind this increased risk is unknown, but the researchers state it’s possible that the pathways of some biomarkers that are dysregulated in ADHD, Mads, dementia and Parkinson’s, namely, cortisol, are also affected after a concussion.

The paper, published in the BMJ journal, states that future research is needed to explore the relationships between concussion and ADHD, MADs, dementia and Parkinson’s in other populations.

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