Rehabilitation

Rehabilitation and healthcare maintenance is an integral part of health and social care delivery; extending from acute hospital based care through to care within the community. It encompasses the recovery, maintenance of function and prevention of avoidable complications in people who have resolving conditions (such as low back pain, head injury or stroke), and those whose condition is long-term, static or deteriorating (such as multiple sclerosis, Parkinsons disease, diabetes or arthritis).

Our research in this area reflects the priority given by health and social care services to provide evidence based management of people with these broad ranging conditions.

Rehabilitation Research Group: current and future work

Research into disability and rehabilitation, and prevention and management takes place under the aegis of a cross-faculty group that also involves researchers in the Peninsula Medical School and the local NHS. Its focus is to investigate a broad range of issues, extending from the underlying mechanisms of disability and secondary pathology, to the evaluation of rehabilitation interventions and orthotic devices designed to prevent or manage disability and disease complications across a range of conditions. The research being conducted provides an excellent mix of pathophysiology, behavioural science and health care practice, thus providing a good forum for scientists, health care professionals and service users to exchange ideas and develop new research ventures.

Research to date has focused on four main areas:

Understanding the underlying causes of functional difficulties:

Impact of impairments on function in people with central and peripheral neurological disease (Jon Marsden)

The effects of localised temperature changes on neuromuscular function in Hereditary Spastic Paraparesis and Multiple Sclerosis (Amanda Austin)

Sensory mechanisms of balance impairment in cerebellar disease (Lisa Bunn)

Muscle function in people with Parkinson's Disease (Bernhard Haas)

The effects of foot and ankle impairments on mobility and balance in adults post stroke: a personal and multidisciplinary approach (Terry Gorst)

BEUP: Balance control and the effect of ankle foot orthoses in people with diabetic peripheral neuropathy (Jon Marsden)

Evaluating the effectiveness of whole-care packages and targeted interventions

Standing Up in Multiple Sclerosis. A multi-centre randomised controlled study to assess the effectiveness of a home-based self-management standing frame programme in people with progressive MS (Jenny Freeman)

Balance Right in Multiple Sclerosis (BRiMS): A guided self-management programme to reduce falls and improve quality of life, balance and mobility in people with Multiple Sclerosis (Hilary Gunn and Jenny Freeman)

Development and evaluation of orthoses to optimize healthy foot function (Emma Cowley)

Evaluation of the effects of stretching in people with Multiple Sclerosis (Jon Marsden)

BEUP: INPRINT. Automatic Creation of Low-Cost Insoles for the prevention of diabetic foot ulcers (Joanne Paton)

BEUP: Development and clinical evaluation of a new dual purpose insole used for ulcer prevention and balance-enhancement in neuropathic individuals with diabetes (Joanne Paton)
BEUP: INsTEP – INSoles To Ease Pressure: a mixed methods feasibility study (Richard Collings)
Developing lycra orthoses to accelerate return to sport after lumbo-pelvic injury (Jon Marsden)
Pilates based core stability training in multiple sclerosis (Jenny Freeman)
The effects of foot and ankle joint mobilisation combined with a home programme of ankle stretches on joint range of motion and forefoot peak plantar pressures in people with diabetic peripheral neuropathy: a randomised controlled trial (Vasileios Lepesis)

Understanding mechanisms underlying rehabilitation and factors affecting prognosis

Assessment of deep abdominal muscle function following stroke (Jon Marsden)
Longitudinal study of mobility in people with Multiple Sclerosis (Jenny Freeman)
An investigation of the risk factors associated with falls in people with Multiple Sclerosis (Hilary Gunn)
Biomechanics of the sciatic nerve and spine leading to postoperative residual leg symptoms following spinal decompression for lateral recess syndrome. (Gary Shum, Alan Hough and Jon Marsden)

Development and evaluation of service delivery

Exploring the confidante relationship in people with Multiple Sclerosis (Jane Grose)
Evaluating patient participation in goal setting (Jenny Freeman)
Current Service delivery for people with Hereditary Spastic Paraparesis in the South West (Jon Marsden)
Evaluating the South West Community Peer Support Officer Service for Newly Injured People with Spinal Cord Injury (Bernhard Haas)
Building stakeholder consensus: Development of a falls management intervention for people with Multiple Sclerosis (Hilary Gunn, Ruth Endacott, Bernhard Haas, Jon Marsden, Jenny Freeman)
BEUP: Foot Risk Awareness and Management Education (FRAME) a e-learning module for healthcare workers (Joanne Paton)
BEUP: Development of a complex behaviour change intervention: A patient centred approach to improve insole adherence amongst people with diabetes (Joanne Paton)
BEUP: To design and implement an insole and footwear offloading pathway for people at increased/high risk of diabetic foot ulceration. LIVEWELL SOUTHWEST (Joanne Paton)