Researcher: Dr Celine Souchay and Dr Charity Brown

Institution: University of Leeds

Award:£8,727

Project Duration: Six months

Medical Condition: Autism

Project Title: The development of memory in children with Autism:  The creation of a participant pool

Aim of Study: Autism affects 15 children in every 10,000 born. The project will develop a substantial participant pool of autistic children, develop long-lasting co-operative links with a large network of mainstream and special needs schools and with the appropriate health and educational services in Leeds/Bradford and the surrounding area, assess the cognitive capabilities of each child with several standardized tests, including the assessment of verbal, nonverbal and general intelligence and conduct several pilot experiments with the aim of developing a series of memory tasks adapted to this special population

Benefits: It is increasingly difficult to obtain participant support to projects.  This grant has the aim of creating a participant pool of children with Autism to form a basis of a long-term programme aiming to assess the memory in this population and develop a new area of research at the Leeds Memory Group.  The programme will concentrate on rehabilitation and educational outcomes via the development of new learning methods.  Understanding how memory develops in this population is of crucial importance because a poor memory will lead to learning difficulties. 

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Researcher: Professor Nadina Lincoln and Mr RD Nair

Institution: University of Nottingham, Institute of Work, Health and Organizations

Award: £29,636

Project Duration: Two years

Medical Condition: Brain Damage, memory problems

Project Title: A comparison of the effectiveness of two types of Neuropsychological Rehabilitation for Memory deficits following Brain Damage; a single blind randomized controlled trial.

Aim of Study: Memory deficits affect between 40 – 60% of people with brain damage.  The effectiveness of memory rehabilitation has not been adequately evaluated in previous studies.  The project aims to compare the effectiveness of three different types of memory rehabilitation programmes and to develop a robust programme.  Participants with memory problems will be recruited and their memory assessed.  They will be randomly allocated to one of three types of rehabilitation groups each providing ten weekly sessions.  Follow-up assessments will be conducted to determine whether there are differences between the groups.  The aim is to determine the best rehabilitation strategies for memory function and/or mood problems to reduce memory deficits following brain damage.

Benefits: For participants: education about memory problems, strategies to improve memory function and/or mood problems.  For clinicians: a manualised memory rehabilitation programme that can be easily adapted to various patient populations.  Hospitals:  Evidence of the effectiveness of the programme to justify funding for provision of memory rehabilitation.

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Researcher: Dr David Porter and Dr Shona Michael

Institution: Oxford Brookes University and Leeds University

Award: £172,000

Project Duration: Five Years

Medical Condition: Cerebral Palsy in children

Project Title: Does the use of a knee block influence hip deformity, functional ability and pain in children with bilateral cerebral palsy

Aim of Study: Cerebral Palsy (CP) affects between two and three children per thousand in the UK.  It is the most common disability in children.  This is a study to determine whether using a knee block and sacral pad on a seating system has an influence on outcomes for non-ambulant young children with cerebral palsy.  Patients will be randomly assigned to a modular seat a) with a knee block and b) without a knee block.  Outcome measures are: hip joint migration and range of motion, lower limb configurations in sitting, sitting ability, upper limb function and pain level. 

Benefits:  The results from this study will help to develop a more scientific basis for the use of knee blocks. The majority of (CP) children are dependent on special support and equipment for the rest of their lives. 

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Researcher:  Dr Lindsay Pennington, Dr Nick Miller and Dr Nick Steen

Institution: Newcastle University

Award: £60,268

Project Duration: 15 months

Medical Condition: Cerebral Palsy in children

Project Title: Intensive speech therapy for young children with cerebral palsy

Aim of Study: A current pilot study of therapy to improve the speech intelligibility of older children with cerebral palsy is showing very promising results.  Children rate the treatment highly and school staff understands more of the children’s speech after therapy.  The proposed research will replicate the pilot with younger children, to investigate if they too may benefit from the therapy.  The project will study 15 young children who have speech disorder as part of their cerebral palsy.  They will receive six weeks of individual therapy, given three times per week at school by a research therapist.  Children’s speech will be recorded at four time points; six weeks and one week before therapy starts, one week and six weeks after therapy has finished.  Children will be recorded repeating single words and saying short sentences.  Adults who are familiar with the children and people who have never met the children before will hear the recordings and write down the words they hear.  The number of words heard correctly at each time point will be compared. 

Benefits:   The results of the study will give the information needed to design a pragmatic controlled definitive trial to test the general effectiveness of the therapy. Information on who should be included in the main trial (age range, children with moderate or severe intellectual impairment); what the natural variation in speech intelligibility is and how many children will be required in the main study.

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Researcher:  Dr Michael Steiner and Dr Manoj Menon

Institution: The University of Leicester NHS

Award: £41,385

Project Duration: One Year

Medical Condition: Chronic Obstructive Pulmonary Disease

Project Title: The molecular mechanism for skeletal muscle wasting in Chronic Obstructive Pulmonary Disease

Aim of Study: COPD is a leading cause of disability in the developed and developing world.  Muscle wasting is an important problem in COPD.  The causes of muscle wasting in this disease remain unknown.  The project will extend recent research that has identified genetic pathways involved in the regulation of muscle mass in young healthy humans to study these pathways in patients with COPD and similar aged healthy individuals.  The project will provide new insights into the causes of muscle wasting in these populations and be an important step towards the development of new treatments aimed at reducing disability in chronic diseases such as COPD.

Benefits: The research will advance the understanding of the mechanisms of muscle wasting in COPD.  The results of this project will help plan a wider programme of research aimed at understanding the molecular effects of physical training and nutritional supplementation in COPD which would have a wide application across many chronic diseases where muscle wasting is prevalent.

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Researcher: Dr Brona McDowell, Ms Catherine Duffy and Dr Jose Salazar

Institution: Gait Analysis Laboratory, Musgrave Park Hospital, Belfast HSC Trust

Award:22,065

Project Duration:15 months

Medical Condition: Club Foot – Talipes Equino Varus

Project Title: Ponseti Versus Traditional Orthopaedic Management for children with Talipes Equino Varus; pilot study

Aim of Study:  Clubfoot affects approximately 1 in every 1000 births. The foot typically presents with malformation of the bones, tight tendons and ligaments and weak calf muscles.  If clubfoot is not corrected in infancy it will most likely result in a foot that is unable to weight bear properly, having a significant impact on functional ability throughout life.  In the past, serial casting and surgery was the management of choice.  Surgical procedures ranged from a simple release of the Achilles tendon to a radical release of all tendons, ligaments and joints. Surgery often added the inflexibility of scar tissue to already resistant tissues and imposed “correct” alignment on joints with an incongruent articulation.  More recently, the more conservative “Ponseti” approach has become popular.  It proposes that by a series of gentle manipulations, it is possible to stretch the tendons and ligaments and gradually realign the small joints so that they maintain their congruity.  Many studies have considered the outcome of the Ponseti technique but have not compared it to the traditional surgical approach. 

Benefits: The study will confirm whether the more conservative Ponseti approach results in a better functioning foot, with demonstrable advantage to the children in terms of comfort, function, ease of shoe wear and cosmesis. The study will also compare the outcome of both the Ponseti and traditional orthopaedic approach to children with “normal” functioning feet. The results and subsequent publication of this study will have a significant impact on the management of this potentially very debilitating condition as both forms of management are still currently in practice today.

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Researcher: Peter McGill and Paul Langthorne

Institution: Tizard Centre, University of Kent

Award:£13,000

Project Duration: One year

Medical Condition: Genetic Syndromes in children

Project Title: Genetic syndromes as motivating operations for challenging behaviour: A functional analysis

Aim of Study: Some children with intellectual and developmental disabilities engage in challenging behaviours, such as hitting their own heads (self harm) or aggressing towards others.  The physical and social impact of such behaviours can be devastating.  What causes such behaviours?  On the one hand challenging behaviour (CB) may be especially likely to occur if the child suffers from one or several genetic syndromes.  On the other hand, the environment appears to play a crucial role.  However, little is known about how these “causes” interact with one another, leaving a gap in understanding and knowledge of the interactions between genes and environment in the development and maintenance of challenging behaviour.

The project will study whether parents of children from each group (fragile X syndrome, Smith-Magenis syndrome, and a no-syndrome control group) report different environmental factors as being related to CB displayed by their child.

Whether experimental functional analysis methods indicate a difference in the environmental factors that trigger and reinforce CB displayed by children with fragile X syndrome and Smith-Magenis.

Secondary aim:  whether parents report difference in the types of adaptive and challenging behaviour displayed by children from each group and the types and quality of support they have received by outside professionals.

Benefits: An improvement to the way CB is assessed and treated, particularly in cases in which genetic factors are thought to play a role.  The results of this research may help to identify particular environments that represent a “risk” for the development of CB in children with certain genetic syndromes.  If a child with fragile X syndrome is especially likely to develop CB as a means of escaping task demands, then early intervention could be used to teach the child alternative socially acceptable forms of communication so that CB does not form part of the child’s repertoire.  The impact of this for the quality of life of both the child and the family as well as the financial savings made over the course of the child’s lifetime would be significant.

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Researcher: Professor Kingsley Robinson

Institution: Queen Mary’s Hospital, Roehampton and The University of Surrey

Award: £30,000

Project Duration: no end date

Medical Condition: Prosthetic Limbs

Project Title: Osseointegration Prostheses for rehabilitation of transfermoral amputees – titanium implants

Aim of Study: A trial of the experimental technique of the Branemark/Integrum osseointegration implant system in patients for skeletal attachment of lower limb prostheses.

18 volunteers were recruited and now 14 volunteers are currently using the system with the system in use for a cumulative total of 86 years. The patients are being monitored and the research has continued to eliminate problems associated with the implants, the biggest of which is penetration site infections and prosthetic leg attachment.

Benefits:  The benefit of this project is to identify the relation of bone change to long term function and avoid possible failure.  Skeletal attachment of prostheses can bring mobility to amputees who cannot tolerate a socket and rely on crutches.  If all problems are eliminated, a much wider application could be possible.

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Researcher: Drs Mark Mon- Williams and Andrew Wilson

Institution: University of Leeds and Aberdeen, School of Psychology

Award:£33,272

Project Duration: One year

Medical Condition: Stroke

Project Title: Using a novel task to investigate the influence of learning capacity on functional movement recovery after stroke

Aim of Study: Stroke is the most common cause of severe disability in the UK.  300,000 people are affected at any one time.  This project’s aim is to understand a) why some patients recover better than others following a stroke and b) how stroke affects arm movements on both sides of the body.  Recovery from stroke requires re-learning skills.  Thus, an individual’s ability to learn might be a major determinant of recovery.  If this proves to be the case then it opens the prospect of improving outcome by increasing learning capabilities through drugs and/or other means.

The project will explore the relationship between the general learning capacity of the individual and recovery outcome.  The learning task uses a novel coordination exercise.  Comparisons will be made between the ability in the learning task with changes in functional ability during rehabilitation. 

Benefits: The results will help the refinement of existing therapeutic techniques and provide a framework for development of new and improved strategies for helping people recover after stroke. Linking learning capacity with health outcomes will add to existing theoretical basis for rehabilitation interventions and support the development of new rehabilitation programs.

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Researcher: Dr Paulette van Vliet

Institution: The University of Birmingham

Award: £22,208

Project Duration: Two years

Medical Condition: Stroke

Project Title: Effects of external-focus feedback for motor skill acquisition after stroke; a pilot study

Aim of Study: This project aims to discover whether feedback with an internal focus (IF) or an external focus (EF) is more beneficial for improving performance of reach-to-grasp movements in stroke patients.  The experimental hypothesis is that EF feedback is more effective than IF feedback in improving performance of reach-to-grasp movements after stroke.  This is the first stage in assessing if this simple technique is effective.

External focus feedback is used in sports to improve performance.  It gets the person to focus on performing a task rather than improve on their body position (IF).  The question is to see EF in those who have had a stroke, is more powerful in producing improvement than IF.

Benefits:  Patients receive feedback during physiotherapy training aimed at improving movements.  If feedback about movement effects is more effective, it could easily be integrated into current practice and outcomes may be improved at no or minimal additional cost and could be applied to the retraining of other movements.

The Project team is seeking funding for a longer intervention study and Remedi has agreed the equipment can be used, thus substantially reducing the ongoing costs and thereby enhancing their application for new external funding.