Institution:  Florence Nightingale School of Nursing and Midwifery,

Kings College, London

Researcher:  Dr Richard Wilkie

Aim of Study:  to examine visual function after stroke in individuals who exhibit either visual field loss or visual inattention

Benefits:  This study will allow individuals who otherwise might not be able to return to driving, an opportunity to be considered safe enough to take part in a standard DVLA on-road driving assessment.

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

Institution: Newcastle University

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 Brona McDowell, Ms Catherine Duffy and Dr Jose Salazar

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

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

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: Drs Mark Mon- Williams and Andrew Wilson

Institution: University of Leeds and Aberdeen, School of Psychology

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.

RECENTLY COMPLETED PROJECTS: