A Neuro Physio Podcast – Details, episodes & analysis

Professor Janice Eng, OC, is a University Killam Professor and Canada Research Chair, University of British Colombia Department of Physical Therapy. Janice is currently the co-director of the Centre for Aging SMART at Vancouver Coastal Health. Her work includes the GRASP upper limb program, the FAME fitness and mobility program, robotic exoskeleton research and her most recent Walk n’ Watch multi-site trial. Having published over 300 peer-reviewed journal articles, we discuss how her work is focussed on how to effectively and safely deliver high doses of therapy in complex healthcare environments, and make sure it is implemented widely in clinical practice.

4.43 Intro

5.30 sec Career Pathway 

8.05 Filling the neuro evidence gap

10.45 Control groups in clinical trials 

13.40 Capturing meaningful improvements with outcome measures 

18.55 Impact of sufficiently funded trials 

20.55 How Janice changed practice across the world 

25.12 Clinicians hesitant about high volume independent practice  

29.30 GRASP program 

31.30 FAME program 

34.53 Walk n’Watch 

37.29 Feedback on performance, do clinicians or patients benefit? 

41.08 Avoiding boredom doing reps 

43.50 Gender issues in rehab trials 

50.15 Matt & Erin's reflection

Links & Resources

Janice's Home Page | Neurorehabilitation Research Program

REACH scale Everyday Arm-use - REACH | Neurorehabilitation Research Program 

Rating of Everyday Arm-Use in the Community and Home (REACH) Scale for Capturing Affected Arm-Use after Stroke: Development, Reliability, and Validity - PMC 

Full article: A biomechanical analysis of the effectiveness of the Graded Repetitive Arm Supplementary Program (GRASP) for chronic stroke rehabilitation - Movement quality (speed, smoothness) improved in GRASP 

GRASP – GRASP | Neurorehabilitation Research Program 

FAME - FAME – Fitness and Mobility Exercise Program – A Group Exercise Program for People after Stroke 

Walk ‘n Watch Walk ‘n Watch | Neurorehabilitation Research Program 

Safety and effectiveness of the Walk ‘n Watch structured, progressive exercise protocol delivered by physical therapists for inpatient stroke rehabilitation in Canada: a phase 3, multisite, pragmatic, stepped-wedge, cluster-randomised controlled trial - ScienceDirect

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A Neuro Physio | Facebook

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Dr Vivienne Travlos is a Respiratory Physiotherapist at the MND Association of Western Australia and Principal Physio at Breathe Physio. She has a PhD, MSc of (Management of hildhood Disability) a GradCert in university teaching. This episode is all you want to know about neuro respiratory. We chat neuromuscular disorders, respiratory pathophysiology and disease, night respiration, airway clearance, assessment and measurement, intervention according to severity. Also heard answers to listeners questions - evidence base, physio role across the complex disability continuum of care.

2.03 Welcome & Career Pathway

8.59 PhD – Adolescents with NMD physical health & mental wellbeing

12.59 What are neuromuscular disorders? What resp issues occur?

18.25 Night respiration issues

21.49 NIV

26.15 Lung volume recruitment

31.00 Airway clearance

39.46 EBP in neuro respiratory

43.19 Key outcome measures

49.22 Lung tissue integrity

52.49 Future proofing

1.00.44 Reflection

Links & Resources

Email: vivienne.travlos@gmail.com

Physiotherapists: A vital part of MND multi-disciplinary care

Viviennes' LinkedIn

Vivienne's phd papers/ research gate

Neuro Respiratory Physiotherapy Academy (Jac Agostinello)

MND Western Australia

MND Victoria

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Dr Kim Jennings is an Advanced Bobath tutor with over 35 years of clinical expertise. Kim became a Bobath Tutor in 2000 and an Advanced Tutor in 2012. She holds a clinical doctorate in physiotherapy at La Trobe University investigating barriers and facilitators to implementation of the Bobath concept and a Master of Public Health from Monash University. We get the lowdown about what sparked her interest in Bobath, what makes people choose to apply it or not apply it in practice, how the concept has changed over time, and where Bobath sits in evidence based practice. She also tells us all about a Clinical Doctorate and what her research found about factions in the neuro physio community.

If you'd like to listen to more of an intro to The Bobath Concept check out Season 1, Episode 9 with Janet Stevens https://aneurophysio.com/janetstevens/
https://podcasts.apple.com/au/podcast/a-neuro-physio-podcast/id1493324068?i=1000484935724

3.00 Intro

3.30 Bobath career pathway

9.03 Working with culturally diverse populations

11.19 IBITA – Tutors around the world

14.30 Who are Bobath courses for?

16.40 How Bobath has changed over time

26.00 What is a clinical doctorate?

29.50 Kim’s research - Implementation of the Bobath concept

45.24 The lack of RCT evidence for Bobath

53.50 Personalisation of rehab

55.10 The need for more research  

1:08.40 Episode reflection

Links
Australian Bobath Training Association https://www.bobathaustralia.org/

International Bobath Instructors Training Association https://ibita.org/

British Bobath Tutors Association https://www.bbta.org.uk/

The Bobath Concept has Changed - paper in Journal of Physiotherapy

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Dr. Simon Mills is the principal clinician in the South Australian Brain Injury Rehabilitation Service. He recently completed his PhD (University of Adelaide) in postural alignment and recovery of mobility after acquired brain injury, focusing on brain injury survivors with severe mobility impairment. Simon has 20 years clinical experience and his research interests include methods for clinical assessment, biomechanics and enhancing effectiveness of rehab intervention. 

Intro 4.05

Career Pathway 4.48

Simon’s PhD – postural alignment and mobility in ABI 9.25

The emphasis people put on regaining mobility 14.43

Physio role in cognition 20.46

Measurement of postural alignment 24.40

Why is postural alignment important? 31.04

Interpreting postural observations to find impairments 35.15

Application of results across populations 42.14

Future development of Simon’s research 46.10

Simon's PhD – Postural alignment and recovery of mobility after acquired brain injury – focused on severe mobility impairment

Papers:

Improvement in postural alignment is associated with recovery of mobility after complex acquired brain injury: An observational study

Improving physical mobility is critical for wellbeing in people with severe impairment after an acquired brain injury: a qualitative study

Is there a relationship between postural alignment and mobility for adults after acquired brain injury? A systematic review

Research gate - https://www.researchgate.net/profile/Simon-Mills-3

Twitter - @SimonJMillsPT

Email - Simon.Mills@sa.gov.au

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Professor Susan Hillier is a Professor of Neuroscience and Rehabilitation and Dean of Research in Allied Health and Human Performance at the University of South Australia. Her teaching and research interests are broadly in neuroscience and rehabilitation. She has particular interest in the role of afferent stimulation and training using multi-modal feedback. Susan is also trained in Feldenkrais and works clinically at the university private practice. She is especially experienced in Cochrane and other Systematic reviews. We cover most of these topics in this episode! – check out the show notes below. 

Intro 6.16
Proprioception Research 7.15
Sensory perception 10.00
Feldenkrais training 15.50

The Neuroscience Behind Body Image workshops 23.30

Afferent Feedback – know what you're doing to make better choices 26.00

Clinical Reasoning & Generating new ideas in practice 30.20

Supervising PhD students 35.15

Obtaining grant funding 37.57

Gender discrepancy in research 40.08

Systematic reviews 49.06


Prof Hillier's Research Gate

https://www.researchgate.net/profile/Susan-Hillier

Uni SA profile

https://people.unisa.edu.au/susan.hillier

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Professor Nora Shields is a prolific researcher in the youth disability space. Dr Shields is a professor of physiotherapy at La Trobe university in Melbourne, Australia. She hails from Ireland completing her Physiotherapy degree and PhD at Trinity College in Dublin, and also holds a Graduate Certificate in Higher Education. Dr Shields developed a program called FitSkills, an innovative program which facilitates young people with disability (YPWD) to exercise with a physiotherapy student mentor, addressing the lack of social support barrier to physical activity for YPWD. Nora tells us about the program and how it’s making a difference to the lives of YPWD as well as physio students. We also chat about the less general skills you learn by doing a PhD and explore some of the social and societal barriers preventing YPWD living their best lives.

Nora’s bio – 3.23
Intro – 5.16
Career pathway – 6.16
PhD - inelectro therapy – 11.44
Skills you gain in a PhD – writing – 16.03
Physical activity in disability benefits – 19.22 
Barriers – 22.52
FitSkills story – 27.34
Contact theory in fit skills – 37.04
Importance of experience with YPWD for Physios & health workforce – 38.32
YPWD in the workforce – 44.46
FitSkills early outcomes – 46.24
New project Gym Spark – 51.56
Final thoughts - Prevention, Brain Health & Adult care of YPWD – 55.19

Prof Shield’s Latrobe Uni profile (contact details & publications tab) https://scholars.latrobe.edu.au/nshields

LinkedIn - https://au.linkedin.com/in/nora-shields-a401226

Research Gate - https://www.researchgate.net/profile/Nora-Shields

Twitter - @DrNoraShields

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

This episode is all about understanding the impact of sensory deficit on function after stroke on function, and what to do about it. Dr.Leeanne Carey is the Head of the Neurorehabilitation and Recovery Research Group co-located at the Florey Institute of Neuroscience and Mental Health and La Trobe University. She's also a professor in Occupational therapy at La Trobe university and the developer of SENSe therapy (study of the effectiveness of neurorehabilitation on sensation). We cover the powerful problem of sensory loss, how it can hide from clinicians but why it should be front of mind. There are plenty of clinical takeaways and links and resources to find out more, including referring your patients for sense therapy and attending a course yourself.
Intro - 3.42
Career pathway - 7.17
SENSe implementation / knowledge translation projects - 13.16
SENSe training approach & workshops - 17.16
Computer interface sensory assessment & learning - 24.53
More about PhD - 28.42
Task specific training vs transfer in sensory training - 31.17
Which modality is most important in the sense approach? - 37.10
Functional MRI changes with sense sensory training - 42.20
Where does sense fit into the sensation literature? - 43.37
Clinical impact of sensory loss - 46.09
Sensory impact is a hidden problem for clinicians - 48.22
Do clinicians who are more skilled get better sensory outcomes? - 52.18
SENSe for lower limb - 54.26
Therapy accessibility - via therapy - 55.10
OT/PT joint UL therapy - 'call to arms' - 57.18

Leeanne’s La Trobe University Profile page
Stroke survivors with upper limb somatosensory issues may be eligible to participate in a program of SENSe Therapy at one of the following SENSe Therapy Centres:

• Victoria: Florey Institute of Neuroscience and Mental Health (Austin Campus), or Alfred Health (Caulfield General Hospital), Melbourne.
• New South Wales: Hunter New England Health (Rankin Park site), Newcastle.
• South Australia: UniSA Health, Adelaide.

Details: https://sensetherapy.net.au/stroke-survivors-families/where-can-i-get-sense-therapy/

Contact: i.Koukoulas@latrobe.edu.au

SENSe therapy is also being provided at several health care networks in Victoria and NSW

All papers and references can be found on the SENSe website

Recent Stroke Foundation webinars about SENSe

Assessment webinar:

https://www.youtube.com/watch?v=o4OwN100bvk

Therapy webinar:

https://www.youtube.com/watch?v=S-t0gLf5cRg 

Also available at: https://informme.org.au/resources/loss-of-sensation – a great sensation resource page, see the videos at the bottom including an earlier presentation by SENSe team member Dr Liana Cahill

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

In this episode, we explore using technology in your clinical practice in a really practical and realistic way with Dr. Kelly Bower who completed her PhD in technology use in rehabilitation. Join us as we discuss Wii, Kinect, newer rehab-specific devices, the evidence base, barriers & facilitators in the clinic and what patients get out of tech - be ready for some surprises here! Kelly also shares her journey through PhD to educator & researcher whilst remaining a clinician. Her story will help others searching for a similar path.
Intro - 3.56
Career pathway - 6.12
Phd research - Wii balance board as Ax & intervention - 11.23
Using Wii balance board as a force platform or as a clinical OM - 16.01
The motivation of tech for both intervention and tracking progress - 20.00
What is it about tech that is interesting? - 21.24
What are the limitations? - 24.23
Linking use of tech to goals - a tailored intervention - 25.22
Evidence base variability - 26.40
Clinicians' thoughts on tech - 31.45
Advice for addressing barriers - 34.20
Best devices? - 35.49
Kelly developing a video game - 39.00
Emerging tech rehab devices - 46.54
How Kelly balances her workload (pun intended!) - 49.40

Links

Kelly’s University Profile

Resources to support selection and clinical implementation:

Website on using the Kinect in rehabilitation

A Clinical Decision-Making Framework for the Use of Video Gaming as a Therapeutic Modality

Papers and References

Clinical feasibility of the Nintendo Wii™ for balance training post-stroke:

Clinical feasibility of interactive motion-controlled games for stroke rehabilitation

What factors influence clinicians’ use of technology in neurorehabilitation?

Quiet standing postural control variables in subacute stroke

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Heidi is the queen of the concept of environmental enrichment to maximise recovery potential post stroke and other neurological conditions. She shares all about her work in this episode, including her latest venture partnering with end users to develop a community model for environmental enrichment (ESTEEM). We also chat about the Yarning Up After Stroke program she co-leads, designed to help Aboriginal and Torres Strait Islander stroke survivors take control of their stroke recovery.

4.06 Intro
4.39 Current roles & Career pathway
6.45 Perspective as a clinician in health system and researcher
8.15 Engaging with the community to ascertain research priorities
11.00 Environmental enrichment (EE) community model
15.34 Good intervention development - Basic science to clinical research to clinical practice
18.23 Competing demands in research
19.34 Components of ESTEEM community group
What carers want out of EE groups
How to measure these components

26.25 Rehabilitation in a utopian world
28.20 Overcoming barriers in EE research
32.50 Virtual vs Reality in EE
36.48 Crucial elements of EE
38.21 How to apply EE in the clinic
42.25 Being a change agent of EE
44.15 Yarning Up After Stroke

Papers and References

Enriched environment research

Links

Dr. Janssen’s Newcastle University profile

ESTEEM study

Yarning Up After Stroke

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.

Emeritus Professor Sheila Lennon is semi-retired but still manages to keep driving powerful change for neuro patients. She's from Flinders university in Adelaide South Australia, has worked all over the world, and stays involved on the Physiotherapy Board of Australia and the Chartered society of Physiotherapy in the UK. She's a clinician and educator, continues clinical work for the MS society, has been an important contributor to our global body World Physiotherapy and has edited neurology textbooks. This episode covers her divisive research on the bobath concept, her thoughts on the complex interventions we provide and whether they are effective, clinical reasoning frameworks and her passionate work in self-management in multiple sclerosis. Sheila has fantastic perspectives on physio from her broad worldview

3:30 - Intro
4:24 - Experience around the world
13:00 - Be a healthy sceptic
15:30 - Keeping the passion
19:25 - Sheila's career growth
20:45 - Balancing part time PhD
22:40 - Bobath and theoretical assumptions
28:35 - Complex interventions
31:10 - Taking the RCT to interventions
33:15 - Is the RCT the gold standard for physio research
36:28 - Work with MS
42:25 - What is unique for physio management of MS
44:55 - The importance of motivation
48:05 - Reflection and clinical reasoning
51:20 - New inclusions to undergrad
53:30 - Flinders University Chronic Disease Management
55:30 - INPA


References and Papers:
Self-Management:
– Feasibility of an integrated stroke self-management programme: a cluster randomised controlled trial
– Self-management programmes for people post stroke: a systematic review

Bobath:
– The Effectiveness of the Bobath Concept in Stroke Rehabilitation
– Gait outcome following outpatient physiotherapy based on the Bobath concept in people post stroke
– The Bobath concept: a critical review of the theoretical assumptions that guide physiotherapy practice in stroke rehabilitation

Links:

APA National Neurology Group on-demand lecture on Self-management-focused-falls-prevention for people with MS

INPA

Please contact Sheila on sheila.lennon@flinders.edu.au if you are interested in obtaining free access to materials for clients and therapists on the MSFP program offered by the MS Society of SA 

Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.