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A high quality clinical trial, systematic reviews and meta-analyses performed by a team at Brunel University have directly informed key international clinical practice guidelines, policies and on the management of low back pain and neuropathic pain and have been cited by users (NHS Trusts: Addenbrookes) in response to such guidelines. In this way our research is directly informing clinical practice.
Treating stroke consumes 5% of the NHS budget. Government objectives for improving stroke rehabilitation have driven our important advances in aiding recovery of movement and independence. We have developed and evaluated innovative technologies and directly ensured translation into clinical practice and home use. Over 2,500 therapists have received training in functional electrical stimulation (FES) in the UK and abroad. Our research into FES and upper-limb robot therapy has attracted great media attention, as well as international clinical and commercial success. FES is now incorporated into National Institute of Health and Care Excellence (NICE) and Royal College of Physicians (RCP) Stroke Guidelines. We have demonstrated successful adoption of technologies in practice (the main UK commercial provider reports 16,000 sales of FES devices), and we have published evidence for their continued use.
The University of Glasgow's Centre for Rehabilitation Engineering (CRE) has developed strategies and products that have influenced clinical practice in Spinal Cord Injury (SCI) worldwide. The CRE refined the concept of using Functional Electrical Stimulation (FES) for cycling and abdominal stimulation and defined its benefits to patients by establishing the nature of the medical benefits of the technology.
Working with clinical partners in the Southern General Hospital and Hasomed GmbH, the CRE co-developed FES products that are now used routinely in clinical rehabilitation. Hasomed sell ~500 units p.a. across the world, for use at home, in fitness centres and in SCI clinics to maintain health and wellbeing, thereby reducing patient morbidity and increasing their life expectancy.
Neuro-feedback, utilising a Brain Computer Interface for the treatment of pain associated with SCI, has also been developed into a clinical reality and a limited clinical trial has now shown its efficacy.
The Pain Research Group (PRG) is a research team within the Centre for Health and Social Care Research (CHSCR). The PRG's research programme in chronic pain management encompasses a range of robust methodological approaches to achieve better patient outcomes with local, national and international impact. The PRG has adopted a dual approach to investigating the treatment of chronic pain, incorporating psychological factors with the application of neuromodulation techniques. This has led to significant improvements in patient outcomes and patient satisfaction surveys demonstrate excellent, positive results. The research has had significant influence on clinical practice at national level, underpinning recommendations for best practice issued by the British Pain Society in relation to spinal cord stimulation and intrathecal drug therapy. It has also contributed to NICE's clinical guidelines on the implementation of spinal cord stimulation and influenced clinical decision making through the NHS evidence database. At an international level, our research has contributed to three sets of guidelines issued by the Polyanalgesic Consensus Conference: inflammatory mass, intrathecal drug therapy for chronic pain and recommendations for reducing mortality and morbidity of intrathecal drug therapy. The reduction of morbidity and mortality in intrathecal drug therapy is of particular significance as the reduction of harm and unnecessary complications in healthcare is of high concern to healthcare organisations worldwide.
Adolescents (and their families) in the UK and around the world are now better able to cope with chronic pain because of the unique work carried out at the University of Bath Centre for Pain Research (BCPR), directed by Professor Christopher Eccleston.
The BCPR produced the first multidimensional `one-stop' tool to assess the impact of pain on children's lives, which has now been adopted in at least 12 countries. Pioneering treatments from Bath have influenced therapeutic approaches worldwide.
The Bath team also manage the evidence base for chronic pain, giving access through the Cochrane Library, advising internationally on clinical service development and improvement.
In response to inadequately designed assessment systems for patients recovering from orthopaedic surgery, researchers from the University of Oxford developed a series highly reliable and sensitive patient recorded questionnaires, known as the Oxford Scores. Providing a set of standardised outcomes for appraisal and on-going monitoring of patients, the Oxford Scores enable the informed assessment of clinical outcomes. Used to predict and detect early failure of poorly performing surgical interventions, the Oxford Scores have been adopted by health providers and regulators worldwide, leading to policy and treatment guideline changes and significant improvements in the quality of life of patients.
The Orthotic Research & Locomotor Assessment Unit (ORLAU) (http://www.rjah.nhs.uk/ORLAU) has run multidisciplinary services to improve the function and lifestyle of severely disabled patients since 1975. New specialist clinical services have been established, based on research and development activity. The effectiveness of these services has been the subject of further investigations. Work has focused on the development of novel technology (in gait analysis and orthotics) and increasing understanding of human movement. Conditions treated include cerebral palsy, spinal cord injury, neuromuscular disorders, arthritis and stroke. Technological developments have led to licencing within the commercial sector. ORLAU has also contributed to the development of national and international clinical education and guidelines.
Research at University of Oxford led to the development of the Phase 3 Oxford Knee in 1998, a significantly improved and less invasive knee replacement, allowing implantation through a small incision. Due to its many advantages over other knee replacements, including faster recovery, fewer complications and better function, the Phase 3 Oxford Knee is now the most widely used partial knee replacement in the world. Approximately 1 million people have benefitted from this development.
Lower-limb amputation (LLA) is associated with significant mobility, quality-of-life (QoL) and socioeconomic burdens. Research undertaken at the University of Hull relates to the early rehabilitation of amputees and their risk of falling. The research has influenced practice nationally and internationally by prompting clinicians to use these evidence-based recommendations for muscle strengthening and balance training and has informed policy at national levels. It inspired the British Association of Chartered Physiotherapists in Amputee Rehabilitation (BACPAR), to implement standardised recommendations in the BACPAR Toolbox of Outcome Measures in prosthetic rehabilitation. The findings of the Hull Early walking aid for rehabilitation of transtibial Amputees — Randomised controlled Trial (HEART) study, the first RCT comparing the biomechanics and clinical outcomes of early gait re-training with different Early Walking Aids (EWA), has made a significant impact on current healthcare practice and guidelines.
Collaboration between Imperial College Departments of Mechanical Engineering and Surgery led to the development of active constraint robot solutions which augment surgeon skills so that joint replacement components are implanted accurately and successfully. This led to the founding of Acrobot to develop innovative surgical technologies. Acrobot was acquired by Stanmore Implants Worldwide in 2010. An orthopaedic stereotaxic instrument, based on Imperial research, obtained US Food and Drug Administration (FDA) clearance in 2013. This has led to Mako-Surgical purchasing Stanmore Implants Acrobot technology in April 2013.