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Dizziness is one of the most common presenting symptoms in General Practice, Ear Nose and Throat and neurology clinics. Chronic dizziness in particular has a major impact on individual and health service resources. Researchers at King's College London (KCL) have developed an effective exercise-based rehabilitation programme incorporating optokinetic stimulation to treat a specific form of chronic dizziness, visual vertigo. This programme has been adopted by audiology and physiotherapy services across the UK and is now being adopted internationally and commercialized. The work of KCL researchers is also reflected by inclusion in information and continued educational activities with regard to visual vertigo.
Research carried out at the University of Aberdeen has directly resulted in a new therapy for stroke patients who have suffered partial sight loss. The sight rehabilitation device developed through the research has so far been used to treat around 300 UK stroke patients, who reported significant improvements in their quality of life. The therapy has been publicized by the UK Stroke Association and at national and international events. The research also led to commercial impacts through the creation of a spin-out company, Sight Science Ltd, which was later acquired by its only worldwide competitor, NovaVision Inc, protecting jobs and forging a long-term commercial partnership.
The specific impacts on commerce have been: substantial industrial investment in research and development, job creation and protection within UK industry, commercialisation of a new product, and long term partnership contract with industry with provisions for commercialisation of future products.
Up to 10% of stroke patients experience persistent hemispatial neglect, a lack of perception of space in one half of their visual field, despite their eyesight functioning properly. University of Glasgow researcher Dr. Monika Harvey has led the development of a vision rehabilitation method that was implemented by German stroke units (2011) and applied to over 60 stroke patients. In July 2011 Harvey formulated content for an advanced training module called `Vision after Stroke', a Scottish Government supported online training resource for stroke healthcare professionals provided by the Stroke Training and Awareness Resources (STARs) Project. In just eight months since launch (December 2012) the module series has had 17 473 unique visitors nationally and internationally with `Vision after Stroke' the second most popular module in Scotland. To date, 152 healthcare professionals have successfully completed the `Vision after Stroke' module certificate.
Research at the UCL Institute of Ophthalmology over the last 15 years has developed new treatments for management of uveitis and its sight-threatening complications, which have subsequently become standard practice. Our work, in previously untreatable disease, has allowed restoration of vision in many patients and prevention of further visual loss in others. Many patients have been able to reduce systemic medication, limiting adverse effects of treatment.
A decade of research at the University of Southampton has given thousands of people around the world suffering from dizziness and balance disorders access to a self-management resource that can alleviate their symptoms. Professor Lucy Yardley has pioneered the use of a Balance Retraining (BR) booklet to transform the means of delivering cost-effective, life-changing treatment previously offered to less than one in ten UK patients. The booklet, translated into several languages, has been distributed to patients and practitioners as far afield as China and Japan. Yardley's findings have contributed the bulk of good quality evidence to the Cochrane Review on vestibular rehabilitation.
Work on better management and identification of Medically Unexplained Symptoms (MUS) has led to the introduction of new treatments in primary care in England through the Improving Access to Psychological Treatment (IAPT) programme as well as having an impact on service planning and commissioning. These approaches have also been implemented into the routine training and practice of General Practitioners (GPs) in parts of Europe. A clinical and economic evaluation of a psychosocial approach to chronic fatigue syndrome using general nurses and development of a cognitive behaviour therapy approach has changed general practice and enhanced the patient experience for those with MUS.
Research by Dr Alex Leff at the UCL Institute of Neurology in collaboration with UCL Multimedia, has led to the development of two free online therapies for stroke patients with visual deficits. Read-Right (launched June 2010) treats patients with hemianopic alexia (the commonest acquired reading disorder) and Eye-Search (launched September 2012) treats spatial disorientation and visual search impairment. The websites contain: 1) diagnostic tests, 2) therapy, and 3) interval tests. These materials have been developed from peer-reviewed research. The websites are also research tools; patients sign an online consent form and their data are used to test whether online therapy actually works. At 31 July 2013, 657 patients were using Read-Right and 217 Eye-Search.
Impact: New business, intellectual property, employment and clinical diagnostic capability resulting from the invention, development, validation and manufacture of a peripheral vision-measuring device.
Significance: A new technology, Saccadic Vector Optokinetic Perimetry (SVOP) has been developed and commercialised. SVOP enables the testing of visual fields in patients who previously could not be tested. A spin-out company, i2eye Diagnostics Ltd., raised £900K to commercialise the technology, employs five people and has made sales internationally.
Beneficiaries: Commerce; ophthalmologists, opticians and optometrists; previously untestable patients.
Attribution: UoE team comprising Professor Bob Minns, Professor Brian Fleck, Dr Ian Murray and Dr Harry Brash are inventors on the granted patent for SVOP. The UoE BioQuarter commercialisation team formed the spin-out company and recruited the management team.
Reach: Worldwide: SVOP instruments are now in use in the US, EU and Australia. The technology is suitable for the 30% of patients worldwide whose visual field could previously not be measured.
Findings of Westminster research on motion sickness have been used by professionals working outside academia. Work on motion sickness susceptibility led to development of a screening questionnaire that has been used by the European Space Agency as a diagnostic tool, and the US military in development and evaluation of motion sickness countermeasures. Research done at Westminster underpins both British Medical Association best-practice guidelines and Continuing Medical Education/Professional Development for medical practitioners around the world. Improved desensitisation procedures for vertigo symptoms have been adopted as standard treatment for vestibular disease patients.
King's College London (KCL) research has had substantial impact, through making strong contributions to international and national guidelines which recommend that pulmonary rehabilitation should be made available to all appropriate people with COPD, including those who have had a recent hospitalisation for an acute flare-up.
Recommendations citing our research include those published internationally by a Cochrane Review and the Global Initiative for Chronic Obstructive Lung Disease, and nationally in the UK by NICE and IMPRESS — which provides clinical leadership to the NHS. These recommendations have been taken up by the NHS and are also included in NHS Best Practice Guidance (2012). The Department of Health (2010) estimated "widespread use of pulmonary rehabilitation would bring substantial annual savings".