NR news
Reconnections continues to
expand with new appointment
Groundbreaking neuro-rehabilitation centre Reconnections has continued its expansion by appointing Kelly Hodgson as client car and business development consultant.
Kelly has worked in health and social care for over 20 years, holding client care and business development roles with a number of market leaders including Carewatch, The Priory Group and Exemplar Health Care.
She has also worked for niche companies including Team Brain Injury and NRC Medical Experts, a specialist expert witness chambers of neuro-rehabilitation specialists co-founded by Professor Mike Barnes.
In her new role at Reconnections, Kelly will further develop relationships for the
centre with case managers, solicitors and commissioners.
“I’ve never seen a service like Reconnections – it is truly ground-breaking,” said Kelly.
“Now entering its third year, Reconnections is delivering outstanding clinical outcomes by combining high quality, interdisciplinary neurological care and support with outdoor activities. It’s such an exciting time to join the team.
“I feel really passionate about reaching ABI survivors, through engaging and working in partnership with case managers, solicitors and commissioners in health and social care.
“I am particularly looking forward to introducing our highly skilled and specialist multi-disciplinary team which includes neuro occupational therapists, neuro physiotherapists, neuro speech and language therapists, neuro psychologists, positive behaviour practitioners and rehabilitation coaches.”
2022 was a breakthrough year for Reconnections with the service releasing its first evidence-based outcomes review.
Analysis of participants’ outcomes indicated:
100 per cent improved their ability to carry out everyday activities
100 per cent needed less support when they were discharged and 60 per cent
have progressed onto independent living
100 per cent reported an improved hope for the future and an improved sense of purpose and direction in their life
90 per cent achieved their goals
80 per cent felt more empowered through greater participation and control over decisions that affect their lives.
Head of service at Reconnections, Claire Appleton said: “We are thrilled to be working with Kelly as we build ever closer relationships with solicitors, case managers and commissioners.
“2023 is a massive year for Reconnections.
“People with ABI can sometimes find the set procedures of neuro-rehabilitation too clinical, inflexible and impersonal.
“At Reconnections, we believe in doing things differently. At our unique neuro-rehabilitation centre, we bring together the beauty and benefits of the great outdoors with the very best in person-centred care – delivered in an enjoyable, homely environment that inspires and supports people to become the best they can be.
“ABI is life-changing. It can leave people feeling lost, apprehensive and reliant on others. At Reconnections, we help people face and embrace their new normal empowering them to push perceived limitations and become more independent.”
‘Almost all’ cases of CTE linked to repetitive head impact
Almost all cases of chronic traumatic encephalopathy (CTE) analysed through research are linked to exposure to repetitive head impact, primarily as a result of contact and collision sports, a groundbreaking new study has discovered.
Over 600 cases of CTE have been published in literature from multiple international research groups – and 97 per cent of those have confirmed exposure to repetitive head impact (RHI).
And of the 14 of the 17 purported CTE cases that occurred in the absence of RHI, where up-to-date criteria were used, the study authors found that families were never asked what sports the individual played.
The review of research – led by Dr Ann McKee, director of the BU CTE Center and world-leading authority on CTE – confirms that, despite global efforts to find CTE in the absence of contact sport participation or RHI exposure, it appears to be extremely rare – if it exists at all.
“In studies of community brain banks, CTE has been seen in zero to three per cent of cases, and where the information is available, positive cases were exposed to brain injuries or RHI,” says Dr McKee.
“In contrast, CTE is the most common neurodegenerative disease diagnosis in
contact and collision sport athletes in brain banks around the world. A strong dose response relationship is perhaps the strongest evidence that RHI is causing CTE in athletes.”
CTE has been subject to a significant increase in scientific research over the past 17 years, primarily led by researchers at the BU CTE Center, but despite mounting evidence of the link between RHI and neurodegenerative disease, criticism has been made of sports bodies for not taking action to protect players quickly enough.
CTE became national news in the United States in 2007, but it was not until 2016 that the National Institute of Neurological Disorders and Stroke/National Institute of Biomedical Imaging and Bioengineering (NINDS-NIBIB) criteria for the neuropathological diagnosis of CTE were published, and they were refined in 2021.
CTE has been diagnosed in amateur and professional athletes, including those who took part in football, rugby union, rugby league, American football, ice hockey, bull-riding, wrestling, mixed-martial arts, and boxing.
The research continues to make advances in knowledge around CTE. While it cannot yet be diagnosed during life, evidence is showing that MRI may show the disease in the living.
It is hoped the new review of research to date will help to increase the prevalence of CTE in looking at the impact of RHI, particularly in sport, and to encourage governing bodies to take action, with aims being set out to find a cure for CTE by 2040.
“The review presents the timeline for the development of neuropathological criteria for the diagnosis of CTE which was begun nearly 100 years ago by pathologist Harrison Martland who introduced the term ‘punch-drunk’ to describe a neurological condition in prizefighters,” explained Dr McKee.
“The review chronologically describes the multiple studies conducted by independent, international groups investigating different populations that found CTE pathology in individuals with a history of RHI from various sources.”
Brain health risk
‘raised with each concussion’
Experiencing three or more concussions is linked with worsened brain function in later life, new research has revealed.
The study – the largest of its kind – also found having just one moderate-to-severe concussion, or traumatic brain injury (TBI), can have a long-term impact on brain function, including memory.
Led by teams at the University of Oxford and the University of Exeter, the research included data from more than 15,000 participants of the online PROTECT study, who were aged between 50 and 90 and based in the UK. They reported the severity and frequency of concussions they had experienced throughout their lives, and completed annual, computerised tests for brain function.
The study found that people who reported three or more concussions had significantly worse cognitive function, which got successively worse with each subsequent concussion after that. Attention and completion of complex tasks were particularly affected.
The research adds further to evidence of the links between head impacts and long-term neurological consequences, and researchers say people who have had concussions should be warned of the dangers of continuing high-risk sport or work.
Lead investigator Dr Vanessa Raymont, from the University of Oxford, said: “We know that head injuries are a major risk factor for dementia, and this large-scale study gives the greatest detail to date on a stark finding – the more times you injure your brain in life, the worse your brain function could be as you age.
“Our research indicates that people who have experienced three or more even mild episodes of concussion should be counselled on whether to continue high-risk activities. We should also encourage organisations operating in areas where head impact is more likely to consider how they can protect their athletes or employees.”
The team found that participants who reported three episodes of even mild concussion throughout their lives had significantly worse attention and ability to complete complex tasks.
Those who had four or more mild concussion episodes also showed worsened processing speed and working memory. Each additional reported concussion was linked to progressively worse cognitive function.
Furthermore, the researchers found that reporting even one moderate-to-severe concussion was associated with worsened attention, completion of complex tasks and processing speed capacity.
In the online PROTECT study, participants share detailed lifestyle information, and complete a suite of cognitive tests every year, for up to 25 years. This data helps researchers understand how the brain ages, and the factors involved in maintaining a healthier brain in later life.
Dr Helen Brooker, a study co-author from the University of Exeter, said: “As our population ages, we urgently need new ways to empower people to live healthier lives in later life.
“This paper highlights the importance of detailed long-term studies like PROTECT in better understating head injuries and the impact to long term cognitive function, particularly as concussion has also been linked to dementia.
“We’re learning that life events that might seem insignificant, life experiencing a mild concussion, can have an impact on the brain.
“Our findings indicate that cognitive rehabilitation should focus on key functions such as attention and completion of complex tasks, which we found to be susceptible to long-term damage.”
Dr Susan Kohlhaas, director of research at Alzheimer’s Research UK, said:“Studies like this are so important in unravelling the long-term risks of traumatic brain injury, including their effect on dementia risk.
“These findings should send a clear message to policy makers and sporting bodies, who need to put robust guidelines in place that reduce risk of head injury as much as possible.”
The PROTECT study is conducted entirely online, and is open to new participants aged 40 and over.
To find out more, visit:
https://www.protectstudy.org.uk
‘Pay it forward’
therapy initiative launched
A charity has launched paid-for therapy sessions to enable it to widen its reach of free interventions for those who need it.
The Brain Charity has devised a ‘pay it forward’ initiative in its specialist neuro psychotherapy service, which involves the delivery of paid-for sessions for the first time to individuals across the UK.
Through the introduction of a charge for those who want to access therapy without having to wait, it is supporting other people who would not be able to afford to pay for specialist counselling to access the service for free.
The Brain Charity has a team of licensed therapists who are specialists in neurological conditions and the mental health challenges that are often associated with them.
Sessions are available in-person at its base in Liverpool, or via video or telephone call to anywhere in the country. ectly through improved wellbeing of nurse leaders,” added Bunn.
The Brain Charity said it decided to launch a paid-for therapy service in response to increasing numbers of clients nationally who were accessing the free service asked if they could make a contribution for their sessions to support the charity’s work.
Sharon Berry, counselling coordinator at The Brain Charity, said: “When you purchase specialist neuro psychotherapy through The Brain Charity, you are not only accessing high quality professional therapy – you are also funding one of our clients to receive this for free.”
The Brain Charity’s therapists offer a range of psychotherapy types, including CBT, person-centred and integrated.
Its interventions can support many of the mental health concerns associated with brain injury or neurological conditions, including anxiety, depression, PTSD, bereavement and grief, anger management, relationship problems and communication barriers.
Prices for a single therapy session start at £65 per hour, with block bookings available for individuals, or for businesses wanting to find new ways to support their workforce.
Chroma set for growth in
10th anniversary year
Chroma is looking to build on the success of 2022 as the UK’s leading arts therapies provider as it approaches its tenth anniversary in October.
Established in 2013, Chroma now employs over 100 therapists, and that number looks set to grow as demand for arts therapy services increases, with a series of contract extensions and new deals set to be agreed.
Chroma collaborates within sector-leading partnerships including with STEPS Rehabilitation, Sue Ryder, Hobbs Neurological Rehabilitation and Voyage Care. Additionally, they’re entering the eighth year of supporting HCA Healthcare UK, a leading healthcare provider in the UK, working at the Wellington and Portland Hospitals on a full-time basis.
Chroma has also seen a 100 per cent increase in medico-legal work in the past 12 months, handling over 700 cases with many of the UK’s leading case managers, deputies, insurers, and injury lawyers including Stewarts, Bush & Co, Stokes, Jaqueline Webb, Irwin Mitchell, Slater & Gordon, AXA, Aviva, and Allianz.
Chroma’s successful business approach was recognised last year when it won the Supporting the Industry Award at the prestigious Personal Injuries Awards 2022; an acknowledgement of their success in professionalising the Creative Arts Therapies (CATs) through collaborative working as part of a multi-disciplinary team.
Daniel Thomas, managing director at Chroma, said: “This year looks set to be another amazing one and we could not be more thrilled, especially as we approach our 10-year anniversary this October! I’m always amazed at how Chroma has grown over the last ten years from my kitchen table to what we are today.
“From our continued partnerships with some of the very best rehabilitation specialists in the UK; specialist schools and medico-legal partnerships, our ongoing CPD sessions, and the implementation of innovative software – Goal Manager to enhance rehab goal setting, 2023 is set to be a good one.”
Building upon the success of its CPD sessions, Chroma is looking to widen its CPD training programme of specific theory and techniques, to better prepare educators, lawyers and case managers to support clients with trauma or attachment difficulties.
Sessions range from understanding how questions around gender and identity can affect adolescents, with practical advice on how to help, to using arts therapy and wellbeing techniques in the classroom.
“We consider ourselves a socially aware organisation and aim to continually educate ourselves which is why we have taken steps to become more diverse –
as a workforce and in the delivery of our sessions – and inclusive by introducing
the ReciteMe tool to the website. With each year we aim to be better, and thankfully, we are on target to achieve that,” said Daniel.
“For us, the key to growth is providing added value services to our partners as well as spending more time with clients and less time on admin work. We’re also excited to be introducing more technology and Goal Manager, a new clinical tool that improves the quality of rehab goal setting and streamlines the goal setting process which sets a new gold-standard practice around this aspect of arts therapy work.
“As we approach our tenth year in the industry, I’m very optimistic about
the future for Chroma and the arts therapy sector.”
Top brain injury experts to debate the need for “female-specific concussion protocol” for women athletes
The international nongovernmental organisation PINK Concussions will host top brain injury experts in a groundbreaking event in Dublin to debate the need for a female-specific concussion management protocol for women athletes.
The 12th PINK Concussions Summit, taking place on March 30 in Dublin, aims to bring together international medical experts to debate changes needed to level the playing field for female athletes, from rules changes to a new concussion protocol.
The event, moderated by founder and executive director of PINK Concussions, Katherine Snedaker, will focus on the need for a female-specific concussion management protocol in sports, equal access to medical care on the pitch for women’s sports teams and whether women’s sports teams should consider modifications in “rule-specific engagement” based on current concussion research.
Snedaker says: “For over a decade, PINK Concussions has been advocating for recognition of sex differences in brain injury mechanisms, symptoms, and recovery trajectories to support practitioners in delivering individualised medical care.
“We believe a debate on a female-focused concussion protocol in sport will highlight the updated medical training needed on sex differences in brain injury.
“This is essential as brain injury is not identical in women and men.”
“Back in 2012, the American Medical Society for Sports Medicine issued a position statement stating that “in sports with similar rules female athletes sustain more concussions than their male counterparts”.
In addition, they highlighted that female athletes experience or report a higher number and severity of symptoms as well as a longer duration of recovery than male athletes in several studies.
Research over the last decade has continued to support these findings yet there has been no change in the protocol and care for female athletes.
“Worldwide research into female concussion continues to support and strengthen the view that females suffer an increased incidence of concussion compared to males in contact sport,” explains Dr Marshall Garrett from the University of Glasgow School of Medicine.
“Their symptoms also appear to be more persistent and cognitive deficits more pronounced than males.
“World sporting bodies need to acknowledge this difference and make provision for female specific assessment and recovery protocols.”
While the event focuses on female athletes, PINK Concussions hopes the impact will be broad, reaching girls in youth sports and women with non-sport brain injuries.
The summit will be held during the IBIA 14th World Congress on Brain Injury, in partnership with Acquired Brain Injury Ireland, at the Convention Centre Dublin from 4-5:30 PM GMT.
Speakers participating in the debate include: Willie Stewart, Queen Elizabeth University Hospital, Dr Marshall Garrett, University of Glasgow School of Medicine, Katherine Snedaker, LCSW PINK Concussions, Abigail C. Bretzin, University of Michigan, Christopher C. Giza, Mattel Children’s Hospital, UCLA, Christina L. Master, University of Pennsylvania and Dr Inga Katharina Koerte, Ludwig-Maximilians-Universität.
For more info, visit pinkconcussions.us or email katherine@PINKconcussions.org.
Bringing new levels of client support to case management
In looking for new ways to assist a client, Circle Case Management’s Nicola Weller devised a bespoke and innovative way of supporting him to achieve his goals – with her work now helping to change the lives of other clients.
NR Times speaks to the award-winning marketing and events manager
From the desire to use all available expertise to help a client with a brain injury to achieve his goal of setting up his own business, has come a new and innovative model in delivering ‘outside the box’ support.
In assisting a case manager colleague at Circle Case Management, the company’s marketing and events manager Nicola Weller has delivered an accessible and truly life-changing way of empowering a client through the creation of bespoke video content.
Through bitesize tutorials covering all aspects of establishing his business – covering topics such as what is marketing, what is PR, setting up a Facebook account and how to sell on social media – Nicola has now created around 40 videos, all supporting the client to achieve his goal.
Now, several months later, the client is running a thriving Facebook-based business which is generating profit and has fast-growing numbers of followers – but crucially has given him back his independence, confidence and self-esteem.
And in recognition of her efforts in this case, Nicola was awarded the case management (internal) supporter of the year at the CMSUK Awards 2022 – following case manager Maria Morris, who received an accolade from VRA for the same pioneering initiative.
“The main goal of rehabilitation is helping somebody back either to how they were pre-injury, or to give them enough tools and confidence to be able to re-engage in independent life. Our client has absolutely smashed his goals in this case, and our very bespoke support has enabled him to do that,” says Nicola.
“He’s fully motivated and is really happy, because now he has a reason to get up on Monday mornings. He has a structure, he has a routine back and he feels like he has a role in society again. It has been life-changing for him.
“He wanted to set up his own business and we gave him the tools to do it – and by us empowering him to do it, that has been so much more impactful than if we just did it for him.
“There isn’t enough business support for disabled people, and I think that if us as professionals can help in any way, then we are well placed to do that. We understand our clients, we know their back story, and we have the skills to help propel them further toward their goals.”
The innovative approach is demonstrative of the new strategy Nicola – whose background spans communications, marketing, sales and business development – has introduced into Circle, with digital and video content playing a key part of its forward-thinking approach.
“I was working with our rehabilitation case manager Maria and discussing this particular case, and I realised from what she was telling me about this client that I had skills and expertise that could help,” says Nicola.
“We are very keen to push boundaries and make positive change at Circle, and while me becoming involved in this way might not have been a traditional thing to do, I have always enjoyed thinking outside of the box and I knew I could make an impact.
“From speaking to the client, I could see how badly his executive function had been affected through his brain injury, so I realised we could make something bespoke for him which would enable him to understand – we could use video, with big text, with sounds, addressing issues in small chunks.
“We trialled the approach and it was really well received by the client, but also by his support network, who were able to take part in supporting him if needed and in understanding what he was doing and trying to achieve.”
And from the involvement of Nicola in the client’s rehabilitation and the sharing of her expertise – a substantial part of which she did on a voluntary basis, in her own time – he was able to achieve one of his biggest goals.
For Nicola, this is indicative of how effective the skills of the wider workforce or network in a case management company can be.
“I really hope the success of this project is a reminder that in case management, you’ve got a team of professionals who sit in your head office, and they could be really valuable to your clients,” she says.
“Whether you’re a secretary or work in HR, you have skills that could help a client get one step closer to their goal. I would love other case management companies to look at what we’ve done and see if this approach could help any of their clients.
“When I tell people about what we’ve done, they often remark that it’s quite a simple idea and why didn’t they think of it – but I think sometimes, it’s not until you have a specific problem and hit that wall in solving it that you find the solution.
“In this case, I’m so pleased that I could help and I’m so pleased my award has helped to draw attention to it. If one thing could come out of me winning this, it would be for others to consider doing something similar, because I’ve seen for myself how important it has been.
“Being involved in a client’s case in this way was something new, but the feeling of job satisfaction and knowing I’d made a difference to someone’s life was very special.”
Nicola is now implementing this approach with other clients, including one client with a brain injury who is now becoming a public speaker to share his experiences.
“This client is from a business background, so I didn’t need to tell him how to market – but public speaking and essentially building your own brand is something totally different,” she says.
“I’m really enjoying doing this kind of work with this client and others. I have seen how valuable my insight and input can be, so to use it in other situations is fantastic and a genuine privilege.
It also shows just how we work at Circle – we are always looking at how we can do things different and better, to do the absolute best we can for our clients.
“Case management is changing and we are really pleased to be seen as one of the names in helping to drive it forward – and I’d absolutely love to see others follow our lead in this instance, and using the expertise they have in-house for
the good of the clients.
“Clients are the priority for absolutely everyone at Circle, and we’ll do anything and everything we can to make a difference to their lives and rehabilitation.”
* For support or guidance in creating content of this kind and offering additional ways of supporting clients, contact Nicola via circlecasemanagement.com or by calling 01297 24145
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