Assisted Healing and Rehabilitation

Theme Leads:  Professor Hemant Pandit and Professor Carl Thompson

 

Background

West Yorkshire’s surgical and rehabilitation service users are a diverse mix of ethnicities, social and cultural backgrounds (https://forumcentral.org.uk/wp-content/uploads/2020/06/Leeds-CCG-Health-Inequalities-Framework-for-Action.pdf). The poor and old are less likely to access and benefit from rehabilitation services and new technology.

Only 2% to 4% of inpatients over 65 years old receive rehabilitation or reablement post-discharge. Those receiving social care (in care homes or in their own homes) are even more disadvantaged: rehabilitation/reablement support varies widely and access to rehabilitative technology and equipment largely relies on private funding (http://arma.uk.net/wp-content/uploads/2021/12/ARMA-msk-health-equalities- roundtable-report.pdf).

Up to 13,000 patients a day fail to leave NHS hospitals because suitable care and access to short term bedded support is lacking. Effective technologies that augment social care’s workforce skills, add value to the sectors, and increase capacity, have a valuable role to play in reducing these numbers, equitably.

 

 

Areas of Focus

Optimising pre and re-habilitation using remote (sensor) technologies with a diverse patient population. Working with existing and new industry partners, we will evaluate “upstream” technologies, e.g. implantable / wearable sensors; and “downstream”, market-ready, technologies – e.g., “Virtual Knee School” pre and reablement app.

Extending learning beyond orthopaedics by developing, refining and evaluating new rehabilitative technologies aligned to our technology themes and contributing to the science and theory of technology-related adoption, diffusion and (cost) effectiveness.

Developing and providing a portal and platform for commercial and academic technology developers to access and work with social care (domiciliary care providers, care homes and community services).  We will provide technology-enabled solutions and routes to improve outcomes and reduce inequalities in access to technology- enabled services. We aim to target the full range of populations we serve, including those in care homes and domiciliary care recipients. Delivering efficient rehabilitation, extending service reach and releasing potential in social care – in part using technology – is a key policy goal (https://www.england.nhs.uk/coronavirus/documents/discharge-centres-care-units-in-care- homes-short-term-rehabilitation-and-reablement-care/).

Our research includes evaluating technologies in social care: wearables and environmental smart sensors, analysis of social networks, falls risk and gait analysis.

 

Logo for the START tool. Open hands around a heart with a technology theme.

START: Social Care Tech: Asking The Right Questions Tool

The development and adoption of new technology in adult social care is vital. The sector faces considerable challenges that technological solutions could help to solve. However, implementing technological solutions in the sector can be challenging. Social care providers need a platform to express the problems they are facing. Technology companies need to understand the specific needs within the industry to develop the most appropriate product. We have, therefore, created the START tool to facilitate this.

The START Tool

 

 

Projects

 

A Novel, Resistive Exercise Device for Rehabilitation and Healthy Ageing

Virtual Knee School pre and reablement app

Case Studies

 

Improving patient outcomes following knee replacement surgery

Digital technology has advanced significantly over the past decade, with the increasing use of mobile devices and wearable and implantable sensors in medicine. These technologies enable better monitoring and improve patient care before and after a medical procedure.

At LTHT, we have worked closely with public and patient groups and industry partners to co-develop, evaluate, and optimise wearable and implantable sensors for patients undergoing knee replacement. Knee replacements are common but can have life-changing consequences: up to 20% of patients are dissatisfied and may have knee stiffness and pain that can last for many months. Patients with a knee replacement leaving hospital are usually given written instructions for knee exercises and assessed by phone or at a later hospital visit. This provides only a snapshot of a patient’s recovery and does not reduce unwarranted variations in recovery outcomes.

We are conducting a clinical study to assess the use and costs of wearable sensors in patients following knee replacement. These single-use devices, made by B Braun Medical Ltd., connect to a patient’s mobile phone and relay information to the hospital team to monitor progress remotely. The sensors suggest exercises that can be tailored to patient’s individual progress. Early results show improved patient engagement and satisfaction with better continuity in care. With the Yorkshire & Humber AHSN we are determining the costs associated with adoption across the NHS.

Our next steps include introducing sensors in the knee replacement itself. This will provide valuable information about potential infection and the stability of the knee replacement. Our collaboration with industry (Medacta International), led to development and testing of a prototype implantable sensor and funding for regulatory approvals and first-in-human studies at LTHT. We have secured funding of £2.4 million (worth another £2 million in kind support for regulatory approvals, supply of implants, implant testing, know-how and access to market). The UoL and its academic partners will receive licensing fees and royalty of £2 million+ from the industry partner.

Our “SMART” implant could revolutionise recovery for patients after knee replacement. By integrating relevant and important information from primary and secondary care, patients will have more control over their recovery and clinicians will be able to intervene faster should a problem occur.

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Fellowships

 

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Publications

 

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Patient and Public Involvement/Engagement

 

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Events

 

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