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Morrello: Rehabilitation through innovation

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Morrello is a Newport-based rehab clinic offering the very latest in rehabilitation techniques and technologies.

Stroke Rehab Times checked in with Clinical Director Jakko Brouwers to find out more about how Morrello is helping stroke patients get back on their feet.

How and why was Morrello established?

We started Morrello in 2009 with the aim of bringing high quality rehabilitation and technology to the local population.

This came after a frustration with the then-current services not being able to invest in technology or adopt the most recent and innovative treatment practices.

We began investing in, and teaching the use of, technology in rehabilitation, after which we were asked to provide rehabilitation to some Complex Brain Injury and Spinal Cord Injury clients.

To provide a base for these clients to access the increasing pool of technology available, we established our current premises at Nelson House in 2016 which has been growing steadily ever since.

Over the years, we’ve started to occupy more and more space in the building and are now utilising 250m2 of ground floor space.

We are now looking to expand again as we are once more bursting at the seams.

How has the company evolved over the years?

Morrello has evolved from initially providing only community services and training, to providing more specialist treatments within a specialist centre, as well as medicolegal assessments and reports.

Over recent years this has become a smaller proportion of our work.

As we continued to grow in client-base and became more established, we continued to invest in a greater number of state-of-the-art technologies for rehabilitation.

Such as?

Our C-Mill Virtual Reality (VR) Augmented Feedback (AF) Treadmill was purchased specifically to enhance rehabilitation for people post-stroke and post-amputation.

Over the years, we’ve built a lot of experience with this technology for use within other client groups and have reported case studies on technology and gait rehabilitation both nationally and internationally.

More recently, we have added TyroMotion equipment to our range and are seeing great results.

What do you see as the greatest challenges facing stroke patients in their recovery?

The need to meet the right intensity for long-lasting change.

There is increasing evidence emerging on the positive effect of high intensity rehabilitation, and technology can play a big role in intensifying rehabilitation input as well as outcomes.

Stroke patients are often deconditioned to exercise and physical activity following a prolonged stay in hospital. There are many contributing factors to this, ranging from comorbidities to institutionalisation.

Upon discharge home, stroke patients often deteriorate and lose some of the gains made during inpatient rehabilitation.

How do you help them overcome this?

We often start people on a reconditioning to exercise and physical activity programme. Followed by intensifying rehabilitation input, addressing functional goals as well as aspirational goals which are meaningful to the patient, thus improving quality of life.

For this, we set up technology in people’s homes so they can continue their exercise individually, creating a better dose and intensity of practice.

We have developed activity monitoring methods to give additional insight into behaviours and activities at home and reported on this at the World Stroke Conference 2021.

Fundamental to overcoming recovery challenges is the use of technology to intensify and target specific elements of stroke patients’ rehabilitation programmes.

We endeavour to make sure that our stroke patients always feel supported and will reach the intensity needed for lasting change.

Why is it important to utilise the latest technology?

Technology has been and always will be at the forefront of the rehabilitation packages that we provide at Morrello.

We see technology as a tool that engages the patients at a higher level creating the right circumstances for neuroplastic change to occur, and new pathways to be formed.

Morrello continues to develop new treatment packages based on evidence around treatment intensity.

Most recent examples are our clinical gait assessment service and high intensity gait and balance rehabilitation packages which have been derived from the Queens Square upper limb rehabilitation programme which we adopted in 2019.

Our collaboration with Morrello Marvels CIC and the National Lottery has allowed us to set up high intensity rehabilitation at home as part of the Physio in a Box project.

This project was designed to support those adversely affected by the Covid-19 pandemic and involves providing equipment and a bespoke treatment plan in a patient’s home, so they can access much needed rehabilitation without risks.

The beneficiaries’ exercises are supported by virtual sessions with one of our specialist physiotherapists, as well as a library of pre-recorded exercise videos to be followed at their own pace.

After running the Physio in a Box project in 2021 as a pilot, we have now been successful in securing a second bid to roll the project out over a larger geographical area, and we are ready to take new referrals from February.

What other measures have you introduced during the pandemic?

Initially at the start of the first lockdown, we worked day and night to support our patients who were going into shielding and set up a lot of equipment in people’s homes. Like so many other services, we quickly pivoted to online service provision, and managed to turn this around in 24 hours.

We remained open all the way through each of the lockdowns and provided a valuable and essential service both online and in person, adopting safe working practices early on.

This allowed us to continue with the high intensity rehabilitation packages and to support our large Parkinson’s and Stroke communities.

To date, all our group sessions remain online, although some small-scale testing has been done recently with group sessions in face-to-face environments in collaboration with our patients in the way they feel safest.

Unfortunately, our local hydrotherapy facilities have not yet reopened, and we are looking forward to a return to providing hydrotherapy services in the near future.

What are your priorities for this year?

Our priority this year is to increase our capacity to deliver high-intensity rehabilitation as well as rolling out the Physio in a Box project further.

We will continue to support patients with any further Covid challenges that may arise, and we like to use our new website more to support our patients in more nuanced ways.

To find out more about Morrello or to book as assessment,

Email: Clinicreception@morrello.co.uk

Tel: 01633 412211

morrello.co.uk

 

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