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Think Therapy 1st set for future through leadership change

Helen Merfield will become chief executive, with Penny Wosalho taking over as managing director



Specialist rehabilitation occupational therapy provider Think Therapy 1st is set to take its growth to the next level through strategic changes to its leadership team. 

TT1st has built a reputation for its commitment to home and community-based multi-disciplinary team (MDT) approach to rehabilitation, lead by its Specialist Rehab Occupational Therapists (SROT) and to delivering outcomes to clients that exceed all expectations, with a track record of success verified by standardised assessments. 

Having built a strong network of referrers from the insurance, legal and case management world – all impressed by the outcomes and progress it delivers to clients who have sustained life-changing injuries – TT1st continues to grow its team of associate OTs across the country. 

And now, to help propel its ongoing growth to the next level and plan for the future of the business, TT1st is making changes to its top-level team. 

Helen Merfield

Managing director Helen Merfield will become chief executive, with a remit to grow the profile of TT1st and its unique approach to restorative  functional OT, building new relationships and partnerships nationally to build on TT1st’s progress to date. 

Penny Wosahlo, currently director of operations, will become managing director, to oversee and develop the running and logistics of the business and help map out its future growth. 

TT1st has already pioneered a number of initiatives to empower clients to progress in a range of specialist areas – from its Children and Young Adult Service (CAYAS) to its Holistic Education for Living with Pain (HELP) programme – and continues to help redefine the role OTs can play in rehabilitation. 

Now, through its internal structural change, it is set to develop that even further, with Helen – a former military nurse – committed to highlighting the TT1st difference in approaching therapy and rehabilitation. 

“I get so excited about our approach to home and community-based MDT functional rehabilitation  and what these guys can do. They’re like the OTs I worked with in the military, you don’t get this very often in the private sector,” she says. 

“Many OTs take an adaptive and compensatory approach – but for us, the focus is on restorative and rehabilitative OT. Unless you’ve been in the military, people might not have come across functional restoration – but that’s what we are committed to. We only look at compensating or adapting when restoration has been exhausted first, we are focused on functional rehabilitation.

“We help people get their lives back together and to live their best lives. We’ll get people doing what they never thought they could again, even when the doctors have told them they’ll never do something again, if there’s a chance then we’ll go for it. 

“But as well as showing people just why TT1st is different, why our OTs are so amazing, I think one of the big challenges we face is with people not really understanding what OTs are capable of doing, if given the chance – when you use the word ‘occupation’, everyone thinks of work.

Penny Wosalho

“So I feel, in my new role, I want to educate people about what OT is. My big mission is to try and educate the market.”

Having worked closely with Penny for several years, Helen is delighted to now be handing over the MD reins. 

“I feel like Penny and I are like Yin and Yang, she loves all the things I don’t and vice versa, so it’s a totally winning team. We can both focus on what we love and that is going to be amazing for us going forward,” she says. 

Penny, who has worked in the field of OT since graduating in 2002, is excited at the challenge ahead. 

“We’re an OT company run by OTs which is really exciting, and our focus on, and commitment to, rehabilitation is why we are growing as we are,” she says. 

“We are constantly delivering improvements in outcome measures for clients, and are meeting their goals, but as OTs we aren’t very good at taking the credit for that.

“We’re so keen to put the success back onto the client and how hard they’ve worked, but really they couldn’t have done that without the OT’s guidance and formulating how the programme would run. There are so many intrinsic roles we have in the process that sometimes aren’t recognised, because we don’t shine a light on what we do. 

“But with Helen now being able to tell people about what we do and how we do it, educating them about the role we play, she will be illuminating the way for us.

“This is really exciting and I’m really looking forward to working with Helen and the team to take this forward to the next level.”


Neuro Convention returns next week

The event brings together neuro-rehab professionals and leading organisations from across the UK



Neuro-rehab professionals and organisations will be attending one of the key dates in the sector calendar next week – Neuro Convention 2022. 

The event showcases the latest technology and innovations in the neurological sector, with the goal of improving patient outcomes. 

Neuro Convention, held on Wednesday and Thursday at the NEC Birmingham, will focus on four key areas – rehabilitation, mental health, diagnostics and brain and spinal injury. 

The free event includes a programme of more than 50 free CPD-accredited seminars, hosted by leading experts from across neuro-rehab, as well as interactive workshops hosted by the specialist neuro-rehab team at the University of Plymouth. 

Technology will also be showcased, with a programme of live demonstrations, to show how the latest innovation can benefit people’s lives. 

More than 50 exhibitors will also be in attendance, including the team from NR Times, who can be found on stand N-G3. 

Neuro Convention will be co-located with Naidex and UK Care Week within the NEC, highlighting the shared dedication of all three events to improve mobility and the technology introduced to support independent living.

Deborah Johnson, editor of NR Times, who will be attending Neuro Convention, said: “Neuro Convention is known as being one of the must-attend events in the neuro-rehab calendar, and 2022 looks to be another excellent event, with a packed programme of speakers and workshops and an array of leading exhibitors. 

“It’s absolutely fantastic that the opportunities for the neuro-rehab sector to come together again in person are returning, and I’m personally looking forward to meeting as many people as possible – those who are new to NR Times, others who are old friends, and those who to date we have only met via Zoom!” 

Tickets are free and to register, visit here. 


Dates & Times 

Wednesday 6th July 2022 | 09:30 – 16:30

Thursday 7th July 2022 | 09:30 – 16:00 

Venue Address 

Hall 19

National Exhibition Centre (NEC)


B40 1NT, UK

Social links #NeuroCon

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Role of sleep in memory and learning uncovered

Research findings could aid development of assistive tools for people with neurological injury or disease



New research into sleep may help explain how memories are formed and how learning is consolidated, and could aid the development of assistive tools for people affected by neurological injury or disease. 

Scientists previously studying laboratory animals discovered a phenomenon known as ‘replay’ that occurs during sleep – a strategy the brain uses to remember new information. 

Scientists believe that this replay of neuronal firing during sleep is how the brain practices newly-learned information, which allows a memory to be consolidated, and converted from a short-term memory to a long-term one. 

However, replay has only been convincingly shown in lab animals.

Now, a new study has investigated whether replay occurs in the human motor cortex — the brain region that governs movement — focusing on a 36-year-old man with tetraplegia who cannot move his upper and lower limbs due to a spinal cord injury. 

The man, identified in the study as T11, is a participant in a clinical trial of a brain-computer interface device that allows him to use a computer cursor and keyboard on a screen.

The investigational device being developed by the BrainGate consortium, a collaborative effort involving clinicians, neuroscientists and engineers at several institutions with the goal of creating technologies to restore communication, mobility, and independence for people with neurologic disease, injury, or limb loss.

In the study, T11 was asked to perform a memory task similar to the electronic game Simon, in which a player observes a pattern of flashing coloured lights, then has to recall and reproduce that sequence. 

He controlled the cursor on the computer screen simply by thinking about the movement of his own hand. Sensors implanted in T11’s motor cortex measured patterns of neuronal firing, which reflected his intended hand movement, allowing him to move the cursor around on the screen and click it at his desired locations. 

These brain signals were recorded and wirelessly transmitted to a computer.

That night, while T11 slept at home, activity in his motor cortex was recorded and wirelessly transmitted to a computer.

“What we found was pretty incredible,” said Dr Daniel Rubin, lead author and a neurologist at the MGH Center for Neurotechnology and Neurorecovery. 

“He was basically playing the game overnight in his sleep.

“This is the most direct evidence of replay from motor cortex that’s ever been seen during sleep in humans.”

Most of the replay detected in the study occurred during slow-wave sleep, a phase of deep slumber. 

Interestingly, replay was much less likely to be detected while T11 was in REM sleep, the phase most commonly associated with dreaming. 

The researchers see this work as a foundation for learning more about replay and its role in learning and memory in humans.

“Our hope is that we can leverage this information to help build better brain-computer interfaces and come up with paradigms that help people learn more quickly and efficiently in order to regain control after an injury,” said neurologist Dr Sydney S. Cash, co-director of the Center for Neurotechnology and Neurorecovery at MGH.

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Pioneering project could revolutionise capacity assessment

Sector-leading research is set to generate a framework of wellbeing indicators for patients



Specialist neurological care provider PJ Care has partnered with the University of Leicester for a sector-leading research project that could revolutionise the assessment and care of residents who lack capacity.

The two have come together in a knowledge transfer partnership (KTP) to support the creation of a centralised system at PJ Care to create algorithms that will generate a framework of wellbeing indicators for those who are non-verbal as a result of their neurological condition.

So far, a review has been completed of existing research into this area, which will be published jointly by PJ Care and the University of Leicester later this year.

Leading the project is Dr Allan Perry, consultant clinical neuropsychologist and director of clinical services at fast-growing PJ Care.

“The current models for assessing the health and wellbeing of those without capacity and who cannot readily communicate their feelings and experiences are limited and don’t take advantage of the recent advances in technology and data analysis that can give us much more detailed information,” he explains.

“There is a wealth of monitoring technology that we use which allows us to collect real-time data on a number of wellbeing indicators such as a person’s oxygen levels, heart rate, fluid intake and the number of steps they take to reach a certain distance.

“We believe this data can be analysed by an algorithm to provide insights into personal wellbeing, sense of agency, independence and self-determination, that are more accurate than those offered by traditional methods. We can then apply this information to tailor our care to that individual.

“While there is plenty of information on bringing more technology into the care sector and using the data being created by it, this isn’t being married with the questions posed by a person’s capacity as yet. We don’t believe any other care provider is delivering anything like what we are proposing to.”

PJ Care is a specialist neurological care provider with three specialist care centres – the first of which has just celebrated its 21st anniversary – for more than 200 adults with progressive conditions such as young onset dementia and Huntington’s disease, and care and rehabilitation for people with acquired brain injuries.

Dr Zehra Turel holds a PhD in cognitive neuroscience from the University of Leicester and serves as KTP research associate for the project, working with Professor John Maltby and Professor Elizabeta Mukaetova-Ladinska of Leicester’s Department of Neuroscience, Psychology and Behaviour.  

She says there is an urgent need for an accurate assessment tool for those who have difficulty communicating.

“We have so far uncovered that the available wellbeing measurements neglect or fail in understanding of the clinical populations such as cognitively impaired individuals, with or without capacity,” says Dr Turel.  

“This project will provide micro and macro insights about residents’ health and wellbeing, and support decision-making at both resident and business level.

“With the increasing use of new data-driven technologies and streamlined data collection at PJ Care, this project will improve personalised care and provide more accurate and faster predictive and preventive measures, and more informed decision-making along with lowering costs and simplifying internal operations.”

“This KTP has the potential to develop resources that could not just be transformative for PJ Care and how our staff support people without capacity, but, eventually, for the whole care sector,” says Dr Perry.  

“We will be looking to market this if it proves to be as effective as we believe it will be.”


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