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‘Whatever you do you have to keep moving forward’ Reflections from the UK Stroke Forum Liverpool 2022

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By Dr Sarah Moore

Last week saw the welcome return of face-to-face for the UK Stroke Forum conference in Liverpool after two years of online delivery.

Rachel Stockley (University of Central Lancashire) and I were invited over a year ago to represent the Association of Chartered Physiotherapists in Neurology (ACPIN) on the UKSF scientific conference committee.

We were therefore in the privileged position to help shape the conference and ensure the content met the needs of the delegates and more importantly influenced the lives of stroke survivors and stroke care pathways.

What I have always loved about the UK Stroke Forum is its broad multi-disciplinary appeal from stroke prevention and pre-hospital pathways to long-term community care and rehabilitation.

This was very much in evidence this year with over 1500 delegates including stroke survivors, informal carers, clinicians, policy makers, charity workers and researchers. Everyone I spoke with about the conference were impressed by the sheer quantity and standard of work that is being conducted in stroke and I heard many discussing how to implement their learning to practice.

Delegates seemed delighted they were finally able to meet face-to-face with colleagues after two years of watching the conference from their offices and their bedrooms!!

Rachel and I were lucky enough to chair three sessions across the conference.

The first session focused on tools to aid walking recovery. Professor Jane Burridge discussed guidelines released this year on the use of Functional Electrical Stimulation for the lower limb. Miriam Golding Day then spoke about the under recognised role of the orthotist in stroke care and the need to better understand how orthotics can be used to aid early recovery of walking after stroke.

Alahna Cullen finished the session presenting on her experience of using robot assisted gait training for early walking training with stroke survivors.

This sparked much discussion about the pragmatics and costs of using this technology versus the benefits of allowing repetitive practice of walking .

The second session we chaired was part of a new section of the conference called ‘After Dark’. As the conference had been online for two years, we were keen to promote social engagement and reflection through a series of more informal talks.

The session we chaired explored innovative pathways for nurses and Allied Healthcare Professionals and leadership roles. Louise Clark a consultant OT and Suki Wong a physiotherapist who sits on various BAME leadership and advisory teams discussed their career pathways and shared top tips.

The final session we chaired explored implementation using Constraint Induced Movement Therapy (CIMT) as a case study. CIMT has a strong evidence base, and is cited in worldwide clinical guidelines, yet is infrequently used in clinical care.

In this session Dr Kathryn Jarvis discussed implementation of CIMT and then two world leading CIMT Australian Researchers: Dr Annie McClusky and Dr Lauren Christie, shared research undertaken in this field. Finally, Jessamy Boydell presented her experiences of using CIMT delivered using Telerehabilitation and freely available resources.

By the end of the session a poll indicated the audience felt more confident about CIMT and many were keen to try to embed this tool into practice.

Stroke outcomes measured via the Sentinel Stroke National Audit Programme (SSNAP) unsurprisingly deteriorated during the COVID-19 pandemic, and we now have the job of rebuilding and improving stroke recovery and rehabilitation pathways. Two key areas focused upon at the conference that will be important for rebuilding and improving stroke care were the use of technology and community care pathways.

The pandemic led to a rapid development of telerehabilitation with the potential to improve stroke care. In a fishbowl style workshop on methods of delivering community stroke care the use of telerehabilitation was discussed.

Although some were worried about a lack of therapeutic alliance when using telerehabilitation, the experiences of others during the pandemic disputed this and many clinicians had continued to use telerehabilitation to deliver group and individual sessions post pandemic.

The theme of technology enabled rehabilitation was explored widely during the conference with encouragement to be open to the use of technology but to think carefully about what we are using it for and who we are using it with to ensure it enhances rehabilitation.

Community rehabilitation was the other key area on the agenda at the UKSF and we heard about the delivery of three different pilot schemes in community care. How this work is taken forward and how we can capture the impact of community care on recovery and rehabilitation now requires careful consideration.

On our return from UKSF22 our mission now is to implement learning to stroke rehabilitation practice. Implementation and change take energy, patience, and leadership but, with passion and enthusiasm, we can all play a role in improving lives after stroke.

“If you can’t fly, then run. If you can’t run, then walk. If you can’t walk, then crawl. But whatever you do, you have to keep moving forward” – Martin Luther King Jr.

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