The Royal Hospital for Neurodisability at Putney has an active rehabilitation technology department and presented evidence at the start of the day on the management of patients with severe brain injury. This included a recent study that examined the effect on swallowing of alternative sitting positions. Such patients swallowed more safely when in a tilt in space position and the whole seat is rotated backwards (maintaining 90degrees between the seat and the back), when compared to a conventional upright position.
There is a drive to reduce the cognitive load of both augmented communication (AAC) equipment and environmental control equipment (ECE) that enable severely disabled users to control everyday electronic appliances. This can be achieved by ‘intelligent’ devices that learn from previous use and context, and from using familiar visual images rather than icons. Commercial technical advances are driving this and equipment such as Head Up Displays (‘Google Glasses’) may soon make AAC users indistinguishable from their able bodied peers. The same is happening with ECE in the form of home automation and the multiple functions of the ubiquitous iPad. The newest version with IOS 7 includes a switch facility whereby the camera picks up head movement and could enable the user to select an option from a sequential display of alternative peripheral switches. Touching the screen is quicker but apparently the more recent iPad has a capacitive rather than a resistive screen which is less responsive to ataxic actuation. We were then introduced to the potential of robotics. UK research and experience is focused on the use of upper limb devices as an adjunct to stroke rehabilitation. Other devices may be of practical help and we were shown the concept of an assisting drone operating both in the house and in the neighbourhood.
Taken together these two days, supported by posters of superior quality, had a profound impact on the clinical practice of all who attended. It bodes well for the move by the BSRM to an annual scientific meeting with the next one planned to be held at Bristol on 13-15 October 2014.
See also http://www.acnr.co.uk/2014/04/prolonged-disorders-of-consciousness-pdoc/ for Dr Burn’s report on the Prolonged Disorders of Consciousness meeting.
ACNR. Published online 43/4/14.