The BSPRM (British Society of Physical and Rehabilitation Medicine) Annual Scientific Conference 2024 was held in Coventry from the 6th to the 8th of November 2024. The theme of the conference was “Improving function – The third new indicator of health,” which was explored from a multitude of perspectives over the 3 days.
The 6th was the pre-conference day, during which three workshops ran simultaneously from 14:30 to 16:30. The Scar, Burns & Wound Rehabilitation session was run by Dr RuthAnn Fanstone and Dr Annie Price, where attendees were able to get up to date with new techniques and protocols in the rehabilitation of patients with scars, burns & wounds. In the Ultrasound Identification of Neck Muscles, Dr Fahim Anwar went over the complex muscular anatomy of the neck. He provided attendees with an opportunity to do some hands-on work by learning how to use an ultrasound to inject botulinum toxin as a therapy for neck dystonia. The Research Options for Every Clinician session was run by Professor Manoj Sivan and Professor Anand Pandyan, and was a way to encourage clinicians to find practical ways to get involved with research, which ultimately is the cornerstone of the advancement of medicine as a whole.
To support registrars, a trainee forum was held after the workshops. It was tailored to early-career professionals to allow them to meet one another and learn from each other’s experiences. After this, the post-workshop dinner was held at the Hilton restaurant, allowing the members to get to know one another in a more relaxed environment, which led to the building of new bridges and fostering connections that were strengthened over the rest of the week.
The main conference kicked off the following day (7th November) with a welcome message from the UK Chief Medical Officer Professor Sir Chris Whitty. The opening plenary lecture was by Professor Gerold Stucki (Director of the Centre for Rehabilitation in Global Health Systems), titled “Functioning – The Third New Indicator of Health”. Professor Stucki discussed how functioning is an often an under reported measure of health. With morbidity and mortality often at the centre of all public health discourse, functioning is frequently neglected, even though it is often the health metric that patients feel the loss of on a day-to-day basis. With an ever-ageing population and an increasing incidence of lifestyle-related diseases, the optimisation of functioning throughout life is a key challenge for the 21st-century doctor. This lecture set the tone for the rest of the sessions on specific conditions for the rest of the day.
The Traumatic Brain Injury session consisted of Professor Toni Belli’s overview of mTBIs (mild traumatic brain injuries), and an insight into patients’ unique needs. He emphasised that the clinic must be a “one-stop shop”, where initial assessment, neuroimaging, and neuropsychology are done consecutively, leading to immediate therapy. Virginia Newcombe then presented research that pointed to blood biomarkers – glial fibrillary acid protein and neurofilament light – that can be used to characterise TBIs in their acute and chronic stages. The levels of the biomarkers were also examined in relation to changes in imaging and functioning to explore potential causations. Next door, a parallel session on Tracheostomy Weaning was delivered by Dr Moheb Gaid, Anna Money, and Ramez Nassif discussing the indications of tracheostomies and the challenges that accompany weaning. They also discussed the role of an MDT in helping patients recover from a tracheostomy, including nurses, rehabilitation & ENT doctors, and speech therapists.
After a short break, we moved on to the next set of parallel sessions. In one room, the Cancer Rehabilitation session informed attendees about the complexities that accompany these patients. Dr Cindy Forbes spoke about patient-reported clinical outcomes to evaluate the current efficacy of rehabilitation protocol, and Dr Rebecca Robinson delved into a doctor’s role in exercise oncology, a field that cares for athletes who require cancer care. In the other room, Dr Gail Allsop and Dr Nina Amedzro discussed Vocational Rehabilitation. A career often makes up a large portion of a person’s day-to-day life, and losing the ability to participate in that may reduce a patient’s independence. The loss of an active workforce is also detrimental to the economy, therefore it’s important to consider the ability to work as a health outcome and rehabilitate people back to their jobs.
The lunch break was in a spacious hall with stalls from numerous companies lining the room. Medico-legal firms, orthopaedic device sales, long-term rehabilitation care homes – representatives from all sorts of companies were able to network with the attendees to market their products and services. The delegates were also able to get professional headshots taken. After that, we moved on to the second plenary lecture of the conference, delivered by Professor Jalesh Panicker about the management of Neurogenic Bladder. As a uro-neurologist, Professor Panicker is at the forefront of “building collaborative bridges between Neurology and Urology.” He shared his valuable perspective on urological symptoms caused by underlying neuropathology. This led to the oral abstract presentations, where 16 delegates had the opportunity to present their research abstracts which were scored to determine the winner of the Best Oral Presentation award.
We then heard about Shoulder Rehabilitation from Dr Will Goodison, Dr Ben Beare, & Rachel Higgins. They highlighted the pathogenesis of shoulder pain that is derived from neurological arm weakness, and discussed how to treat it within an MDT. The Stroke Rehabilitation session ran concurrently, with Professor Charlie Stagg providing a scientific update about newly published stroke literature, Dr Joseph Kwan providing a clinical update about new treatments and protocols, and Alexis Kolodziej providing the perspective of the Stroke Association. The final sessions of the day followed- the CESR Network chaired by Dr Javvad Haider, the Nursing Home Guidance Update chaired by Dr John Burn, and the Use of Antiepileptics in Adults with Brain Injury in Acute and Rehab Settings chaired by Dr Emily Mason & Dr Joanna Corrado. These sessions wrapped up the lectures for the day, and the Annual General Meeting followed. The Honorary Life Membership Award was presented during the AGM, to Dr Vera Neurmann and Professor Jai Kulkarni, for their lifetime contributions to the specialty of Rehabilitation Medicine. The conference dinner, a lovely buffet accompanied by live jazz music, rounded the day off, and attendees returned to their hotels to get some rest before Day 2.
Day 2 began with Professor Bethany Phillips delivering a plenary lecture on Sarcopenia and Deconditioning. She discussed the physiology of sarcopenia, especially in immobile and elderly patients, and how lifestyle measures that include diet and resistance exercise training can be better employed to improve the musculoskeletal health of these patients. She also highlighted emerging therapies such as neuromuscular electrical stimulation that can help patients who may not be able to exercise. Next, in the Amputee & Cardiac Rehabilitation session, Edwin Jesudasan provided a service overview of cardiac rehabilitation care in Edinburgh, Professor Natalie Vanicek described a grassroots initiative to keep amputees active, and George Smith shared insights from the HAMLET trial, which compared through-knee amputations and above-knee amputations in terms of their impact on quality of life. Simultaneously, the session on Advances in Spasticity Management discussed novel therapies to address spasticity, with Dr Anton Pick and Dr Valerie Stevenson presenting Cryoneurolysis and Intrathecal Baclofen respectively. A short break with tea, coffee and snacks was enjoyed, followed by the next pair of lectures. Dr Rohit Bhide and Dr Swaroop Shanbhag discussed Autonomic Dysreflexia, providing listeners with a window into the history of the evolution of the field, future predictions, and a spotlight on how autonomic dysreflexia can be caused by spinal cord injuries. In the other room, the role of Technology in Rehabilitation was considered, with Ganesh Bavikatte, Professor Heba Lakany, and Dr Mohamed Sakel discussing various ways in which technology can be harnessed to improve patient rehabilitation. This included virtual rehabilitation assistance, robotic exoskeletons, and using EEG feedback to relieve chronic neuropathic pain.
The second conference lunch was relished before attendees returned to the hall for the final set of lectures. The plenary lecture about Phantom Limb Pain was led by Professor Tamar Makin – she spoke extensively about how the brain is remapped in patients who experience phantom pain after limb loss, and she emphasised that treatments must be outside the box to help these patients. The final set of paired lectures included a session about Cerebral Palsy in Adulthood and Rehabilitation of the Hand/Upper Limb. In the former, Dr Charlie Fairhurst and Dr Ruth Kent-Rogers provided a complete overview of the aetiology, epidemiology, manifestations, and treatment guidelines surrounding cerebral palsy, and Emma Livingstone provided a patient perspective as a woman who lives with the condition. In the latter session, Dr Samit Chakrabarty, Mr Richard Pinder and Dr Abayomi Salawu spoke of various aspects of upper limb rehabilitation. This included muscle fatigue and its implications on rehabilitation capacity, the use of surgery in post-stroke upper limb rehabilitation, and a comparison of transplants and prostheses to replace a lost limb. With these sessions, the lectures of the conference came to an end.
After a final break, it was time for the conference awards to be presented. Awards were given for the Best Oral Presentation, Best Poster Presentation, Best Research Paper, and Medical Student Essay Prize. After a final round of photo-taking and farewells, the attendees departed from the Coventry Arena with their minds full of the knowledge they absorbed, and hearts full of the connections they made. At a time when medicine is becoming increasingly politicised and technologised, it was refreshing to meet physicians whose primary goal was to humanise the profession. I realised that as future doctors within an overwhelmed healthcare system, we’re taught to view the avoidance of death as the be all and end all, prioritising acute interventions and viewing patients as a number on a waiting list. Rehabilitation Medicine acts as the antithesis of that by seeing patients holistically, recognising the functioning they’ve lost, and unlocking their potential.
