Rehabilitation and Ageing

Research aims to optimise recovery, restore function and empower and support patients of all ages and their carers/family to lead the lives they wish.

Research includes studies to develop and evaluate individual and group based psychological interventions to improve emotional adjustment and wellbeing in people with long term neurological conditions, such as multiple sclerosis, traumatic brain injury or stroke. Studies to evaluate screening measures for cognitive impairment after stroke and to evaluate novel rehabilitation technologies, for example weighted blankets to reduce sleep and reduce agitation after brain injury and virtual reality for pain management in progressive multiple sclerosis. Randomised controlled clinical trials to test the clinical and cost effectiveness of rehabilitation interventions.  Studies mapping rehabilitation pathways to identify unmet needs and developing novel interventions to address them. Studies exploring the use of home-based rehabilitation and factors affecting remote rehabilitation delivery, including digital exclusion. Studies exploring the use of Magnetoencephalography  as a tool for monitoring neurorehabilitation, with partners in physics and neurology.

We have also developed cognitive test batteries, to identify those who are safe to drive and those who need further on road driving assessments for people with stroke, multiple sclerosis, and dementia. See our Published assessments. 

This theme addresses issues presented by people who acquire or develop health conditions or sustain serious injuries that affect their ability to return to and or remain in work. Research involves a) developing and testing the clinical and cost effectiveness of vocational rehabilitation interventions to support people to return to and remain in work e.g. following stroke, or serious injury or in people with MS or inflammatory arthritis, and b) developing and evaluating processes, tools and technologies to support health care professionals, patients and employers to support return to work and prevent job loss.

Studies include First Contact Point Physiotherapy for musculoskeletal limitations, Femur3, a Phase III multi-centre trial of multidisciplinary rehabilitation following fracture in older people and a definitive trial of a job retention intervention for people with serious injuries, admitted to major trauma centres (Rowtate).

A study exploring dementia friendly communities and the impact on participation in people with dementia and those exploring re-enablement. 

Research to improve understanding of the effects of ageing for men and women with cerebral palsy (CP), and their changing healthcare needs and access to services across the life course. Studies to explore the best methods of communicating understanding about the effects of ageing in cerebral palsy to healthcare professionals and those exploring access to sexual and reproductive healthcare for girls and women with cerebral palsy across the life course.

We host the Building Community Resilience and Enabling Independence (BCREI) theme of the NIHR Applied Research Collaboration-East Midlands (ARC-EM). This focusses on closing the second translation gap (research into practice).  Recent and ongoing work has looked at the role of enhanced stroke rehabilitation in the community, telerehabilitation for stroke, benchmarking as part of routine community stroke rehabilitation, how innovation amongst care home managers and staff can be harnessed and used for policy and service planning, how evidence-based approaches to falls in care homes can be implemented, and how closer attention to blood sugar levels can enable deprescribing in care home residents with diabetes mellitus.

We lead a number of research programmes focussed on health in older people including: protein nutrition in older people with frailty; pain identification and management in older people with frailty and dementia; use of electromuscular stimulation (EMS) as an adjunct to exercise in specific clinical populations; prehabilitation interventions for cognitive protection in ageing populations; and aerobic and resistance training in older patients living with Parkinson’s disease.  Our group also researches optimal approaches to peri- and post-operative care for older people with fractures, and interventions to improve muscle mass and quantity in older people undergoing surgery.

Care homes provide accommodation to around 450,000 older people with frailty in the UK.   They are a unique care setting because of the complexity of care needs experienced by residents and because of the opportunities that the model of care provides.  Previous work from our group has focussed on efficient and effective ways to deliver healthcare for care home residents, Quality Improvement approaches in care homes, benchmarking of care delivery, and development and use of minimum datasets.  Researchers from Nottingham led work during the COVID-19 pandemic to evaluate novel point of care tests in care homes.  The largest ever RCT conducted in UK Care Homes – the Falls in Care Homes study – was led from Nottingham, demonstrating that falls prevention approaches could be both effective and cost effective in this setting,

Ongoing work will focus on further work to improve and benchmark the quality of care and quality of life in care homes, to develop and test novel technologies in care home settings, and to further adapt the care home environment to better meet the care needs of older people who live there.

We have a large programme of research aimed at reducing falls in older people, stroke patients, people with dementia and people living in care homes. Studies include developing and evaluating falls prevention rehabilitation interventions; falls in care homes and falls risk identification and stratification tools.