In fact, it is a tri-ciprocal relationship and we cannot understand health and wellbeing without including all three in our enquiries and understanding their effect on each other. See examples below how damage to the brain affects our behaviour (stroke) how what we do with our bodies affects our brain and behaviour (concussion) and how the environment our bodies are in can affect our brain and behaviour (delirium).
Brain injury invariably has consequences for behaviour. This may be the loss of speech, movement or cognitive ability. Whilst neurorehabilitation techniques are in widespread practice for these impairments, those who experience visual loss after brain injury are and have not been served by the NHS.
At Durham University we have developed DREX (Durham Reading and EXploratory) training in collaboration with patients, their carers, and various health professionals such as consultants, occupational therapists and nurses. This e-rehab is helping patients in the UK and beyond regain the visual performance they need to re-engage with everyday life, improving their quality of life and lessening service demand on the NHS.
This is an online rehabilitation programme (e-rehab), and we are evaluating its use in a holistic sense, investigating factors that can affect its uptake and efficacy such as loneliness, multimorbidity and support. By understanding the patient’s needs, condition, aims, targets and surroundings, we can achieve a patient-focused approach to the challenge of rehabilitation that is of economic value to the NHS.
Visit the DREX website to learn more about the free-to-download app available on the Google play and Apple store for sufferers of partial visual loss. DREX training can be used to compensate for partial visual loss following stroke or brain injury. Get in touch with us for further information by emailing firstname.lastname@example.org.
Intensive Care Units (ICU) have garnered a lot of attention in 2020 due to the COVID-19 pandemic. Their function and design are focused on infection control. They are stark in nature and devoid of natural light. The materials used for their construction are relatively colourless. In this alien environment there is a strange combination of sensory deprivation, due to a detachment from the familiar, and sensory overload, as a result of 24/7 lighting “pollution”, constant activity of medical staff, “alarming” machinery sounds, and patient view-perspectives. The lack of familiar and ‘variable’ sensory stimuli can be detrimental and disorientating to patients, staff and visitors alike, especially after long periods.
The Enlighten Programme brings together several disciplines and the community (ICUsteps) to address how the physical environment and access to natural light impact our health, well-being and recovery, and what changes can be made to improve this. The project focuses on the clinical nature of hospital environments, particularly the stark, highly technical ICU. The project seeks to understand whether the experience of the ICU community (patient, carer and staff) can be improved by introducing personalised ‘natural’ lighting, sound and other sensory and aesthetic changes.
Alongside innovative information and communication technology for internal and external re-engagement, these changes can be implemented in the future design of hospitals and clinical settings. The project also explores the possibility, through design, of integrating the dedicated interior and exterior “sensory garden” intensive care space available 24/7 for the benefit of the ICU community.
You can read more about the En’Light’en project in book chapter “Health & Wellbeing benefits of light across the spectrum - the Enlighten Project” in ‘A Namaste Care Activity Book - Sensory stories and activities for people living with advanced dementia’ 2021 Jessica Kingsley Publishing, London and our Annual Report (2017).
Concussion is a mild traumatic brain injury and repeated mTBI is increasingly recognised as a substantial public health problem, particularly in the sporting context. The acute symptoms can include headache, visual disturbances, nausea and confusion. In the longer term, there can be chronic symptoms and persistent cognitive decline linked to long term neurodegeneration.
At Durham University, we are leading an interdisciplinary research programme to improve understanding of concussion, sub concussions and longer term effects. The research takes three approaches with a focus on sport and linkage to the UK Rugby Health project and the Global Rugby Health Research Group. First, we are objectively quantifying concussive and sub concussive impact forces experienced in professional rugby union and applying multi-modal analyses to identify aspects of play that might expose athletes to the greatest risk. Second, we are exploring novel biomarkers in current and retired athletes to unravel mechanisms of injury and advance diagnostics. Third, we are developing interventions for improving the management of concussion in sport and for the treatment of post concussion syndrome. While the research uses sport as a model, the findings can be applied to advance understanding of of mTBI in different contexts.