I'm finally over my jetlag from a flying visit to Vancouver to attend the World Congress of NeuroRehabilitation. This was my first international conference, and I was fortunate to present one of my studies orally and another via a poster. There was a small contingent from Perth that attended, although it would be great to see more clinicians attend conferences like this to expand the knowledge base that is practiced in the Perth neurological rehabilitation space.
Conference Highlights and Reflections:
Before diving into my presentations, I want to reflect on what was an overwhelmingly high-quality, jam-packed program. NeuroRehabilitation research is booming, and it's hugely exciting to be part of this expansion. As a clinician, I love extrapolating new findings and translating them into my own practice.
Pre-Conference Workshops: Janice Eng presented on the implementation and scaling of GRASP, an evidence-based adjunct to usual upper limb rehabilitation designed to increase daily practice for stroke survivors. GRASP shares many similarities with CIMT, such as the behavioral contract and graded impairment-based upper limb practice. I agree with the need for behavioral strategies to get stroke survivors to take ownership of their practice to facilitate long-term upper limb improvements—key concepts I apply to all of my practice.
Brain-Computer Interfaces (BCI):Â I attended a hands-on session on brain-computer interfaces, where non-invasive brain recording connected with a hand exoskeleton to perform functional movements. The data presented indicated neuroplastic changes from training with a BCI, suggesting potential rehabilitation uses beyond assisting with tasks. This technology's future developments will be fascinating to watch.
Real-World Data in Rehabilitation:Â A major theme among several speakers was the use of real-world data to evaluate rehabilitation outcomes. Conducting and recruiting for large clinical trials in rehabilitation is challenging, but the advent of electronic medical records and AI for big data analysis offers great opportunities to demonstrate the effectiveness of neuro rehab and justify its funding.
Motivation in Rehabilitation:Â The motivation symposium explored the links between intrinsic motivation and functional outcomes, such as improved FIM and Fugl-Meyer scores. As therapists, we need to ask how we can facilitate this motivation. Enriching a person's environment, either through their setting or our actions, is crucial to augmenting their motivation.
Role of Aerobic Exercise:Â Numerous presentations highlighted the superiority of high-intensity exercise (both HIIT and HICT) over moderate and low intensities in improving fitness, activity levels, and enhancing neuroplasticity. This aligns with my practice at Cortex Neuro Rehab, where HIIT is a key component of treatment programs when safe and appropriate.
Intensity and Dose of Practice: A session on the final day focused on the importance of practice intensity and dose in rehabilitation outcomes. Kate Hayward proposed a dose articulation framework for greater transparency and consistency in clinical trials. This framework includes concepts like time on task, rest periods, intensity, and difficulty. Inspired by her publication, I’ve structured my sessions with less rest and more focused activities, yielding significant client improvements.
My Presentations:
My oral presentation was part of an engaging session on stroke rehabilitation, covering exercise, vagus nerve stimulation, and upper limb rehabilitation. I presented on the behavior change intervention we developed to improve the delivery of modified constraint-induced movement therapy in a large home-based rehab service. The session was well attended, with engaging questions indicating strong interest in my study.
Conclusion:
Overall, it was a great trip and conference, filled with valuable learnings to bring back to Perth and integrate into my practice at Cortex Neuro Rehab. Vancouver is an awesome city, and I even got to do some touristy things, like attending Game 7 of the playoff series between the Vancouver Canucks and Edmonton Oilers (the Canucks lost).
Contact Us:
If you're interested in working with a neurological physiotherapist who not only stays up to date but also contributes to the latest research, get in touch with Ashan Weerakkody at Cortex Neuro Rehab. We provide mobile neurological rehab for all neurological and vestibular conditions across the northern suburbs of Perth.
Thank you for reading,
Ashan Weerakkody
Cortex Neuro Rehab, Perth
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