NIHR Grant Programme RP-PG-0707-10012

2. NIHR Grant ProgrammeRP-PG-0707-10012 Executive Team Meeting 28/9 September 2009 Glanville Centre, Salisbury District Hospital

3. Development of an integrated service model incorporating innovative technology for the rehabilitation of the upper limb following stroke

4. Development of an Integrated Service model incorporating innovative Technology for the Rehabilitation of the Upper limb following STroke DISTRUST

5. Working TitleAssistive Technolgies in the Rehabilitation of the Arm following Stroke The ATRAS project www.atrasproject.org

6. Agenda

7. Project Overview • 3 year extension to 5 year • Aim: Evidence based clinical service for upper limb rehabilitation following stroke over the course of the first year • Three Work Packages • Work Package 1: Determine current UL rehabilitation for stroke & outcome measures used • Work Package 2: Literature survey • Work Package 3: User acceptability • Plan clinical trial and write report at 24 - 27 months

8. Project Team

9. Project Team 2 • Salisbury • Duncan Wood, Paul Taylor, Geraldine Mann, (Stef Scott R&D advice) • Gloucester • Frank Harsent • Nottingham • Hywel Williams, Diane Whitham • Oswestry • Neil Postans • Southampton • Caroline Ellis-Hill, Paul Chappell, Lucy Yardley • Newcastle • Garth Johnson, Paul Charlton • Stoke • Tony Ward, Alexandra Ball • Birmingham (WP4) • Christine Singleton

10. Overview • How each package contributes to the end result… • Key Question 1 • How do we decide which ATs to incorporate in the clinical trial? • Key Question 2 • How soon can we submit the Interim report? • Key Question 3 • How quickly do we get an answer from NIHR after submitting the interim report?

15. Definition of ATs An AT is a mechanical or electrical device used in a functional task orientated training process which will have a systemic or rehabilitative effect on the person. This specifically excludes devices used to improve a single function such as a modified spoon, dressing aid etc. It is possible that the evidence will be stronger for an AT which his used in conjunction with another treatment such as a drug treatment eg Botulinum or physiotherapy. If so that combined package will be considered as ‘The AT’ to go forward as one arm of the clinical trial. We will not consider treatments that do not include a device.

16. What can be used • Rehabilitation Robots • Functional Electrical Stimulation • EMG Biofeedback • Active Orthotics • Constraint Induced Movement Therapy • Combinations of the above • Including use of current treatments • Physio, passive splinting, botulinum toxin

17. Key Deadlines • 3 months delay by DOH • Start date 1/3/09 • 12 months: Financial Reporting • 1/3/10 • 18 months: Progress Report to NIHR • 1/9/10 • 24 months: Interim Project report • 1/3/11 • Determines whether clinical trial continues • Submitted to NIHR at the end of Year 2

18. ATRAS Web site • https://portal.nihr.ac.uk/sites/nihr-ccf/ATRAS/Pages/Description.aspx

19. Steering Committee • Rhodda Alison – Devon PCT • Prof Anne Ashburn – Southampton University • Stephen Little/Debbie Wilson – Different Strokes • Dr. John Chae – Cleveland Ohio • Prof Herme Hermans – Het Roessingh NE • Stephanie Armstrong - Stroke Association • Dr Chris Price – Newcastle NHS • Dr. Paulette van Vliet – Nottingham University

20. Suggestions/Comments from the Steering Committee • Contact Val Pomeroy to utilise her work on current treatments • ICF Guidelines should be used for classifying evidence in WP2 • Revise project plan to allow sufficient time for producing the Trial Design Report (1/3/11) • Employ Prof Maarten Ijzerman as a consultant to help with decision making for WP4 • Is 2 years going to be long enough for the clinical trial?

21. To do in near future • WP3 interactive exhibition 7-9 October, Southampton University • Stroke Forum – workshop and poster • Financial report 1/3/10 • Project progress form 1/9/10 • DONM end of March 2010

22. www.atrasproject.org