Annual Professionals Conference 2015
Annual Professionals Conference 2015 - Developments in the Management of Hemiplegia
Date: Thursday 17th September
Venue: St Georges Centre, Great George Street, Leeds, LS1 3BR
This years' conference covers presentations on aspects of working with hemiplegia from head to toe. All designed to help enhance your practice and keep you up to date with developments in the management of the condition. Liz Barnes reports.
September is not just the start of the conference season for political parties – medical professionals like meeting then as well. Which is why HemiHelp CEO Amy Couture and I could be found running a stall at a meeting for paediatricians and other child health workers in Leeds a day before HemiHelp’s conference there – and signing up at least twenty new professional members!
Our own conference attracted over sixty delegates from as far away as London and Northern Ireland to keep abreast of new developments in the management of hemiplegia. Our Chair was Dr Kim Bevan, head of the Tuke Centre in York, who started the day off with a talk on living with the condition from a dual perspective – she is a psychologist whose adult son has hemiplegia. Kim gave us some interesting insights into the condition’s less visible effects and the need for psychological screening to be part of routine care, but at the same time she stressed the psychological strength of children and young people with hemiplegia. They do not show lower scores than other children on tests of general self-worth, though they may feel less competent in areas such as sport and social acceptance, and they are less likely to be bullies or aggressive. They also feel better about themselves than their parents, especially mothers, imagine, so healthcare providers should always talk to both children and parents when making decisions about treatment and also give attention to mothers’ mental health, as this can have an impact on the young person’s future.
Many children with hemiplegia need orthotics at one time or another, and Kate Chauhan, a specialist from the Steeper Clinic in Leeds, gave us an exciting overview of the changes taking place in this area. On the one hand, computer-aided design and manufacturing can produce a better fit; on the other, new materials such as carbon fibre are lighter and more flexible than more traditional ones and mean that splints will fit inside an ordinary shoe. Meanwhile lycra sleeves and gloves reinforce good positioning of elbows, wrists and fingers, and the increased stability they produce helps reduce muscle tightness.
After lunch, Rebecca Chawla and Vanessa Gronow, two senior physiotherapists from the Humber NHS Foundation Trust, told us about their project to increase children and young people’s access to physiotherapy in this cash-starved age by running specialised group gym sessions at local leisure centres. The hour-long sessions are run after school, in six week blocks, with groups of twelve children and young people, half under and half over 11. The younger children do group work; the older group also develop their own individual programmes and goals. The sessions are run by a physiotherapist, an assistant and a gym instructor – a skill range that releases senior physios to treat children with more complex conditions.
The results are encouraging: parents report increased confidence as well as function and fitness, and the young people enjoy being with others who face the same challenges. One child in a mainstream school reported ‘not feeling alone’; another, ‘We work at the same level and I don’t feel singled out’. At present the groups are mixed, with 80% of the children having some form of cerebral palsy, but the physios now plan to pilot a group specifically for children with hemiplegia.
Fatigue is a major issue for children with hemiplegia, but one that doesn’t get much professional attention, so a presentation by physiotherapist Helen Duneen was of great interest. Helen’s son Luke has hemiplegia, and noticing his struggle with tiredness prompted her to look at how it could best be minimised.
The main factor is the disorganisation of the brain that caused the hemiplegia that makes everyday life more exhausting than for most other children, physically, mentally and emotionally. But other things – epilepsy, cold weather, anxiety, pain etc – are additional factors. Fatigue can also lead to bad posture, uneven breathing, prolonged colds and other ailments, as well as moodiness and tearfulness.
Fortunately, this vicious circle can be turned round by a fatigue assessment and a management programme. This may include attention to better posture, exercises, breathing patterns, pain management and medication, and studies are also looking at other possible treatment options such as acupuncture; weighted blankets and compression vests to provide more sensory feedback and reduce muscle tension, and therapies such as counselling, Cognitive Behavioural Therapy and Mindfulness.
More research is needed in this area but programmes for stroke patients and other conditions such as MS are reported as being beneficial. It is good that the medical profession is finally turning its attention to the serious effects of fatigue on the lives of our children and young people.
You can find out mroe about our professionals conferences here.