Rehabilitation and living with disability

We are leaders in stroke rehabilitation research along with patient, carers and public involvement, both nationally and internationally.

We aim to improve experience and health outcomes and transform the lives of people affected by neurodisability. Our work promotes an understanding of unmet needs, recovery mechanisms, effectiveness of interventions and optimal care pathways for those living with neurological conditions.

Since 2010, we have led and collaborated on research into cognitive, communication, motor and mood difficulties.

Our research

Some of our research activities include:

Health inequalities and stroke rapid literature review

Funder:  Stroke Association
Researchers: Dr Verity Longley, Ann Bamford (public contributor), Professor Audrey Bowen et al.

Health inequalities are unfair differences in health between different groups in society. Researchers from The University of Manchester, The University of Edinburgh, Northern Care Alliance NHS Foundation Trust and other networks have conducted a commissioned rapid review of the research literature of health inequalities and stroke as a first step to finding out what research exists on health inequalities across the stroke pathway, and collated these studies.

This review highlights the type of research evidence that exists, as well as obvious gaps, which could inform research commissioning. It concludes that most studies explored socio-economic status or ethnicity rather than other lenses of inequalities, resulting in sparse evidence for vulnerable groups and urban/rural geographical differences.

• Read the full report and findings: Health inequalities and stroke rapid literature review(PDF)

Development of a core outcome set for clinical research on interventions for speech impairments in stroke (COS-Speech)

Funder: NIHR
Researchers: Claire Mitchell, Jamie Kirkham, Paul Conroy, Annette Dancer, Audrey Bowen

Dysarthria (reduced speech intelligibility) is a common consequence of stroke leading to social isolation and low self-confidence. This speech difficulty after stroke has been neglected with few research studies.

The study aims to agree what aspects of communication we should measure when monitoring speech recovery: what is the core outcome set (COS) for all types of dysarthria caused by any type of stroke?

• Learn more about COS-Speech (NIHR).

Speech after stroke recovery study (SayS): exploring speech recovery over time and agreement of a core outcome set with measures

Funder: Stroke Association
Researcher: Claire Mitchell and Paul Conroy
Supervisor: Audrey Bowen

Around 50% of stroke survivors have dysarthria. This research aims to understand how people recover from dysarthria over time and to improve our understanding of how to measure the impact of dysarthria on a stroke survivor’s life.

This can allow researchers and healthcare professionals to measure recovery to find new treatments and support for stroke survivors with dysarthria.

• Learn more about SayS (Stroke Association).

How does the relationship between therapist and stroke survivor affect stroke recovery?

Funder: Stroke Association
Researcher: Lauren Lucas
Supervisor: Audrey Bowen, Sarah Peters and Sarah Cotterill

Recovery after stroke is tough, but with the right specialist support and a ton of courage and determination, the brain can adapt. Almost 75% of stroke patients require physiotherapy at home, and survivors may need support for many years after to live the best life they can.

The relationship between a therapist and patient is thought to be important. However, very little is known about how this relationship impacts recovery with the physical effects of stroke in the long term.

This research is the first step to understand if new guidelines, training, tools and treatments should focus on this aspect of care to improve recovery after stroke. The research will also identify the most important aspects of the relationship that could improve recovery and life after stroke in the long term.

• Learn more about this stroke recovery study (Stroke Association).

Wellbeing After Stroke-2 (WAterS-2)

Funder: Stroke Association
Researcher: Audrey Bowen, Emma Patchwood and team

Stroke survivors face a range of mental health difficulties adjusting post-stroke, yet there are few evidence-based treatment options and workforce challenges with under-resourced clinical psychology services. Acceptance and Commitment Therapy (ACT) has been used successfully in clinical services to improve wellbeing.

In the recently completed WAterS pilot study, we co-developed an online group intervention based on ACT and a staff training programme for delivery by non-psychologists.

Both proved acceptable to stroke survivors and staff and led to WaterS-2, a two-year project starting in October 2023 that aims to upskill a wider workforce to deliver inclusive, accessible psychological support to improve wellbeing after stroke.

• Learn more about WAterS (Stroke Association)

VAlidation of the Mcast CommunicAtion Screening Tool (VAMCAST)

Funder: NIHR
Researcher: Dr Mark Jayes

This project aims to improve mental capacity assessment. Mental capacity refers to the ability to make informed decisions. People may find it harder to make a decision if they have difficulties using their communication and/or cognitive (thinking) skills.

By law, health and social care staff have to complete a mental capacity assessment if they think someone they are working with may have difficulty making a decision. Currently, many staff find these assessments challenging and their practice needs to be improved.

The MCAST has been designed according to user-centred design methods to ensure it is responsive to users’ needs. This means that health and social care staff and patients were directly involved in the design of the toolkit.

Evidence from the research literature, case law and a staff focus group study was used to identify what components the toolkit should include to make it useful and useable.

• Learn more about VAMCAST (NIHR).

Investigators