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Boot camp revolutionises treatment for stroke patients



With their reputation for putting participants through a punishing regime of cardio exercises, military-style fitness workouts are not for the faint-hearted.

So imagine enrolling for boot camp training when you’ve suffered a stroke.

But that’s just what stroke patients in South Australia are being given the chance to do to help them on the road to recovery.

The University of South Australia (UniSA) has created an innovative five-week take on the stereotypical idea of a boot camp that is delivering life-changing results for people affected by strokes.

According to UniSA, which is located in the stunning Limestone Coast region of South East Australia, initial results show outcomes from the ‘stroke bootcamp’ that are three times better than standard treatments.

The stroke recovery clinic for people needing ongoing rehabilitation in their arms and hands is being led by UniSA physiotherapy students under the guidance of practitioners, and has been supported by an $80,000 grant from The Hospital Research Foundation Group (HRF).

Physiotherapist and UniSA researcher, Dr Brenton Hordacre

Physiotherapist and UniSA researcher, Dr Brenton Hordacre, said preliminary data and patient results showed the programme is highly effective.

He said: “After a stroke, many patients cannot move their bodies in the same way they used to. And practically, this might mean they can no longer grasp a coffee mug or bring a fork to their mouth during mealtimes.

“Our programme focussed on helping people regain these fundamental movements, so they get back some sense of normalcy, independence, and a higher quality of life.

“Our initial results show that improvements to patients’ upper limb function are almost three times the clinically meaningful change score we use to measure arm recovery.

“We’re also finding that patients are really enjoying the intensive rehab – and want to do more.

“Going into the programme, we also thought there was a risk that patients would not enjoy it, because the rehab was too challenging or intense. However, what we’ve found is that patients really enjoy the programme, and the results they’re seeing, and don’t want to leave.”

The exercises are tailored to improve essential skills that most people take for granted. They can include practicing writing on a white board and trying to pick up marbles with a finger and thumb to improve motor activities.

The UniSA physiotherapy students work with patients for up to three hours a day, five days a week, to provide personalised support and guidance to help the stroke recovery process.

In Australia, there are more than 100 strokes every day. One in four people will experience a stroke in their lifetime.

According to the World Stroke Organisation, more than 12 million people globally will suffer their first stroke this year, and 6.5 million will die as a result. More than 110 million people worldwide have experienced a stroke.

In response to the success of the stroke bootcamp, the UniSA team is looking at how to expand the intensive programme to a supervised `drop-in’ service.

Dr Brenton Hordacre with stroke survivor Adrian Fitzgerald

Dr Hordacre commented: “The best available evidence for upper-limb recovery points towards more practice. Stroke patients say they want more intense, longer therapy to help restore their arm movements.

“Thanks to the HRF grant, we can meet this need and establish a dedicated upper-limb stroke recovery service for community patients that will deliver intensive, high-dose therapy.”

Because of the student-led programme, the service has been delivered at a lower cost to patients and they are also provided with home-based exercises and take-home kits.

Executive Director of The Hospital Research Foundation Group’s Stroke division, Olivia Nassaris, said: “There is a huge need for more rehabilitation both for the early and later stages of stroke recovery.

“Up to 65 per cent of patients have persistent upper-limb impairment and are unable to incorporate their paretic hand in their daily activities.

“Other studies worldwide have shown that greater improvement can be achieved with higher doses of therapy, so we are very excited about putting this into practice for our clients and positioning South Australia as a leader in stroke recovery.”



Innovative robotic cup could empower older adults to stay hydrated



A one-of-a-kind robotic cup designed to help people living with cerebral palsy stay hydrated could also be a game-changer for older adults suffering from mobility impairments.

The aptly named RoboCup enables people with limited upper body mobility to stay hydrated without relying on a caregiver for help.

The battery-powered device, which can be mounted on a user’s wheelchair and customised to suit their mobility needs, is activated either by a button or a proximity sensor that brings a straw directly to their mouth.

The user can then take a drink, and once they have finished the straw automatically withdraws.

The cup is the brainchild of engineering students Thomas Kutcher and Rafe Neathery, who came up with the innovative idea after Rice University’s Oshman Engineering Design Kitchen (OEDK) in Houston, Texas, in the United States, was approached by spastic quadriplegic cerebral palsy patient Gary Lynn for help creating an assistive drinking device.

The result is RoboCup, which Thomas and Rafe hope will offer users greater freedom as they won’t need to rely on a caregiver whenever they need a drink.

To this end, the undergraduates have generously made their design available for free to anyone with access to a 3D printer to assemble their own drinking device by downloading instructions from RoboCup’s OEDK website.

Having made it possible for those living with cerebral palsy to drink water autonomously, Thomas and Rafe are now looking at the cup’s wider application – and believe it could prove to be a life-changing piece of technology for those with age-related eating and drinking problems caused by muscle weakness, pain, disease, and neurological conditions that can seriously affect mobility.

Thomas told AgeTech World: “While our client who had the idea for this device has cerebral palsy, the potential use cases spread far and wide. Rafe and I wanted our design to be as generalisable as possible.

“The device is catered to anyone with impaired mobility in a wheelchair, to the extent that they can either push a button or hold their finger in front of a motion sensor, and sip water from a straw.

“Once the device is set up it is very intuitive. It just needs to be set up in a manner where the straw rotates directly to a comfortable location for the user, and the sensor should be placed in a position where the user is able to trigger it.

“Once that criteria is met it should be very easy for the user.”

Rafe Neathery (left) and Thomas Kutcher with the robotic cup. Credit: Brandon Martin/Rice University

Dehydration is dangerous for anyone of any age. But older people are at a greater risk than any other age group.

This is because as people age their bodies don’t demand the same levels of liquid as they did in their younger years. This in turn changes a person’s sense of thirst.

However, the body still needs fluids to function, whether that be helping lubricate joints, regulating body temperature, pumping blood to the muscles, or ensuring the kidneys and urinary tract continue to function properly.

According to the British Nutrition Foundation, dehydration is not only a common cause of hospital admissions in older people but is associated with increased mortality.

For example, a two-fold increase in the mortality of stroke patients has been reported.

Even mild dehydration can be dangerous, affecting tiredness levels and mental performance, potentially leading to low blood pressure, dizziness, weakness, and an increased risk of falls.

In older people, dehydration is often associated with dementia, poorly controlled diabetes, Alzheimer’s disease, and stroke.

Certain medications can also cause dehydration.

The obvious way to prevent a lack of fluids is to drink more. But this can be easier said than done if you have impaired physical or mental abilities that may confine you to a bed or a wheelchair.

There are several hydration aids on the market aimed at older adults and those with cognitive impairments such as dementia and Alzheimer’s, from water sweets to sports-type bottles and wearable devices that can monitor fluid intake.

But Thomas and Rafe believe RoboCup is in a class of its own.

Rafe said: “RoboCup is primarily focused on allowing those with limited mobility to find increased autonomy in their day-to-day lives. The primary alternative to something like RoboCup would be a water bottle with a long adjustable straw that can be positioned near the user’s mouth.

Thomas Kutcher (left), Gary Lynn and Andrea Lynn at the OEDK. Credit: Brandon Martin/Rice University

“However, the issue with these products is that they intrude on the user’s headspace, and they tend to leak water down their shirt. RoboCup gives people autonomy to have hydration when they want it, and to have control over their own personal space.”

Whilst currently designed for use with a wheelchair, Rafe and Thomas say the RoboCup could be adapted for use in other situations, such as a hospital or care home environment, where a patient is confined to bed.

Thomas and Rafe, who are both 21 and in their final year at Rice University studying bioengineering and mechanical engineering respectively, are currently busy with senior design projects in other fields.

But Thomas said: “As far as assistive devices go our focus is still on RoboCup. As there is such a wide range of potential users, we’re still looking for and exploring ideas to make RoboCup more customisable.

“The main ones are investigating different sensors and locations to fit an individual’s personal ability, adjusting the design to accommodate more viscous fluids, or making it simpler for people to adjust the timing of the motion.”

Making the device as accessible as possible has meant simplifying it. During its development, the duo removed some of the more complicated or expensive parts and found alternatives for custom pieces that required special equipment to be made.

Rafe explained: “It was challenging walking that thin line between simplifying the device and sacrificing functionality or robustness. We wanted to keep it working well while still making it simpler and cheaper.

“Balancing all these considerations was really tricky, but we did get to a point where it’s now a lot easier to 3D print and assemble the device using simple, readily accessible tools.”

The pair worked closely with Gary Lynn during the development stage to optimise the design, which went through several iterations. An initial prototype featured a camelback but was scrapped for the current mounted cup-and-straw version.

Both Gary and his mother Andrea Lynn have expressed their hope that the project will bring attention to the struggles of people living with disabilities who can often strain with something as seemingly easy as drinking water.

Gary has said of Thomas and Rafe’s design: “This cup will give independence to people with limited mobility in their arms. Getting to do this little task by themselves will enhance the confidence of the person using the device.”

To help spread the word about RoboCup, Rafe and Thomas entered the device in the World Cerebral Palsy Day Remarkable Designa-thon competition intended to promote “ideas for a new product or service that could change lives” for people in the cerebral palsy community.

Sadly, RoboCup didn’t win. The prize went to a woman with cerebral palsy who developed an idea for an app that knows who she is, and where she is, and contains a list of her contacts for emergencies, allowing those with speech challenges to effectively communicate their needs to anyone.

Rafe said: “I’m glad the money is going to someone with cerebral palsy who has an important need to be met.”

That hasn’t stopped Rafe and Thomas from getting the word out about RoboCup.

But why did they decide to make their invention freely available rather than taking the entrepreneurial route?

Thomas said their goal had always been to bring it to as many people as possible, especially as they had neither the time nor the investment to commercialise it.

“Helping other people make their own is best,” he commented. “We have open-sourced the part files and code online, and everything else is available to buy from other vendors. After everything is printed, all it takes is a screwdriver and less than an hour to assemble Robocup – the instructions are also online with a few dozen pictures.

“The idea behind all of this effort is to enable others to make Robocup themselves, regardless of access to tools or machinery.

“The low cost, small size, and wide capabilities of a desktop 3D printer are bringing it into more and more households, as well as schools, labs, and maker spaces. There are also several online services that can print and ship 3D-printed parts.”

He added: “We hope the manufacturing process doesn’t prove too burdensome, as Rafe and I worked hard to make it as simple as possible. We do believe that the fully idealised version of this device is purchasable off the shelf to make it as easy as possible for the consumer.”

With graduation looming, Thomas and Rafe admit they are keen to move on to future endeavours. Rafe is going to work for SpaceX post-graduation and Thomas is planning to pursue a PhD in Neural Engineering.

That doesn’t mean if the RoboCup takes off, it might not become a commercial enterprise.

Thomas said: “Like I said before, Rafe and I have wanted to get the word out about RoboCup and move on, as we are graduating. We were potentially hoping that another organisation could take the reins on the RoboCup, or our open-source website could become popular.

“We mostly just wanted to get our work out there through open sourcing, but Rafe and I have more things to discuss in terms of making sure the RoboCup is successful, reaching as many people as possible.

“I personally am somewhat interested in turning it into a commercial enterprise if there is a clear path there, but I need to do more research.”


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The online club helping inspire a more joyful retirement



The founder of an online activity club providing inspiration for a happier and more fulfilling retirement has told Agetech World she believes a link-up with the NHS could have “huge benefits” for both older people and the UK’s publicly funded healthcare system.

Hannah Thomson was inspired by her late grandmother to launch The Joy Club in December 2020 to help tackle loneliness in retirement and empower older people to make the most of their later years by leading a more physically active and intellectually stimulating life.

The online platform that offers members the chance to connect with others who share their interests, access activities, and take part in expert-led live-streamed classes and talks, already collaborates with several private partners, including retirement villages, and is looking at the potential of working with two leading financial institutions.

But entrepreneur Ms Thomson has told the latest Agetech World podcast that a tie-in between The Joy Club and the NHS could be mutually beneficial.

Click here to listen to the latest Agetech World podcast

Ms Thomson said: “We would love to work with the NHS. At the moment we have our partnerships with the private sector, so we started off focusing on retirement living, particularly integrated retirement communities, and we work with the likes of Audley Villages, BUPA’s retirement village in Richmond Villages, and Anchor – the largest provider of retirement housing in the UK – so we work with amazing providers who really are at the forefront of delivering a health and wellness package that will support prolonged independence of their homeowners.

“Integrated retirement communities are very much focused on delivering a new model to enable people to age in place in a way that extends life expectancy, but importantly a healthy life expectancy as well, having good healthy later years.

Hannah Thomson, founder CEO of The Joy Club

“So that model works really nicely in the private sector, and we think as well it would work really well for the NHS.

“When we look at the stats, loneliness is an interesting way to frame this because I think I am very mindful of contributing to a positive dialogue around healthy ageing.

“I think sometimes loneliness as an issue amongst people in later life can perpetuate negative stereotypes, so I’m very careful when I’m talking about this.

“But it is true to say, that the research would suggest, that a third of people in later life are lonely and that if you are lonely that costs the NHS an extra £12k per person over the 15 years of later life.

“There are huge mental health issues around loneliness, as well as physical health issues. It is twice as harmful as obesity, it is just as harmful as smoking 15 cigarettes a day, so there are lots of reasons from patient well-being to system pressure, to system finance, why the NHS should support people in later life to remain active and connected and joyful through The Joy Club.

“We are starting to have a few conversations around that, and we would love that to happen. We think there would be huge benefits.”

Ms Thomson added: “But I think for us there are also enormous opportunities for us elsewhere in the private sector, and we are starting off some proof-of-concept work with Lloyds Banking Group, for example, and we are doing some work with Standard Life.

“These are organisations that have access to millions of people and are under less funding pressure than the NHS as well.

“So, we would be very excited about the NHS opportunity but we can also see huge opportunities in the private sector, including retirement villages, pensions, banking, and financial services, that enable us to have impact of scale.

“And that is what we are really thinking about; how we get The Joy Club in the hands of millions of people as quickly as possible to have that positive impact.”

The inspiration for The Joy Club dates back to 2015 when Ms Thomson witnessed the deterioration of her ‘Granny Jean,’ following a dementia diagnosis.

She sadly passed away just before the first UK Covid lockdown in March 2020. Ms Thomson said it was this experience combined with voluntary work she had been doing with Age UK, that made her realise that as a nation we are not doing enough to support people in later life.

She said that all too often we only treat age-related illness once it has taken hold when instead we should be keeping people well for as long as possible.

Ms Thomson spent months speaking to experts and listening to the concerns of older people before coming up with her idea for the online-based The Joy Club.

Currently only operating in the UK, she acknowledged it’s a concept that can be easily rolled out to other countries, with a US platform likely in the near future.

She said: “For us the UK, the home market, is our focus at the moment, and we have lots of exciting plans in place to extend our presence in the integrated retirement community sector and also then move into other sectors like finance and pensions and banking, so that’s our focus in the short term.

“But certainly, in the medium term, we would be looking to take this elsewhere. The US is likely to be our second market, but ultimately it is our ambition to build the largest and most joyful community of retirees globally.”

She added: “We are continuously involved in the cycle of experimentation, testing, iteration, and as I’ve mentioned, audio is something that we have just launched, and that is going tremendously well, so we will be looking to evolve the platform further, very much based on feedback, extend our reach and impact through partnerships, and then there are international expansions, so lots of exciting things in the pipeline.”

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Ageism: kicking one of the last socially acceptable prejudices into touch



A leading expert on ageing has said society needs to stop thinking of older people in terms of “us versus them” and reassess the often negative language used when talking about the over-65s.

Trish D’Antonio, the executive director of the US National Center to Reframe Aging, said one of the most widespread terms employed when talking about late adulthood is “us versus them, like always using the word ‘they’ to talk about older people.”

Pointing out that everyone is a member of an ageing population from the moment they’re born, Ms D’Antonio said when she’s asked how collective misconceptions about older people can best be tackled in the wider community, she explains “the us versus them is really a place where I tell people to start first…if I’m a health care practitioner and I have to write an education piece, or if you’re working on a website, a webpage, write what you have to write, and then go through and see how many times you refer to older people as ‘they’ – when ‘they’ age – and really think about how we can make it about all of us as we age.”

The language used to describe older people is another area Ms D’Antonio said she sees an opportunity for positive change.

“I have to admit that I use this term – not recently – but when we talk about the ‘silver tsunami’, so that fatalistic thinking, that crisis thinking. It’s very negative.

“What would you do if someone was telling you there was a tsunami coming? You’d run. So, really thinking about how we phrase and recognise we are all members of our community is so important and so valuable.

“And it can even be as subtle as when we start talking about statistics about older people…if we frontload any discussion with statistics, people start to say, ‘that’s a little bit too much for me to handle’.

“Really you can start to talk about your solution first, your systemic solution. Maybe the statistics come in the second paragraph.

“The last way that I think would be really good… is when we talk about what we call a super senior, that person who is 80 years old and has just run a marathon, which is fantastic, but what is the context that helps support that person?

Trish D’Antonio, executive director of The National Center to Reframe Aging

“There is transportation, there are sidewalks, so they run every day on a sidewalk. There are other services in the community, other supports in the community, that help that person continue to be able to run the marathon, or jump out of the airplane.

“You can make a significant change by just tweaking a little about what you say and what you write.”

The National Center to Reframe Aging is led by The Gerontological Society of America and is a long-term social change endeavour working to improve the public’s understanding of what growing older means and the many positive ways the over 65’s contribute to society.

Ms D’Antonio shared her thoughts on ageing in a new Vlog chaired by Rear Admiral Paul Reed, director of the US Office of Disease Prevention and Health Promotion, in which they discussed the importance of highlighting older people’s contributions to society and addressing ageism and the collective misconceptions.

She described ageism as “any kind of discrimination towards older people. When we think about definitions of ageisim, it goes a little more deeply to think about not only the external ageism that we may experience but our own internalised ageism. It’s a constant battle and one that really has health implications for us all.”

With the global population ageing – the World Health Organisation predicts there will be 2.1 billion people aged 60-plus by 2050, with the number of over-80s expected to triple to 426 million in the next 27 years – the need to change how society speaks and thinks about older adults, has never been more critical.

Ms D’Antonio told Rear Admiral Reed: “We are bombarded with messages that give us a negative perception or, maybe not always negative, but a singular perception of what it means to grow old.

“We see that from a very young age. We see that on television, we hear that in jokes that people tell, so we really hear that in our culture.”

She continued: “When we talk about ageism…this is any kind of discrimination toward older people. What we do recognise about ageism is that ageism can occur across the life course, so while our project is focused on older people certainly, we hear ageism across the life course.

“People will make comments about someone being too young to be part of something. She’s too young to run that department. She’s 24. As if your chronological age has something to do with it.”

But having a positive internal perception of ageing can be good for our health, Ms D’Antonio said. She shared research conducted by a team at Yale University that had shown that people’s internal positive perceptions of ageing could increase their life span by more than seven-and-a-half years.

Ms D’Antonio commented: “When we think about that internalised ageism, that can impact our health and wellbeing…that doesn’t start at a certain age. That impacts our health and well-being across the life course….it doesn’t start at 60 or 65. It starts when we’re born.”

To listen to the full interview between Ms D’Antonio and Rear Admiral Reed, click here 

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