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Trauma recovery: new science and technology for mental and physical health

Event

March
042020

09:00 - 17:30

Location

The Royal Society, London, 6-9 Carlton House Terrace, London, SW1Y 5AG

Overview

Credit: Invictus Games Foundation

Read the conference report (PDF).

This Transforming our Future meeting, held by the Royal Society in partnership with the Invictus Games Foundation, will bring together leading experts from industry, academia, government and the wider scientific community to discuss recent advances in technologies and treatments that have the real possibility of helping individuals recover from injury across the health spectrum.

The conference will focus upon two broad themes: Our increased understanding of the biology of human health after injury, and especially the impact of trauma on both mental and physical health and the application of innovative new technologies and treatments to help individuals adapt to life-changing injuries. Following the presentations, speakers will discuss what can be achieved in the short- and medium-term, and how such developments should be prioritised and driven forward based upon the experiences of those who have suffered injury. 

Attending this event 

  • This event was held on 4 March 2020

Please direct any questions to the Industry team

About the conference series

This scientific meeting is part of the Royal Society’s Transforming our Future conference series. The Transforming our Future meetings are unique, high-level events that address the scientific and technical challenges of the next decade. Each conference features cutting edge science from industry and academia and brings together leading experts from the scientific community, including regulatory, charity and funding bodies.

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Event organisers

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Schedule of talks

04 March

09:00-09:30

Registration

09:30-09:30

Welcoming remarks

1 talk Show detail Hide detail

Chairs

Dame Sue Ion FREng FRS, Chair of the Royal Society Science, Industry and Translation Committee

Dame Sue Ion FREng FRS, Chair of the Royal Society Science, Industry and Translation Committee

Show speakers

09:35-10:30

Trauma recovery: Group studies and personal perspectives

2 talks Show detail Hide detail

The ADVANCE Study: Study rational and preliminary cardiovascular results

Dr Christopher Boos, Poole Hospital NHS Foundation Trust

Abstract

Historical and retrospective data have suggested an association between combat-related traumatic injury and an increased risk of cardiovascular disease. 

The ArmeD SerVices TrAuma RehabilitatioN OutComE Study is the first prospective study to investigate the long-term physical and psycho-social outcomes of battlefield casualties related to recent armed conflict. 

In this study 600 adult male UK Military Servicemen who have sustained significant combat-related injury following deployment to Afghanistan between 2002 and 2014 will be compared to 600 non exposed adults frequency-matched for deployment to Afghanistan, age, sex, service, rank and role. 

Professor Boos will be presenting a brief overview of ADVANCE and the preliminary cardiovascular results from the first 845 consecutive participants. 

Show speakers

The principles of (recovering from) war

David Henson MBE, Imperial College London

Abstract

Recovering from the realities of traumatic injury is a long, complicated and often painful process. However, this process can, and should, be optimised. Using the context of the principles of war, this talk provides a personal perspective of the impact of traumatic injury of all aspects of health; the process for optimising the recovery pathway; and the role of new technology and treatments within this process.

Show speakers

10:30-11:00

Coffee and networking

11:00-13:00

Innovations supporting physical and mental health

5 talks Show detail Hide detail

Chairs

Professor Russell Foster CBE FRS, University of Oxford

How to sleep well – understanding the causes and cures for a bad night after trauma

Dr Kirstie Anderson, Newcastle-upon-Tyne Hospitals NHS Foundation Trust

Abstract

Better nights for better days? Normal quantity and timing of sleep is vital for normal brain function. If sleep is interrupted for any reason it affects mood, memory and metabolism. Therefore improving sleep after a physical or mental health problem should be thought of as a key tool for recovery. The talk will cover the different causes of sleep disturbance after trauma and the evidence for effective therapies. Our research and sleep clinic work focuses upon the impact of sleep upon mental health and the benefits and sometimes side effects of the therapies and in particular medications used during and after major trauma. Education of health professionals, patient and families about sleep and sleep disorders is needed for health after injury.

Show speakers

Innovations in The Treatment of Post-traumatic Stress Disorder

Professor Barbara Rothbaum, Emory Healthcare Veterans Program

Abstract

The pharmacotherapy and psychotherapy literatures for post-traumatic stress disorder (PTSD) will be succinctly reviewed and discussed, focusing on cognitive behavioral treatments (CBT) and specifically exposure therapies. Innovations in the treatment of PTSD will be broadly divided into 1) Medium of Delivery of Exposure Therapy; 2) Enhancing Exposure Therapy with Pharmacological Agents; 3) Timing of Exposure Therapy, and 4) Treatment Delivery Schedules. The medium of delivery of exposure therapy will focus on Virtual Reality Exposure Therapy (VRE). Some of the pharmacological enhancing agents will include cognitive enhancers such as D-Cycloserine and psychedelics such as 3,4-methylenedioxymethamphetamine (MDMA). The timing of exposure therapy will discuss early interventions administered within hours of trauma exposure. Finally, massed prolonged exposure (PE) treatment delivery will be presented using the example of the Emory Healthcare Veterans Program intensive outpatient treatment model and pilot data will be presented.

Show speakers

Improving lives for people following traumatic brain injury

Professor Melinda Fitzgerald, Curtin University and the Perron Institute for Neurological and Translational Science

Abstract

Traumatic brain injury (TBI) arises as a result of a physical injury to the brain and dramatically impacts the lives of both the patient involved and the people around them. There is a desperate need for new options to improve lives following TBI and give patients and their families hope for the future. TBI arises from a range of circumstances, such as concussion from playing sport, an elderly person having a fall or severe injury arising following a road accident. The resulting injuries vary in severity, ranging from mild to moderate or severe trauma to the brain. Symptoms also span a spectrum of severity, such as deficits in cognition through to vegetative states, varying degrees of lack of emotional control, poor mental health, disrupted balance and sleep disturbances. These can lead to dramatic, often long-lasting, impacts on patients and their families and a substantial financial drain on society.

The Australian Mission for TBI is a large scale federally funded initiative in Australia, providing 10 million AUD over 10 years. The Expert Advisory Panel for the Mission will define priorities for research funding that will improve outcomes for people following TBI of all severity, from concussion through to severe injuries. It is likely that the approach will include a large scale research registry that will enable the prediction of outcomes following injury. In addition, nationwide clinical trials of promising treatments will be conducted. The research of the Australian Mission for TBI has the potential to be transformative and lead to substantially improved outcomes for people who have experienced a TBI.

Show speakers

Using Virtual Reality (VR) to deliver engaging, efficacious, and fast psychological intervention

Professor Daniel Freeman, University of Oxford, UK

Abstract

Mental health disorders are very common, but far too few people receive the best treatments. Much greater access to the best psychological treatments may be achieved using automated delivery in virtual reality (VR). With virtual reality simulations, individuals can repeatedly experience problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties. A key advantage of VR is that individuals know that a computer environment is not real but their minds and bodies behave as if it is real; hence, people will much more easily face difficult situations in VR than in real life and be able to try out new therapeutic strategies. VR treatments can also be made much more engaging and appealing for patients than traditional therapies. A systematic programme of work developing and testing automated VR psychological treatments will be described, with a particular focus on the gameChange (www.gameChangeVR.com) project for schizophrenia.

Show speakers

Knowledge for the benefit of Blind Veterans and wider humanity

Major General (Rtd) Nick Caplin CB, Blind Veterans UK

Abstract

Losing your sight is devastating. It is both physically and mentally challenging and leads to a plethora of difficulties at different stages of life. What do we know about our Blind Veterans? We research factors to enable beneficiaries to maintain and improve the quality of their health and well-being, and their level of social inclusion and satisfaction with life. We accelerate innovation by stimulating the rapid development of technologies such as autonomous vehicles for disabled individuals.

Our detailed research of Blind Veterans’ state of health allows for a personalised approach, whilst gathering valuable longitudinal data. With an international approach to all that we study, our research cohort includes both UK Blind Veterans and the Blinded Veterans of America. Can we predict sight loss? Can we prevent avoidable sight loss? Whilst focussed on blind veterans, our research has relevance and applicability beyond this population, with implications for both wider veteran and visually impaired communities throughout the world.

Show speakers

13:00-14:00

Lunch and networking

14:00-16:00

New technology to advance the recovery of physical health

5 talks Show detail Hide detail

Chairs

Professor Jackie Hunter CBE, BenevolentAI

RoboTrainer: Making effective rehab training available to everyone

Dr Anders Sørensen, University of Southern Denmark

Abstract

A large amount of trauma victims suffer neurological damage to motor function, that severely inhibit rehabilitative training. Overcome by gravity, they are locked in a viscous circle, risking atrophy, circulatory disease and other physical complications, while depression may further undermine their quality of life. Underwater training, exoskeletons and advanced training machines may break the circle, but their high operational cost is in stark contrast to the high amounts of training needed to make a difference. In the RoboTrainer projects, we explore the design and impact of training robots optimized for simplicity and low cost. Our initial studies show that such devices can easily be operated by physical therapists in simple clinics, and potentially also by patients and their helpers at home. Case tests on the long term robot training made feasible by RoboTrainer show promising results in terms of strength and functional improvement in chronic (abandoned) patients with neurological damage.

Show speakers

The future of human wearable bionics from industry's point of view

Dr Andreas Goppelt, Ottobock

Abstract

In its 100 years history, Ottobock has been a leader in human mobility: The introduction of C-leg®, the world's first microprocessor controlled knee (MPK), in 1997 has set a new standard for safety of people with transfemoral knee disarticulation and hip disarticulation amputations. Advances in the fields of bionic reconstructive surgery and the use of artificial intelligence in controls allow patients to intuitively move their artificial limbs, and to lead a more active and independent lifestyle. 

Clinical evidence provided by us and others has demonstrated that patients with lower mobility grades benefit most from MPKs as evidenced by gains of the health utility score EQ5D. 

The translation of these advances in prosthetics into orthotics led to the first knee-ankle foot orthosis (KAFO) with stance and swing phase control: The C-Brace® helps patients suffering from neurological indications such as incomplete spinal cord injury, poliomyelitis and post-polio syndrome to regain a natural gait.

Exoskeletons like the personal assistive device Paexo® help prevent work related disorders of the musculoskeletal system.

As the field of wearable human bionics is rapidly evolving, new opportunities emerge to overcome previously unsolved challenges. This includes the optimization of human comfort, and man-machine interfaces for improved control and somatosensory perception to foster embodiment - make users feel that the device becomes part of them.

 

Show speakers

Driving neural recovery following Spinal Cord Injury

Professor Jane Burridge, University of Southampton

Abstract

Recent research both with animals and people with SCI has shown the potential for neural recovery. Some studies have used implanted systems, but we have recently designed and tested an inexpensive non-implanted novel cycling ergometer with a small number of patients. The ‘iCycle’ uses Functional Electrical Stimulation (FES). Electrical stimulation activates the leg muscles during each revolution of the pedals. The position of the crankshaft enables the stimulation to be timed accurately. The amount of effort the person exerts is monitored and used as feedback in a virtual cycle race. We propose that greater neuroplasticity will be achieved by synchronising stimulation with voluntary drive and that the motivation provided by the race will encourage the cyclist to work harder.

In this talk I will explain the neuroscience that underpins the concept, describe the device, how we developed it and report on the effect it had on a small number of people who trained on it for four weeks. 

Show speakers

Making direct neural interface therapies a clinical reality

Dr Oliver Armitage, BIOS

Abstract

Direct neural interfaces for limb control have been used in a variety of research and pilot studies for multiple decades now and clinical practice makes regular use of neuromodulation for pain or other conditions. However, continuous bi-directional connections to the nervous system for treating physical health have so far remained clinically elusive. This is in large part due to the technology required for real-time decoding and encoding being unpractical to put in implantable medical devices. Yet this technology is essential for realising the promise shown by direct neural recording and stimulation for prosthetic control, SCI, neurotrauma or a host of other therapies. BIOS is pioneering AI technologies for long-term direct neural interfaces for lifelong health by continuous decoding and encoding of neural information on small-scale devices for bringing to clinical practice the promise shown over decades of research.

Show speakers

Amputee Biomechanics: it is not just about getting active

Professor Anthony Bull, Centre for Blast Injury Studies, Imperial College London

Abstract

The ability of young, fit, healthy traumatic amputees to achieve very high levels of performance through their own determination, excellent rehabilitation and advanced prosthetics is one of the features of modern life. Expectations have risen that all should be able to achieve these levels of activity and maintain them through to old age, and yet this seems to be out of reach for so many. Biomechanics is the study of the interaction between forces, motion and deformation and is the underlying science that can shed light on the reasons why such high levels of performance are unsustainable for most, unattainable for many, and detrimental for others. Understanding amputee biomechanics can aid in devising novel rehabilitation, surgery and prosthetics. 

Show speakers

16:00-16:30

Coffee and refreshments

16:30-17:30

Panel discussion: Where should scientists focus efforts?

1 talk Show detail Hide detail

Chairs

Sir Simon Wessely FMedSci, King's College London

Air Commodore Rich Withnall QHS, UK Defence Medical Services
Wing Commander Marcus Stow, JHubMed
Professor Barbara Rothbaum, Emory Healthcare Veterans Program
Professor Jane Burridge, University of Southampton
Alexandra Crick, Consultant Plastic and Reconstructive Surgeon, Salisbury NHS Foundation Trust

Show speakers

17:30-17:35

Closing remarks and conference close

Related events

Trauma recovery: new science and technology for mental and physical health

Bringing together scientists from industry and academia and the wider scientific, medical and policy community to discuss science employed to help patients recover from traumatic events. Speakers will explore technologies and treatments for those who have suffered from physical and mental trauma.

The Royal Society, London 6-9 Carlton House Terrace London SW1Y 5AG UK
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