The Integrated Spinal Rehabilitation Foundation

THE INSPIRE

Spring NEWSLETTER 2014

SIR PAUL & LADY NEWTON - join INSPIRE

Nicola Cecil, The Lady Amherst (LEFT) joins us from Cheriton near Winchester. A keen horsewoman and busy mother of three, she has many charitable interests including Riding For the Disabled. She and her husband William also invite visitors to their lovely garden each summer and this year has generously offered to donate the proceeds to the INSPIRE Foundation. Nicola also won tickets to the Polo at this months Wine Auction!

INSPIRE Website is launched Tuesday 2nd April 2014. Read this Newsletter on line at

www.inspire-foundation.org.uk

As a young mother of four children including twin boys aged three, Gill Matthews broke her back (complete T5) falling from her horse Sunsketch at the Larkhill Point to Point in 1965. After six months rehabilitation at Stoke Mandeville, she went on to represent UK in four Para-lympic Games and in 1988 became the Paralympic World Champion Table Tennis player in Brisbane, Australia. Gill served as a Dorset JP and Magistrate from 1978 – 2006 and was made an MBE in 2004 for her Services to Charity. Having served as a Trustee of the INSPIRE Foundation for eight years, we were all delighted when she generously agreed to become a Patron in 2013. Gill and her husband Franey have always maintained a keen interest in horse racing and on Thursday 30th Janu-ary 2014 their horse Alder Mairi trained by Seamus Mul-lins and r idden by Andrew Thornton won the Handi-cap Hurdle at Wincanton.

Gill Matthews (centre) with Alder Mairi, jockey Andrew Thornton, husband Franey (right) and members of the family after their win at Wincanton.

A WINNER FOR INSPIRE PATRON MRS GILLIAN MATTHEWS MBE

THE LADY AMHERST - PATRON

Our first husband and wife team have joined as Patrons. On retiring as one of the Army’s senior Generals, Sir Paul be-came the Professor of Strategy at Exeter University as well as chairing the International Board at Babcock International (Defence and Security). Meanwhile after considerable experience teaching in various tertiary education centres in UK and abroad Lady Newton, who prefers to be known as Jan, teaches English at Brockenhurst College in the heart of the New Forest in Hampshire.

WINE TASTING

3rd April 2014 RAISES

£2000 Pictures inside.

Volunteers needed at the Races Autumn 2014 Exeter, Cheltenham, Wincanton & Salisbury

INSPIRE is fighting the effects of spinal

cord injury by funding FOUR projects. Details with photographs inside

`MESSAGE FROM THE EXECUTUVE DIRECTOR’

ntrs@inspire-foundation.org.uk This wonderful charity is going from strength to strength. This year we have increased our Projects, Patrons, Money, Events and expanded our Website yet we can and must do more. For while we are growing,

so too are the numbers of Spinal Cord Injured. Their needs do not diminish neither do the costs of research projects to improve quality of life measures to help them. If you can do a little more for the INSPIRE Foundation please let me know. I am not seeking more of your money but would welcome any time you can give to the charity and any new ideas you can share. Please pick up the phone and dial 01722 336262 and ask for INSPIRE or send an e mail. With thanks & best wishes from us all. Rory Steevenson

£95,760 on Current Projects In this edition we have included a snapshot of the four projects which are currently being researched and funded by the INSPIRE Foundation. All projects have been proposed by the National Scientific Committee and approved by the Board of Trustees. For further information visit the Research section in our new website at: www.inspire-foundation.org.uk

Project 1. Development and Testing of an Ergometer for an Experiment in Functional Recovery

Locations: University College London (UCL) and The London SCI Cen-tre, Royal National Orthopaedic Hospital, Stanmore. INSPIRE Grant: £14,095. Date/duration: September 2012/12 months. Final Report: Due. Research Team: Professor Nick Donaldson MA PhD C Eng MIET MIPEM (Principal Investigator), Professor Jane Burridge, Dr Angela Gall & Professor Maria Stokes The hypotheses behind this project are: (i) that coincident electrical stimulation and voluntary effort promote neuroplastic recovery after SCI; and (ii) that FES cycling exercise, done at home, can improve walk-ing in marginal walkers. Engineering design and development has been conducted with the help of a succession of students at UCL. The Mark 1 machine (LEFT) comprises the mechanics, including a mo-tor drive, a box of electronics which switches the stimulator channels as

the cranks rotate, a torque transducer, and the game interface. To it are connected one or two Odstock 4-channel stimulators, a Tacx Ergotrainer (from the cycle shop), and a Picoscope data logger. The computer records the exercise data and runs the virtual reality cycling game. The first tests with patients started in the summer of 2013. It is now apparent that many improvements should be incorporated into the subsequent iCYCLE (Project 4) for which a modified Mark II machine has been designed. Improve-ments include: crankshaft higher to suit more wheelchairs; fewer cable to plug in; remote monitoring by 3G network; an avatar which is more responsive to effort by the SCI user. By: Professor Nick Donaldson

Project 2. Feasibility of Functional Electrical Stimulation (FES)-Rowing in Spinal Cord Injury: can the pattern of loading increase bone density?

Locations: School of Sport and Education, Brunel University, London and University College London Institute of Orthopaedics and Musculoskeletal Science, Stanmore. INSPIRE Grant: £20,590. Date / duration: 8th May 2013 / 12 months. Final Report: June 2014. Research Team: Dr Richard Godfrey (Principal Investigator), Professor Brian Andrews, Dr James Shippen, Dr Ian McCarthy, Dr Angela Gall, Mr Robin Gibbons (Research Associate) The hypotheses are that a 6 month programme of 8-channel FES-rowing training will: (1) increase the muscle-induced forces on the knee and an-kle joints, and (2) that there will be an improvement in the trabecular bone mineral density in the knee and ankle of people with chronic com-plete spinal cord injury.

Pictured Above: Final adjustments are being made to the system that will record the movement and angles of the participant (red shirt) who has a complete C4 spinal cord injury. The participant’s carer (kneeling right) is connecting the cables between two Odstock muscle stimulators and adhesive electrodes attached to the participant’s legs. This system enables the activation of muscle groups which control the movement of the knee and ankle joints. The rowing ergometer foot plates are attached to floor mounted force plates that record foot force and a load cell in the handle records handle force. These external forces are used in a biome-chanical model being evaluated to determine the joint contact forces in the knees and ankles. The forces at the start of the pro-gramme will be compared to the forces on completion of the programme. In addition, each participant has undergone scans of leg bone density prior to starting the 6 month FES-rowing programme which will be compared to a second set of scans at the ned of the programme. This will provide a comparison in knee and ankle joint forces identifying changes in bone density surrounding the same skeletal sites By: Robin Gibbons

Project 3. Development of a functional electrical stimulation (FES) device for the promotion of hand function in incomplete TETRAPLEGIA Location: The School of Design, Engineering and Computing, Bournemouth University. National Clinical FES Centre, Salisbury Dis-trict Hospital. INSPIRE Grant: £22,500 Date/duration: July 2013/36 months Research Team: Professor Ian Swain BSc PhD CEng FIET CSci FIPEM (Principal Investigator), Dr Paul Taylor, Dr Jon Cobb & Ms Lalitha Venugopolan winner of the Ralph Crossley PhD Case Studentship. Lalitha was born in Chennai (Madras), India and read Engineering at Gujarat University. After completing her Masters in Biomedical Engineering in Vellore, she taught Digital Signal Processing at MNM Jain Engineering College, Chennai. She is now studying for her PhD in ‘Upper limb FES in Tetraplegia’. Abstract of Research: Research has demonstrated that FES based training devices can lead to improved hand and arm function following spinal cord injury. However, there is a need to develop an improved device and control techniques to enable routine

use outside the clinical setting. This PhD project will aim to produce a sys-tem that can be easily used by people with a range of ability following tet-raplegia. New stimulation techniques using ‘current steering’ will be used to automatically fine tune the movement produced, removing variations due to electrode position, fatigue and spasticity. While the principal use of the device will be for training hand function, it is envisaged that it may also be used as a long-term orthosis. A feasibility study/clinical trial will be used to demonstrate the device in clinical use. The principal goal is to in-crease the functional independence of people with C5, C6 or C7 incom-plete tetraplegia. The expected outcome: The aim of the project is to produce a practical system that will enable effective training of upper limb function in tetra-plegia. The training device will enable greater upper limb therapy within hospital and continuity of that therapy between post injury rehabilitation and discharge from hospital. While it is expected that the principal use of the device will be as a training orthosis leading to therapeutic gains, it is

also expected that the device will have utility as a practical orthosis, enabling long term enhanced function. It is expected that the device will enable increased independence and hence improved quality of life. By: Ms Lalitha Venugopolan

Project 4. Hospital and home-based feasibility study of an iCYCLE for functional recovery after in-complete spinal cord injury (SCI). Location: University of Southampton, Faculty of Health Sciences. INSPIRE Grant: £38,575. Date/duration: May 2013/36 months. Research Team: Professor Jane Burridge PhD (Principal Investigator), Professor Nick Donaldson, Dr Angela Gall Abstract of Research: Neuroscience research that has identified po-tential for recovery (neuroplasticity) following incomplete SCI has changed clinical practice away from compensation strategies towards optimizing recovery. Important factors are: repetitive exercise, Func-tional Electrical Stimulation (FES) and appropriate feedback. The IN-SPIRE iCYCLE combines repetitive exercise with FES and provides feed-back on performance in a virtual cycle race. Unlike previous devices, performance in the race is determined only by voluntary effort (i.e. not torque generated by FES plus voluntary effort). In this study with in-complete SCI participants, research will be conducted with six inpa-tients to refine the protocol and make technical improvements. We will then conduct an ABA pilot clinical trial (n=20) in which the Internet ena-bled iCYCLE will be used in people’s own homes. A comparison will then be made between standard care (A) with iCYCLE exercise (B). Changes in neural connectivity (TMS evoked EMG potentials), muscle strength and walking will be measured as well as qualita-tive analysis of users’ views. The expected outcome: If the iCYCLE is found to be both feasible to use at home and effective in improving walking, it could be a cost effective rehabilitation device that would enable people with incomplete spinal cord injury to achieve greater inde-pendence. It will also enable people to continue to exercise at home after discharge from hospital rehabilitation and accrue the potential benefits not only of improved functional recovery but also better fitness. The study is also exploring a new intervention that could provide better understanding of recovery, particularly the relationship between neural and functional recovery. This knowledge may also be useful in predicting which individuals are likely to experi-ence recovery and what other factors are important such as level and severity of the lesion and intensity of training. The research will be published in high impact peer reviewed Journals and at scientific conferences, but in addition the Research Team will host a dissemination event to target the SCI community and clinicians working in SCI rehabilitation. With an estab-lished PR track record, the team intends to publicise this outcome of this project through the media – television, newspapers and popular journals thereby highlighting the INSPIRE Foundations research programme. By: PhD Student Ahmad Alahmary

WILTON HORSE TRIALS SATURDAY 26TH JULY 2014

Held in the grounds of Wilton House, 3 miles west of Salisbury, this annual event sees top

-class riders competing in dressage, show jumping and cross country. This year we will

have a discreet stand for the cross-country event on Saturday 26th July after which we

will present the INSPIRE salver to the high-est placed competitor in the Novice Section.

Any keen supporters of cross-country compe-titions may wish to join us as Volunteers or help in our fundraising efforts. Please call

Lorna McGregor 01722 336262 ext 2465

GRAND SHAFTESBURY RUN SATURDAY 18TH MAY 2014 The Grand Shaftesbury Run is taking place on Sunday 18th May and is divided into three courses: a half marathon circuit, a 10km circuit and a children’s 1km fun run. All courses start and finish in glorious parkland at St Giles House, near Wimborne St Giles, Dorset – the historic home of the

Earl and Countess of Shaftesbury. The cours-es take either the serious runner or nature lover through the park to the fields and hills beyond. This event should ap-peal to any individual, family or team of run-ners. Please think seri-ously about competing

for us and email Lorna McGregor at office@inspire-foundation.org.uk for further information. We will provide you with an INSPIRE running bib and sponsorship pack so you can raise some funds for the charity. Thank

you in advance.

DONATIONS THANK YOU! Since the Autumn 2013 Newsletter we have received countless donations, but regrettably there are simply too many to record. In any event many generous souls wish to remain anonymous. Nonetheless, we wish to record our thanks to each and every individual who has given us money which will go towards our vital research into spinal cord injury. We would also like to record our public appreciation for the very generous Trust Funds who make our increasingly expensive operation possible: Pavilion Trust, Robert Luff Foundation The Walter Guinness Charitable Trust, Main Grants Lottery, Buckland Charitable Trust, Rowan Bentall Trust, The Colin David & Family Charitable Trust, The De Brye Charitable Trust, The Joseph Strong Frazer Trust, The Lyn Foundation, The Mis-selbrook Trust, PP Mackintosh Trust, The Violet Richards Charity, AE Cooper-Dean Charitable Trust, The Valentine Charitable Trust, The Misses Barrie Charitable Trust, The Norman Family Trust, The Tay Charitable Trust, The Cardy Beaver Foundation, N Smith Charitable Settlement, The Chapman Charitable Trust, The Hospital Saturday Fund, GM Morrison Char-

itable Trust, Homelands Charitable Trust.

INSPIRE POLO TOURNAMENT SATURDAY 12th JULY 2014

A wonderful family day out at Tedworth Park just off the A303. INSPIRE has its own marquee or there is a picnic option.

All tickets reduced for INSPIRE members. Full details are on the website www.inspire-foundation.org.uk or

telephone 01722 336262 Ext 2465

DIARY MAY - DECEMEBER 2014

Mon 28th April Fundraising Bath Racecourse Thu 8th May Board of Trustees: 5:00 p.m. Sun 18th May Grand Shaftesbury Run Sat 14th June Charity Market Stall, Salisbury Sat 28th June 30th Anniversary Duke of Cornwall

Spinal Treatment Centre Sat 12th July INSPIRE Polo, Tedworth Park Sat 26th July Wilton Horse Trials Wed 1st October Fundraising Salisbury Racecourse Thu 2nd October National Scientific Committee: 11:00a.m. Mon 20th October Christmas Card Sales commence Sat 18th October Fundraising Cheltenham Racecourse Thu 6th November Board of Trustees: 5:00 p.m. Wed 12th November Fundraising Exeter Racecourse Thu 20th November Fundraising Wincanton Racecourse Sat 6th December AGM & Friends of INSPIRE Lunch: 11:00a.m. Don’t miss the AGM . This year it will be bigger than ever with an emphasis of broadening our horizons, increasing our membership and inviting Friends of INSPIRE to our guest speaker’s presentation followed by a lunch party.

As there are only three of us in the Office, we are constantly looking for volunteers at our fundraising events. With more events than ever, we need to swell our numbers and if you are able to help in any of the Diary events (above), please contact Lorna McGregor Tel 01722 336262 Ext 2465. ‘On the job training’ provided & no previous experience required! RIGHT: Volunteers Tony Blanch and Chris Pearce doing business for INSPIRE on our market stall.

Salisbury Market Stall Saturday 14th June 2014

VOLUNTEERS & BRIC A BRAC NEEDED Please call Lorna McGregor 01722 336262 Ext 2465

Fancy a Day at the Races? Exeter, Cheltenham, Wincanton & Salisbury

After the success of our rosette appeal last year we have secured fundrais-ing days at four top race courses in the autumn. Dates and venues are: 1st October Salisbury; 18th October Cheltenham, 12th November Exeter and 20th November Wincanton. Our best ambassadors and fundraisers seem to be SCI members and if you would like to help we would love to see you.. All venues are wheelchair friendly. These are potentially very lucrative days for INSPIRE with several thousand people attending. If you can give us a little of your time, you could help raise much needed funds for our next round of scientific projects. Please let us know if you can help.

DEATHS

It is with regret that we have been informed of the deaths of the following Members since the last edition of the

Newsletter:

Mrs Doris Albert, Mrs Gillian Gray, Mrs E. Dommett Mr Timothy Barbone, Mr PD Alderman, Mrs Megan Day

Trustees on the Move. It is with great sadness that we have said farewell to Luke March. For nine years he was Chairman of the Salisbury NHS Trust, and a valued

INSPIRE Trustee. His contribution to the Charity was immense and we are sorry to see him go although he is not far away and we were delight-ed to see him back at the Wine Tasting. In his place we welcome Mr Surendra Bandi, MS Or-thopaedics, MRCS, FEBPRM who on hearing of Luke’s departure volunteered to join us. Suren-dra is a consultant in Spi-nal Injuries at the Duke of Cornwall Spinal Treat-

ment Centre. He completed Orthopaedic and Re-habilitation Medicine training in India and various hospitals in UK including Glasgow. Surendra has been in Salisbury for two years and we are delight-ed to welcome a subject matter expert on the front line of treatment and rehabilitation of spinal cord injury.

£2000 raised at The Friends of INSPIRE Wine Tasting & Charity Auction The Spring wine tasting took place on Thursday 3rd April 2014 at the Guildhall in Salisbury. This was a wonderful gathering of Patrons, Trustees, Scientists, Members and many friends who gathered to taste twenty eight wines offered by Charles Steevenson Wines and delicious canapés provided by Joff Bird of the Bird & Carter Delicatessen & Farm Shop. Anne Luttman-Johnson spoke very movingly about her life changes through spinal cord injury and Auctioneer Mike Vesey encouraged generous bidding for the various lots. Patrons Sir Paul Newton and The Lady Amherst then drew the winning tickets for the Surprise Draw.

Our grateful thanks to our main sponsors:

Charles Steevenson Wines Ltd, The Lady Amherst, Quilter Cheviot, Sir Paul & Lady Newton, Clive Pryke Esq

Irwin Mitchell Solicitors, Mr Mark Quinn, Mr & Mrs Richard Firth, Salisbury Racecourse, The Bird and Carter Delicatessen Fletchers & Partners Chartered Accountants, Mr & Mrs Christopher Cann, Newbury Racecourse, Colonel & Mrs Bill Clayden

HW White Estate Agents, Dr & Mrs Paul Taylor, Exeter Racecourse, Mr Werner Stroud, Mr & Mrs Peter Whent

DON’T MISS OUR NEXT WINE TASTING & AUCTION, THURSDAY 19TH MARCH 2015, SALISBURY GUILDHALL