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I am a bioengineer, with a special interest in neurological rehabilitation and applied clinical research. I completed my doctoral training at the Bioengineering Unit (University of Strathclyde, Glasgow). I have also gained five years of relevant postdoctoral experience Centre for Rehabilitation and Engineering Studies-CREST (with Profs G Johnson and M Barnes) where I established the neurological research exploring the phenomenon of spasticity. I have also been supervising at the MPhil/MD and PhD level since 1998.
I came to Keele in March 20002 and was promoted to Senior Lecturer in 2007. On becoming Professor I gave an inaugural lecture on Tuesday 25 October 2011, available online at: "Defining spasticity - the (slow) walk from being a lumper to a splitter".
Improvement in acute medical care, paradoxically, has increased the prevalence of disability in the community, specifically in people neurological and neuromuscular disorders. Changes in population demographics, i.e. increase in life expectancy, exacerbate this problem. The cost of managing disability resulting from these disorders places a substantial financial burden on the state (and individuals) and is set to rise. Furthermore, there is evidence that, in spite of the current levels of investment, patients are currently dissatisfied with their level of care and support. Therefore, a significant focus of my research is to develop optimal rehabilitation programmes (for people with a range of disabilities and activity limitations) and exercise programmes to maintain health. Any process of optimisations also requires an understanding of the normal human performance and pathophysiological process that lead to disabilities, therefore, a substantial proportion of my research effort in targeted at measuring impairments and then modelling the relationship between impairments and functional capability.
Selected Publications
Full Publications List show
Journal Articles
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2013. New guidelines on rehabilitation likely to restrict practices and stifle innovation. BMJ, vol. 347, f4876. link>
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2012. The physiological impact of upper limb position in prone restraint. Medicine Science and the Law, 1-5. doi>
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2012. A review of the scientific literature related to the adverse impact of physical restraint: gaining a clearer understanding of the physiological factors involved in cases of restraint-related death. Medicine Science and the Law, 137-142. doi>
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2012. Proximal interphalangeal joint replacement in patients with arthritis of the hand: a meta-analysis. Journal of Bone and Joint Surgery: British Volume, vol. 94(10), 1305-1312. doi>
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2005. Theoretical and methodological considerations in the measurement of Spasticity. Disability and Rehabilitation, vol. 1/2, 69-80.
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2004. Can treatment with electrical stimulation, to the wrist, be justified in the severely disabled acute stroke patient?. Journal of Disability and Rehabilitation, vol. 2, 156-161.
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2003. A biomechanical investigation into the validity of the modified Ashworth scale as a measure of elbow spasticity. Clinical Rehabilitation, vol. 17(3), 290-294. doi>
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2003. Contractues in the post stroke wrist: A pilot study of its time course of development and its association with upper limb recovery. Clinical Rehabilitation, vol. 17(1), 88-95. doi>
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2002. Are we Underestimating the Clinical Efficacy of Botulinum toxin (Type A)? Quantifying Changes in Spasticity, Strength, and Upper Limb Function after injection of Botox to the elbow flexors in a unilateral stroke population. Clinical Rehabilitation. doi>
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1999. Electrical stimulation of wrist extensors in poststroke hemiplegia. Stroke, vol. 30(7), 1384-1389. link>
Chapters
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2008. Measures of Spasticity. In Upper motor neurone syndrome and spasticity. Barnes MP and Johnson GR (Eds.). (2nd ed.). Cambridge: Cambridge University Press.
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2002. Instrumentation for experiments. In Research Methods for Post Graduates. Greenfield T (Ed.). (2nd ed.). London: Arnold.
Other
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2012. Assistive technologies for the arm after stroke; does lack of evidence mean lack of potential benefit?. INTERNATIONAL JOURNAL OF STROKE (vol. 7, p. 78). link>
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2004. A randomised controlled trial to evaluate surface neuromuscular electrical stimulation to the shoulder following acute stroke. 9th Annual Conference of the International Functional Electrical Stimulation Society (IFESS).
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2004. An Objective measurement of post stroke spasticity. Cerebrovascular Disease 17(ss).
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2004. Can neuro-muscular electrical stimulation of the wrist extensors facilitate the recovery of arm function in the severly disable acute stroke patient?. Spring Meeting of the British Geriatric Society,.
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2004. can treatment with upper limb electrical (foreamr extensors) stimulation can be justified in the severely disabled acute stroke patient?. 9th Annual Conference of the International Functional Electrical Stimulation Society (IFESS).
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2004. Does surface neuromuscular electrical stimulation (SNMES) to the upper limb following acute stroke improve outcome. Age & Ageing (vol. 32, p. 44).
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2003. A biomechanical review of modified ashworth scale for measuring spasticity. British Stroke Research Group.
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2003. Biomechanical Characterization of the stretch Reflex Activity as an approach to Spasticity Measurement and Modeling - A pilot Study. 25th International Conference of the IEEE Engineering in Medicine and Biology Society.
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2003. Does resistance to passive movement, measured using a single velocity, represent spasticity in post stroke hemiplegia?. Journal of the International Society of Physical and Rehabilitation Medicine (vol. Supplement (May), p. 121).
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2003. Does resistance to passive movement, measured using a single velocity, represent spasticity in post stroke hemiplegia?. Journal of the International Society of Physical and Rehabilitation Medicine.
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2003. Does spasticity Result from Hyperactive Strech reflexes? Preliminary findings from a reflex characterisation study. Journal of the international Society of Physical Rehabilitation Medicine.
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2003. Does surface neuromuscular electrical Stimulation (sNMES) to the upper limb following acute stroke improve?. British Association of Stroke Physicians.
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2003. Effects of Initial Muscle Length in stretch Reflex Excitability in People with Post-stroke Spasticty and Healthy Volenteers. 27th Annual meeting of the American Society of Biomechanics.
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2003. Is Clinical measurement of Spasticity following stroke using a modified Ashworth scale Valid?. British Association of Stroke Physicians.
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2003. Is Clinical measurement of spasticity following stroke using the Modified Ashworth Scale Valid?. Journal of the International Society of Physical and Rehabilitation medicine.
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2003. validity of the Modified Ashworth Scale in the measurement of Spasticity. Autum Meeting of the British Geriatric Society.
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2003. Variations in the stretch reflex excitability due to Applied Torque Perturbations in post-stroke and Non-Impaired Volenteers. World Congress of medical Physics & Biomechanical Engineering (Triennial Congress of the IUPESM/IFMBE/IOMP).
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2002. A Biomechanical examination of the modified Ashworth scale. In proceeding of the British Association of stroke physicians.
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2002. A pilot study investigating the effects of electrical stimulation on the wrist extensors on upper limb impairment and function in an accute stroke population. 13th European Congress of Physical and Rehabilitation Medicine. Brighton UK.
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2002. A reterospective study of upper limb problems and their associated interventions following neurological events. In Proceedings of the 3rd World Congress in Neurological Rehabilitation Venice Italy.
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2002. A Simple Biomechanically based technique to maesure spasticity in routine clinical practice - Results from preliminary clinical trial. In Proceedings of the 3rd World Congress in Neurological Rehabilitation Venice.
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2002. Ashworth Score Zero: Normative data estimates for resistance to passive elbow extension obtained from a female impaired adult sample. 13th European Congress of Physical and rehabilitation Medicine, Brighton UK.
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2002. Biomechanical Characterisation of reflex activity at the elbow - A first step to quantifying spasticity. In proceedings of the 3rd world progress in Neurlogical Rehabilitation Venice Italy.
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2002. Biomechanical Characterisation of reflex activity at the elbow - Afirst step to quantifying spasticity. In proceedings of the 3rd World Congress in Neurological Rehabilitation, Venice, Italy.
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2002. can changes in resistance to passive movement be reliably graded by the modified Ashworth Scale?. In proceedings of the 3rd World Congress in Neurological Rehabilitation, Venice.
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2002. Contractures in the post stroke Wrist : A Pilot Study of its time course of development and its association with upper limb recovery. In proceedings of the 3rd World Congress in Neurlogical Rehabilitaion, Venice, Italy.
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2002. How Valid is the clinical assessment of spasticity after stroke?. In proceedings of the British Association of Stroke Physicians.
Currently I teach on a variety of courses (UG & PG) at the School of Health and Rehabilitation. I enjoy the interactions that I have with students at both the Graduate and Undergraduate level. The areas of teaching that overlap with my research activities are research methods, measurement in neurological rehabilitation (specifically non-invasive measurement of impairment and activity, and developing methods aimed at elucidating pathophysiology of common impairments), modelling the relationship between impairment, activity and quality of life, motor control, and therapeutic applications of electrical stimulation.

