• A community-based, bionic leg rehabilitation program for patients with chronic stroke: clinical trial protocol

      Wright, Amy; Stone, Keeron; Lambrick, Danielle; Fryer, Simon; Stoner, Lee; Tasker, Edward; Jobson, Simon; Smith, Grace; Batten, John; Batey, Jo; et al. (Elsevier, 2017-10-30)
      Stroke is a major global health problem whereby many survivors have unmet needs concerning mobility during recovery. As such, the use of robotic assisted devices (i.e., a bionic leg) within a community-setting may be an important adjunct to normal physiotherapy in chronic stroke survivors. This study will be a dual-centre, randomized, parallel group clinical trial to investigate the impact of a community based, training program using a bionic leg on biomechanical, cardiovascular and functional outcomes in stroke survivors. Following a baseline assessment which will assess gait, postural sway, vascular health (blood pressure, arterial stiffness) and functional outcomes (6-minute walk), participants will be randomized to a 10-week program group, incorporating either: i) physiotherapy plus community-based bionic leg training program, ii) physiotherapy only, or iii) usual care control. The training program will involve participants engaging in a minimum of 1 hour per day of bionic leg activities at home. Follow up assessment, identical to baseline, will occur after 10-weeks, 3 and 12 months post intervention. Given the practical implications of the study, the clinical significance of using the bionic leg will be assessed for each outcome variable. The potential improvements in gait, balance, vascular health and functional status may have a meaningful impact on patients’ quality of life. The integration of robotic devices within home-based rehabilitation programs may prove to be a cost effective, practical and beneficial resource for stroke survivors.
    • When transport policy becomes health policy: A documentary analysis of active travel policy in England

      Bloyce, Daniel; White, Christopher; University of Chester (Elsevier, 2018-09-17)
      There has been a succession of policy documents related to active travel published by the British government since the implementation of a National Cycle Network (NCN) in 1995. However, as the latest National Travel Survey (NTS) reveals, the number of journeys made by bike in the UK has remained steadfastly around only 2% (Department for Transport [DfT], 2018a). By using documentary analysis of the available official policy documents and statements, the aim of this paper is to make sense of the policies that have been published concerning active travel (AT) in England. This is done from a figurational sociological perspective. Three key themes emerge from the analysis: (1) the rhetorical, advisory level of the vast majority of the policies; (2) the reliance on a wide network of local authorities to implement AT policy; and (3) the focus placed on individuals to change their behaviour. Furthermore, the analysis reveals that despite a large number of policy publications from a range of government departments claiming to promote AT, little has actually changed in this time period in terms of a national agenda. Despite the successive policies, it seems there is little appetite on behalf of recent governments to make widespread infrastructural changes, where instead the focus has largely been on persuading the individual to seek more active modes of travel, increasingly for their own, individual ‘health’ gains.