A functional electrical stimulation (FES) technique has been shown to improve walking for people with conditions affecting the nervous system.

Functional electrical stimulation can benefit patients such as those with multiple sclerosis (MS), drop foot, spinal cord injury and patients recovering from stroke.Now, a new trial seeks to discover how effective FES can be for Parkinson’s disease.

FES technique for safer walking

The technique has been advanced by Odstock Medical Limited (OML), a company set up by Salisbury NHS Foundation Trust to develop FES devices and clinical services.

Head of Research at the National Clinical FES Centre at Salisbury District Hospital, Paul Taylor, explains that skin electrodes stimulate weakened muscles due to neurological conditions, aiding walking. A pressure pad in the shoe regulates the system’s activation timing.

A typical example is helping those with difficulty walking due to drop foot, which is the inability to lift the foot as they swing forward. “FES stimulates muscles, lifting the foot at the right time and making walking easier and safer,” he says. “People are less likely to trip and fall; there is less energy expenditure; and they can walk faster and further.”

Up to 80% of users say it increases their confidence in walking while OML’s studies show a 72% reduction in falls for people with MS. “This can have a real impact on quality of life,” says Taylor.

Further FES information

The device is accepted by the National Institute for Health and Care Excellence (NICE) for NHS use, and guidance has been updated for upper limb therapies. Meanwhile, the STEPS II trial is currently recruiting 234 participants to a seven-centre UK study to discover how FES can help with Parkinson’s.

OML has FES information packs available. Patient groups, such as the MS Society or the Stroke Association, also offer FES information. MS Society and Different Strokes have campaigned for better funding of FES in the NHS. Taylor adds: “The device is discreet, and the overwhelming majority of people get used to it fairly quickly and use it because it makes a difference to them.”

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Power is the key to maintaining independence and good quality of life. A proactive approach with a tailored plan and tools to empower you on the journey is critical.

The ‘KEES’ toolkit was developed to simplify the key areas and information on the journey to empowerment and self-management of Parkinson’s disease (PD).

Knowledge: what is PD?

Parkinson’s disease is a progressive neurological disorder. The second most common neurodegenerative disease after Alzheimer’s disease. Parkinson’s affects an estimated 15,000 people in Ireland. It is the loss of a neurochemical called dopamine. As we age, we lose dopamine; but for those with Parkinson’s, it is lost at a faster rate.

It is primarily a movement disorder. However, there are 40 potential motor and non-motor symptoms associated with it. It affects slightly more men than women, with most people diagnosed after the age of 60 and one in ten under 50.

As stated by Bas Bloem: “Seven million people, seven million variants of Parkinson’s. In everyone, the disease manifests itself differently.”¹

Education: optimise symptom control

There is currently no cure for Parkinson’s, but medication can provide symptom control.

With medication, it’s important to ask: What is the medication? What is it expected to help? How long before you see improvement? What’s the best way to take it? Also, keep a diary.

Three crucial aspects to optimise medication are (1) consistent timing, (2) avoiding constipation and (3) hydration.

Medication alongside relaxation and distraction techniques are key to symptom management. What works for one person may not work for the next, hence a personalised approach and plan.

There is currently no cure for Parkinson’s, but medication can provide symptom control.

Exercise: prescribe exercise for all

Exercise is essential in the management of motor and non-motor symptoms. The physical benefits of exercise include addressing balance, gait, rigidity/stiffness and strength.

Psychological benefits include building confidence and improving serotonin production, sleep, mood and wellbeing.

Varied exercises adapted to your level of suitability will help. Don’t forget to enjoy it, so you’re more likely to continue rather than avoid it. Some exercises found to be beneficial include Tai Chi, dance, yoga and aqua therapy.

Support: recognise and reach out

Ready to recognise the need for support? Reach out and get involved! It can be daunting but is an essential component of the toolkit. This network can come from peer support and the wider circle of health professionals. Parkinson’s Association of Ireland provides a nationwide branch network, in-person and zoom classes and opportunities to participate in ongoing research.

[1] Bastiaan R. Bloem, Michael S. Okun, Christine Klein. Parkinson’s disease.The Lancet. DOI: 10.1016/S0140-6736(21)00218-X

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Promoting brain health over the life course offers hope for better cognitive ageing and reduced dementia risk.

The rising prevalence of dementia and its devastating impact can lead to some nihilism, but new disease-modifying Alzheimer’s treatments and discoveries offer hope. Up to 40% of dementia could be prevented through better brain health.

Improving brain health

The ‘brain health’ agenda has emerged in response to global population ageing coupled with support from advances in neuroscience. Brain health has various definitions, based on cognition, function or (absence of) brain pathology. These often correlate, but not always.

Brain health is affected by lifestyle at all ages, meaning that a dynamic ‘life course’ approach to it is needed. It is never too early to start improving brain health, but benefits accrue from starting at any age.

Dementia is the UK’s biggest killer, and one in three people born today will get it. It’s no surprise there is huge interest in what might help to reduce one’s risk.

Healthy heart, healthy head

The brain is 2% of our body weight but uses 20% of all our energy. Brain health thus tracks cardiovascular health closely. Promoting both means regular physical activity, a healthy balanced diet, not smoking and avoiding excessive alcohol.

Recent research shows the importance of sleep (seven to eight hours a night recommended) and probably hearing loss (common and correctable) in dementia risk. Traumatic brain injury is another emerging risk factor.

It’s no surprise there is huge interest in
what might help to reduce one’s risk.

Brain plasticity

A second route to a healthier brain relies on its innate ability to adapt at multiple scales over time. Such neuroplasticity is greatest in childhood but is retained throughout life.

Regular mental and social activity is thought to rely on neuroplasticity to strengthen neural pathways and build up ‘cognitive reserve.’ A more resilient brain can tolerate more pathology before symptoms of dementia break through.

Exercising the brain

Activities that build up cognitive reserve can be linked to a delay in dementia of several years. They include learning a musical instrument or new language, volunteering and playing puzzles. Any regular activity that requires attention and challenges the brain will likely bring benefits.

Challenging different aspects of brain function is thought to be optimal for building a broad-based cognitive reserve. My book ‘Mind Games’ includes puzzles designed to exercise a range of cognitive domains: memory and skills using pictures, words, numbers and logic.

Better brain health and reduced dementia risk require change, as individuals and as a society; the rewards could be huge.

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Dr Sonya Miller

Head of Medical Affairs, TauRx

Despite being the UK’s leading cause of death, according to a recent dementia conference, accessing a dementia diagnosis and treatment is a frustrating challenge for patients and families alike.

“There is perhaps a slight misconception that people with dementia are well informed, well supported and well connected,” says Dr Sonya Miller, Head of Medical Affairs, TauRx. “There are certainly amazing organisations within the UK, who give people lots of support and information. But getting initial guidance from healthcare professionals to then signpost to those societies and associations is sometimes difficult”.

However, it is an issue that the government and the medical profession are currently prioritising. “The Scottish Government’s campaign is called ‘everyone’s story’ and highlights that almost everyone knows someone who is affected.” says Dr Miller, “It’s something that most people fear or think ‘will this happen to me when I’m older at some point?’ However, the disease often has a different trajectory for each person.”

Accessing the pathway via GPs

People who find themselves or a loved one exhibiting early signs of dementia – forgetfulness, communication issues, confusion – usually present at their GP.

From there both the GP and patient “look out for signs” and control certain risk factors – diet, exercise, sleep – before progressing to a neurologist, psychiatrist or a memory clinic, which take a deeper look at brain health.

You can’t access treatment without an official diagnosis, and you can’t be diagnosed without seeing multiple medical professionals, even if the symptoms seem glaringly obvious.

“Getting a diagnosis relieves a lot of uncertainty,” says Professor Claude Wischik, CEO and Co-founder, TauRx, “It’s important that people receive reassurance. Getting a diagnosis is as big an adjustment for the family as it is for the person directly affected.”

Depending on when you get diagnosed, slowing
the condition down is priority number one.

Streamlining the way to accurate diagnosis

“Current diagnostic pathways are a bit long and a difficult to access, and it is quite frustrating for both physicians and the patients and their families because it does take a lot of time. And the support is often quite variable,” says Dr Miller.

However, technology is evolving to streamline this initial diagnosis stage. An app is under development, that enables people to monitor themselves, “then if they are concerned they are prompted to see their GP who will have access to an advanced version of the technology to support a thorough diagnosis,” says Professor Wischik.

In a dream future, it will be comparable to people who have high blood pressure where the GP only refers the particularly challenging cases to specialists.

Breakthroughs for treatment

When you are diagnosed, treatment then becomes the focal point. Depending on when you are diagnosed, slowing the condition down is priority number one.

Significant scientific developments are happening: in particular, there are new treatments and being developed targeting the key pathological processes underlying Alzheimer’s, including amyloid and tau. Amyloid based treatments on market in the US are administered by regular intravenous infusions of a drug designed to reduce the amyloid plaques in the brain. Tau treatments are aimed at reducing tau aggregation and tangles, which are closely associated with cognitive symptoms of the disease. 

Recently completed clinical trials by TauRx, focused on the development of a tau-targeting drug, indicate sustained cognitive benefits following announcement of their 24-month data1. “A practical benefit of the experimental treatment is that it can be taken orally,” says Prof Wischik. “It could fit within the current standard care pathway for patients, and it doesn’t need an intravenous treatment clinic or special monitoring for side effects.”

Ultimately, “I want to project a message of positive progress”, says Prof Wischik, given that we see the government is taking on board what the medical professionals are telling them and supporting progress through initiatives such as the Dementia Mission. With potential new treatments and technologies in the process of development, “We are in the midst of managing dementia in terms of the drugs that could soon be available and the resources, and yes, I can say I’ve got a very clear sense that we’re on the move now.”

[1] TauRx Press release dated 7th March 2024 

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Find out why early diagnosis of dementia matters. Learn about the challenges, support options and steps to getting a diagnosis.

Seeking a dementia diagnosis can be daunting. People often worry about losing their independence, having to stop work or going into care. The truth, however, is that receiving a diagnosis can open various avenues of support.

Why early dementia diagnosis is important

The sooner someone who has the symptoms of dementia receives an accurate diagnosis, the sooner they can start planning for the future.

A timely diagnosis can help the person and their family understand what form of dementia they have, how their symptoms affect them and what they can do to manage them. It also enables them and their family to seek out suitable support such as financial assistance, planning and specialist advice.

The route to diagnosis isn’t always straightforward. Getting a diagnosis of young onset dementia (where symptoms occur before the age of 65) can be particularly challenging as symptoms are similar to stress, vitamin deficiency and menopause in women. A person may be reluctant to see a doctor due to fear or denial, however, it’s important to remind them that a prompt assessment and diagnosis can lead to the right treatment and support sooner.

There are several common challenges
people face both during and after a diagnosis.

Preparing for memory assessment

In some areas, people experience delays due to waiting lists for a memory assessment or diagnosis. However, there are steps you can take while waiting for an assessment.

Keeping a symptom diary is helpful so that key issues can be listed and passed on to the assessor when the time comes. Starting a life story can also be a good way to record the person’s biography, relationships, needs and wishes to enable better communication between health and social care staff.

Accessing specialist support

Receiving a diagnosis of dementia can be distressing for the person and their family and friends because if you love someone living with dementia, then you’re living with it too.

There are several common challenges people face both during and after a diagnosis, so we have created a series of free bite-size guides to complement the support and advice our dementia specialist Admiral Nurses offer through our Helpline, clinics and in other healthcare settings.
Five steps to getting a diagnosis of dementia

1. Making an appointment with a GP
2. Explaining symptoms and medical tests and checks
3. Referral to specialist clinics and specialists
4. Memory clinics and tests
5. The timeline of a diagnosis and what to do next

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Understand the impact of Parkinson’s on daily life. Learn about the struggles of applying for benefits, and join us in urging the UK Government to act.

Parkinson’s is a fluctuating degenerative neurological condition, which people experience in different ways. Many are being left unable to afford basic essentials due to inadequate cost of living support and failures of the benefits system.

The DWP needs to understand Parkinson’s

At Parkinson’s UK, we have heard from people left feeling like criminals or contemplating suicide after their benefits assessments by the Department for Work and Pensions (DWP). A shocking 50% of people with Parkinson’s who have applied for benefits say the person assessing their claim didn’t have a good knowledge of the condition.

Steep increase in benefits enquiries

Our advice service has seen a steep rise in enquiries from people living with the condition accessing our information about benefits. More than one in five (22%) of all enquiries in 2023 were about benefits and maximising income, and we’ve seen a 59% increase (2021–2023) in people accessing our online money, grants and benefits information pages, plus a 215% (2021–2023) increase in people ordering our printed information packs.

Around 43% say that their symptoms have
been made worse by their financial situation.

Left unable to afford basic needs

Our latest report, ‘Still nowhere near enough’, reveals many damning insights. Out of those living with the condition who are struggling financially:

• Almost 40% say that they do not have enough money to cover basic needs.
• One in four are having fewer meals to save money.
• Around 43% say that their symptoms have been made worse by their financial situation.

It’s unacceptable that due to a lack of support from the Government, people with Parkinson’s eligible for the benefits — designed to support them — are poorer than they should be. Cutting back on essentials, including heating and food, is hugely damaging to their physical and mental health. Join us in calling on the UK Government to take urgent action to prevent further damage.

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