Just a reminder that the NZRA Conference 2021 early bird registration closes on 31 July.

Current rego prices for full conference are: NZRA member $550 / Non-member $600 / student/person with lived experience* $350.

From 1 August the prices for full conference are: NZRA member $750 / Non-member $800 / student/person with lived experience* $400

One day conference rego til 31 July: NZRA member $350 / Non-member $400 / student/person with lived experience* $200

One day conference rego from 1 August: NZRA member $400 / Non-member $450 / student/person with lived experience* $250

It's definitely worth your while to register now! Save yourself (or your organisation) up to $200.

Go to www.nzrehabconference.co.nz/register to secure your spot!

#rehabilitation #conference #earlybird #NZRAconference2021

Congratulations to NZRA life member and current board member Anne Hawker on becoming an Officer of the New Zealand Order of Merit for her services to disabled people. 

We caught up with Anne and asked her about her Queen’s Honour. Anne says she was humbled but proud to be acknowledged for her work.

Anne became the first woman president of Rehabilitation International and used that to “assist disabled women to have a different life,” says Anne. She’s also proud to have been President of the Disabled Persons Assembly and get the Human Rights Act passed as well as the Disability Survey.

Despite having achieved so much, Anne still sees potential for more change and development within the disability space. “[I’d like to see a] continued move from special into mainstream and clearer when specialised services are required,” says Anne. She’d also like to see more community development in rehabilitation, and for rehabilitation to be available to everyone.

Anne also wants disability to be part of the diversity conversation, for the stigma towards disabled people removed, for people’s strengths not their deficits to be seen, and for a move away from the medical model to the social model.

“Disabled people are proud of who we are, and we are proud to use the term disabled people without having others define us,” She adds.

Anne says that her career path chose her, as she had to give up teaching after being diagnosed with disseminated sclerosis.

We asked Anne why people should come to the NZRA conference this year. “Be part of the conversation to drive change in the rehabilitation sector to ensure you contribute to a revitalised and relevant rehabilitation sector.”

The full impact of Anne’s work cannot be measured as her work has been life-changing for so many, but milestones in her career were curated for the Queen’s Honours announcement, and we’ve added some others that need acknowledging.

• President of Otago DPA & Otago MS Society

• Setting up Total Mobility in Otago

• The first non-DHB to establish a home support service for ACC

• Established the first stroke club and carers group in New Zealand

• Set up the attendant care scheme in Otago

• Member of the Taieri Social Service & Dunedin Social Service Committee

• Ran the Dunedin women’s school girl cricket competition

• Managed the Otago women’s school girl cricket and school girl hockey teams

• President of Rehabilitation International from 2008 to 2012 and chaired their Social Commission from 2000 to 2008.

• Played a leading role in Rehabilitation International’s work towards the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD).

• President of the Disabled Persons Assembly New Zealand from 1993 to 1997, where she led and partnered a range of policy initiatives and championed all issues facing disabled people from employment, data, human rights; education, health and accessibility.

• Advocated for the New Zealand Disability Strategy, which then became New Zealand’s negotiating mandate for the UNCRPD.

• Treasurer of the New Zealand Rehabilitation Association and the Federation of Disability Information Service in the late 1980s and 1990s.

• New Zealand’s representative to the International Federation of Multiple Sclerosis Society from 1988 to 1993.

• CEO of the Head Injury Society in 1995/1996.

• Principal Disability Advisory for MSD since 2007. With the Ministry for Social Development, she singlehandedly implemented the ‘Lead Toolkit: A guide for employing disabled people’, published in 2018.

• Instrumental in establishing the ‘We Enable Us’ network, providing leadership on effective and inclusive employment of disabled people in the public sector.

• Been a driving force behind ‘The Accessibility Charter’.

Well done Anne, we are so proud of you and your achievements so far! And we are grateful for your ongoing involvement in the NZRA.

 Jo Nunnerley (and team) were announced as one of our three finalists for the NZRA Innovation Award 2021, for their use of virtual reality to help with brain injury rehabilitation.

In collaboration with Laura Fergusson Brain Injury Trust (LFBIT), CerebralFix, University of Otago and Callaghan Innovation they used a co-design process with clinicians and people with traumatic brain injury to develop a therapeutic virtual reality tool aimed at increasing the awareness of and teaching self-management strategies for cognitive fatigue after brain injury.

This tool can simulate real-world situations without having to bring the client to those locations. This could include a supermarket, a cafe/restaurant or a place of work—activities the client would need to interact with as part of their normal daily lives post-injury.

Cognitive fatigue is the most troubling and longest lasting symptom in 73% of individuals recovering from a traumatic or acquired brain injury. The long-term effects of fatigue can considerably impair an individual's ability to work and lead a normal life, including participating in social activities  with whānau and friends.

The team used a three-phase co-design approach to develop the virtual reality system, to ensure that input and opinions of people with lived experience of brain injury and experienced clinicians were integrated throughout the entire process.

Jo spoke to NZRA about what it means to be chosen as a finalist for this year's award.

This innovation will be presented at the conference and you will have an opportunity to vote for which innovation you think is most deserving of this year's award.

The three finalists for this year's inaugural Innovation Award have been chosen, and all three presenting their innovations as part of the NZRA conference where one will be chosen as the overall winner.

Tim Young and the team from Disabled Person's Assembly submitted their 'Mahi Tika—Equity in Employment', a disabled-led employment programme for the Waitako region.

Matthew Bryson from Peke Waihanga–Artificial Limb Service submitted 'Te Pou Aropā Takitoru, a nation-wide coordinated peer support service for those adapting to limb loss.

Jo Nunnerley and her team submitted a therapeutic virtual reality tool for people who've experienced a traumatic brain injury—developed in collaboration with Laura Fergusson Brain Injury Trust, CerebralFix, University of Otago and Callaghan Innovation.

Each of the finalists will be profiled over the coming weeks, in the lead-up to the conference and will have 15 minutes to present their innovation at the conference. There are no rules for what this presentation should look like.

Finalists have been encouraged to choose a presentation approach that best conveys the innovation and helps them demonstrate that the innovation meets the award criteria.

The audience will determine the final winner of the 2021 Rehabilitation Innovation Award, judging against the award criteria. The winner will receive an additional $1000 to put toward activities of their choosing.

As a finalist, they will receive financial support of up to $1500 to attend the NZRA conference, He Mahi Tahi Tātou: Achieving Equity in Rehabilitation, 17-19 September 2021 in Rotorua. 

The following is a message from “Hidden Abilities”, which we have agreed to share on our website. However, NZRA is not involved in any aspect of Hidden Abilities, or its parent organisation SIM Ethiopia. Hidden Abilities and SIM Ethiopia do not represent NZRA. If you are interested in exploring this opportunity further, you will need to do your own research into this organisation and the terms and conditions of contributing to their work. Contact details are supplied below.

If you’ve ever wanted to use your rehabilitation skills and experience to help other countries flourish, then Ethiopia is a land of opportunity (and great coffee). 

With very few physiotherapists, particularly with any experience in paediatric therapy, and no occupational therapists or speech and language therapists, they are facing an uphill battle to support those who most desperately need the help. 

Hidden Abilities is a SIM project based in Bahir Dah, Ethiopia who provide therapy to children with physical disabilities such as cerebral palsy, spina bifida, club feet and other developmental delay. 

There is an opportunity for you to visit them on a short-term trip to upskill their staff, or share your resources or simply donate to help fund the work they do. 

In Ethiopia having a disability or a disabled child is seen as a curse from God. The shame drives many parents to hide their children in their homes, or for the father to abandon his wife and children. 

Hidden Abilities works to “help children discover and develop their ‘hidden abilities’, and to feel loved and valued for who they are”. 

Nati is one of the children they are helping flourish. While in the Neonatal Unit after a difficult birth, his parents were told that they shouldn’t waste their money as he’d probably die soon. His parents insisted that as long as he was breathing, they would do all they could for him. 

He went home after a few weeks but it wasn’t until he was about one that they noticed he didn’t stand or walk like other children and always sat with one leg bent backwards. Most medical people told them “ there’s no hope; take Nati home and feed him but he will never be able to walk”. 

But someone told them about Hidden Abilities and the family travelled over 30km to the centre where after several months Nati was able to crawl, stand and then walk. His parents dream of the day when he will be able to run and go to school like all ‘normal’ children. 

Each week they are providing free therapy twice a week for 80 children up to 18 years old. They also provide nutritional support for the poorest families and educational support for those children fortunate enough to attend school. 

They are currently in discussions with the Government training hospital about starting an Early Intervention Programme. “By treating early, we can potentially undo damage within days or weeks rather than years, which would significantly improve the quality of life of the child and their family.” 

If you’d like to know more about Hidden Abilities and the possibility to visiting them you can contact Emily Ling: emily.ling@sim.org / whatsapp: +251965179122 

Researchers from the Centre for Person Centred Research at Auckland University of Technology would like to interview:

• People and whānau experiencing age-related neurological impairment such as Stroke, Parkinson's, Mild Cognitive Impairment and Dementia.
• Health professionals who work with these people

about their experiences of living or working with age-related neurological impairment and the people and environments that help them build their personal resources for living with long term neurological impairment.

"We recognise that living with long-term neurological impairment can be challenging. We believe that things – services, people and organisations that work with people living with neurological impairment can help to build their confidence and ability to manage these challenges.

Our focus for this research is to find out what positive things services and health professionals do to contribute to a person’s ability to develop skills and confidence to thrive /manage their health condition. We are also keen to understand your impressions of why these positive things work and in which circumstances.

The interviews will be based around people reflecting on one or two critical incidents (either as health care providers or patients/clients and their whānau).

Can you tell me what happened?

What was it about this event that made it a positive experience for you?

What was the context?

What was the clinician / service doing?

How did it make you feel?

Did this incident change anything about the way that you think?

Did the incident change anything about what you do?

What was the outcome for you? "

You can view the flyer for the research here

If you are interested in participating or know of someone else who is interested, then contact Christine Cummins via email: ccummins@aut.ac.nz or visit their website https://cpcr.aut.ac.nz/

When people think about who is affected by stroke, they commonly think of older people. Yet 25-30 percent of people affected by stroke are under the age of 65, according to Stroke Foundation NZ. 

Stroke Foundation Australia’s EnableMe podcast, produced a four-part series called “Young Stroke Podcast”. 

This features people sharing their stroke stories and their recovery journey, with each episode focusing on a different aspect of rehabilitation. 

Episode one is called “I’ve had a stroke, now what?” and introduces people to the reality that stroke affects younger people and looks at the early stages after a stroke. The guests share their top tips for navigating those challenging early days and living a good life. 

Episode two explores “recovery mindset” and acknowledges that recovery means different things to different people. For most people who have experienced a stroke, the recovery is a lifelong journey rather than a destination.  

Episode three “finding the new normal” explores renewal and growth after stroke. The guests share quite openly the struggles they’ve experienced along the way, as well as the silver linings. There is an element of grief and loss with stroke, and a level of acceptance that comes, as the journey progresses. 

The final episode is especially for “parents of stroke survivors” and features Kim Beesley, whose daughter had a stroke when her and her husband were commencing a holiday on the other side of the world. She talks about what it was like in those initial months and what it’s like now, with their daughter now living at home with them. 

This podcast is well worth listening to whether you work directly with stroke patients or not. Each guest speaks from their own lived experience of stroke, and this is always a powerful position to learn from. 

Ngā Whāriki Kōrero—Kaupapa Māori Speech Language Resources

By Julianne Johns

Committed to communication as a basic human right, and recognising that stroke pathways for Māori needed improvement, speech-language therapist and Kaupapa Māori researcher Dr Karen Brewer (Whakatohea, Ngaiterangi) launched Ngā Whāriki Kōrero in July 2020 at the University of Auckland.

A few years ago, Karen undertook a Health Research Council-funded Eru Pomare post-Doctoral Research Fellowship in Māori Health. Her research aimed to develop a therapy package in collaboration with Māori whānau, speech-language therapists, Māori health researchers and health advisors.

She started listening to stories of Māori and their whānau after stroke, as well as the experiences of speech-language therapists, Māori health specialists and Stroke Foundation community advisors. Karen unpacked the complexities of designing therapy for Māori living with stroke-related communication disorders in her insightful 2016 article that NZRA profiled in January.

Ngā Whāriki Kōrero—a superb kaupapa Māori speech-language therapy package for whānau with communication difficulties caused by stroke—is the culmination of her work.

You can hear Karen talk about how to use Ngā Whāriki Kōrero in the webinar of the launch.

There are three components available to view or download in PDF format.

• The website: gathers a collection of video and written resources to help Māori who have experienced stroke to understand what has happened and what to expect. Aphasia and speech-language therapy is explained, as well as ideas as to how to rehabilitate.

• The booklet: written especially for Māori and their whānau, explains stroke, aphasia and roles of speech-language therapists and communication-based groups communication. There is a strong focus on moving forward with aphasia and ideas for enhancing recovery and ways whānau can help.

• The interactive resource utilising Talking Mats: Talking Mats is a therapy package with communication symbols depicting topics with response options and a scale placed in a way that explores feelings and opinions. Karen consulted with Māori advisers to adapt Talking Mats for the needs of Māori users.

Used together, Ngā Whāriki Kōrero helps speech-language therapists and other communication partners to build successful relationships. It also allows for them to hear about what is important for a person with aphasia and their whānau, as they develop a rehabilitation plan.

Karen sees the usefulness of this resource trending to events with big impact and slow recovery. This means the resource may transfer to other situations in which communication access could be better supported for Māori, such as to traumatic brain injury, chronic illness, dementia and spinal cord injury.

While Ngā Whāriki Kōrero was designed with speech-language therapists and Māori clients in mind, we see its scope expanding to improve communication for other allied health and medical professionals working in rehabilitation. We also love its possibilities for advancing tiro rangatiratanga and mātauranga Māori in health research—building empowerment and inclusion in research design, and participation for Māori whānau experiencing communication disorders or access barriers.

Karen is the guest speaker for Burwood Academy’s March Peer Group meeting on 11 March at 12:00pm. This will be an online presentation. For more information, please email admin@burwood.org.nz. They will provide you with the link to the online meeting.

Karen has generously distributed hard copy resources across Aotearoa to each of the District Health Board speech-language therapy departments, in numbers correlating with the proportion of Māori in that area. If you would like a set for your workplace, Karen may provide copies (on receipt of an addressed courier bag). You can contact her here. Alternatively, you can download the PDFs.

Nga mihi, Dr Karen Brewer and your research team.

Intersection of the Elements of Evidence-Based Practice in Interdisciplinary Stroke Rehabilitation: A Qualitative Study 

Authors: Catherine Vingerhoets, Jean Hay-Smith, Fiona Graham 

Within the health sector evidence-based practice (EBP) is “a foundational approach to clinical decision-making that integrates scientific research; clinical expertise; and patient preferences, values and circumstances.” 

The authors of this study, published in the latest edition of the New Zealand Journal of Physiotherapy, set out to explore how these three elements of EBP intersected in care planning within an interdisciplinary stroke rehabilitation team based in a Canadian hospital. 

The principal investigator (responsible for the recruitment, data collection and analysis) observed a ‘rehabilitation round’ where the allied health team, along with the patient’s primary nurse, met with each patient in their room to discuss care plans and set goals. 

Immediately after the rehabilitation round, the principal investigator facilitated a focus group where the rehabilitation team were asked four key questions: 

1. How do you value each of the three elements of EBP? 

1. How does the team utilise EBP for decision-making? 

1. Is there one element of EBP that is most influential during care planning? 

1. What contributes to an unequal weighting of EBP elements? 

“Patient preferences were at the forefront of discussion, and clinicians continually came back to the patient as the primary influence on care planning and team-patient negotiation.” 

Each element of EBP was evident, however “the patient was the dominant influence in decision-making.” 

The study looks at the primacy of patient-centeredness, patient-directed goals, being patient-specific as well as EBP as a fluid process, and the collaborative aspects of both within the team, patient-clinician, and professional. 

Barriers to “accessing and utilising research evidence” were identified but clinicians were more concerned with “limitations to providing patient-centred care than adherence to research-informed treatment”. 

Each patient brings their own needs, circumstances and preferences to the situation and they have the greatest influence on the clinicians. In order to deliver care that fully incorporates all three elements of EBP, a wholly collaborative approach is essential. 

You can read the full article here. 

More detail about the paper can be found here: 

For more information, contact Gwyn Lewis: gwyn.lewis@aut.ac.nz