Exeter Collaboration for Academic Primary Care (APEx)

Rehabilitation

The Exeter Primary and community care Rehabilitation research Theme (ExPeRT) conducts both qualitative and quantitative research relating to ageing, long term conditions and how rehabilitation services are delivered.  

Our vision is to ensure people in primary care and community settings have access to evidence-based rehabilitation to maximise health, wealth and wellbeing.

ExPeRT is a multidisciplinary team. It has clinical expertise in ageing, musculoskeletal disorders, human movement and technology in primary and community care settings. We also have broad methodological expertise in patient and public involvement, randomised controlled trials, complex intervention development, behavioural science, qualitative and mixed methods, and implementation.

Aims:

  • To build multidisciplinary research capacity and capability in Primary and Community Care Rehabilitation research
  • To ensure our research is grounded in what is important to patients, the public, communities and practitioners as well as health and care providers
  • To embrace new technologies and methodologies to improve rehabilitation outcomes and adapt to the changing health and care environment

 

Theme Leadership

Professor Vicki Goodwin
Rehabilitation Theme Lead		 Dr Sam Van Beurden
Deputy Rehabilitation Theme Lead		 Dr Lianne Wood
Deputy Rehabilitation Theme Lead

 

 

Projects

Title Funder Amount £ Project/ Programme/ Fellowship Exeter lead investigator Web link
Comprehensive geriatric assessment (CGA) to sustain independence for older people living with heart failure with preserved ejection fracture (HFpEF) and frailty: The CHART Trial NIHR   Project Vicki Goodwin Comprehensive geriatric assessment (CGA) to sustain independence for older people living with heart failure with preserved ejection fracture (HFpEF) and frailty: The CHART Trial - PenARC
Prehabilitation for lumbar spinal stenosis NIHR   Project Lianne Wood  
Realist economic evaluation of mHealth apps for low back pain in primary care NIHR   Fellowship Rebecca Hunter  
A new, novel walking frame for older adults in community settings – a single-arm feasibility study with embedded qualitative evaluation (FORWARD) Chartered Society of Physiotherapy   Project Abi Hall A new, novel walking frame for older adults in community setting- FORWARD - PenARC
Implementation of the Falls Management Exercise (FaME) programme (FLEXI). NIHR   Project Vicki Goodwin The FLEXI Study (FaLls EXercise Implementation) - PenARC
Diagnostic utility of early symptoms in degenerative cervical myelopathy, and understand barriers and facilitators to receiving a diagnosis NIHR   Fellowship Lianne Wood  
Improving the usability, accessibility, and inclusivity of digital dyadic cardiac rehabilitation for people living with heart failure EPSRC/LEAP   Project Sam Van Beurden  

Other current active projects

Title Funder Amount £ Project/ Programme/ Fellowship Exeter lead investigator Project web link (if none, please state)
Randomised controlled trial of a facilitated home-based rehabilitation intervention in patients with heart failure with preserved ejection fraction and their caregivers: The REACH-HFpEF Trial NIHR   Project Julia Frost REACH-HFpEF trial with process evaluation > Rehabilitation Enablement in Chronic Heart Failure
Enhancing Mobility support for people with dementia: BRidging the gap between needs And CarE NIHR   Project Abi Hall  

Other recently completed projects

Title End date Funder Amount £ Project/ Programme/ Fellowship Exeter lead investigator Project web link (if none, please state)
Recovery after an episode of delirium (ReCOVERED) March 25 NIHR   Programme Louise Allan https://sites.exeter.ac.uk/recovered/
Maintaining Independence in People with Dementia who have had a fall: a pilot cluster randomised controlled trial (the Maintain study) Dec 24 Alzheimer’s Society   Project Louise Allan https://sites.exeter.ac.uk/maintainstudy/
Digital and Remote Enhancements for the Assessment and Management of older people living with frailty (DREAM) Mar 23 NIHR   Project Vicki Goodwin https://sites.exeter.ac.uk/dream/
Redesigning Health Services for Multiple Long-Term Conditions: A systems engineering approach Oct 25  NIHR   Programme Helen Dawes SPHERE: Systems and People-Centric Innovation in Healthcare Redesign - NIHR Funding and Awards 
Patient and public involvement and engagement for people living with dementia Oct 25  NIHR   Project  Vicki Goodwin  
Home-based Extended Rehabilitation of Older people (HERO) Oct 25  NIHR   Project Vicki Goodwin Home-based Extended Rehabilitation of Older people (HERO) - PenARC

Publications

No. Title
1 Including older people in health and social care research: best practice recommendations based on the INCLUDE framework | Age and Ageing | Oxford Academic
2 Clinical Effectiveness of a Physiotherapy Delivered Physical and Psychological Group Intervention for Older Adults With Neurogenic Claudication: The BOOST Randomized Controlled Trial | The Journals of Gerontology: Series A | Oxford Academic
3 Cohort profile: Oxford Pain, Activity and Lifestyle (OPAL) Study, a prospective cohort study of older adults in England | BMJ Open
4 A facilitated home-based cardiac rehabilitation intervention for people with heart failure and their caregivers: a research programme including the REACH-HF RCT | NIHR Journals Library
5 How can we improve Comprehensive Geriatric Assessment for older people living with frailty in primary care and community settings? A qualitative study | BMJ Open
6 A pragmatic effectiveness-implementation study comparing trial evidence with routinely collected outcome data for patients receiving the REACH-HF home-based cardiac rehabilitation programme - PubMed
7 Fidelity, pragmatism and the “grey line” in between—exploring the delivery of a pragmatic physical activity randomised controlled trial—a secondary analysis | BMC Medical Research Methodology | Full Text
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Recent publications

  • Morag E Taylor, Karen Sverdrup, Julie Ries, Erik Rosendahl, Gro Gujord Tangen, Elisabeth Telenius, Katherine Lawler, Keith Hill, Annika Toots, Hans Hobbelen, Vanina Dal Bello-Haas, Abi Hall, Susan W Hunter, Victoria A Goodwin, Julie Whitney and Michele Callisaya, A core capability framework for physiotherapists to deliver quality care when working with people living with dementia and their families/caregivers: An international modified e-Delphi. Physiotherapy (2024) https://doi.org/10.1016/j.physio.2024.07.002
  • Ambroz M, de Vries S, Buitenhuis G, Frost J, Denig P. Willingness of people with type 2 diabetes to engage in healthy eating, physical activity and medication management. Primary Care Diabetes. 2024. 1751-9918. https://doi.org/10.1016/j.pcd.2024.03.006
  • Noonan MC, Frost J, Dalal HM, Taylor RS. Caregiver presence in a home-based cardiac rehabilitation programme improves the health-related quality of life of patients with heart failure. European Journal of Cardiovascular Nursing. 2024. 23.1:90-94 https://doi.org/10.1093/eurjcn/zvad031
  • AJ Hall, VA Goodwin, DJ Clarke. Fidelity, pragmatism and the “grey line” in between—exploring the delivery of a pragmatic physical activity randomised controlled trial—a secondary analysis. BMC Medical Research Methodology 24, 118 (2024). https://doi.org/10.1186/s12874-024-02242-1
  • AJ Hall, S Nikolova, M Prescott, VA Goodwin. Older people’s perception of being frail: a qualitative exploration. BMC Geriatrics 25, 453 (2024) https://doi.org/10.1186/s12877-024-05079-x
  • A Mahmoud, VA Goodwin, N Morley, J Whitney, SE Lamb, H Lyndon, S Creanor, J Frost. Comprehensive Geriatric Assessment for older people living with frailty in primary care and community settings? A Qualitative Study.? BMJ Open 14(3):e081304-e081304 Mar 2024
  • L Greene, R Barber, A Bingham, J Conners, S Conroy, K Elkhafer, C Fox, VA Goodwin, A Gordon, AJ Hall, R Harwood, C Hulme, T Jackson, R Litherland, S Morgan-Trimmer, S Pankiewics, S Parry, S Ashima, O Ukoumunne, B Whale, L Allan. Maintaining independence in individuals with dementia at home after a fall: a protocol for the UK pilot cluster randomised controlled trial (MAINTAIN) BMJ Open 14(2):e083494 01 Feb 2024
  • Wood L, Dean S, Booth V, Hayden JA, Foster NE. An Online Training Resource for Clinicians to Optimise Exercise Prescription for Persistent Low Back Pain: Design, Development and Usability testing. Musculoskeletal Care. June 2024 Online Preprint.
  • New P, Al-abbadey M, Wood L. 2024. Persistent Pain Management in Prison: an exploration of current practice and patient needs, and facilitators and barriers to intervention engagement. Prison service journal
  • Wood L, Booth V, Dean S, Foster NE, Hayden JA, Booth A. Contexts, behavioural mechanisms and outcomes to optimise therapeutic exercise prescription for persistent low back pain: a realist review. British Journal of Sports Medicine. Accepted. 2024. https://doi.org/10.1136/bjsports-2023-107598
  • Plappert H, Byng R, Reilly ST, Hobson-Merrett C, Allard J, Baker E, Britten N, Calvert M, Clark M, Creanor S, Davies L, Denyer R, Frost J, Gask L, B, Gibson J, Gill L, Gwernan-Jones R, Hosking J, Huxley P, Jeffery A, Jones B, Keeley T, Laugharne R, Marwaha S, Planner C, Rawcliffe T, Retzer A, Richards D, Sayers R, Williams L, Pinfold V, Birchwood M. Collaborative care intervention for individuals with severe mental illness: the PARTNERS2 programme including complex intervention development and cluster RCT. Programme Grants Appl Res 2024;12(6)
  • S Febrey, J Frost, AJ Hall, N Morley, J Whitney, V Johnston, P Wilson, C Kilgore, VA Goodwin. Advanced practitioners working with older people in primary care and community settings: a cross-sectional, web-based survey of roles and use of technology. International Journal of Advancing Practice (In press)
  • AJ Hall, F Manning, V Goodwin. Rehabilitation for people with advanced dementia who fracture their hip – expert consensus process. Disability and Rehabilitation 2023 https://doi.org/10.1080/09638288.2023.2260739
  • Lazem, H., Hall, AJ., Gomaa, Y., Mansoubi, M., Lamb, S. and Dawes, H., (2023). The Extent of Evidence Supporting the Effectiveness of Extended Reality Telerehabilitation on Different Qualitative and Quantitative Outcomes in Stroke Survivors: A Systematic Review. International Journal of Environmental Research and Public Health, 20(17), p.6630. https://doi.org/10.3390/ijerph20176630
  • E Taylor, VA Goodwin, A Clegg, S Ball, L Brown, J Frost. Participation, autonomy and control are shared concepts within older people’s interpretations of independence: a qualitative interview study. Ageing and Society https://doi.org/10.1017/S0144686X23000740  
  • AJ Hall, F Manning, V Goodwin Qualitative study exploring health care professionals' perceptions of providing rehabilitation for people with advanced dementia. BMJ Open 2023;13:e072432. doi: 10.1136/bmjopen-2023-072432
  • VA Goodwin, AJ Hall, A Bethel, E Taylor, L Tatnell, M Turner, J Frost Understanding joy amongst older people: A scoping review. Archives of Gerontology and Geriatrics 115 (2023) https://doi.org/10.1016/j.archger.2023.105118
  • Brusco, N.K., Graven, C., Boyd, L., Kugler, H., Dawes, H., Rawson, H., Clayton, L., Tan, S., Goodwin, V.A., Hall, A.J. and Taylor, N.F., (2023). Feasibility of implementing an innovative manual handling risk assessment training program for staff working in long-term care. Archives of Public Health, 81(1), pp.1-9. https://doi.org/10.1186/s13690-023-01074-7
  • E Taylor, J Frost, S Ball, A Clegg, VA Goodwin. (2023) Older adults perspectives of independence through time: results of a longitudinal qualitative study. The Gerontologist 64(2) 01 Feb 2024 https://doi.org/10.1093/geront/gnad073
  • Goodwin, V. A., Low, M. S. A., Quinn, T. J., Cockcroft, E. J., Shepherd, V., Evans, P. H., Henderson, E. J., Mahmood, F., Ni Lochlainn, M., Needham, C., Underwood, B. R., Arora, A. & Witham, M. D. 2023 Including older people in health and social care research: best practice recommendations based on the INCLUDE framework. Age and Ageing 52, 6, https://doi.org/10.1093/ageing/afad082
  • Hall, A.J., Manning, F. and Goodwin, V., (2023). Key Considerations When Providing Physical Rehabilitation for People with Advanced Dementia. International Journal of Environmental Research and Public Health, 20(5), p.4197. https://doi.org/10.3390/ijerph20054197
  • Byng R, Creanor S, Jones B, Hosking J, Plappert H, Bevan S, Britten N, Clark M, Davies L, Frost J, Gask L, Gibbons B, Gibson J, Hardy P, Hobson-Merrett C, Huxley P, Jeffery A, Marwaha S, Rawcliffe T, Reilly S, Richards D, Sayers R, Williams L, Pinfold V, Birchwood M. The effectiveness of a primary care-based collaborative care model to improve quality of life in people with severe mental illness: PARTNERS2 cluster randomised controlled trial. Br J Psychiatry. 2023 Jun;222(6):246-256. doi: 10.1192/bjp.2023.28.
  • Morrow E, Morris C, Theologis T, Frost J. What Outcomes Do Allied-health Professionals Consider Important For Children After Elective Lower Limb Surgery? A Qualitative Study to inform a core outcome set. Disability and Rehabilitation. 2023. DOI: 10.1080/09638288.2023.2233893