Rehabilitation and Ageing Research themes
Click on each theme to see examples of research projects undertaken by the Rehabilitation and Ageing Research.
Stroke care and rehabilitation
- Big CACTUS: Computer aphasia therapy
Rebecca Palmer led a programme of research evaluating the use of technology for the provision of self-managed aphasia therapy exercises to increase the amount of therapy practice available to people with aphasia after a stroke.
The programme consisted of a pilot randomised controlled trial funded by NIHR Research for Patient Benefit (2009-2012) followed by a full randomised controlled trial in 21 NHS speech and language therapy departments across the UK, with health economic evaluation funded by NIHR Health Technology Assessment programme (2014-2018).
We found the therapy approach was effective for learning new words and was cost effective for people with mild and moderate aphasia. Madeleine Harrison, carried out doctoral research finding that tailoring software to patient specific requirements and practising words in sentences were associated with a good outcome.
The work has informed recommendations for computer aphasia therapy in the NICE Stroke Rehabilitation Guidelines (2023) and the RCP National Stroke Guidelines (2023). It has also led to improvements in commercial aphasia software. We are preparing an impact case study to demonstrate the extent of the impact Big CACTUS has achieved.
- COM-STAR: Communication in stroke care and rehabilitation
The COM-STAR study, led by Rebecca Palmer and Prof Madeline Cruice from City St Georges University, and delivered in Sheffield by Madeleine Harrison, was funded by NIHR Health & Social Care Delivery research programme (2024-2027).
In a national survey, we found that only 45% of health care staff working with stroke survivors have had any training on how to best communication with them, despite the fact that stroke will have affected communication in more than 60% of stroke survivors.
The COM-STAR project used experienced based codesign with stroke staff and stroke survivors with communication disorders to develop a new national communication training programme and resource pack. We worked with NHS England elearning for healthcare team to ensure the training is available as elearning modules and in formats for face-to-face delivery. This is hosted on the NHS learning hub.
We are evaluating the training’s implementation and effect on communication in a number of diverse NHS stroke services. Following any refinements, the training and resources will be freely available to all services in 2027.
- Aphasia Partnership Training (APT)
Acquired communication impairments such as post stroke aphasia not only affect the stroke survivor, but also their familiar communication partners. Many couples find this communication frustrating and upsetting, affecting their relationships and quality of life. Whilst speech and language therapy often focusses on trying to improve the language impairment itself, communication partner training (CPT) is designed to help people with aphasia and their closest communication partner/s communicate together more easily and enjoyably. How best to provide CPT is not well described in the literature, however.
The Aphasia Partnership Training (APT) programme began with an NIHR Programme Development grant (2021-2023) in which we used consensus methods (eDelphi, and nominal group technique) to establish candidate components of a new APT programme, along with important outcomes, and appropriate outcome measures, forming the basis of a programme therapy. We currently have an NIHR Programme Grant (2025-2031) led by Rebecca Palmer and Prof Madeline Cruice.
The programme has three inter-related work packages:
- Understanding the implementation context (Madeleine Harrison & Prof Emma Power)
- Experience-Based Co-design of APT intervention, manual, resources and staff training (Madeline Cruice and Ian Kellar (Psychology Department))
- Adaptive randomised controlled trial across 28-30 speech and language therapy departments (Rebecca Palmer, Prof Katerina Hilari, Sheffield CTRU – Katie Biggs, Munya Dimairo, Tracey Young)
- BISTRo: Breakfast Group Interventions in Stroke Rehabilitation
Dr Nat Jones, stroke occupational therapist leads BISTRo, an innovative rehabilitation approach designed to support stroke survivors with eating and drinking as part of their recovery. It brings people together in a supported morning breakfast group, where they prepare and share food while working on physical, communication, and everyday living skills.
The BISTRo study aims to refine and evaluate this breakfast group intervention and its implementation toolkit to improve eating and drinking rehabilitation for people recovering from stroke. Researchers are working with stroke survivors, carers, and clinical teams to test and improve the intervention across stroke units. Pilot studies have shown that the approach is feasible, well-received, and has already been adopted as part of routine rehabilitation in some services.
The long-term goal of the study is to develop BISTRo into an evidence-based, scalable intervention that can be implemented across stroke rehabilitation services to enhance recovery, wellbeing, and quality of life after stroke.
- ReSTORe: Remote Stroke Rehabilitation
After a stroke many people experience long term challenges such as fatigue, low mood, or reduced fitness and confidence. Stroke survivors say that when their hospital or follow up care finishes, the lack of treatment for their ongoing physical and mental health problems is challenging and frustrating.
ReSTORe aims to find out if a home based, supervised online exercise and recovery support programme can help improve wellbeing after a stroke through a large randomised controlled trial.
The study is funded by NIHR Health Technology Assessment programme and is led by Prof Gordon McGregor and Warwich University clinical trials unit. Rebecca Palmer and Dr Ali Ali (SITRAN) are co-investigators.
- Neuromuscular electrical stimulation (NMES) for dysarthria
Pasquale Balzan investigated the use of NMES to augment the speech improvement gained through behaviour speech exercises for dysarthria. Dysarthria is a motor speech disorder commonly acquired post stroke. Pasquale and Rebecca are continuing to progress this field of research.
- Computerised aphasia therapy in Saudi Arabia
Bader Mohammed I Alhejji is a speech and language therapist conducting PhD study into adoption of technology to support aphasia therapy in Saudia Arabia. Bader is supervised by Dr Stuart Cunningham and Rebecca Palmer
- Transcutaneous Vagal Nerve Stimulation (tVNS) and aphasia therapy
Samantha Dorney is conducting PhD study to assess the acceptability and feasibility of using tVNS to augment the language outcomes people with aphasia gain from computerised aphasia therapy. Supervised by Dr Ali Ali and Rebecca Palmer, Sammy is conducting a pilot randomised controlled trial to compare tVNS + computer aphasia therapy with computer therapy alone. Under the supervision of Madeline Harrison, Sammy is using qualitative methods to understand the acceptability of tVNS as an adjunct to behavioural aphasia therapy.
Dementia
- Technology Empowered Dementia Independence (TEDI) Network Plus
The Technology Empowered Dementia Independence (TEDI) Network Plus brings together people living with dementia, families, researchers, designers, and care professionals to explore how technology can support independence and wellbeing.
Funded by UK Research and Innovation, TEDI connects communities and universities to co-create new ways of living well with dementia. Through our community hubs, visioning sessions, and innovation projects, we aim to shape technologies that reflect people’s lived experiences, challenge inequalities, and build a more inclusive future for dementia care. Phil Joddrell leads on this project from the group.
- AcTo Dementia
AcTo Dementia, also led by Phil Joddrell from the group, is focused on the use and accessibility of digital technology for people living with dementia and provides recommendations and guidance on accessible touchscreen apps.
- Music and Dementia
Isaac Vohra is conducting PhD study into the benefits of music for people with dementia. He is supervised by Phil Joddrell.
Design of digital solutions
- TellLab
Stephen Potter is lead researcher on the Technology-Enabled Living Lab for Ageing Better (TELLAB) project, a collaboration with Sanctuary Housing funded by the Vivensa Foundation. TELLAB aims to address the credibility and evidence gaps that exists in domestic digital care and wellbeing services by enabling older people, their family and friends, and their care and support teams to be directly involved in the development and evaluation of these services. Their participation takes place in and around the environment in which the services are intended to be used: namely, older people’s own homes. In this way, their living environment becomes a “living lab”, allowing the richness and complexity of the real world to steer the development of practical and effective services.
- Voice Input Voice Output Communication Aids
Voice input voice output communication aids have been developed by this research group over a number of years. Our VIVOCA was evaluated in a recent NIHR RfPB project INVITE lead by Dr Kate Fryer in collaboration with Barnsley District General hospital.
- Digital Nudging on Mobile Healthcare Applications
Badr Nhari is a PhD student whose research investigates the role and acceptance of "digital nudges" for encouraging beneficial behaviours in younger and older adults with Type 2 diabetes mellitus in Saudi Arabia. This work is supervised by Stephen Potter.
Inclusion in research and decision making
Being included in decisions about your own life and even in research studies is really not a given when someone has compromised communication skills or cognitive skills as a result of many neurological conditions acquired as people get older.
With a plethora of speech and language therapists in our group, both as core and associate members, we are committed to supporting people to make their own decisions where possible as the adults that they are.
Rebecca Palmer works on this theme with Dr Mark Jayes from Manchester Metropolitan university. Together they have created and published the Consent Support Tool: Including people with communication difficulties in health research.
Dr Jayes has also developed a mental capacity assessment support tool (MCAST) through his PhD at the University of Sheffield and further evaluated the use of this tool in a recent NIHR RfPB project VAMCAST with Rebecca Palmer as collaborator.