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Clinical Rehabilitation

We aim to improve outcomes and quality of life for people with long-term physical conditions by working across the research spectrum: developing measurement tools; identifying the mechanisms underlying impairments; developing evidence-based interventions; and evaluating effectiveness of interventions and their impact on patients and clinical services.

We have breadth and depth of expertise and activity with national and international standing. Since 2005, the group has been awarded £5 million of research grant funding from leading medical charities, the National Institute of Health Research, research councils, the NHS, European and commercial companies. Members have over 70 publications including high impact journals in their relevant fields and supervise 14 post-graduate research students.

A feature of our research is its’ impact on clinical services, patients’ lives and policy nationally and regionally through our close links and involvement with national policy makers, patient groups and charities, clinical services, professional bodies’ research groups to build capacity and capability.

As the Rehabilitation Research Group (RRG) currently we explore five lines of enquiry:

1)  Clinical Measurement Tools

  • Develop measurement tools that address patient-focused problems and are ‘fit for purpose’ for use in clinical practice.  
  • Explore how measurement tools are used in clinical practice and evaluate their impact  
  • Work with clinical partners to implement measurement tools into clinical practice.  

2) Understanding patients’/ clients’ problems

This work helps gain greater understanding of the nature, cause and severity of patients’/ clients’ experiences and problems. This assists developing evidence based interventions and measurement tools and ensures appropriate patient-focused outcomes in clinical trials.

3) Understanding and evaluating current therapy

To develop more effective rehabilitation interventions and ways of delivering services we need to have a clear understanding of current services / practice, whether they are effective, insight into staff and service users’ experiences, perceptions and priorities. Many aspects of current clinical  practice have insufficient evidence, so research includes evaluating current practice in trials.

4) Designing and evaluating novel interventions

New, more effective, interventions based on theory and current evidence can help improve patient outcomes. We work collaboratively with therapists and other health professionals to develop interventions and conduct clinical trials.

5) Implementing research into clinical practice

Our aim is to help improve patient outcomes. Thus research findings need to be implemented in clinical practice. Members of the Rehabilitation Research Programme have a strong record of this. Our research has been included in national clinical guidelines and we have actively contributed to developing  such guidelines, for example from the National Institute of Clinical Excellence. We contribute chapters to undergraduate and specialist textbooks, and contribute to national and international education programmes for specialist health professionals. We also work with clinical service providers, service  user groups and Third sector organizations to develop clinical services and self-management materials.

We have two main themes under the RRG :

1) MSK/ Rheumatology Rehabilitation

2)  Neuro-rehabilitation

Theme 1 Rheumatology rehabilitation

  • R-PROMs      
  • Work Rehabilitation      
  • Self-management    
  • Hand    

Rheumatology rehabilitation

Led by Prof Alison Hammond and Dr Yeliz Prior, this research theme focuses on the rehabilitation of people with musculoskeletal and rheumatic  diseases, with particular reference to the test and development of rheumatology patient reported outcome measures (R-PROMs), rheumatology occupational therapy interventions and patient education in self-management for people with rheumatic or musculoskeletal conditions.

Theme 2 Neuro-rehabilitation

Gait Adaptability

  • Impairments  
  • Treatment: Visual cue training  
  • Measuring Gait Adaptability  

Upper limb rehabilitation

Current Projects under MSK/ Rheumatology Research (Theme 1)

Current Projects under the neuro-rehabilitation research (Theme 2)

Led by Prof Hammond and Dr Prior. Current projects include:

Understanding and evaluating therapy interventions:

A. Work: we are part of the Arthritis Research UK/ Medical Research Centre for Musculoskeletal Health and Work. 

WORKWELL: development and evaluation of a "staying in work" job retention programme for employed people with Inflammatory Arthritis: a randomised controlled trial. Alongside this we are surveying Rheumatology Occupational Therapy provision for working people with arthritis; and conducting interviews with participating employed people with arthritis and the treating therapists. Please visit our WORKWELL study page to find out more about the WORKWELL trial and our earlier feasibility trial (WORK-IA).  

B. Orthoses:

A-GLOVES: A randomised controlled trial (RCT) to evaluate the effectiveness of compression gloves in rheumatoid arthritis. We have previously completed a pilot observational study (C-Gloves) to assist planning this trial. Please visit our A-Gloves study page to find out more.

HOOT: Hand Orthoses in musculoskeletal/rheumatology OT: surveys of OT orthoses provision, systematic reviews and clinical trials of orthoses.

C. Self-Management:

SMART: Self-Management in Arthritis. A programme of studies investigating: self-management information needs; evaluating and disseminating the Looking After Your Joints Programme in inflammatory arthritis and hand OA; qualitative studies, collaboration in fatigue management trials. 

LMAP: evaluation of a self-management programme, the Lifestyle Management for Arthritis Programme: long term follow-up of a randomised controlled trial; observational and qualitative studies.

FAME: development and evaluation of a fibromyalgia self-management programme.

MSKHub.com: a digital self-management and advice platform on which the MSK-PROMS and WORK-PROMS are also located.

Clinical Measurement Tools: Patient Reported Outcome Measures:

MSK-PROMs: Musculoskeletal Patient Reported Outcome Measures for using in rehabilitation practice, audit and research. This includes linguistic validation and psychometric evaluation of different language versions of measures of:  

  • activities of daily living: British English, Dutch and German versions of the Evaluation of Daily Activity Questionnaire (EDAQ) in rheumatoid arthritis. The British English version is also tested in 7 other musculoskeletal conditions (Osteoarthritis; Ankylosing Spondylitis; Fibromyalgia and Chronic Pain; Chronic Hand Conditions; Sjogrens Syndrome; Scleroderma; and Systemic Lupus Erythematosus.   
  • participation (British English Valued Life Activities Scale (VLAS) in RA
  • hand function (British English Measure of Activity performance of the Hand (MAP-HAND) and Disabilities of the Arm Shoulder Hand (DASH) in RA

WORK- PROMS: British English, Swedish and Czech versions of the Work Activities Limitations Scale (WALS) and 6 other measures evaluating work contextual factors in RA; the British English version is also being tested in OA, AS and FM.

Understanding patients/ clients problems:

OCC-IMPACT:  using data gathered in the MSK- and WORK-PROMS studies to investigate the Occupational Performance impact of 8 musculoskeletal conditions.

WORK-IT: a systematic review and interview studies with employed people with osteoarthritis and employers of people with arthritis, identifying work-related problems.

Who we work with:

We work collaboratively with researchers in the UK at the Universities of: Manchester, Nottingham, Southampton, Lancaster, UCLAN (Central Lancashire), Lancaster, Keele, Leeds. Internationally, we work with researchers at the Universities of:  Zurich University of Applied Sciences (ZHAW, Switzerland), ICF Unit, Swiss Paraplegic Research (Switzerland); Leiden University Medical Centre (Netherlands), Lund (Sweden), Gothenburg (Sweden), Prague Institute of Rheumatology (Czech Republic), Rosenheim University of Applied Sciences (Germany), Marmara (Istanbul, Turkey), Ankara (Turkey), Boston (USA), British Columbia and Toronto (Canada).

We also have extensive networks with Rheumatology and Therapy departments throughout the UK, with whom we work collaboratively in identifying and recruiting patients and with therapists providing treatment in trials. A wide range of arthritis and musculoskeletal charities also kindly assist with contacting people with msk conditions who may wish to take part in our studies.

Led by Dr Kris Hollands current projects include:

Treatment of gait and gait adaptability:

  • Visual cue training for the rehabilitation of gait and gait adaptability after stroke
  • Development of community exercise groups to improve or maintain functional mobility for people with mild cognitive impairment/dementia
  • Mechanisms of recovery and treatment effects in rehabilitation of functionally adaptive walking after stroke.

Measuring Gait Adaptability: how can adaptability of gait be measured in clinical settings and is the ability to alter walking in response to the environment relevant to/predictive of functional outcomes following stroke. Exploration of the use of activity monitors to identify adaptations to walking and disruptions in turning, stand-to-walk.

Impairments in gait adaptability following stroke: how is the control of footfall location during walking achieved and what difficulties do stroke survivors have in controlling foot placement (as is necessary to step to safe places when walking in cluttered and uneven surfaces). Kinematic analyses of target stepping, turning and obstacle avoidance.

Rehabilitation and recovery of upper limb function: are there shared mechanisms of recovery in the upper and lower limbs after stroke?

Peer-reviewed journal Peer-reviewed journal articles (full publications since 2014) 

2019

Hewlett S, Almeida C, Ambler N, Blair PS, Choy E, Dures E, Hammond A, Hollingworth W, Kadir B, Kirwan J, Plummer Z, Rooke C, Thorn J, Turner N, Pollock Jon behalf of the RAFT Study Group (2019). "Reducing Arthritis Fatigue impact: Two-year randomised controlled trial of cognitive behavioural approaches by rheumatology Teams (RAFT)" Ann Rheum Dis  78 (4): 465-472.

Prodinger B, Hammond A, Tennant A, Prior Y, Tyson S (2019). Revisiting the Disabilities of the Arm, Shoulder and Hand (DASH) and QuickDASH in Rheumatoid Arthritis: a psychometric study. BMC Musculoskeletal Disorders 20:41

2018

Prior Y, Tennant A, Tyson S, Kjeken I, Hammond A (2018). Measure of Activity Performance in the Hand (MAP-Hand) questionnaire: Linguistic validation, cultural adaptation and psychometric testing in people with Rheumatoid Arthritis in the UK. BMC Musculoskeletal Disorders 2018 19:275

Radford K, Sutton C, Sach, T, Holmes J, Watkins C,  Forshaw D, Jones T, Hoffman K, O’Connor R, Tyerman R, Merchán-Baeza JA, Morris R, McManus E, Drummond A, Walker M, Duley L, Shakespeare D, Hammond A and Phillips J (2018). 'Early, specialist vocational rehabilitation to facilitate return to work after traumatic brain injury: the FRESH feasibility RCT' , Health Technology Assessment: 22 (33), pp. 1-124.

Hammond A, Prior Y, Tyson S (2018). Linguistic validation, validity and reliability of the British English version of the Disabilities Arm Shoulder Hand (DASH) questionnaire and QUICKDASH in people with rheumatoid arthritis. BMC Musculoskeletal Disorders 19:118

Hammond A, Prior Y, Horton M, Tennant A, Tyson S, Nordenskiold U (2017). The Reliability and Validity of the Evaluation of Daily Activity Questionnaire in seven musculoskeletal conditions. Disability and Rehabilitation 40(17):2070-2080 [DOI: 10.1080/09638288.2017.1323027 Published online 8.5.17]

Weerdesteyn, V., K. Hollands, and M.A. Hollands (2018). “Gait adaptability” Handbook of Clinical Neurology, 159 (8): 135-146

Van der veen, S., U. Hammerbeck, R.J. Baker, and K.L. Hollands (2018). “Validation of gait event detection by centre of pressure during target stepping in healthy and paretic gait” Journal of Biomechanics, 79: 218-222

Trinler, U., F.Y. Leboeuf, K. Hollands, R. Jones, and R. Baker (2018). “Estimation of muscle activation during different walking speeds with two mathematical approaches compared to surface EMG” Gait & Posture 64: 266-273

Trinler, U., K. Hollands, R. Jones, and R.J. Baker (2018). “A systematic review of approaches to modelling lower limb muscle forces during gait: applicability to clinical gait analyses” Gait & Posture 61: 353-361

2017

Hammond A, O’Brien R, Woodbridge S, Bradshaw L, Prior Y, Radford K, Culley J, Whitham D, Pulikottil-Jacob R. (2017) Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial. BMC Musculoskeletal Disorders  18:315

Prior Y, Sutton C, Cotterill S, Adams J, Camacho E, Arafin N, Firth J, O’Neill T, Hough Y, Jones W, Hammond A (2017). The effects of arthritis gloves on people with Rheumatoid Arthritis or Inflammatory Arthritis with hand pain: a study protocol for a multi-centre randomized controlled trial (the A-GLOVES trial). BMC Musculoskeletal Disorders 18:224 DOI 10.1186/s12891-017-1583-4

Prior Y, Amanna AE, Bodell SJ, Hammond A (2017). A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Participants’ views. Br J Occup Ther  2017;80:39-48

Medeiros, F.M., J. Myskiw, P. Baptista, L. Neves, L.A. Martins, I. Izquierdo, C. furini, L. Xavier, K.L. Hollands, and R.G. Mestriner (2017). “Can an aversive, extinction-resistant memory trigger impairments in walking adaptability? An experimental study using adult rats” Neuroscience Letters 665: 224-228.

Prenton, S., K. Hollands, L.P.J. Kenney, and P. Onmanee (2017). “Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop: a meta-analysis providing direction for future research” Journal of Rehabilitation Medicine 50 (2) DOI: 10.2340/16501977-2289

2016

Hammond A, Prior Y (2016). The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review. British Medical Bulletin. 119 (1): 49-62 doi: 10.1093/bmb/ldw024..

Al Khlaifat L, Herrington LC, Tyson S, Hammond A, Jones RK (2016). The effectiveness of an exercise programme on dynamic balance in patients with medial knee osteoarthritis: a pilot study. The Knee 23(5): 849-856. doi: 10.1016/j.knee.2016.05.006.

Cuperus N, Vliet Vlieland T.P.M, Brodin N, Hammond A,  Kjeken I, Lund H, Murphy S,  Neijland Y, Opava CH, Roškar S, Sargautyte R, Stamm T, Torres Mata X, Uhlig T, Zangi H,  van den Ende CH. (2016). Characterizing the concept of activity pacing as a non-pharmacological intervention in rheumatology care: results of an international Delphi survey. Scandinavian Journal of Rheumatology 45(1):66-74

Vliet Vlieland, T.P.M., C.H.M.Van den Ende, F. Alliot-Launois, C. Beauvais, M. Gobbo, A. Iagnocco, I.E. Lundberg, P.V. Munuera-Martínez, C.H. Opava, Y. Prior, A. Redmond, H. Smucrova, and D. Wiek (2016). “Educational needs of health professionals working in rheumatology in Europe” RMD Open, 2 (2)

Prior, Y.,  N. Walker (2016). “Rheumatology occupational therapy-led fibromyalgia self- management education using motivational interviewing and mindfulness based cognitive therapy: a new approach” British Journal of Occupational Therapy, 30 (1): 8-13.

Kerr, A., D. Rafferty, K. Hollands, M. Barber, and M.H. Granat (2016). “A technique to record the sedentary to walk movement during free living mobility: a comparison of healthy and stroke populations” Gait & Posture 52: 233-236

Prenton, S., K. Hollands, and L.P.J. Kenney (2016). “Functional electrical stimulation versus ankle foot orthoses for foot-drop: a meta-analysis of orthotic effect” Journal of Rehabilitation Medicine 48 (8): 646-656.

2015

Hewlett S, Ambler N, Almeida C, Blair PS, Choy E, Dures E, Hammond A, Hollingworth W, Kirwan J, Plummer Z, Rooke C, Thorn J, Tomkinson K, Pollock J on behalf of the RAFT study team (2015). Protocol for a randomised controlled trial for Reducing Arthritis Fatigue  by clinical Teams using cognitive behavioural approaches (RAFT). BMJ Open 5:e009061. doi:10.1136/bmjopen-2015-009061.URL: http://bmjopen.bmj.com/content/5/8/e009061.full?sid=468dc91a-ce8f-4b03-bf30-d7117a7fe564

Prior Y, Amanna A, Bodell S, Hammond A (2015) A qualitative evaluation of an occupational therapy-led work rehabilitation for people with inflammatory arthritis: perspectives of the therapists and their line managers. British Journal of Occupational Therapy. 78: 8 465-466 doi: 10.1177/0308022615599175

Hammond A, Tennant A, Tyson S, Hawkins R, Nordenskiold U, Prior Y (2015) The Reliability and Validity of the English version of the Evaluation of Daily Activity Questionnaire for people with rheumatoid arthritis. Rheumatology  54 (9):1605-1615

Hammond A, Prior Y, Tennant A, Tyson S, Nordenskiold U (2015) The content validity and acceptability of the Evaluation of Daily Activity Questionnaire in musculoskeletal conditions. British Journal of Occupational Therapy 78 (3) 144-157 (Publication highlighted as Editor’s choice).

Al-Khlaifat, L., L.C. Herrigton, A. Hammond, S.F. Tyson, R.K. Jones (2015). “The effectiveness of an exercise programme on knee loading, muscle co-contraction and pain in patients with medial knee osteoarthritis: a pilot study.” Knee 23(1): 63-69

Hammond, A., Jones V,  Prior Y (2015). “The effects of compression gloves on hand symptoms and hand function in rheumatoid arthritis and hand osteoarthritis: a systematic review.” Clinical Rehabilitation 30(3): 213:224

Thomas, N., S. Plant, K. Woodward-Nutt, Y. Prior, and S. Tyson (2015). “Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial” Trials 16 (1)

Dziedzic KE. Nicholls E, Hill S,  Hammond A, Handy J, Thomas E, Hay E (2015). “The clinical effectiveness of self-management approaches for osteoarthritis in the hand: a community based 2x2 factorial randomised trial.” Annals of the Rheumatic Diseases 74:108-118. DOI: 10.1136/annrheumdis-2013-203938–

Oppong, R., S. Jowett, E. Nicholls, D.G.T. Whitehurst, S. Hill, A. Hammond, E. Hay, and K. Dziedzic (2015).“Joint protection and hand exercises: an economic evaluation comparing methods for the evaluation of factorial trials.” Rheumatology 54(5): 876-83. DOI:10.1093/rheumatology/keu389

Hollands KL, Pelton TA, Wimperis A, Whitham D, Tan W, Jowett S, Sackley CM, Wing AM, Tyson SF, Mathias J, Hensman M, van Vliet PM. (2015) Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial. PLoS One. Oct 7;10(10):e0139261. doi: 10.1371/journal.pone.0139261

Hollands, K., T.A. Pelton, A. Wimperis, D. Whitham, W. Tan, S. Jowett, C.M. Sackley, A.M. Wing, S.F. Tyson, J. Mathias, M. Hensman, and P.M. van Vliet (2015). “Feasibility and preliminary efficacy of visual cue training to improve adaptability of walking after stroke: multi-centre, single-blind randomised control pilot trial” PLOS ONE, 10 (10), e0139261 DOI: 10.1371/journal.pone.0139261

Hollands KL, Pelton TA, van der Veen S, Alharbi S, Hollands MA. (2015) A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors.Gait Posture. Sep 30. pii: S0966-6362(15)00886-3. doi: 10.1016/j.gaitpost.2015.09.018..

2014

Prior Y, Hammond A (2014) Work Rehabilitation for those with Rheumatoid Arthritis in the UK: A Systematic Review. The Journal of Rheumatology Occupational Therapy 28(1):12-16.

Hammond A, Tyson S, Prior Y, Hawkins R, Tennant A, Nordenskiold U, Thyberg I, Sandqvist G, Cederlund R (2014) Linguistic validation and cultural adaptation of an English version of the evaluation of daily activity questionnaire in rheumatoid arthritis. Health and Quality of Life Outcomes 12:143 doi:10.1186/s12955-014-0143-y

Hammond A (2014). The Elizabeth Casson Memorial Lecture 2014: Changing Ways, Changing Times. British Journal of Occupational Therapy 77(8):392-399

Hollands KL, Agnihotri D, Tyson SF (2014). Effects of dual task on stepping patterns of walking and turning in healthy older adults and stroke survivors. Gait and Posture. Sep;40(4):564-9

Currently we have the following PhD studentships available for prospective students:

Science without borders

Pathway to Excellence studentships

Prospective research students, who already have sources of funding, with an interest in musculoskeletal or neurological rehabilitation, development patient reported outcome measures, self-management  or similar topics to our research interests  are welcome to contact us and discuss potential supervision/ application to the University of Salford.

Prof Alison Hammond

Clinical Rehabilitation Research Group

University of Salford
L701 Allerton Building
Frederick Road Campus
M6 6PU

t: +44 (0) 161 295 0038
e: a.hammond@salford.ac.uk

Alharbi S. (Sept 2014-2017). PhD

“Consequences of gait asymmetry: biomechanical risk factors for the development of Osteoarthritis and musculoskeletal comorbidities in Stroke survivors”

Lead Supervisor: Kris Hollands
Co-supervisor: Rich Jones

Avgoustaki F. (October 2015 – October 2018)

“Work problems in people with Osteoarthritis”

Lead Supervisor: Yeliz Prior
Co-supervisor: Alison Hammond, Karen Walker-Bone (University of Southampton)

Blaakmeer J. (January 2015-July 2016). MSc research


“Effects of training at different walking speeds on footfall accuracy in older adults and stroke survivors”

Lead Supervisor: Kris Hollands
Co-supervisor: Vivan Weerdesteyn Radboud University Medical Centre, Amsterdam NL

Hammerbeck U. (Nov 2014- July 2015).

Post-doctoral project title: “Effects of training at different walking speeds on footfall accuracy in older adults and stroke survivors”

Sani Pour F. (Sept 2014-2017) PhD

“Positive Psychological Change in People with RA”.

Lead Supervisor: Peter Eachus
Co-supervisors: Linda Dubrow-Marshall, Alison Hammond, Yeliz Prior

Trinler U. (Sept 2012-Sept 2015) PhD

“Forward dynamic modelling of lower limb muscle forces during healthy walking: a normative database for clinical gait assessment”

Lead supervisor: Richard Baker
Co-supervisors: Kris Hollands, Rich Jones

Onmanee P. (Sept 2012-Sept 2015) PhD

“EMG of deep lower limb muscles during walking in healthy older adults and stroke survivors: a normative database for clinical assessment”

Lead supervisor: Richard Baker
Co-supervisors: Kris Hollands, Rich Jones

van der Veen S. (Sept 2014-2017) PhD

“Gait adaptability after stroke: measurement, impairment and treatment”.

Lead Supervisor: Kris Hollands Co-supervisor: Richard Baker 

The Team

Professor Alison Hammond

Rheumatology and MSK Rehabilitation

Dr Yeliz Prior

Rheumatology and MSK Rehabilitation

Dr Kris Hollands

Neurorehabilitation

Dr Angela Ching

Rheumatology