DREX Workshops

As part of my research project investigating the barriers and facilitators experienced by stroke and brain injury survivors we have recently hosted and run some workshops, inviting survivors to discuss how we can improve our training and showcasing some of the improvements we have already planned in order to continue to provide an accessible training option that is designed for, and as much as possible by, the people that will be using it.

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This past month we have hosted our most recent workshop, looking at a few specific changes we are looking to make over the next few weeks. One of the most important items for us is the production of informational videos covering a number of different subjects such as how to download DREX and the specific assessment and training trials that you will see when using the app. As these videos will be seen by users when they are looking to find out more about DREX, or to troubleshoot any issues they are having, then it is imperative that these videos convey these messages simply and in the easiest possible way to understand. Therefore it is best if these videos are made in conjunction with the people that will be using them. We make the user the most integral part of any update process as the only way we can guarantee these updates will be of benefit is if they work for the intended audience. Therefore these videos were seen by the workshop attendees, all of whom were stroke and brain injury survivors. The feedback provided has directly influenced and changed the final videos which will be uploaded in the coming weeks.

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There are other aspects that we have been looking to update and other ideas that we are keen to implement such as the best way to advertise our training, whether or not user manuals would be of benefit and how we can best help people download the DREX app. Through conversation with stroke and brain injury survivors at these workshops we have been able to change these ideas that we have had into actual tangible outputs that can be used. It is great to have a supportive network of individuals willing to assist us with progressing the app and hopefully this will lead to a greater positive impact on the quality of life stroke and brain injury survivors experience.

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We are looking at running more workshops over the coming months for stroke and brain injury survivors, carers and occupational therapists. If you know of anyone who would be interested in attending, or you yourself would like to attend then don’t hesitate to get in touch with us. There are a number of ways you can contact us so feel free to choose from one of the options below.

Contact Paint

Thanks for reading and we will see you soon!

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DREX Engagement

Hello! It has been quite a while since I last uploaded a blog post. In this post I will update you on what’s been happening over the last few months and the new goings on with the DREX app. Now that October has rolled around the University has once again become a hub of activity with the return of hundreds of students. However for the DREX project, work never stopped. We have been constantly active over the summer taking part in a number of different engagements. These have mainly taken the form of informational talks at a number of different places including NHS trusts, schools and stroke and brain injury charities.

One of the best ways to inform people about DREX training and the positive impact stroke and brain injury survivors have experienced using our training is to directly engage with stroke and brain injury survivors or healthcare professionals. The DREX team attended the County Durham and Darlington Research and Innovation Day in May of this year. This was a really great event with a number of exciting and interesting research projects presented, all of which will and have had a positive effect on the lives of patients with a whole host of varying conditions. It was great to be a part of this event and engaging with other researchers and interested healthcare professionals. We were able to host a stall at this event which was an excellent way to discuss our project with a whole host of individuals from varying disciplines.

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The DREX team has also presented at the inaugural Wolfson Research Institute for Health and Wellbeing Early Stage Research Conference. This event took place in the Wolfson Research Institute based in Stockton-On-Tees. The event played host to a number of talks from early career researchers from a wide range of varying research backgrounds. This event gave the DREX team the opportunity to present our research to colleagues and professionals who may have previously not been aware of our research. This event has also led to future plans for collaboration with colleagues from different departments, applying our DREX training to other fields.

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A final development from the DREX team is that we have recently launched a Facebook page for our training. We will be using this page to upload videos and post updates regarding any developments occurring on the DREX project. If you would like to view the page then you can do so by following this link:- https://www.facebook.com/DREXDurham1

It would be a great help if you could like the Facebook page and stay tuned for updates.

As always there are a number of ways to get in touch with us. For further information, to request a talk or demonstration, or to talk to us about anything then select from one of the options below.

 Contact Paint

Thanks for reading and we will see you soon

 

DREX Website Tour

This week I thought it would be interesting to do a different type of blog post. Instead of talking about what we have been up to recently I thought it would be good to take you through a tour of our web pages, showing you the information that’s on there and how to find the answers to any questions you may have.

To access the website the go to www.durham.ac.uk/drex

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Clicking on the above link will take you directly to our webpages. You can access information about the DREX training, who we are, published research articles and user guides by using the navigation bar on the left hand side of the screen. On the right hand side of the screen you will be able to see our most recent tweets and our contact details.

We have had a number of positive responses from DREX users in relation to how the DREX training has made a difference in their everyday lives. To read a selection of these click on the ‘Testimonials’ tab on the left hand side of the website.

The most visited pages of our website have been the detailed user download and user guides for the DREX app on android tablet, iPad and computer. Depending on your preference for how you access the app, you can learn about how to download and use the DREX app for your tablet or computer. These guides are also printable should you wish to access this information in paper form.

For any healthcare professionals looking to track the progress of their patient, we have our clinician portal, discussed in a previous blog post, which can be used to do this. This free webservice allows DREX users and healthcare professionals to share training data, enabling the tracking of progress whilst accessing the training. To find out more about the clinician portal, to access it or to download a user guide for this free service then click on the ‘Clinician Portal’ tab on the left hand side of the screen.

Finally, should you wish to get in touch with us about anything then click on the ‘Contact Us’ tab on the left hand side of the screen. Here you will find details of how to contact us about DREX training and the details of the DREX Project Director and Manager should you wish to contact someone directly.

For further information, to request a talk or demonstration, or to talk to us about anything then select from one of the options below.

Contact Paint

Thanks for reading and we’ll see you soon

DREX Clinical Trial

In a previous blog post we have talked about one of our projects looking at improving rehabilitation for stroke and brain injury survivors in great detail. However this is not the only question we are investigating. Today, let us have a look into our recent clinical trial which aims to investigate the effectiveness of using DREX for touchscreen tablets and personal computers.

The previous versions of the training demonstrated positive therapeutic effects and improved quality of life. Now, the training has been developed into a multi-platform app called Durham Reading and Exploration (DREX) training in order to improve usability and access. Will this new training work as well as the previous version or are both touchscreen and computer training equally effective so patients could opt for any preferred method for rehabilitation?

To answer this question, this research project will evaluate the effectiveness of the DREX app in a controlled trial. If successful, the training app could benefit many patients with partial visual loss by providing a free, effective and accessible rehabilitation aid. In this trial, we train individuals with non-progressive visual field loss such as hemianopia (visual loss at right or left side of visual field) or quadrantanopia (visual loss at a quarter part of visual field, could be right or left, upper or lower part). Participants are able to complete the assessment and training at their own home. However, if they would like to do the assessment at Durham University, we can make an arrangement for a suitable slot.

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(Reproduced from https://commons.wikimedia.org/wiki/File:Fullvf.png)

The impact of DREX training on the primary behavioural functions of reading and visual exploration will also be evaluated to demonstrate if the impaired reading and visual exploration skills can be improved after both are trained. This trial will further investigate the transferability of the benefits to the activities of daily living, mood and depression, participation and motivation to engage in rehabilitation, and attitude towards visual impairment and disability. The result of these assessments will reflect patient’s acceptance for the training program and the potential wider impact of this on socio-emotional factors.

One of the interesting features of this new training app is we have incorporated self-assessment tests which will help patients to monitor and know their progression. This trial will validate these self-assessment tests by comparing them with the standardised measures. If the assessments are validated, it will allow the clinical team, such as doctors, optometrists and occupational therapists, to track patients’ progression remotely and will enable suggestions be made to improve training experience. With the built-in assessments, patients will then know how well they are doing and how much benefit they have gained from the training.

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Do you know anyone with partial visual field loss? Would they benefit from training? Or are you interested to take part and join us? Here at the Psychology Department, Durham University, we are looking for patients with partial visual field defects like hemianopia or quadrantanopia, aged 18 years and above, to take part in this clinical trial. If you would you like to know more or ask us any questions then feel free to contact the Chief Investigator of this trial, Mr Azuwan Musa at 0191 334 0588 or send an email to azuwan.musa@durham.ac.uk.

Thanks for reading and we will see you soon!

DREX: The Clinician Portal

Up to two thirds of people suffer from some visual problem following stroke. The DREX app aims to train stroke and brain injury survivors to compensate for this visual loss. However, we also provide an additional service for all healthcare professionals (G.P.’s, occupational therapists, etc.) working in the rehabilitation of stroke and brain injury survivors:- The Clinician Portal.

The Clinician Portal is a free webservice which enables healthcare professionals to connect to their patients. This is beneficial as it allows the healthcare professional to track the progress of their patient and can also be a great motivation tool for the patient.

The Clinician Portal can be accessed using the following link https://apps.dur.ac.uk/drex/login. The portal is available for all healthcare professionals wanting to both refer and track their patient’s progress. The first thing required is to register with the portal. To do this we require your full name, an email address, a password and the company that you work for (Stroke Association, County Durham and Darlington NHS Trust, etc.). After creating an account we will verify your account based on the information you have provided. After this you can begin using the portal.

When first logging in you will be presented with the Clinician Dashboard. This is where you will be able to view all of the patients you are connected to and see a summary of how they are doing. The portal also allows you to click on specific patients to see how each individual is progressing. The data can also be downloaded.

 Clinician Portal Summary

For more information about the portal and how to use it then check out our web page detailing a step-by-step guide with screenshots here:- https://www.dur.ac.uk/psychology/research/drex/clinicianportal/

Thanks for reading and we will see you soon!

How can we improve rehabilitation?

We currently are investigating a number of different research projects in the DREX team. In this blog post I’ll talk about one that is very close to my heart…My project! The project I am currently working on is an examination of factors influencing the success of rehabilitation. Or more affectionately known by the team as the DREX Personal Rehabilitation Project.

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Rehabilitation after stroke and brain injury is a long and arduous process. We have been graciously funded by the Dunhill Medical Trust to look into the barriers and facilitators experienced by stroke and brain injury survivors, to see whether we can make a difference generally to rehabilitation after stroke and brain injury. We are also looking at how we can make the DREX training more accessible and easier to use for those with visual problems following brain injury and stroke.

This project is still in its infancy but we have already learnt so much. We initially conducted a number of focus groups with stroke and brain injury survivors all over the U.K. These were within charities, stroke groups and within NHS trusts. The focus groups were designed to give us a greater understanding of the barriers and the positives experienced after stroke and brain injury and what could be done to assist with making rehabilitation easier.

Some of the findings from these groups were very interesting and eye-opening. Individuals from these groups highlighted a “lack of stability” in who was providing support for them throughout their rehabilitation. They also found that “everything is blamed on the stroke even when it’s unrelated”. However, the groups identified that “support from charities and my family has been vital”. The main finding that we took away from these groups is that at present there seems to be a real lottery element to the rehabilitation individuals receive after stroke or brain injury. Some individuals experienced no problems throughout their rehabilitation and felt that they received constant and adequate support. However, the larger majority of people felt there was a great deal of instability throughout their rehabilitation and they felt very much on their own. The disparity between experiences was quite startling.

After discussing the findings of these focus groups with the team we decided the next step would be to see if the feelings of those canvassed during the focus groups generalised across other stroke and brain injury survivors. The best way we could think to do this was to create and distribute a survey tapping into some of the key points raised. The survey also asks a number of different questions aimed at learning more about the individuals personal rehabilitation experience. We have circulated the survey far and wide by post and online and have received over 100 replies so far. We have just this week taken a first look at the data so we only have preliminary results for this. However, it would appear that so far, the survey findings match those found within the focus groups.

The survey is still currently open so should you know of anyone who has survived a stroke or brain injury and who would be willing to take part then please point them in the direction of the following weblink https://durham.onlinesurveys.ac.uk/drex. Clicking on this link will take you to our survey which should only take 10 minutes to complete. If you’d prefer a paper version then please get in touch with us and we can post one out to you.

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So what does the future hold for this project? The next stage will be trying to put the findings of the survey and focus groups into practice. It is one thing to listen to and gather this information but another to use it. So from this information we hope to be able to take this to NHS England in order to change how stroke and brain injury survivors are treated throughout their rehabilitation. We also hope to conduct a number of workshops over the coming months with survivors and healthcare professionals to further our understanding of the problems.

For further information about this project or to talk to us about anything then check out our contact details via our Contact Us page or select from one of the options below.

Contact Paint

Thanks for reading and we will see you soon!

DREX: Assessment and Training

So our previous blog posts have outlined how we have gone from lab-based training in a University to a free app accessible around the world. For this blog post we will be looking in a bit more detail at the app itself. Specifically the tasks the app contains and how to complete these.

After downloading and registering with the app the very first thing you will be able to do is to complete an assessment. The assessment consists of 7 separate tasks that are designed to test your current visual functioning in a number of different ways.

 

Assessment

Perimetry

In this task, 4 red dots are presented in the centre of the screen. A white dot may or may not appear briefly at some point, either at the centre of the red dots or elsewhere on the screen. When you see this dot your objective is to tap or click on its location.

Perimetry

 

Visual Search: Images

A number of items that you might find in everyday life will be presented to you during this task. The number of items presented will vary. The objective here is find the pen among these items and either click or tap on it.

Vis Search Images

 

Visual Search: Numbers

For this visual search assessment, the numbers 1-20 are displayed around the screen in a random order. To complete this task you will need to either tap or click on the numbers in order, starting with 1, then 2, then 3 and so on. To finish this assessment after working your way to number 20 or if you can’t find the next number then just click or tap on the “I’m finished” button at the bottom of the screen.

Vis Search Numbers 

Reading

For this assessment you will be presented with a paragraph of text taken from Grimm’s fairy tales. There is no time limit so you can take as much time as you need to read this text. After reading it just tap or click the screen and you will be asked three questions. These questions will ask you to identify a word from the text, identify the type of formatting from within the text and to answer a question related to the content discussed within the text. These questions can be selected by either clicking or tapping on your chosen answer.

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Short Term Memory

You will see two sets of numbers within this assessment. The first set will appear in white for a period of 10 seconds and will disappear. After a short period of time, a second set of numbers will appear. For this assessment you will need to click or tap on the number in the second set that was replicated from the first set.

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Quality of Life

This assessment presents you with a series of questions about your everyday life. You can use the sliding scale provided to give the answer that best represents your views.

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After completing these assessment tasks you can then select the type of training that you would like to complete. The two options are Reading training or Exploration training. It is important that you select the type of training that corresponds to the area you want to improve most. For example if you want to improve your reading, then select Reading training. If you want to improve your vision and your ability to explore the world then select Exploration training.

 

Training

Reading

In this type of training, a word will be displayed in the centre of the screen. The purpose of this is for you to decide whether this word is a real word or a made-up word by either tapping or swiping the screen respectively. In this type of training you are being made to read the entire word prior to making a decision. Therefore, your eyes are being made to move across the entirety of the word. As you get better at this training type it will get harder. More words and longer words will appear.

Reading Training 

Exploration

In Exploration training you are presented with a number of items on the screen and the purpose is to find the item that is different from the rest. This could be an item of a different size, shape or colour. This training type makes you move your eyes around the whole screen to find the target.

Exploration Training

Through using the training within the DREX app we hope that those with partial visual loss following stroke and brain injury can get the rehabilitation they so desperately need. If you’d like to get in touch with us or want to find out more then check out our contact details on the Contact Us page.

Thanks for reading and we’ll see you soon!