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The 2009-2010 ARNI TRUST/MIDDLESEX UNIVERSITY FUNCTIONAL TRAINING AFTER STROKE ACCREDITATION
WOULD YOU LIKE TO BE ABLE TO TEACH EFFECTIVE FUNCTIONAL TRAINING AFTER STROKE?
ARNI UK runs a popular course which teaches specialist exercise instructors how to teach stroke survivors functional training. Functional training after stroke taught by ARNI is characterised by: essential task related practice to stimulate action control, creative physical coping strategies to perform ADL independently & resist damage, and appropriate resistance training.
ARNI trains Professional Instructors to teach functional training after stroke. These Instructors are usually Level 3 REPs Exercise Instructors (who have some cardiac training experience). ARNI welcomes onto the Course:
1. Self-nominated Independent professional trainers (including Different Strokes Instructors).For exercise instructors who wish to teach functional training after stroke, receive regular recommendations from the ARNI Trust and have their business placed on the ARNI Instructors page, please apply now to register for the Accreditation.
2. Stroke Network-nominated Independent professional trainers, NHS Technical Instructors, CouncilHealth & Physical Activity Co-ordinators, and Referral Consultants/Leaders. For Stroke Networks who want professional, accredited Instructors to continue the work of the PTs and OTs in the community, ARNI will locate and train the most suitable Instructors to teach functional training after stroke. Once accredited, they in turn will supply the necessary commitment and time to the Network to take charge of the rehabilitation of stroke survivors referred to them (both in peoples' own homes and groups).
The ARNI Trust Functional Training After Stroke Course
1. The ARNI Trust is associated with the Clinical Exercise and Sports Rehabilitation Depts at Middlesex University.
2. The ARNI Trust Exercise After Stroke Course has been accredited at Middlesex University. The course is designed to enhance knowledge and skills in the area of stroke rehabilitation for PT trainers, many of whom will be already be training stroke survivors. The Trust is also working towards a qualification which will (projected 2010) be presented to Skills Active in order to be ratified by REPs (Register of Exercise Professionals) at Level 4.
3. The ARNI Trust has worked with the North East Cardiovascular Network and now with the Beds/Herts Cardiovascular and Stroke Network and the Black Country Stroke Network in order to provide for PT trainers and physiotherapists to go through exercise after stroke courses. The Trust is also working with Councils (eg. Blackburn and Darwen) and some GP Prescription for Exercise schemes around the UK.
The 1st Exercise After Stroke PD course at Newcastle
3. The Director has produced a comprehensive syllabus of reality task-related training techniques and physical coping strategies which is due to be published next year in 3 volumes. Neurological research experts and supporters (eg, the President of the World Council for Neurorehabilitation, Professor Michael Barnes, who is writing the Foreword for the ARNI Trust training manual) tell the Trust that indeed: physical therapists and personal trainers must be mobilised and facilitated to help at the end-of-line, where stroke services fall off…and developing their understanding concerning the implications of stroke, and what they can do to help in the community, is essential.
..THE COURSE STRUCTURE
1. DAYS 1 AND 2 – PRACTICAL
The Director will go to an arranged location in the UK and train a cohort of professional trainers, grouped by the Stroke Network Stroke Services Improvement Manager in the area. During these 2 days, as much practical training takes place as possible from 9-4/5pm. The training is taken directly from the course manuals compiled to cover rehabilitation of action control in the lower and upper body. Please make sure to contact Director for full info on practical course structure.
The Director is assisted in the area by his Instructors who travel to the areas to help and to keep up with PD. A stroke survivor or two is usually present for demonstration purposes (see pic, left). Instructors are given a comprehensive data folder including stroke research reviews (EBRSR) to digest in preparation for the Theory day.
.2. DAYS 3 AND 4 - THEORY............................................................................................................... .........roll mouse over pic for another pic..
A fortnight or so later, 20/30 Instructors come to the Royal Society of Medicine, London for 2 full days of Theory part of the training. They will learn about stroke in much greater depth from experts (on rotation) from the research and practice from the Universities, Labs, Research Groups, Hospitals, Rehab Units, Charities and Associations. They learn about brain structure and examine a model of brain. They learn about cortical remapping, treatment of brain damage, how the motor cortex (M1) controls voluntary action, somatosensation and how deficits affect perception and control of action.
They learn about neuroimaging, diagnoses and management of acute stroke, restorative neurology, organisation of care,national standards and clinical protocols, the role of the neurophysiotherapist and occupational therapists, the neuropsychologist and the speech therapist, about swallowing problems, reasoning, planning and learning problems and how to help stroke survivors regain self confidence and self esteem. ... .......
Interventions such as robotics, CIM, virtual reality, BOTOX, acupuncture for stroke etc are discussed, along with other issues like orthotics and the role of products such as Saeboflex. On each course, a stroke survivor panel is present. Instructors are given further resources and web-links in preparation for assessment.
Dr Pip Logan: Associate Professor in Community Rehabilitation,
Division of Rehabilitation and Ageing and Division of Primary Care, University of Nottingham.
Professor Sophie Scott: Institute of Cognitive Neuroscience, Speech, Hearing and Phonetic Science, UCL, London.
Dr Nick Ward: Sobell Department of Motor Neuroscience,Institute of Neurology, UCL.
Dr Ian Wellwood: Lecturer in Public Health and Health Services Research, Kings College Division of Health + Social Care Research Division, London.
Dr Alexander Leff: Lecturer & Consultant Neurologist, Wellcome Trust Centre for Neuroimaging, Institute of Neurology, UCL, London.
Dr Sandrine Thuret: Cell Research, CCBB, Institute of Psychiatry at the Maudsley Hospital, Kings College, London.
Dr Alex Nowicky: Course Leader Neurorehabilitation, Brunel University, London.
Dr Lakshmanan Sekaran: Consultant Stroke Physician, Clinical Director, Stroke Unit, Luton & Dunstable Hospital, Bedfordshire.
Dr Fiona Jones: Senior Lecturer, Faculty of Health and Social Care, St George's, University of London.
Sandra Chambers: Clinical Specialist Physiotherapist, Guy's and St Thomas' NHS Foundation Trust, London.
Amanda Wallace: Senior Research Physiotherapist, Sobell Department of Motor Neuroscience, Institute of Neurology, UCL, London.
Liz Barber: Stroke Services Improvement Sister, Royal Berkshire Hospital Acute Stroke Unit.
GrandMaster Lee+ Ko Young: Stroke Treatment Specialist, Sungji School & Middlesex University.
Ayfer Kahraman: Doctoral Student, Faculty of Health and Social Care, St George's, University of London.
a) Three weeks/ 1 month later, assessments of knowledge and skills take place back in the same local studio used for Days 1&2 Practical Teaching. In an agreement with the ARNI, a group of Different Strokes stroke survivors is mobilised for the each event. In the morning a Master Class from the Director takes place for Instructors to see how techniques work in practise and how a class structure differs by necessity from the training of any other cohorts. They get to see how to manage different ages, degrees of functional recovery and how to tackle differentiation of training.
..... .roll mouse over pics for another pic ..
b) 2 Instructors are then allocated to 1 stroke survivor. Training skills are then assessed to according to Accreditation criteria, with guidance as sought. To give you an idea of what we expect: within each hour class, each stroke survivor should have done something significant under the guidance of the Instructors that they had not been able to do post-stroke. See video (left) for example of sum-up from group.
Read some feedback from one of the stroke survivors (Anne) in 2009. And Anne-Marie in 2010.
c) Instructors are then put through a 3-part Stroke Knowledge test which requires answering short MCQs and written answers to demonstate their understanding of the care pathway and current applications of interventions post-stroke.
They then write a full report concerning the training of the stroke survivor from their notes at the time, and lastly indicate future training suggestions/class-plans as a case-study, which is then assessed.
The next courses are taking place in the Beds/Herts and Black Country Stroke Networks: Applying Instructors from REPs/NRPT etc, click on this page for area details.
Collaboration with Later Life Training
The ARNI Trust Functional Training after Stroke course has linked formally with the Later Life Training (Queen Margaret's University) course in Exercise and Fitness after Stroke to provide one Gold standard for UK exercise instructors working with stroke patients. This standard is evidence based, exercise science based, uses clinically led approaches to individually tailored exercise, and is endorsed by Skills Active and recognised by REPS at Level 4. Instructors who require qualification can do both courses as one package with the ARNI Course as high-level CPD. The CPD as Level 4 Accreditated Functional Training after Stroke Course will continue as normal.
Upcoming Research on ARNI approach 2010
1. Stroke Research Network
Statement from Jacqueline Briggs (South West Stroke Research Network Manager) and Dr Sarah Dean (Peninsula College of Medicine) (July 2010):
‘The Peninsula Collaboration for Leadership in Applied Health Research and Care (PenCLAHRC) and the South West Stroke Research Network, are working with Dr Balchin and James Irving (Lay member SWSRN) to develop a research funding proposal that will evaluate the effect of the ARNI rehabilitation Technique and at the end of June 20101 the research team has submitted an outline proposal for funding:
ReTrain: evaluating the effectiveness and cost-effectiveness of a physical REhabilitation TRAINing programme for people six to twelve months post acute stroke.
This research will compare the clinical effectiveness and cost-effectiveness of a physical rehabilitation intervention (in addition to usual care) with treatment as usual, for people six to 12 months on from stroke. Action for Rehabilitation from Neurological Injury (ARNI) is a manual-based, exercise programme designed for use at least six months after stroke when very few stroke survivors will be receiving further rehabilitative therapy. The programme addresses activity restriction in daily life through exercise tasks that are based on functional activities, strength and cardiovascular fitness training and could be plausibly delivered across the UK.
We are working with our colleagues in other research and clinical Networks across the region and nationally so that if the project is funded we can study the technique over a large number of people in different regions. In preparation for this we are looking for instructors to train in the ARNI technique initially from the south west Peninsula, as this is where the study will start’.
2. Brunel University
A 24 week feasibility study is due to be performed in collaboration with Hillingdon Hospital starting August 2010. Dr Cherry Kilbride and colleagues from Brunel University will carry out the research.
Extensionsto Exercise After Stroke Course 2010
Those who go through the Exercise After Stroke Award may apply to ARNI to become an Instructor. This means that they may be able to take advantage of our continual free PD courses (worth thousands, over time), receive the latest research, receive ARNI newsletters, and above all, take advantage of exposure on the ARNI Trust website. The site receives hundreds of hits per day due to Google Ads. This means that if a stroke survivor types in 'stroke help', or hundreds of other combinations, they will be able to find ARNI on the top of the first page listed.
We will put your details on our map of the UK, and they can click directly through to your own site, or find your contact details immediately. Your exposure to stroke survivors and their requests will instantly be ramped up. We receive at least 5 calls per day at ARNI Central, and the matching service is working extremely well. Email for details, particularly if we have recommended to you, whilst teaching you on the courses, that we would like you to go further with us, as well as taking care to fulfill the requirements of your PCT. We are always looking for excellent representatives of ARNI.
2010 - One day CPD for Therapists
1. FOR PHYSIOTHERAPISTS AND OCCUPATIONAL THERAPISTS: ONE DAY CPD.
A number of hospitals, special care homes and companies specialising in rehabilitation need one-day CPD.Indeed, many of the Networks contacting us now require this, rather than a 5 day course spread over a number of months. Please download a sample flyer constructed for the North and East Yorkshire & Northern Lincolnshire Cardiac & Stroke Network (NEYNL). Preferred numbers are 20 and over, and Dr Balchin and a physio from his team will COME TO YOUR VENUE, WHEVERER IT IS IN THE COUNTRY, BY ARRANGEMENT, and run this CPD.
Approaches presented in this CPD day are pulled from the advanced sections of the ARNI Trust 5 day Level 4 (HE) Accreditation in Functional Training after Stroke (run at Middlesex University and the Royal Society of Medicine). The Trust hopes that these strategies will add to your existing armoury of practical skills in rehabilitation following stroke.
2010 - Two day CPD for Professional Trainers
Want to get Functional Training after Stroke training as an individual Professional Trainer? Are you a Different Strokes Instructor, or other? Didn't get an invite from your PCT or too busy to take time off when an offer of sponsoship was made? Are you a gym manager who wants to send your own Instuctor(s) on our course?
Don't worry. Email or phone ARNI to go on a two day intensive training session with the Director and Instructors. Dates of these are usually listed on the Home Page, but we set these up on request, so make sure to email or phone to arrange a mutually convenient date. Price for 2 days practical training (11am - 5.30pm) - just 100 pounds per day.
We teach practical, real-life skills developed by the Director to achieve mastery over the limitations of residual paralysis to enable you to teach stroke survivors to move more easily, and develop strength, balance and confidence. Contact with ARNI is an excellent chance to get involved with a rehabilitation charity to help others and for your own personal professional development!
PAST AWARDS: The 2007-2008 ARNI TRUST Tripartite Award
The ARNI Trust developed the ARNI Trust Tripartite Award to facilitate the efforts of stroke survivors who want to train to cope with life again. It is being phased out now, in preference for the Exercise After Stroke Course above and Special Courses. But from this Initiative, we gained 30 Instructors, trained first in seminars and then on a one-to one basis, to ensure each is confident to help stroke survivors in the required way. Instructors gained the ARNI Trust Award, a professional development award which equips trainers with the techniques we developed over 10 years of training stroke survivors. There were at least 15 seminars per year and Instructors could start at any time, at any point during the course, as long as they finshed the whole content.
The training syllabus was especially designed to introduce trainers gradually to the concept of training stroke survivors via a succession of seminars, and exposure to existing stroke survivors so that they could understand better the needs of this cohort. Training in specific techniques was then given in 3 days of formal seminars, plus compulsory one to one (or two Instructors) teaching.
Instructors then shadowed existing ARNI Instuctors, if this could be set up, and involved themselves with an existing class so that we were sure that they came away with the knowledge and confidence to work with the patients. Home learning was a requirement, as is still, the attendance at seminars around the country on the new Exercise After Stroke Course to help Instructors sent by the PCTs. Most ARNI trainers are currently training at least a couple of stroke survivors, with some remarkable results. Continual PD is kept up by attendance at seminars.
The Trust found it nearly impossible to attract as volunteers (who also possess the necessary prior qualifications) to these responsible positions as necessary around the UK, so we are falling in line with many charities, and asking stroke survivors to pay a nominal fee to trainers (see your trainer for details). This subsidises their availablity to help, and costs every week. We regarded the fact we are able to refer needy people to them in their areas as the best benefit of this approach. Please click on the below buttons to find out what some Instructors who have been through the 2008 course think. Many of these people below are now ARNI Trust Instructors. One is a Middlesex University student who went through a 4 day taster course and wanted to highlight the experience in writing. Feel free to contact them independently at their own clubs or businesses about ARNI.
Testimonials from Instructors who have been through the ARNI Trust Tripartite Award
ARNI TRUST........working for st
1. The ARNI Trust is associated with the Clinical Exercise and Sports Rehabilitation Depts at Middlesex University. 
1. DAYS 1 AND 2 – PRACTICAL 
