FEEDBACK AFTER DAY 3 OF THE HYBRID COURSE (HALF-TIME REPORT)
1. Natasha Briggs
Pre course Tom Balchin was incredibly helpful, by replying to emails quickly and reassuring me that I would be able to complete the course even with one absence. He ensured me that he would give me enough materials to mean I caught up with the first session that I was going to miss. We got given plenty of course materials before hand and I really appreciated the 2 extra books we received. They have been really informative particularly for widening your horizon on what its like from the clients point of view.
The course has been split into about ARNI, what actually happens in the stroke treatment process, lower limb and upper limb training so far. Each week we have an update on what is advised to read, watch and learn about before we have an online zoom learning day to recover what we have learnt.
Pre course I have had 3 years experience in a neurological clinic where I would work with at least 10 people who had a stroke every week. I have also assisted in my own mums care after her stroke in 2009. But the course has still been hugely beneficial. I have found in healthcare there is a lot about protecting the stroke survivor and a lack of empowerment. Learning about how to get up from a fall, as opposed to bubble wrapping them. Focus on hand exercise and not just shoulder exercise. These are things I have found hugely interesting.
The online learning has been beneficial as a way of confounding what we have learnt and I have had plenty of opportunities to ask questions and check my understanding. Tom has been excellent at engaging all members so that people are encouraged to stay engaged and learn the content. I often see online courses having people sailing through without active engagement which can result to poor learning. It is refreshing to see someone challenge each person to engage. Tom is good at correcting people and has extensive knowledge on the subject in a unique way that most other trainers/educators have not been able to provide in my previous learning. I have found that by learning by myself and then recap online has been forcing my brain to remember the content better than usual. It is repetitive enough to build memory but not bore.
I have a masters which covered stroke, and as said above some experience so I find the course to move at a good tempo. I have noticed some members struggling to answer Tom’s relatively simple questions. I believe this to be not down to a lack of intelligence but that the course has a lot to learn (rightfully so to be able to properly help someone after a stroke it needs to be) and others with full time jobs and less experience cant necessarily keep up. I don’t believe there is much way to overcome this other than emphasising at the start of the programme that maybe some reading is necessary. However, people would likely still not do this and the best way to learn is practice. However, Tom has never made someone feel stupid for an incorrect or lack of answer so you always feel welcome to have a go at a question. It has enabled me to test my own understanding by speaking up with my thoughts and allowing Tom to explain why it may be wrong or right as opposed to staying quiet. Seeing others find it difficult is reassuring to everyone and creates a welcoming environment.
In terms of improvements there really isn’t much to say. It would be great if one day there was an additional course to learn more about gait, this is something I was very interested in previously and finding a course that can help you learn about efficient gait in normal gait patterns and stroke can be hard as a personal trainer and not physiotherapist. However, it would be too much to dive into in this course.
The course has been value for money so far and I would recommend it to other trainers. My advice to them would be to buy the successful stroke survivor book and read it before the course started and gain some experience with stroke survivors to see what certain presentations look like. That way the course may feel less daunting to someone very new to this world.
I am excited to continue the learning with ARNI.
2. Mary Stevens
I have found the ARNI course so far to be very educational, informative and inspiring. I was a little unsure before the course started about how it would work being fully remote (except from the optional in-person assessment day), but the days so far have been very well structured and kept my focus and attention throughout. It would be nice to be able to meet the other group members in person and learn the many techniques face-to-face, but the online aspect allows a wider cohort to access the course, which in turn will ensure support for stroke survivors is spread further afield.
I have been sent many course materials before and during the course so far. These have felt like they have been carefully staggered and an appropriate amount each time, which has meant that it hasn’t felt overwhelming. The course materials and content are increasing my knowledge and understanding of stroke a great deal. I feel confident to apply new techniques straight away with stroke survivors, and I am excited to learn more to further my skills and knowledge.
As the course leader and founder of ARNI, I have found Tom to be incredibly inspiring and a generous and thoughtful teacher. No one on the course is made to feel silly if they don’t know the answer to a question, and Tom is keen to learn from the experience and expertise of the other course members. There is always the time and space to ask questions, and I feel part of a diverse and skilled group who are keen to share knowledge and personal stories of working with stroke survivors.
One aspect of the course so far that I have particularly enjoyed was the session with Harry, a young stroke survivor. As with Tom, it was very inspiring to hear his story and how hard he has worked on his rehabilitation, which shows in the remarkable progress he has made. I find this type of case study learning to be most effective for my personal learning style, and this is used quite a lot throughout the course, with videos regularly being shown to demonstrate specific techniques and progress of stroke survivors.
I think the ARNI course offers excellent value for money. I can already implement my newly acquired knowledge and skills from the course in sessions with stroke survivors, and I am looking forward to learning more and solidifying this education as I continue the course. I would happily recommend the ARNI course to a friend or colleague, and I am very glad that I took the decision to invest in my learning and future career and do the course. I hope to become an ARNI instructor once I have completed the accreditation, and I would be proud to be a representative of this leading organisation.
3. Katie Godolphin
So far, I’ve been very impressed with the course. Before the course started I received a welcome pack which had my student guide, which goes into detail what will we be covering each day, reading material and relevant leaflets, this was great as I could start reading and researching before the course started so I felt prepared for the first online classroom session.
I’ve thoroughly enjoyed what I’ve learnt from the course, I wasn’t sure how the practical side was going to work, with it being online, but with Tom’s instructions we all seem to understand it and with the help from the video’s I feel confident about the techniques I have been shown which I will be able to incorporate into my work.
Tom encourages us, to ask questions and always gives us enough time so we fully understand before moving on, if for any reason I’ve had questions in between the course days I’ve been able to email Tom and he has responded quickly and always been happy to help with any query.
Within the online classroom set up we have been encouraged to answer questions making it engaging and interesting, sometimes it feels we are all in the classroom together and not at in different rooms on our laptops. Which is a great thing and helps us interact more with each other.
Tom has so much knowledge and experience and I feel I’m learning a lot from the course, and I can’t wait to take it forward into my work. There are lots of little tips that are so simple yet so effective, and I can already see how they will help my clients in a way I haven’t been able to before, they are such valuable techniques.
There is so much information that sometimes it’s a bit overwhelming, however the 2 weeks in between the days give me time to go through it all with the help of the videos and other information that Tom sends out to us.
Overall, I’m very happy with the course and really looking forward to the next half.
4. Adrian Grant
I found out about the course via a current client’s Physiotherapy Team who called it the ‘gold standard’ of Stroke rehab courses and widely recognised within the profession. I have had the privilege to support a client who survived a stroke and my father has recently suffered a stroke himself so both professionally and personally, I felt this was the direction I am meant to take. However, due to my specific personal circumstances: running my own busy practice, home educating and caring for my two neuro-diverse children (alongside my wife), etc – attendance courses are difficult and sometimes, impossible for me to access both financially (travel costs, lost earnings etc) and practically (time away from home/caring and travel). The fact that ARNI offer an online option opened this opportunity up for me and I’m extremely grateful for this.
I had to make a ‘last minute’ application due to my insurers taking time to return to me (as to whether they would insure me once qualified) and I was a little concerned that my later application would be a barrier. However, Tom has been fantastic as a Course Leader, made me feel very welcome and the enrolment process was seamless. Upon enrolment, I received a comprehensive email explaining the course, key dates, times etc. I also received a hard-copy delegate pack prior to the course starting, containing high quality resources including: course manual, stroke rehabilitation books and other key materials. Tom and the administrative team have also processed orders for additional books and resources quickly (arriving the next day) which is great and much appreciated.
Tom is a great course leader, I feel rather privileged to learn from someone of his experience and standing who is also approachable and down-to-earth. Tom is a mine of information: theoretical, practical and lived experience which has been extremely helpful for me as a student; he has also been extremely kind and generous prior to, and after enrolment when discussing my own learning needs with him and I feel confident that should I need support or reasonable adjustments these will be accommodated. One suggestion (and this in no-way detracts from the course at all, it’s just an idea for adding a further dimension for dyslexic learners and those with caring responsibilities…or both!) is audio versions of the books/reading materials as this is an information rich course. Due to my experience of dyslexia, it takes me much longer than others to read materials and take them in. Audio materials would help me to access the material while cooking, cleaning, washing up etc – which is a good time for me to focus on learning at times where sitting and reading may not be possible! That being said, while reading and absorbing written material takes me longer, Tom’s books are easy to read and digest, they are well set out, accessible, clear, and the information in them is interesting and relevant and has enhanced my practice already.
Tom sends session information and course links in plenty of time for me to plan and prepare for the session. Logging in and accessing the sessions has been easy and straight forward and my cohort is a really nice group of people from a range of backgrounds and a variety of experience. Tom has facilitated the group brilliantly and helped us gel quickly within the first session. Tom facilitates group discussions, ensuring everyone has the opportunity to participate, ask questions (and receive answers to their satisfaction) and share their own unique experiences with fellow delegates. Nothing is lost with the course being delivered on-line in my opinion, if anything, I would say it’s a testament to Tom’s course leadership that he is able to make it feel like an in-person course. Practical skills are demonstrated by each delegate in turn and we have the opportunity to receive feedback from Tom and fellow delegates which helps to reinforce learning and develop a supportive environment within the group. Learning objectives in each section are explained and reviewed upon completion of each unit to ensure learning has taken place for each delegate. My learning to date has had a very positive impact on me, my client who is a stroke survivor and my wider clients who haven’t experienced stroke but have mobility issues associated with older age/disability (I’ll cover this in more detail in later sections).
Session one comprised: welcome and introduction, course overview, the ARNI concept, what is stroke?, functional training and the role of repetitive activity in neuroplasticity, functional training after stroke (practical) and considerations for professional practice (assessing functional and psychological limitations caused by ABI/Stroke). This session helped me to understand the scope of the ARNI concept and Charity, the causes of stroke, stroke prevalence, clinical features and the varying degrees of disability arising from stroke. I found this helpful in understanding the causes of stroke and impact of stroke nationally and on individuals and their families. The role of the various services from acute public services to the private and charity sector – helped me understand the scope of service delivered by each layer of the public sector and where the private and charity sectors play an important role in ensuring the best outcomes for stroke survivors. Aside from developing my understanding in this area, the learning from this unit has helped me strengthen connections both within the NHS and wider public sector and also the charity sector which will not only help me support and signpost stroke survivors to relevant services but also enhance and develop my own personal practice beyond the course through sharing of knowledge and access to information.
Functional training, repetitive activity and their role in neuroplasticity – helped reinforce and develop my existing knowledge in the area but enhanced my knowledge in terms of its relevance to stroke rehabilitation. This has been particularly helpful in supporting a current client who has become frustrated and overwhelmed by, what they feel is their own ‘too slow’ progress – in part due to the emotional impact of the stroke on their mobility and their desire to return to pre-stroke ‘normal’ as quickly as possible.
The learning from this element has helped me have supportive conversations with the client to help them understand that a combination of repetitive activities, appropriate cardiovascular and strength training, may take time but are essential for their long-term health and recovery. These conversations have helped the client re-assess their expectations and prioritise their time, energy and resources more effectively. While it is early days and they still have days that are physically and emotionally harder than others, the client is feeling less overwhelmed by their situation and more empowered. Functional Training after ABI/Stroke, Transfer to and from the Floor – this element has had a transformational impact on my client. While (by their own admission!) they didn’t want to do this as the idea of moving to and from the floor triggered an emotional response that they found overwhelming and they felt vulnerable, they have trusted the method and are now feeling more confident in their ability to transition to and from the floor. Again this is early days but the client’s avoidance is reducing and they are feeling a sense of achievement, resilience and self-reliance should they need to transition to/from the floor. This has had a positive impact on their self-esteem too. This element has also had a wider positive impact on my other clients (non-stroke survivors).
As part of my wider practice I teach Pilates and fitness to older people, those with disabilities and chronic conditions – many of which have difficulty/cannot transition from standing to the floor; falls are also more common. Since learning the methods in this section of the course, I have been able to share them with other clients who are now able and/or more confident in participating in floor-based exercise (and their daily lives) as they have the tools to transition to and from the floor.
Day 2 focussed on the practical aspects of cardiovascular fitness, warm-ups and cool-downs, revision on seated/standing to floor transitions, floor-work strategies, functional training for the lower body and trunk, lower body strength training, programme progressions and potential, collaborations with health providers and seeking relevant permissions from medical professionals for rehabilitation. I found this session helpful in learning new techniques to support stroke survivors in developing strategies to improve functional deficits. The seated/standing to floor transitions
have been particularly helpful for my client who is a stroke survivor in developing confidence and self-reliance but has also helped many of my other clients who for reasons of limited mobility and chronic conditions cannot/struggle to transition to and from the floor.
I learned Gait control techniques. turning, avoidance strategies and correcting balance have had a positive impact on my client. The strategy called Heel Brushes in particular has helped with difficulties they’ve experienced with foot drop which had been a source of frustration for them that had impacted their confidence and independence. Sharing these techniques with them has also helped them to integrate them into different daily scenarios that had previously caused them fear and distress which has improved confidence and self-reliance should they lose balance or fall. The strength training components have added variety and more stroke-specific options to programmes for my client but has also added several options to my repertoire for clients with other, non-stroke related mobility impairments. The referral and governance components of this section have helped me to be able to effectively screen participants, understand and review inclusion criteria, how to collaborate with healthcare providers and securing relevant permissions from medical professionals for rehabilitation for stroke survivors. This will ultimately help me ensure my practice is compliant an in accordance with ARNI requirements.
Day 3 focussed on the upper body and hands. I found this session particularly reaffirming as prior to hearing about the ARNI course, I instinctively sensed the importance of restoring and developing functionality in the hands and fingers and had been working with my client on this. He has regained some level of function in his paretic hand which is extremely positive. However, the learning in this session has expanded my knowledge considerably, in particular, in the prioritisation of rehabilitative techniques and the order they should be added in to a stroke survivor’s rehabilitation journey. I now go on Dr Tom’s 60/20/20 percent rule covered in the upper body section of ‘The Successful Stroke Survivor’, prioritising task training focusing on fingers then shoulder and elbow movement. I have now started using this method with my client, also using ‘The Tipster’ and stretching techniques that were covered to help open up the thenar space between the index finger and thumb to enable my client to carry out task training to the best of his ability. I’m particularly excited by the task board approach and am actively sourcing materials to make my own, so I can pass it on to my client to help with his recovery.
Summary: I have found the course invaluable so far and the change in my client’s confidence and self-esteem has made it well worth the time and financial commitment. I am also grateful for the help and resources the techniques have given my other clients, some of whom are elderly ladies who live alone with limited support networks. The course is value for money in terms of course content, the skills and knowledge of the Course Leader and the great customer service I’ve received from both Tom and the admin team. I would highly recommend the course and my eldest son who is due to complete his final year of compulsory education (home educated) has expressed an interest in gaining qualifications and experience that will enable him to become eligible to enrol on the ARNI course and work alongside me in helping stroke survivors.
5. Abdul Moeed
I am a physiotherapist from Pakistan and I received full pack of course material and any-where accessible videos before 2 weeks from starting date of course. Every day I had learnt new things in this course for example: how we can teach new technique to stroke person for getting off from floor and chair and then again stand to sit back with safely, then lower limb stability exercises. One of most important and interesting was upper limb rehabilitation by using that persons own house space.
The techniques which we were learning in this course was all evidence based and simple. These techniques enhance my background knowledge regarding stroke rehabilitation. We have enough time and space where we had attend lectures of this course. During session the instructor was in touch with all participants and freely allowed everyone to ask what ever participant want anytime regarding course, and all enquires was well responded. Dr Tom has a very strong evidence-based grip on stroke rehabilitation and is capable to deal with all severity of stroke.
After all productive sessions we got notes and practical videos, through which we can learn hands on practice too. All my questions or doubts was listened and cleared and the atmosphere was so supportive to focus on learning and lectures also consist of much interesting materials. I’m much happy with these services and I have recommended my all colleagues.
6. Jo Jones
I have really enjoyed the ARNI course so far. The learning approach is motivating, supportive, and open and Tom makes it really easy to ask any questions at any time. The quality of teaching and materials far exceeded expectations with a good itinerary sent pre course and weekly up to date Every workshop has built on the last that gives structure to the learning. This allows for a very well informed and clear run course with guidance of what we need to prepare for the next workshop. I’ve been learning new practical techniques, and gaining insights from a stroke survivor’s perspective from Tom’s inclusion of stroke survivors and Tom sharing his own rehabilitation journey.
Tom is very knowledgeable, approachable, and genuinely invested in our learning making sure each of us fully understands both the theory and practice before moving on. There is a good mix of visual, interactive, and discussion-based approaches which makes the online course inclusive. There is plenty of time to share ideas and contribute to discussions and everyone is encouraged to contribute and the responses have always been thoughtful and informative due to everyone’s different professions. Definitely a course to be recommended and a service that should be more familiar within the stroke community! It’s such a worthwhile experience — both personally and professionally.