PhysioUpdate 23rd August 2022

Every NHS hospital will be asked how staff manage patients with cauda equina syndrome as part of a bid to highlight what constitutes best practice. Clinical lecturer David Metcalfe, who is based at the University of Oxford, will lead a study looking into the diagnosis of the spinal condition after being awarded an advanced fellowship worth more than £1 million from the National Institute for Health and Care Research.

Claire Thornber, founder of the Cauda Equina Syndrome Association, welcomed the announcement and looked forward to supporting the study: ‘We are reassured by these efforts to address the issues around cauda equina syndrome diagnosis, management and rehabilitation as so many patients are being lost in a system without pathways.’ 

The study could also have implications for the physiotherapy profession, as practitioners have faced legal action from patients seeking compensation over what they perceive to be shoddy treatment. The Chartered Society of Physiotherapy (CSP) has stated that settlements in such cases can reach £1 million or more.

Healthcare centres should receive extra support to enable them to cope with a rise in the number of people who will develop neurological and mental health conditions linked to Covid-19 infections. That is one of the suggestions made by researchers in a paper published today (18 August) in The Lancet Psychiatry. They argue that new cases are likely to occur for a considerable time after the pandemic has subsided, and that the risks remain for up to two years.

Their study, which is based on data linked to more than 1.25 million people diagnosed with Covid-19, suggests there is an elevated risk of developing conditions, such as psychosis, dementia, ‘brain fog’ and seizures, and that the risks are greater than those associated with other respiratory infections.

Paul Harrison, the study’s lead author who is based at the University of Oxford, said: ‘In addition to confirming previous findings that Covid-19 can increase the risk for some neurological and psychiatric conditions in the first six months after infection, this study suggests that some of these increased risks can last for at least two years.'

Office workers who used standing desks reduced their sitting time by about an hour a day over one year, according to the results of a randomised control trial (RCT). The first author of a paper based on the study, which appears in today’s edition of The BMJ, is Charlotte Edwardson, associate professor of physical activity, sedentary behaviour and health at the University of Leicester’s department of health sciences. 

As well as the standing desks, the office workers received a package of measures to encourage them to move more and sit less. Sitting less was also linked to minor improvements in stress, wellbeing, and energy levels at work – although these improvements were not deemed to be clinically meaningful. 

Dr Edwardson was one of a team of researchers based in the UK and Australia that evaluated the impact of an intervention called SMART Work & Life (SWAL). Its aim is to reduce sitting time and increase moving time at work – with and without a standing desk – delivered by ‘workplace champions’.