The Waltham Forest Children’s Community Physiotherapy Team is proud to be among the 32 participating sites across England and Wales contributing to two national research studies, SPELL and ROBUST, led by Professors Tim Theologis and Sally Hopewell at the University of Oxford and funded by the National Institute for Health and Care Research (NIHR).

About SPELL and ROBUST

The SPELL Study is investigating the clinical effectiveness of a specific, dynamic stretching programme for ambulant children (aged 4-11 years) with cerebral palsy.

The ROBUST Study focuses on a specific strengthening programme for ambulant adolescents (aged 12-18 years) with cerebral palsy.

Both studies aim to assess if the specific dynamic stretching or strengthening programme is better at improving walking and ability to carry out daily activities, compared to usual physiotherapy treatment.

Why is this important?

Physiotherapy is an integral part of the management of children and young people with cerebral palsy; however, the evidence base supporting commonly used paediatric physiotherapy interventions remains limited. Opportunities for community children’s physiotherapy services to participate directly in large-scale clinical research are even less common, with research often centred within universities or specialist and tertiary services.

Being a participating site for SPELL and ROBUST therefore provides our community physiotherapy team with an exciting opportunity to support research and to contribute directly to the generation of evidence that could influence future physiotherapy clinical practice.

Preparing our team for research delivery

Before commencing the studies, our physiotherapy team met with the study teams from the University of Oxford and participated in a training day along with NELFT Research and Development (R&D) team members. This provided training on the research design and study protocols, intervention delivery and the standardised outcome measures required for the research.

This preparation has enabled us to integrate the research protocols into our community service while ensuring consistent delivery of the study interventions and assessments, across all participating sites.

Our physiotherapists are now contributing to identifying and screening potentially eligible children and young people, recruitment, study assessments, and delivery of the intervention programmes.

Developing AHP research leadership

Alongside our contribution as a participating site, the studies have also provided valuable opportunities for professional and research development within the team.

Vivian Yeung and Louise Burkwood are the Associate Principal Investigators (Associate PIs) for SPELL and ROBUST respectively. Both enrolled in the NIHR Associate Principal Investigator Scheme alongside their involvement in the studies and have successfully completed the scheme.

The Associate PI role has provided an opportunity to develop practical experience of research leadership and clinical research delivery within an NHS community service, while working collaboratively with national research teams and other participating sites.

Working together across the Trust

We would also like to extend our thanks to colleagues in the R&D team, whose advice, assistance, and ongoing support have been invaluable in enabling our service to participate in these studies.

One of the additional benefits of becoming involved in research has been the opportunity to meet and collaborate with colleagues from the R&D team. Developing these working relationships and bringing together different areas of expertise to deliver a shared project has been a positive experience for our team.

From evidence-based practice to helping create the evidence

As physiotherapists, we continually aim to provide evidence-based care. Participating in SPELL and ROBUST has given our team the opportunity to take this one step further: directly contributing to evidence that may inform future physiotherapy practice.

For us, this has been particularly rewarding because it demonstrates that research does not have to take place solely within universities or specialist centres. Community Allied Health Professional services can also play an active role in generating clinically relevant research.

We are proud to contribute to these national studies and look forward to seeing the findings and understanding how they may help shape future physiotherapy practice for children and young people with cerebral palsy.

SPELL Study: www.spell-study.org  
ROBUST Study: www.robust-study.org