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ultimately change practices and help patients in the future,” says Maggie-Lee. Since forming, the centre has graduated a whopping 46 postgraduate students, including Honours, Masters, and PhD-level projects. A current PhD student, Madeline Mills, is leading development of research funded by a Neurological Foundation small project grant, which will support completion of her PhD. Madeline’s project, supervised by Maggie-Lee and Phoebe, is using EEG (electroencephalography) and neuroimaging to measure brain activity immediately before a person swallows, to see how this activity changes with rehabilitation. This research challenges the long-held view of swallowing as a ‘reflex’ and reframes it as a skill that can be relearned. In the past, experts believed that swallowing could be rehabilitated by strengthening the muscles that executed the reflex – underpinned by the assumption that weakness was the only possible cause of swallowing problems. However, research from the team at the Rose Centre has showed that the issues can be caused by more complex problems with sequencing, and muscle strengthening could actually make things worse. Patients might, for example, swallow ‘backwards’, squeezing from bottom to top, which could lead to food and liquid ending up in the lungs or nose. Patients referred to the Rose Centre undergo intensive rehab to changemotor behaviour and learn how to swallow more efficiently. Electrodes can be placed over themuscles used during swallowing, using tools like a catheter or a sticky patch under the chin, which helps people visualise their own swallowing. Through trial and error, they’re able tomodify the timing and precision. This approach has had great results. In a sample group of 12 patients, 11 returned to oral feeding – even, in some cases, after years of being unable to eat. ‘Intensive’ means just that – often twice a day, every day, for two to four weeks at the beginning of a patient’s rehab journey. Funding doesn’t cover it all, so students are brought in to work with patients where needed. The resource-heavy nature of the work limits the number of people seen at the clinic. So far, the clinic has diagnosed around 240 people (starting with stroke patients, then broadening in recent years to people with other conditions). More than 80 have had intensive rehabilitation, while another 20 have had treatment to help with language or motor speech disorders. This quote from the mother of a three-year-old boy treated at the clinic sums up the truly life-changing impact of this work. “My child is non-verbal but there was no hiding the delighted squeal of happiness as I gave him a banana and chocolate muffin, and the wee smile he gave as he tried a fresh raspberry straight off the bush. We’re so excited about his future, the food that he can now eat and the potential for him to develop and grow.” When asked about her personal highlight, Phoebementions another child: a 10-year-old boy who had never eaten solid food. After treatment, he was able to join his mates eating pies – something he had yearned to do and that made him feel ‘normal’. She’s equally passionate about adults who’ve had a life-changing experience, such as a stroke, or diagnosis of a degenerative disease such as Parkinson’s. “These people’s lives have changed and will never be the same. If we can help themeat and drink again, it’s one layer of normality that they can reclaim,” she says. “It’s really nice to feel that we are able to use our expertise to make a difference in this way.” “We LOVE the work we do. It’s such a great thing to have a career that lets you make a difference in quality of life for so many people.” Maggie-Lee Huckabee 2017 Small Project Grant $12,000 – Dr Kristin Gozdzikowska 2019 Senior Research Fellowship $228,264 – Dr Sarah Perry 2020 Small Project Grant $14,696 – Dr Sarah Perry 2023 Small Project Grant $14,700 – Madeline Mills Phoebe, Tally Smith, Maggie-Lee and Madeline Headlines 11
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