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Archive for September, 2015

Performance Stress

Every one responds to stress in different ways. Performers can enter a different physical and sometimes psychological state when playing. No matter how skilled the performer some physical signs will be experienced and indeed a heightened state of awareness can make a performance more powerful. However, due to the extreme demands and delicate movements that are required of a musician, anxiety can lead to panic, concentration and memory lapses and more stress. Aaron Williamon from the Royal College of Music has developed a virtual concert hall to help aspiring soloists develop the necessary resilience. Whilst this may assist in managing the nerves of course there needs to be a drive for performers to want to walk out onto the stage and ‘fly’ because of the other hard work they have put in – both emotionally and physically.

You can read the full article here …

Posted in NEWS on September 10th 2015

Christopher Wynn Parry (1924-2015)

In Memoriam                                                                                           

It is with great sadness that we record the death of Dr Christopher (Kit) Wynn Parry who was a driving, innovative force in the development of Hand Therapy, nationally and internationally. His support for the independent development of hand therapy was inspirational. A pioneer of rehabilitative medicine and a world expert on the hand, he was always eager to learn, had wide interests with a full commitment to excellence. He was one of the leading medical practitioners of his generation.

Born on October 14 1924, he was educated at Eton and then read medicine at Oxford during the Second World War. His grandfather, Lord Moyniham, was an eminent surgeon and a strong influence on him.

In 1948 Kit began working at the combined services rehabilitation units RAF Chessington and Headley Court. He was instrumental in establishing integrated programmes involving surgeons, physicians, physiotherapists, occupational therapists and physical training instructors. He described the rehabilitation service as a ‘dynamic, progressive and integrated programme’. Natalie Barr OT and Maureen Salter PT, were part of this dynamic team and pioneers of hand therapy. With his leadership and encouragement Maureen and Natalie made a significant contribution to the development of Hand Therapy. Chessington became a centre of rehabilitation for all the Armed Services treating a wide range of conditions.  Kit was awarded an MBE in 1954, aged 29, for this work.

Kit was an early researcher into EMG as a diagnostic tool. He published Rehabilitation of the Hand, in 1958, the first such specialist text in the English language and which is now in its fifth edition. He contributed to the recognition of Rehabilitation as a separate sub-specialty and the development of the Diploma in Physical Medicine.

In 1975 Kit became the first Director of Rehabilitation at the Royal National Orthopaedic Hospital. The only physician among hand surgeons, he forged links within the Rehabilitation and Peripheral Nerve Injury Unit, pioneered by Sir Herbert Seddon. He had a special interest in Brachial Plexus Injuries and set up models of good practice introducing a comprehensive rehabilitation/return to work programme for these severely disabled, predominantly young adults. The pioneering work he had introduced to the RAF was now implemented in the NHS and became nationally and internationally renowned.

In 1975 he established a pain clinic, one of the first in the world to study pain associated with peripheral nerve injuries. The clinics included old Oxford colleges, Professor Patrick Wall (Pain Mechanisms – a new Theory 1965) Dr Peter Nathan, Consultant Neurologist and the therapy team. He developed charts for measuring and recording hand function and recovery of sensation, as well as developing sensory retraining for the hand after nerve injury. He was one of the first to work in this area and co-authored Surgical Disorders of the Peripheral Nerves with Professors Bonney and Birch.

In 1982 he served as President of the British Society for Surgery of the Hand, the only non-surgeon to have held this post. While President, he introduced the first combined meeting of hand surgeons and hand therapists. This was to set a precedent which continues to this day.

Kit loved music, playing the trombone and singing at Eton and Oxford. He continued singing into adult life and his passion for music and medicine converged beautifully when he became friends with Charles Mackerras (later Sir). Whilst attending concerts at the conductor’s house, musicians would consult him about the aches and pains in their hands and arms. Kit began to meet and advise musicians about their injuries, particularly those relating to the upper limb, and in 1998 he co-authored The Musician’s Hand with Mr. Ian Winspur, the first book in the English language on this subject.

From 1989-94 he was director of rheumatology at King Edward VII Hospital at Midhurst. He was instrumental in setting up the British Association of Performing Arts Medicine (BAPAM) realising there was a gap in care for musicians, many of whom had limited financial resources. This charity continues to provide medical advice and care to performers and Kit continued to work there until he was 89. His research on 1046 patients with upper limb conditions revealed that only 48 per cent were suffering from a recognised ‘organic or structural lesion’ and 52 per cent were suffering with pain due to lack of breaks, poor posture, inefficient practice techniques or a mismatch with the instrument. He highlighted the contribution of psychological and emotional factors impacting on performers’ physical problems and the pressure of financial and job insecurities and the demanding sometimes destructive lifestyles of the performer. Kit played a major role in the development of the Royal College of Music’s Centre for Performance Science and was made an honorary member of the RCM in 2011.

It has been a great privilege and honour to have known and learnt from this inspirational man. He will be remembered for his legacy of skilled assessment and diagnostic techniques, gentle healing hands, and the time he took with patients with a genuine interest in them as a whole. He was a wonderful raconteur, a lover of cricket a loyal friend, and a true man of his word. He will be missed acutely, we are indebted to him, not only for his legacy of rehabilitation of the hand and performing arts medicine but also as an example of a man who loved and lived life to the full.

 

Katherine Butler and Victoria Frampton

Posted in NEWS on September 3rd 2015

London Hand Therapy:

  • Injury prevention
  • Hand and upper limb assessment and treatment
  • Postoperative management

Hand Therapy is both an art and a rehabilitation science for the upper extremity. The injured limb is evaluated and assessed, and a variety of treatment methods are used to achieve set therapeutic goals.

Hand therapists are qualified Occupational Therapists and Physiotherapists who have become skilled in treating upper limb injuries and deformities through further education, training and clinical experience.