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Queen Square Upper Limb Neurorehabilitation Programme

The Queen Square Upper Limb Neurorehabilitation Programme is an NHS service that was started at the National Hospital for Neurology and Neurosurgery in 2014.

The Programme

The programme offers high dose, high intensity physiotherapy and occupational therapy focussed for those with upper limb dysfunction as a consequence of centra nervous sytem disease, particularly stroke. In addition, participants have the opportunity to take part in cutting edge clinical research that will improve our understanding of upper limb recovery and help to further improve the treatment we provide.

In 2019, we published the results of the first 224 people with stroke to go through the programme. The scores on 3 different outcome measures are shown for all participants at admission and discharge as well as 6 weeks and 6 months after discharge. The group median scores are shown at each time point, illustrating both change over the 3 week programme but also continued improvement over 6 months of follow up.

QSUL results

Published work from the programme:

  1. Intensive upper limb neurorehabilitation in chronic stroke: outcomes from the Queen Square programme - download the full paper for free here
  2. Pushing the limits of recovery in chronic stroke survivors: User perceptions of the Queen Square Upper Limb Neurorehabilitation Programme - download the full prepint for free here

Who to refer:

  • The focus of the intensive 3 week upper limb programme is achieving individualised goals relating to functional tasks.
  • The intense goal-directed nature of the programme is best suited for people with some forward reach and at least the beginnings of thumb and/or finger extension.
  • Those with stiff and painful shoulders and/or loss of range in wrist and fingers are likely to need these problems managing before considering admission to the programme.
  • Please consider whether people will tolerate a 3 week intensive programme, considering conditioning, fatigue, cognition.
  • It is a day-attender programme and so most people are relatively independent.

How to refer:

  • GPs should refer via the NHS electronic referral system using the following information
    • Hospital: UCLH
    • Speciality - Rehabilitation
    • Service - Multidisciplinary Neurorehabilitation for the Upper Limb Clinic - NHNN - Queen Square- RRV
    • Clinic Type - Neuro-rehabilitation
  • Consultant to consultant referrals should be sent to: Professor Nick Ward, Professor of Clinical Neurology and Neurorehabilitation, The National Hospital for Neurology and Neurosurgery, Box 146, Queen Square, London WC1N 3BG, or by email to nick.ward4@nhs.net
  • For administrative matters relating to the Queen Square Upper Limb Rehabilitation Programme please email uclh.referrals.upper.limbadmin@nhs.net
  • For queries about the waiting list, please contact uclh.referrals.nhnnchooseandbook@nhs.net

Our Research

The Programme offers a unique opportunity to investigate how we can further our understanding of recovery of the upper limb after focal brain injury through a range of studies using brain imaging, neurophysiology or behavioural measurements

    Media

    • Professor Nick Ward discusses the programme on the Journal of Neurology, Neurosurgery and Psychiatry podcast

    SoundCloud Widget Placeholderhttps://soundcloud.com/bmjpodcasts/neurorehabilitation-in-chronic-stroke

    • BBC2 Horizon - My Amazing Brain - Richard's War - the story of Richard Gray and his remarkable recovery from a catastrophic stroke Watch here

    • BBC Radio 4 - The Life in My Head: From Stroke to Brain Attack - Robert McCrum, who survived a severe stroke in 1995, goes on a journey into his own brain to understand more about what happened to him Listen here.

    • The i newspaper reports on the Queen Square Upper Limb Neurorehabiliation programme Read here