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Joanna Fletcher-Smith

Senior Research Fellow, Faculty of Medicine & Health Sciences

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Biography

Joanna is a Health and Care Professionals Council (HCPC) registered occupational therapist by professional background and is employed by the University of Nottingham as a Senior Research Fellow. She is Principal Investigator for the NIHR RfPB funded ESCAPS study. This single centre feasibility randomised controlled trial with integrated qualitative study will investigate early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm.

Prior to the ESCAPS study, Joanna was the research therapist at the Nottingham site for an NIHR (£1.9 million) HTA funded phase III multi-centre cluster randomised controlled trial of occupational therapy for care home residents with stroke. Joanna was also involved in research into long-term follow-up after stroke in collaboration with the Global Stroke Community Advisory Panel (GSCAP), and was previously the research OT on Professor Marion Walker's 'DRESS' study.

She completed her MPhil at Nottingham and was awarded the Community Health Sciences part-time studentship to complete her PhD on 'Occupational therapy for stroke survivors residing in UK care homes'.

Joanna has presented at national and international conferences and won the UKOTRF 'Research Capacity Award', the 'Early Researcher Award' and the 'Verna Wright Prize' for her research in stroke rehabilitation.

Joanna is currently a member of Council for the Society for Research in Rehabilitation and prior to this was the research and development officer for the National Executive Committee of the College of Occupational Therapists Specialist Section for Neurological Practice.

Joanna is a reviewer for the Royal College of Physicians Intercollegiate Stroke Working Party, the British Journal of Occupational Therapy, and the Canadian Journal of Occupational Therapy.

Joanna has published a Cochrane systematic review of 'occupational therapy for care home residents with stroke' as lead review author as well as other peer reviewed papers in scientific journals.

Expertise Summary

Keywords:

Occupational therapy, stroke rehabilitation, dressing rehabilitation, cognition, occupational therapy in care homes, Cochrane systematic reviews, electrical stimulation, upper limb rehabilitation, patient and public involvement (PPI) in research.

Teaching Summary

Joanna Fletcher-Smith teaches on the Stroke module for the MSc in Rehabilitation Psychology and the MSc in Health Psychology at the University of Nottingham. She is also an Associate Lecturer for the… read more

Research Summary

Joanna Fletcher-Smith's main area of research interest is stroke rehabilitation, and she is involved with a number of current trials and projects in this area including the use of electrical… read more

Selected Publications

  • FLETCHER-SMITH, J., WALKER, M., SUNDERLAND, A., GARVEY, K., WAN, A. and TURNER, H., 2010. An interrater reliability study of the nottingham stroke dressing assessment British Journal of Occupational Therapy. 73(12), 570-578
  • FLETCHER-SMITH, J.C., WALKER, M.F. and DRUMMOND, A., 2012. The influence of hand use on dressing outcome in cognitively impaired stroke survivors British Journal of Occupational Therapy. 75(1), 2-9
  • FLETCHER-SMITH JC, WALKER MF, SUNDERLAND A and DRUMMOND A, 2012. To what extent does upper limb hemiparesis affect dressing performance in the presence of cognitive impairment? Clinical Rehabilitation. 26(3), 282-3
  • FLETCHER-SMITH JC, WALKER MF and DRUMMOND A, 2012. To what extent does upper limb hemiparesis affect dressing performance in the presence of cognitive impairment?: Proceedings of SRR Conference 2011 Clinical Rehabilitation. 26(3), 280

Oral Presentations and posters

Platform Presentations

  • "Occupational therapy for care home residents with stroke: A Cochrane systematic review" College of Occupational Therapists Specialist Section Neurological Practice Stroke Conference, Cardiff, September 2013.
  • "Occupational therapy provision for care home residents with stroke: what is routine practice?" College of Occupational Therapists Specialist Section Neurological Practice Stroke Conference, Cardiff, September 2013.
  • "Occupational therapy for care home residents with stroke: A Cochrane systematic review" Society for Research in Rehabilitation Summer Conference, Nottingham, July 2013
  • "Stroke care in care homes" Medical Crisis in Older People Conference: "Health Care in Care Homes - Can We Do Better?", Nottingham, June 2013
  • "Occupational therapy provision for care home residents with stroke: what is routine practice?" College of Occupational Therapists Annual Conference, Glasgow, June 2013
  • "A survey to explore the acceptability of the treatment approaches used in the DRESS Study", UK Stroke Forum Conference, Glasgow, November 2011.
  • "Does upper limb hemiparesis affect dressing performance in cognitively impaired Stroke survivors?", College of Occupational Therapists Annual Conference, Brighton, June 2011
  • "To What extent does Upper Limb Hemiparesis affect Dressing Performance in the Presence of Cognitive Impairment?", Society for Research in Rehabilitation Winter Conference, Cardiff, February 2011.
  • "Dressing Rehabilitation Stroke Study: a randomized controlled trial (The DRESS Study)", UK Stroke Forum Conference, Glasgow, December 2010.
  • "Dressing Rehabilitation Post Stroke", College of Occupational Therapists Specialist Section Neurological Practice Stroke Conference, Manchester, September 2010. (Invited speaker)
  • "An Inter-Rater Reliability Study of the Nottingham Stroke Dressing Assessment (NSDA)", College of Occupational Therapists Annual Conference, Brighton, June 2010.

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Poster Presentations

  • "Occupational therapy provision for care home residents with stroke: what is routine practice?" Society for Research in Rehabilitation Conference, Nottingham, July 2013.
  • "A Cochrane systematic review of occupational therapy for care home residents with stroke" European Stroke Conference, London, May 2013
  • "Occupational therapy provision for care home residents with stroke: what is routine practice?" Nottingham University Medical School Poster Competition, Nottingham, May 2013.
  • "A Cochrane systematic review of occupational therapy for care home residents with stroke" Nottingham University Medical School Poster Competition, Nottingham, May 2013.
  • "Occupational therapy provision for care home residents with stroke: what is routine practice?" UK Stroke Forum, Harrogate, 2012.
  • "The inter-rater reliability of the Nottingham Stroke Dressing Assessment", UK Stroke Forum, Glasgow, 2010.
  • "To what extent does upper limb hemiparesis affect dressing performance in the presence of cognitive impairment?", UK Stroke Forum, Glasgow, 2010.
  • "The Inter-Rater Reliability of the Nottingham Stroke Dressing Assessment (NSDA)", European Stroke Conference, Barcelona, Spain, May 2010.
  • "An Inter-Rater Reliability Study of the Nottingham Stroke Dressing Assessment (NSDA) - Work in Progress", Society for Research in Rehabilitation Conference, Salford, February 2010
  • "An Inter-Rater Reliability Study of the Nottingham Stroke Dressing Assessment (NSDA) - Work in Progress", Society for Research in Rehabilitation Conference, Derby, February 2009.
  • "Dressing Rehabilitation Evaluation Stroke Study-Work in Progress", UK Stroke Forum Conference, Glasgow, December 2009
  • "Dressing Rehabilitation Evaluation Stroke Study-Work in Progress", UK Stroke Forum Conference, Harrogate, December 2008.

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Prizes and Awards

  • "Verna Wright Prize", Society for Research in Rehabilitation, 2010.
  • "Early Researcher Award", College of Occupational Therapists, 2010.
  • "Postgraduate Travel Award to attend and present at the European Stroke Conference in Barcelona", School of Community Health Sciences, University of Nottingham, 2010.
  • "Research Capacity Award", College of Occupational Therapists, 2009.
  • "Postgraduate Student Scholarship", Constance Owens Memorial Trust, 2009.
  • "Postgraduate Student Scholarship", Elizabeth Casson Trust, 2008.
  • "Travel scholarship for attendance at the World Federation of Occupational Therapists Congress in Stockholm, Sweden", The Elizabeth Casson Trust, 2002.
  • "Student Travel Scholarship to attend World Federation of Occupational Therapists Congress in Stockholm, Sweden" Northumbria University, June 2002.

Joanna Fletcher-Smith teaches on the Stroke module for the MSc in Rehabilitation Psychology and the MSc in Health Psychology at the University of Nottingham. She is also an Associate Lecturer for the occupational therapy programmes at the University of Derby. She is an accredited Practice Placement Educator for the College of Occupational Therapists.

She also devised and taught a stroke course for care home staff whilst working on the OTCH study. This training workshop has since been used to create a UK Forum for Stroke Training endorsed DVD training package for care home staff.

Current Research

Joanna Fletcher-Smith's main area of research interest is stroke rehabilitation, and she is involved with a number of current trials and projects in this area including the use of electrical stimulation for upper limb rehabilitation after stroke, patient peer mentoring, and interventions to support stroke carers (the BISC study).

Joanna is Principal Investigator for the NIHR RfPB funded ESCAPS study. This single centre feasibility randomised controlled trial with integrated qualitative study will investigate early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm.

http://www.nottingham.ac.uk/research/groups/strokerehabilitation/projects/escaps.aspx

Joanna started her research career as the research occupational therapist on the Dressing Rehabilitation Evaluation Stroke Study (DRESS), a recently published phase II randomised controlled trial (RCT) of a neuropsychologically informed approach to dressing rehabilitation for cognitively impaired patients with stroke.

Read more about the DRESS study

As part of Joanna's MPhil degree she completed an inter-rater reliability study of the Nottingham Stroke Dressing Assessment (NSDA), which was the primary outcome measure used on the DRESS RCT and in previous dressing research in Nottingham. She was also involved in the upper body dressing study, exploring the importance of bimanual skills when dressing in the presence of cognitive impairment. Joanna also designed and worked on an acceptability study, which compared the conventional functional dressing rehabilitation approach to the neuropsychological approach to dressing used in the DRESS study.

Joanna was the research occupational therapist for the Nottingham Centre of the Occupational Therapy in Care Homes (OTCH) study. OTCH is a £1.9 million multi-centre NIHR HTA funded study under the leadership of Chief Investigator Prof. Catherine Sackley. It involves a cluster RCT of an occupational therapy intervention for residents with stroke living in UK care homes, and plans to run for 3 years.

Read more about the OTCH study

Joanna's PhD programme of research focused on the area of stroke rehabilitation for care home residents with stroke. The PhD study included a national survey of occupational therapy for care home residents in the UK; Joanna then led an international team of researchers from the UK and the Netherlands in carrying out a Cochrane review of occupational therapy for care home residents with stroke; and the final chapters on the thesis included sub group analysis and logistic regression modeling and GEE modeling of the data set from the main OTCH trial (n=1400).

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010116.pub2/pdf

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University of Nottingham
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