NHS Lambeth CCG and Breathe Arts Health Research CIC

Winner: Rehabilitation Challenge Prize

Magicians have teamed up with specialist occupational therapists and academics in the field of neuro-rehab to develop a fun and effective therapy programme for children and young people with hemiplegia (paralysis of one side of the body), which achieves dramatic results in just 10 days.

A group of young magicians at the Breathe Magic ShowUnder the Breathe Magic intensive therapy programme, children and young people attend a special summer camp, where they learn traditional therapy exercises that are taught in the guise of magic and sleight-of-hand tricks. After going through the programme, children are able to wow their friends and family with their magic skills – not to mention the fact that some young people are showing up to 80% improvement in their hand and arm function.

Hemiplegia is as common as Down’s syndrome, affecting approximately 1 in 1000 people, but many of the usually-available treatments have a range of problems, for example traditional therapy exercises often do not engage the young people sufficiently, which means that the children do not repeat and practice the exercises as they need to. Research shows at least 65% of people with hemiplegia could benefit from intensive motor therapy and, crucially, 44% suffer from psychological and social difficulties as a result of their condition.

Although NICE supports intensive programmes focussing on building strength and ability on both sides of the body (bimanual motor therapies), most clinical services do not currently have enough staff or resources to offer such intensive therapy programmes in-house. Instead, treatment is often paralysis-weakening injections of the toxin Botulinium – sometimes with additional occupational therapy – which only works for some individuals and has no built-in support to address any emotional or social issues related to the condition. Some offer other therapies like splinting, stretching or neurodevelopmental therapy, which have not been shown to really benefit children in terms of their functional independence.

Breathe Magic Intensive Therapy Programme is aimed at young people aged seven to 19, and is run over two weeks in summer, with 1-1 therapy delivered within group settings. The programme is based on the Hand-Arm Bimanual Intensive Therapy (HABIT) programme, which follows NICE best-practice guidelines, but the difference is that this innovative programme is delivered as a training course in magic! Afterwards, the young people attend monthly three-hour magic clubs, where specialists can help them maintain their better motor functions and support further psychosocial development.

Results show clinically-significant motor skills improvements are maintained at 6 months, with reports from parents and children of better psychological wellbeing. Families need fewer hours of care and support after taking part, and the approach is more cost effective than giving standard care. The programme also has important additional effects like building friendships and grass-roots support networks between families.

Breathe Magic is delivered by Breathe Arts Health Research – a social enterprise which began life as a project by Guy’s and St Thomas’ Charity before setting out as an independent community interest company in 2012. Its holistic approach to therapy is grounded in specialist, world-class medical research.

It is delivered in partnership with NHS Child Development Centres in some boroughs and gives NHS occupational therapists and physiotherapists the chance to develop their own skills in this type of therapy. It was recently re-commissioned and awarded three-year rolling contracts by both NHS Lambeth CCG and NHS Wandsworth CCG.

Awarded Rehabilitation Challenge Prize of £50,000 funding plus a dedicated mentoring package from AHPF.