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'Magical' therapy for Lambeth kids

 

Children with physical disabilities such as hemiplegia, are being given the chance to obtain greater independence thanks to the new found skills and confidence gained through an innovative clinical intervention which incorporates magic tricks into an intensive programme of therapy. Breathe Magic has a life-changing effect for the young people, who can subsequently perform everyday skills such as dressing or cutting up food by themselves for the first time in their lives, thanks to this magical intervention.

Hemiplegia is a neurological condition that results in a weakness or complete loss of motor function on one side of the body. It is one of the most common forms of cerebral palsy, a childhood motor disorder, affecting 1-2 per 1000 live births. Additionally, some children acquire a hemiplegia later in childhood due to brain injury or illness.

The innovative clinical intervention has been spearheaded by Breathe Arts Health Research, a social enterprise which designs creative approaches to healthcare. Breathe Magic consists of a ten-day magic camp at which participants (aged between 7–18 years) learn magic tricks that incorporate therapeutic exercises for improving upper limb (hand/arm) function. Following the camp the participants attend a ‘refresher’ magic club for six months, to help sustain their skills and motivation.

Clinical research into the programme, undertaken since 2010, revealed that the intervention significantly improved the ability of the participating children to complete everyday tasks independently, such as dressing themselves or cutting up food. The study showed that prior to attending the camp, children could perform only 25% of activities independently and using two hands, whereas 10 days later they can perform 93% of activities using two hands.

The clinical evidence has helped Breathe Arts Health Research obtain a commission from NHS Lambeth Clinical Commissioning Group to deliver the intervention for 12 children with hemiplegia from south London. The initial 10 day camp is taking place at the Menier Chocolate Factory, Southwark, from 19 – 28 August, with the final two days (29 – 30 August) taking place at The Magic Circle.

Emma Stevenson, Assistant Director Children and Maternity Joint Commissioning, Lambeth Clincal Commissioning Group/ London Borough of Lambeth, said: “Lambeth Clinical Commissioning Group wants to fund innovative and evidence-based clinical interventions and whilst we were keen to fund the intervention to benefit  children in Lambeth, we hoped that our funding would enable the programme to increase their evidence-base and examples of good practice to help secure future funding from other areas and benefit more children. The fact that the intervention engages with children in the community, rather than in a conventional healthcare environment also appealed to us."    

Sue Gallagher, lay member of Lambeth Clinical Commissioning Group said: “Lambeth is always looking at ways to improve its services and the outcomes of local people. Given the strong evidence base of the Breathe Magic, the service is set to have a radical impact on the health and wellbeing of children taking part this summer. Additionally, the intervention promises to reduce isolation and potential mental health problems by helping to increase independence and boosting confidence levels."

Will Cardwell’s son, Jack, 9, took part in a Breathe Magic camp this summer. Will says the experience has not only improved Jack’s motor skills, but boosted his self esteem: “Thanks to the camp, Jack can now feed himself with his weaker hand – something he was unable to manage previously. Doing exercises at home is always a chore, but the magic tricks are something which Jack really enjoys doing. The magic doesn’t seem like therapy to the children, it’s actually giving them a talent which the other kids don’t have at school, and that makes a massive difference to their inner confidence.”

World renowned magician, Dynamo, has shown his support for Breathe Magic by recording a special video message for the participants to see on the last day of the camp before their final performance. He says that he is really impressed with the children and he will be arranging a surprise visit to see some of them performing their tricks, (using both their hands!), soon.

The NICE guidelines for management of “spasticity in children and young people with non-progressive brain disorders” recommends active task-focused therapies such as the HABIT (Hand Arm Bi Manual Intensive Therapy) protocol. Breathe Magic builds on the HABIT approach by embedding the magic tricks within occupational therapy.  The specially selected magic activities aim to improve movement control and functional ability, particularly in two-handed skills, whilst also working on building the young people’s confidence and self-esteem.

The Breathe Magic programme has been designed to address common difficulties that these young people face in every-day life, such as being able to open a door, hold a knife and fork, or do up a zip or button. All these activities require children to be able to do basic movements such as stretching the arm, rotating the wrist and grasping an object. Each magic trick has been chosen to require repetition of these foundation movements to help the children build up their strength and dexterity in their hand and arm. The act of making a ball disappear with sleight of hand, for example, requires motor skills that will be of high value in these every-day tasks. In addition, a successful performance requires the ability to clearly communicate with an audience, building cognitive and communication skills.  Breathe Magic is therefore able to tackle both the motor skills element of the disability, alongside the psychosocial needs of the young people, which is a unique and effective combination.  This makes this intervention stand out against traditional approaches to therapy which focus only on the physical needs and do not address the fact that 44% of children with brain lesions such as cerebral palsy have associated psychiatric problems.

Breathe Magic incorporates the recommended repetitive hand movements (HABIT); offering the same medical benefits at a competitive cost, but in a fun and engaging way. Additionally, as the children are motivated to master the tricks they are more likely to keep practicing their new skills when they return home. 

Dr Dido Green, Director of Research at Breathe Arts Health Research and Reader in Rehabilitation at Oxford Brookes University, said: “Integrating magic within occupational therapy is more effective with the additional focus on psycho-social development. It engages children in a fun way, improving the outcomes of bimanual therapy. The young people enjoy using two hands to show their new magical skills to friends and family, rather than having to use 2 hands to practice repetitive exercises which they may find frustrating or tedious”.

Yvonne Farquharson, Managing Director, Breathe Arts Health Research, said: “Breathe Magic not only improves the functional ability of children with hemiplegia, but also boosts their psychological wellbeing and self confidence. Over five years of research and development we have carefully shaped an evidence-based clinical intervention and we’d like to see more children with hemiplegia across the country benefit.”

Local MP for South West Surrey, Jeremy Hunt, visited the Breathe Magic camp at Stepping Stones School, Haslemere, Surrey, earlier this month. He said:

“At a time when innovation is key within the NHS, Breathe Magic is a prime example of developing new approaches to healthcare which harness the therapeutic benefits of the arts and creativity. Breathe Arts Health Research has shown through clinical research of their Breathe Magic Camps that there is a demonstrable clinical and cost benefit to the NHS.”