A Stimulating Environment


When I finished my first degree in biological sciences at the University of Oxford, I found myself slightly lost, with no clear goal in mind. All I knew was that I wanted to do something 'useful', but pinpointing what that could be was the tricky part. It took me a few months of mindless temporary work in the impersonal and unforgiving environment of London (whilst half-heartedly applying for jobs related to my first degree) to realise I wanted to break into a new field.

What did attract me to biomedical engineering? To be honest, when I look at the products of engineers' work I can't help seeing them as mediocre imitations of the amazing creations of the natural world. To take just one example, which of the solar-powered cell and your average houseplant would get your vote as an efficient sunlight-fuelled energy-converting system? However, like all machines natural ones can become damaged or break down. When the machine in question is the human body, there is a lot at stake for us to find ways of repairing it, and biomedical engineering is one of them.

That, to me, sounded like a 'useful' thing to try to do, so I set out to acquire some relevant knowledge and a further qualification. But as driven as I felt myself to be, I did not particularly revel in the thought of returning to the student life of poverty. I was thus glad to discover that the Engineering and Physical Sciences Research Council (EPSRC) was offering a number of studentships for a new course at the Bioengineering Unit of the University of Strathclyde.

This excellent Master of Research (MRes), aimed at individuals with biological, medical, and engineering backgrounds alike, consisted of 4 months of intensive courses, followed by a 6-month research project. During a 1-month conversion course, basic engineering principles were drummed into those of us with a biological or medical background, while the engineering graduates were thrown into a sea of lectures on anatomy and physiology.

For both groups, the challenge was not only in absorbing the wealth of new information, but also in adapting to a whole new way of learning and thinking. We were then able to choose from a number of short courses covering biomedical engineering fields, from biomechanics and biomedical electronics to artificial organs and biomaterials. For our small group of MRes students, the short courses ended after 4 months, after which our major research project began. For the MSc and Diploma students, however, the intense courses continued for a further few months followed by a 3-month research project at the end for the MSc. Inspiring teaching and guidance are always extremely valuable to a young researcher, and both of these came in no small measure in the Bioengineering Unit.

My MRes project in functional electrical stimulation (FES) was the stepping stone to my current position as a research assistant at the University of Glasgow's Centre for Rehabilitation Engineering (CRE). FES allows temporary restoration of function in paralysed muscle by applying small pulses of electrical current directly to the nerve, replacing the signals that would otherwise be sent from the brain. The FES system I did my MRes research project on allows two types of hand-grasping and consists of implanted electrodes in the arm, an implanted stimulator, and an external controller. Just as I was coming to the end of my dissertation, I was lucky to find out that Professor Ken Hunt at the University of Glasgow was advertising for a research assistantship to work on the development of systems for arm-cranking, a pilot study funded by EPSRC.

In spinal cord injury (SCI), which affects approximately 50,000 people in the UK today, communication between the central and the peripheral nervous systems is either cut or impaired as a result of the injury. Around half of all cases of SCI result from an injury at the neck, generally leaving the individual with reduced voluntary control of the arms and legs as well as the bladder, bowel, and other organs: A condition known as tetraplegia. It is plain to see that the individual is left with little remaining functional capability even for everyday tasks.

Although in the last 40 years much FES research has been devoted to the restoration of muscle function in tetraplegics, one issue patients are facing has not yet been addressed--the increased risk of cardiovascular disease that goes hand-in-hand with reduced activity. Indeed, patients' aerobic fitness deteriorates rapidly and substantially following injury.

So what exercise options can we give to people with no voluntary control of their arms and legs? With the FES systems my colleagues at the CRE and I have put in place, tetraplegics are able to propel the cranks of an instrumented arm-cranking machine through electrical stimulation of the biceps and triceps muscles.

The challenge now is to determine and demonstrate the health and fitness benefits of exercising regularly with this device, and this has become my own focus in our project. My first job was to design the exercise training and testing protocols for the analysis of cardiopulmonary fitness and pulmonary function.

The arm-cranking systems and training protocols are now being tested with tetraplegic volunteers at the Queen Elizabeth National Spinal Injuries Unit (QENSIU) of the Southern General Hospital in Glasgow. Therein lies the greatest source of my job satisfaction: interacting with tetraplegic people. A combination of inpatients and outpatients, whether newly injured (and still in an early stage of rehabilitation and adjustment to the extent of their disabilities) or a few years post-injury, these people make up the most enthusiastic group that I could hope to work with.

I spend a large proportion of my days at the hospital, which leaves me little time to complete the office-based work at the university; but the hospital is where I feel most motivated. Indeed, I feel that the clinical setting suits me well, and I enjoy cooperating with the QENSIU staff. So once I've finished at the CRE (which is getting worryingly near, as I'll be starting the final year of my PhD this October), I will attempt to find a position as a clinical bioengineer, even though such posts are few and far between.

That is not to say that the clinical side is everyone's cup of tea. Many of my colleagues much prefer the laboratory environment, where they can get their hands dirty with the machinery or spend hours on end at the computer developing the optimal controllers. They are what I refer to as the real engineers.

Fortunately, our research group benefits from the multidisciplinary requirements of our field. However, finding my niche took me longer than I had anticipated. When I started at the CRE--although there was no pressure from my colleagues--I felt compelled to try to fit in, and to become a real engineer. I thought that by attending a few lectures, I could acquire sufficient knowledge for this transformation to occur. I eventually realised that this was wholly unnecessary, and not entirely helpful! Integrating within a research group requires the recognition of one's own strengths within the team, in order to build upon them. Equally beneficial is identifying other peoples' areas of expertise and, providing they are cooperative and willing to help, asking for their assistance. Within a group such as ours, the trick is to find what skills each individual can contribute.

Don't get me wrong, I am not saying that, as a researcher, one should forget about acquiring new skills, but simply that it should be done in moderation. Three years pass surprisingly quickly when you are doing a PhD and, if too much of that time is spent on training, precious little remains for getting on with the real thing: finding out something new! Especially considering that things don't always go to plan ... and that is when patience, adaptability, and some extra motivation are called upon to keep you going. For me, working in a stimulating environment with people who do not let their extensive disabilities get them down gives me that extra boost every time.

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