Marine mobility

The underwater world is a strange and challenging place for humans but for people living with disability it is a world of possibility and fun that is difficult to find on land. That’s the discovery of an Adelaide-based enterprise, Determined2, that has developed a pioneering approach to unlocking opportunities for movement and interaction for people with disabilities. It has twice been a finalist in the Telstra Business Awards, winning the State category for Social Change in 2019 and reaching the South Australian finals in the Championing Health in 2023.

It also represents the ‘holy grail’ in program development, being truly person-centric in design, having been developed by managing director and founder Peter Wilson after a motorbike accident in 2007 left him with significant physical impairments.

‘I had the classic experience of having had a near-death experience and, given hope, thinking maybe I should use the experience to make a difference,’ Pete says.

Despite extensive rehabilitation, he was unable to work in the same way he had before his injury. He had a lightbulb moment and decided to develop a program using scuba in the swimming pool as therapy.

He tried it with a few people, including a young lad who had become a tetraplegic and a patient with cerebral palsy who was non-verbal and in a wheelchair – both of whom experienced significant gains in mobility through the treatment, both under water and when they emerged back on the surface.

‘A big part of it was to make it fun – my experience of hydrotherapy was that it was boring – but this uses games to get people to do things they don’t even realise they are doing,’ he says.

It’s since been tried with people with autism who may not otherwise engage with other people in games and play.

The underwater environment provides a level playing field, with everyone’s face inscrutable behind a mask and breathing a challenge for all, That, Pete says, in itself can be a boost for people with disabilities.

Evolving from lived experience and observation, the program is now delivered by allied health practitioners such as exercise physiologists and is being rigorously validated as a therapy.

With a grant from the Lifetime Support Authority in 2017, Pete set about finding a way to clinically evaluate the program with the help of rehabilitation medicine physician Dr Adrian Winsor and Associate Professor Kade Davison in the UniSA Allied Health and Human Performance team.

Initial qualitative studies of patients, doctors and other health providers revealed benefits including reduced pain and increased mobility, strength and confidence. It also showed that the psychosocial impact of the immersion was important.

‘People felt a real sense of achievement and empowerment. Under water they can leave behind their impairment and live in a different world for a moment,’ explains Associate Professor Davison.

‘The qualitative evidence is all pointing in the same direction, that people are deriving a benefit. There’s an overwhelming commonality in reports of improved sleep, mobility, management of pain – but we need to tease out the mechanism a bit.’

The Lifetime Support Authority is now funding a 2-year randomised control study, led by UniSA, that aims to discover other potential users. It has a rolling recruitment of people with acquired brain, spinal and other traumatic injuries who have completed hospital rehabilitation.

‘Going home after an accident is one of the toughest times for people, because they realise there aren’t too many things they are able to do better now than they could before,’ Pete says. ‘Immersion therapy could be one of them.’

Dr Winsor says that while it’s not for everyone with a disability (including those with lung pathology, uncontrolled diabetes or uncontrolled epilepsy), for many others immersion therapy can level the playing field.

‘We see immersion therapy as an extension of hydrotherapy – it allows total immersion,’ Dr Winsor says. ‘There are additional benefits with the additional buoyancy, additional freedom of movement.

‘Pete makes it fun – you don’t go there to swim 10 laps but if jumping through hoops is something you can’t do on land, it is something you might be able to do in the water. It’s an achievement.’

The Determined2 website has information about self-referrals. An approved doctor screens would-be participants to ensure they are suitable.

• Medical retina (age-related macular degeneration (AMD)

• Diabetic eye disease

• Retinal Vein Occlusion

• Retinal tears

• Medical retina (age-related macular degeneration (AMD)

• Surgical retina (retinal detachment, macular holes, epiretinal membranes)

• Diabetic eye disease

• Retinal tears

• Retinal Vascular Diseases

• Uveitis

• Cataract surgery

• Medical retina (age-related macular degeneration (AMD)

• Surgical retina (retinal detachment, macular holes, epiretinal membranes)

• Diabetic eye disease

• Retinal tears

• Retinal Vascular Diseases

• Cataract surgery

• Management of glaucoma

• Laser treatment for glaucoma

• Minimally invasive glaucoma surgical techniques

• Trabeculectomy

• Novel Glaucoma devices

Adelaide Eye and Retina Centre are pleased to welcome Dr Dev Supramaniam and Dr Neena Peter to the team.

• Medical Retina (age-related macular degeneration (AMD)

• Surgical retina ((retinal detachment, macular holes, epiretinal membranes)

• Diabetic eye disease

• Retinal Vascular Diseases

• Ptosis repair, blepharoplasty and brow ptosis repair

• Eyelid cancer excision and periocular reconstruction, including reconstruction of Mohs’ micrographic surgery defects

• Surgical Repair for watery eyes including endoscopic tear duct surgery

• Orbital surgery, enucleation, evisceration, orbital implantation and socket care

• Surgical rehabilitation of thyroid eye disease

• Use of Botox in the management of blepharospasm and hemifacial spasm

• Cataract surgery

• Pterygium surgery

• Cosmetic eyelid surgery

More than 250 guests attended the Australian Chinese Medical Association of SA’s Chinese New Year Celebration Dinner on 4 February 2023, with the theme ‘The Year of the Rabbit’. The event was held at the Adelaide BMW Showroom and featured a traditional lion dance.

1 – Assoc Prof William Tam, Assoc Prof Lilian Kow, Cindy Jade Shi and Dr Lydia Huang

2 – Paul McHugh, Fatima McHugh, Stacey Ann and Graeme Hedges

3 – Dr Kohei Funahashi, Dr Earl Lam, Dr Kristy Yang and Dr Leong Tiong

4 – Dr Khimseng Tew, Dr Dustin Pham, Thi Pham, Dr Stephanie Vuong and Dr Sharon Chua

5 – Dr Kim Le

6 - Karina Ng and Dr Kar Woh Ng

1 2 3 4

The Royal Australasian College of Surgeons Charity Ball was held at the Rose Garden Pavilion in the Adelaide Botanic Gardens on 1 February.Proceeds of the black-tie event benefited the Maggie Beer Foundation.

1 – Bridey Smith, Georgina Juniper, Dr Nick Smith and Dr Giri Krishnan

2 – Maggie Beer AO and Dr Ashani Couchman

3 – Dr Jennifer Catford and Dr Bernard Carney

4 – Lachlan Ophof, Sharon Kendall and Michael Eades

5 – Dr Conor Marron, Kate Marron, Dr MaryAnn King and Dr David King