This photograph was my submission for the Images of Research Competition at the beginning of 2020. When I view it again now, , I see how hard this gentleman is working to walk at a steady pace and to keep his balance in an exciting and wild landscape that forms the Brecon Beacons National Park. I am walking alongside, offering support and sharing conversation about how he continues to run his family business, how he attends physiotherapy sessions 3-5 times per week, cycles along the Monmouthshire and Brecon canal on his adapted tricycle, and how he finds it difficult to see the small improvements he is making each day. After having a stroke, this gentleman’s life changed irrevocably. Stroke. It can vary in severity, such as being able to return to the activities you enjoyed before or become so severely affected that you find yourself returning to a “new normal” that you are not wanting to be a part of.

Stroke is a debilitating neurological condition; it affects how we walk, how we move, how we think and speak. Despite stroke traditionally being perceived as a condition affecting the older  population, 26% of stroke-affected adults in the United Kingdom are under the age of 65. These young adults who have had a stroke are unable to complete activities of daily living, return to work, participate in social, leisure and outdoor activities; all of which can lead to increased time indoors, loss of independence, social isolation and depression. Despite this increased prevalence of young adults having a stroke, there is very little research and limited clinical guidelines to support their care.

Many rehabilitation programmes developed for conditions like stroke are formulated using research from the older stroke population and are delivered indoors, in clinical settings like leisure centre gyms and hospitals. However, there is an emerging area of research into physical activity conducted in natural outdoor environments, termed “green exercise”. This form of exercise is being associated with improving both physical and mental health for both healthy individuals and individuals with conditions such as  dementia or diabetes, – making it the ideal setting for rehabilitation programmes.

My PhD project focuses on developing a rehabilitation programme that uses the outdoor natural environment for the positive impact it has on health and wellbeing, for young adults who have had a stroke. These individuals deserve to have a rehabilitation programme prescribed to them, that is both exciting and engaging; a group activity with other young stroke survivors that can offer social interaction, support and understanding. A rehabilitation programme that will motivate them to spend more time outdoors as their confidence grows and their walking ability improves. We have all been under the restrictions to stay indoors, not see our loved ones and only exercise locally outdoors once per day, all caused by the Covid-19 pandemic this year. However, imagine if that was for a year, or many years under the restrictions of social isolation, and having no confidence in your ability to walk outside?

2020 has been a year that has been difficult for all globally. In the research community, we have seen our projects be postponed due to concerns over our personal safety and Covid-19 trials taking the utmost priority. Personally, I have found this time difficult, de-motivating and somewhat discouraging due to being unable to collect data and run the outdoor rehabilitation programme. However, it has also been a learning curve and highlighted what is most important; to work hard on this project, in order to improve the lives of young adults who have had a stroke and begin the foundations of implementing outdoor rehabilitation programmes into clinical guidelines.

While writing this blog for the Images of Research Competition at MMU, it has allowed me to reflect on why I wanted and applied for this PhD. Ultimately, I see it as a fantastic opportunity to discover and develop an area of research that I am passionate about. I love spending my time and teaching young people in the outdoors, to the extent that I feel my truest self when walking in the sun, wind, rain and snow! I would like others to feel the same. Those who may have physical difficulties (such as difficulties walking caused by stroke), should be given opportunities to regain their confidence and to enjoy the natural environment that surrounds them, withthe assurance that it is accessible to anyone who wants a moment in nature.

So, my advice is this: if you have that one impromptu photograph that you took, which relates to your project, and it conveys your passion for your area of research, I highly recommend entering the Images of Research Competition. It is a brilliant way to share a snapshot of your research and for you to reflect on why what you are doing is so important for future generations.

You can read more on our research here: www.bbc.co.uk/news/uk-wales-50168047

Rebecca’s image was named the Judges’ Choice in the postgraduate research category in the 2020 Images of Research competition. The 2021 competition will launch soon. Check out the celebratory brochure and website here: https://www.mmu.ac.uk/research/research-study/events/images/

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