Meet the Researcher: Professor Lynn Rochester

In our eighth Meet the Researcher, we meet Lynn Rochester, Professor of Human Movement Science at Newcastle University. She started her career as a physiotherapist, joining the academic world through a PhD opportunity which she pursued alongside her clinical role. Now, she leads major international consortia and interdisciplinary research groups. She is also the recipient of an NIHR Senior Investigator award. The work she leads is helping to understand mobility loss and conversely, what mobility loss tells us about changes in the brain and body. Through this work she aims to improve disease management in age and long-term conditions.

Can you give us a brief outline of your roles and what that looks like on an average week for you?

I have three main roles. Firstly, I created and lead the Brain and Movement Research Group. This is a multi-disciplinary group focused on the study of mobility (particularly gait – the way we walk). We are interested in understanding what changes in age and disease, why this happens and what can we do about it. Conversely, we also explore discrete signals of mobility to inform us about changes in the brain and body that may help with diagnosis, prognosis and monitoring in conditions like Parkinson’s and dementia, amongst others. The group is a collaborative effort across Newcastle University, including clinicians, engineers, psychologists, statisticians, and computer scientists.

I also have a national leadership role in the National Institute for Health Research (NIHR) Clinical Research Network where I provide strategic leadership and oversite of the NIHR research portfolio. This portfolio covers a cluster of health conditions with the aim of optimising delivery of high-quality clinical research. In this role I am the lead for the flagship NIHR-INCLUDE project that aims to improve inclusion of under-served populations in clinical trials.

Last but not least, I am the co-ordinator of the MOBILISE-D consortium. This is funded through the EU Innovative Medicines Initiative. Mobilise-D is an international consortium of 34 academic and industry partners from 13 countries. It aims to use digital technology to develop better methods to measure mobility in the real-world. We are applying the approach in multiple conditions so we can better measure and treat mobility loss in conditions related to ageing. We will use the results of the work to drive forward innovations in clinical trials, as well as in healthcare.

What drew you to this field originally?

I became interested in mobility after training as a physiotherapist. A major aspect of physiotherapy is getting people active again. I was fascinated by movement and movement control; I wanted to know what I could do to improve patient rehabilitation. At this time, I mostly worked with people who had neurological disorders and long-term conditions where mobility was an issue. I wanted to understand how the brain controls movement, and how I could measure it, so I could know if I was making a difference. My curiosity made me ask a lot of questions about my clinical practice.

Eventually, an opportunity came up to get involved in research and I grabbed it with both hands.
To do this I had to work hard to bring myself up to the academic level of a PhD, but this was a challenge that I really enjoyed. I was stretched by this experience in a way I could never have imagined, but it was just so exciting as well.

What challenge are you currently trying to address in your research?

The challenge hasn’t changed since I began this work because there’s so much to do. Working with my group, we are still trying to understand mobility and mobility loss and what drives it. By understanding this we hope to develop better treatments. The group has developed over the years and now includes individuals leading their own research programmes. Collectively however, we are all focussed on the same goals, and this is facilitated by this expanded group of emerging research leaders.

We are also trying to harness the power of measurement and digital technology. This will not only lead to new interventions to improve mobility, but it means we will be able to measure and detect mobility loss really early, perhaps even before the human eye can detect it. We are using discrete mobility biomarkers (specifically gait signatures) as a window to the brain and the body. This will help us to detect onset of, and progression of disease. It may also help us predict events in the future, like cognitive decline or fall loss. Ultimately, we want to translate our research knowledge into clinical practice and research that will benefit patients.

How have methods of scientific discovery changed since your early research career?

Technology has come a long way. Now, wearable devices are tiny and have improved the way we measure mobility. By placing tiny sensors on people, we can measure mobility continuously in the real world. This was not feasible 10 years ago. Better technology means that we can think about embedding our work into pharmaceutical research and clinical trials, to provide more sensitive outcomes. We can measure a whole range of different symptoms and signs, as well as being able to measure people who are not able to visit us in the clinic. This has the potential to expand the inclusion of people geographically, reduce burden and make healthcare and research more efficient, diverse, and inclusive.

Advances in computer science, data science and engineering have also made a difference. My research would not be possible without input from data scientists and engineers; it is at the heart of everything we do. It is vital to extract knowledge and value from the data we gather.
Advances in imaging technologies are also making an impact on our research in mobility. We have the PET MR Centre in Newcastle and my group works very closely with them on multimodal imaging of mobility. This allows us to visualize movement networks in the brain, which could enhance treatment options, as we would be able to see the difference that we have made by introducing different interventions.

What role do patient cohorts and wider partnerships and collaborations play in your research?

Patient input is fundamental. Years ago, I learned a lesson about involving patients early. It was on a project where an intervention had been designed based on several assumptions. We set up focus groups to ask the patients about the planned intervention. It turned out that the assumptions we had made were completely wrong. If we’d run the clinical trial based on those assumptions, it would have failed. That made me realise how important it was to involve patients from an early stage.

Working with patients is now a routine part of the work that we do. We see patients and the public as long-term partners. We work with them on research, but they also help us communicate our findings and sense check what we are doing. Across the projects I lead, we’re communicating with people across the country, Europe, and America. But beyond geographical inclusion, we’re also looking at how to better understand diversity of experience. For example, there was an assumption that we could just pop a wearable sensor on everyone. In fact, there might be some cultural groups that would be very unhappy about doing that, so we need to understand what that means to different people in different places.

What role does industry play in your research?

Industry plays a massive role in in our research. MOBILISE-D is funded through Innovative Medicines Initiative (IMI), so it is a partnership between industry and academia. I co-lead MOBILISE-D with Dr Ronan Roubenoff from Novartis, and we work with 11 large pharma companies. Everything that the MOBILISE-D consortium does is aimed at sharing knowledge for the benefit of the wider community. Our activity is embedded in partnership working from start to finish. It is a very interesting way to work.

Can you tell us about the research connections you have in Europe and across the world?

I have collaborated extensively across Europe, America, New Zealand and Australia. I have even carried out work in Sub Saharan Africa. My work with MOBILISE-D involves partners all over the world. We have also made a formal collaboration with another IMI funded consortium led out of Newcastle; IDEA-FAST. This has helped to accelerate the impact of our work, as well as giving us the gravitas to reach out to other large consortium in the US and elsewhere.

Once you begin to get enough partners involved, you can really pick up momentum and extend networks even further. These connections in the UK and across the world are effectively helping us to access knowledge that we don’t have. For example, we can connect with engineering companies that can support and enhance our work, which improves our outcomes. It is interesting because academics are often set up to compete, but realistically we can’t do it all alone.

What is the best thing about being a clinical researcher in the North East of England?

I am from the North East and I am very proud of this, it is a fantastic part of the country. All clinical research works best with good networks, and this region has some fantastic networks. We also have some real talent here. Newcastle University and Newcastle Hospitals is filled with fantastic clinical and academic expertise. All of this is accessible to the research here, and really enhances the work that we do.

We also have some specific areas of strength. Even early in my research career, I knew that Newcastle stood out for its expertise in neurology and neuroscience, and it still does. Newcastle University excels in computer science and in digital health and data too, and I have made some amazing collaborations with really talented people by having this all close by. I consider myself lucky to work with such amazing colleagues who are brilliant at what they do. We also have unparalleled networks for patient and public involvement here in the North East.

Lastly, we have a huge number of world-class facilities and infrastructure. Specific to the research group is the Human Movement Laboratory in the Clinical Ageing Research Unit. This is a state-of-the-art facility that is fundamental to the work of the group. For me personally, I feel I have everything here to do my job in every way possible.

What do you think your research brings to this region and the people living here?

People ultimately benefit from having research that helps them to remain mobile and safe. In the future they will hopefully benefit from having the tools to access research, even if they are more geographically isolated. We have multiple health care issues in the North East; deprivation being one of them. The work we do around mobility is highly relevant to the population of the North East, so hopefully people will benefit from the kind of innovations that we are working on here.

Looking forward, what do you think will be the next major breakthrough in your field?

In an ideal world, a breakthrough will mean that digital technology will become a routine part of healthcare and research. We could monitor people’s mobility and other symptoms in their own home. The information we get from monitoring mobility can give a broad picture of health, meaning that we can manage things remotely, such as medications. It will also mean that patients don’t always need to go back and forth to hospitals. This can enable a much more dynamic and flexible delivery of health care and research, which is informed by objective tools. We know this won’t work for everyone, but it will help to support this activity for some.

Another area of work is understanding the mechanisms in the brain; specifically, those that breakdown in conditions like Parkinson’s (PD). Work in my group is looking at what changes occur in the brain in PD. Knowing this can help us target the issue with very specific pharmacological and non-pharmacological treatments.

The BRC has many research themes, do you feel this has been useful for you in carrying out your research?

My group has benefitted from infrastructure funding through the current and previous BRCs in Newcastle. This helped me build the stream of digital health technology and mobility biomarker research which made an essential contribution to our bid to lead MOBILISE-D. It has also developed a new area of research leadership and leaders in my group.

My research sits in the Newcastle BRC’s Dementia Theme, so working alongside the BRC has always been a perfect fit for me and my research group. It has allowed us to contribute new insights in dementia and PD research. However, we have also developed links with other themes across the Newcastle BRC, mainly Musculoskeletal Disease, Liver Disease and Neuromuscular Disease. By working in the structures of these themes, we can deliver impact, not only in our research expertise, but also though wider collaborations. The work we have done with the Newcastle BRC has allowed us to build an international platform for our work and grow our connections from there.