Next Generation Rehabilitation Technologies
Lead Research Organisation:
University of Nottingham
Department Name: Faculty of Engineering
Abstract
This network will focus on developing the next generation of advanced technologies for rehabilitation, targeting musculoskeletal, cardiorespiratory, neurological and mental health conditions. It will be connected to the new £70 million National Rehabilitation Centre (NRC), a major national investment in patient care, innovation and technology, due to open to patients in 2024. The NRC is being co-located with the specialist £300m+ Defence Medical Rehabilitation Centre on the Stamford Hall Rehabilitation Estate so that the two centres can benefit from the sharing of a wealth of knowledge, expertise and facilities. This EPSRC networkplus is therefore an exceptionally timely opportunity to capitalise on this significant investment, actively involving the UK Engineering & Physical Science community in this initiative and embedding technology innovation at the earliest stage.
Advances in medicine have resulted in a significant increase in survival rates from trauma and injury, disorders and disease (acute and chronic). However, survival is often just the start, and the higher rates have led to an increase in rehabilitation needs, involving many patients with complex conditions. Technology has an increasingly important part to play in rehabilitation, to support a limited number of skilled healthcare professionals, reduce hospital stays, improve engagement with rehabilitation programmes, increase independence and improve outcomes. Speeding up recovery and helping patients get back to work and life has considerable personal, social and economic impact.
This network will bring together researchers, healthcare providers, patient & user groups, industrial partners and supporting organisations (e.g. policy makers, charities) to develop a world-class research community and infrastructure for advanced rehabilitation technologies. By connecting new innovative technologies and advanced materials with our growing understanding of mental and physical health, this network will support the provision of novel, transformative, affordable solutions that will address current issues, allowing patients to lead more independent and fulfilling lives and reducing the burden on limited NHS resources.
Supported by a core membership of experts from the rehabilitation field, this network aims to introduce researchers who are not typically involved in rehabilitation technology research into a network of rehabilitation experts. Central to the grant will be a series of Grand Challenge Blended Workshops and supported conversations designed to identify critical areas for research, with funding for feasibility projects to build those collaborations and drive forward innovation. The network will explore multimodal approaches that target both physical and mental rehabilitation. Technology innovation will focus around three key areas: 1) advanced functional materials, 2) patient-specific devices & therapy, and 3) closed loop measurement and rehabilitation.
Advances in medicine have resulted in a significant increase in survival rates from trauma and injury, disorders and disease (acute and chronic). However, survival is often just the start, and the higher rates have led to an increase in rehabilitation needs, involving many patients with complex conditions. Technology has an increasingly important part to play in rehabilitation, to support a limited number of skilled healthcare professionals, reduce hospital stays, improve engagement with rehabilitation programmes, increase independence and improve outcomes. Speeding up recovery and helping patients get back to work and life has considerable personal, social and economic impact.
This network will bring together researchers, healthcare providers, patient & user groups, industrial partners and supporting organisations (e.g. policy makers, charities) to develop a world-class research community and infrastructure for advanced rehabilitation technologies. By connecting new innovative technologies and advanced materials with our growing understanding of mental and physical health, this network will support the provision of novel, transformative, affordable solutions that will address current issues, allowing patients to lead more independent and fulfilling lives and reducing the burden on limited NHS resources.
Supported by a core membership of experts from the rehabilitation field, this network aims to introduce researchers who are not typically involved in rehabilitation technology research into a network of rehabilitation experts. Central to the grant will be a series of Grand Challenge Blended Workshops and supported conversations designed to identify critical areas for research, with funding for feasibility projects to build those collaborations and drive forward innovation. The network will explore multimodal approaches that target both physical and mental rehabilitation. Technology innovation will focus around three key areas: 1) advanced functional materials, 2) patient-specific devices & therapy, and 3) closed loop measurement and rehabilitation.
Organisations
- University of Nottingham (Lead Research Organisation)
- Beko PLC R&D Centre (Collaboration)
- Reckitt Benckiser (Collaboration)
- BAE Systems (United Kingdom) (Collaboration)
- Stroke Association (Project Partner)
- Medical Technologies Innovation Facility (Project Partner)
- Steeper Group (Project Partner)
- Nottingham University Hospitals NHS Trust (Project Partner)
- National Institute for Health Research (Project Partner)
- Medilink Midlands (Project Partner)
- DNRC (Defence and National Rehab Centre) (Project Partner)
- BlueSkeye AI LTD (Project Partner)
- Renfrew Group (Project Partner)
- CHEATA Ctr Healthcare Equip & Tech Adopt (Project Partner)
- Society for Research in Rehabilitation (Project Partner)
- Medicines & Healthcare pdts Reg Acy MHRA (Project Partner)
- Asthma UK (Project Partner)
- East Midlands Academic Health Science Network (Project Partner)
- Footfalls & Heartbeats (UK) Ltd (Project Partner)
Publications
Zhou X
(2023)
Review of recent advances in frequency-domain near-infrared spectroscopy technologies [Invited]
in Biomedical Optics Express
Description | BINUS University Guest Lectures |
Geographic Reach | Asia |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | As a result of the training around 6 new students per year are being sent to UK to continue their education. |
Description | Panelist for EPSRC Horizon CDT 'The PhD Experience' Panel Discussion and Q&A |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Description | 3D assays of vascularised and innervated human skeletal muscle injury for functional screening of pro-regenerative therapeutics |
Amount | £799,961 (GBP) |
Funding ID | NC/C020208/1 |
Organisation | National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs) |
Sector | Public |
Country | United Kingdom |
Start | 01/2022 |
End | 01/2025 |
Description | A platform to investigate multi-tissue crosstalk mediated by exercise induced soluble factors released from human skeletal muscle |
Amount | £201,173 (GBP) |
Funding ID | NC/X001970/1 |
Organisation | National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs) |
Sector | Public |
Country | United Kingdom |
Start | 01/2023 |
End | 06/2024 |
Description | BAE Systems |
Organisation | BAE Systems |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Discussed robotics and shared control mechanisms to be applied on BAE applications, including remote healthcare delivery. |
Collaborator Contribution | BAE has offered use of facilities and supported 3 EPSRC grant proposals with support letters. |
Impact | Project ideas |
Start Year | 2022 |
Description | Beko Plc |
Organisation | Beko PLC R&D Centre |
Country | United Kingdom |
Sector | Private |
PI Contribution | We created a partnership with with Beko to start in the form of one joint PhD studentship to be part funded by the company. The company will benefit from our know how provided through outcomes of different projects to advance their domestic products. We have started discussions on long term autonomy, robotic failure management, and shared control in the device operations. |
Collaborator Contribution | Beko has agreed to share their use cases. Beko will part-fund an international PhD studentship starting in 2023/2024, with agreement to be negotiated afterwards. |
Impact | NA. |
Start Year | 2022 |
Description | Reckitt |
Organisation | Reckitt Benckiser |
Country | United Kingdom |
Sector | Private |
PI Contribution | We discussed our work in long term autonomy with Reckitt and will develop an inspection use case with a mobile quadruped robot. |
Collaborator Contribution | Reckitt has agreed to part fund an international PhD studentship to work on the project and will share the facilities and the use case. |
Impact | NA |
Start Year | 2022 |
Description | 'Rehabilitation Matters' articles published on the NRC website and various social media channels (Twitter, LinkedIn) |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Rehabilitation Matters is a series of stories and perspectives from people who care about effective clinical rehabilitation and the benefits it provides. Started in Spring 2021 with an article by NRC Programme Director Miriam Duffy, the series includes viewpoints from patients, clinicians, surgeons, academic partners and others. Various members of the Rehabilitation Technologies Network team have been featured. See below: Co-I Prof Mark Lewis - 2nd June 2021 - Tech, science, awareness, opportunity - it's 100% the right time for the NRC. Co-I Prof Pip Logan - 10th December 2021 - Why I'm excited about the NRC: research, application, impact. PI Prof Ruth Goodridge - 30th March 2022 - Applying new technology to rehabilitation can be transformative for people's lives. Future Leader Dr Andy Capel - 30th June 2022 - The opportunity for the UK to be a world-leader in rehabilitation is real - and R&D and innovation have an enormous role to play. |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.nationalrehabilitationcentre.nhs.uk/latest-news/rehabilitation-matters |
Description | BAE Systems strategic planning workshop |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Industry/Business |
Results and Impact | Discussions with BAE systems started. Research collaboration links are established with BAE providing support letters to 3 bids currently being evaluated. |
Year(s) Of Engagement Activity | 2022 |
Description | Creation of a Researcher Directory |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | A Member Directory was created and launched on the Rehabilitation Technologies Network website to enable members of the network to collaborate and find expertise in the field of rehabilitation. Created in January 2023. |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.rehabtechnologies.net/member-directory |
Description | EPSRC Rehabilitation Technologies Network+ Launch Event |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | This was the official launch event for our project, held as a webinar and reached around 120 delegates from the research, clinical and PPIE community internationally. This encouraged membership to our project and applications to future events. The aim was for attendees to meet the team, and find out more about our Network. We welcomed registrations from all interested parties, including research staff, healthcare professionals, industry, and patient and user groups. There were presentations outlining the aims of the network, the National Rehabilitation Centre at Stanford Hall, our priority clinical and technical themes, future funding opportunities, and how members can get involved. We held a Q&A at the end of the event. This virtual event was a Teams webinar and was recorded and made available on our website. The event ran from 12:00pm - 13:30pm. The agenda: Welcome & Network Overview The Network & EPSRC The National Rehabilitation Centre, Industry, Clinical, Patient & Public Involvement Clinical & Technical Priority Areas Network events and funding, including Early Career Researcher activities Q&A |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.rehabtechnologies.net/network-launch |
Description | Grand Challenge Workshop - Cardiorespiratory Rehabilitation Technologies |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | The Rehabilitation Technologies Network+ (RTN) invited Members to apply to attend an in-person Grand Challenge Workshop on "Transformative Technologies for Neurological Rehabilitation". Participants helped identify research priorities and questions of central interest, as well as potential disruptive technologies and solutions to clinical challenges. Up to £100,000 of RTN funding was made available to fund interdisciplinary feasibility studies arising from this workshop. Date: 6th & 7th July 2022 Location: The Orchard Hotel, University Park, University of Nottingham Attendees: 45 Project Team Involvement: Led by Prof Ruth Goodridge, supported by Dr Andy Capel, Prof Pip Logan Outputs: New research collaborations and potential feasibility funding applications. |
Year(s) Of Engagement Activity | 2022 |
Description | Grand Challenge Workshop - Musculoskeletal Rehabilitation Technologies |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | The Rehabilitation Technologies Network+ (RTN) invited Members to apply to attend an in-person Grand Challenge Workshop on "Transformative Technologies for Musculoskeletal Rehabilitation". Participants helped identify research priorities and questions of central interest, as well as potential disruptive technologies and solutions to clinical challenges. Up to £100,000 of RTN funding was made available to fund interdisciplinary feasibility studies arising from this workshop. Date: 11th & 12th January 2023 Location: Burleigh Court, Loughborough University Attendees: 45 Project Team Involvement: Led by Dr Andy Capel, supported by Prof Ruth Goodridge, Prof Mark Lewis, Dr Ayse Kucukyilmaz Outputs: New research collaborations and potential feasibility funding applications. |
Year(s) Of Engagement Activity | 2023 |
Description | IN-PERSON EVENT Rehabilitation Technologies: Supporting innovation through Multi-Stakeholder Networks (Medilink) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Date: Tues 29th March 2022 Event description: Technology has an increasingly important role to play in rehabilitation where it can support skilled healthcare professionals, reduce hospital stays and improve engagement with rehabilitation programmes. The East Midlands is well placed to support growth in this sector with the new £70 million National Rehabilitation Centre due to open at Stanford Hall, Nottinghamshire in 2024 and three new EPSRC funded networks being launched in the region to support the development and adoption of rehabilitation technologies. The session provided an update on the vision and delivery of the National Rehabilitation Centre and explained how researchers, clinicians and industry partners can join and benefit from the three new NetworkPlus EPSRC funded initiatives. Members of the networks would be able to draw on the knowledge and expertise of academics, clinicians, industry and other stakeholders to develop new, disruptive technologies for rehabilitation including innovations in advanced materials, patient-specific devices and therapy, closed loop & autonomous systems, robotic solutions for healthcare as well as assisted living products and services. Schedule: 9.30am Registration with coffee 10.00am Medilink Intro 10.05am Mark Lewis and Pip Logan - update on the NRC (20 mins) 10.25am Ruth Goodridge about the EPSRC HT Rehab Tech Network (10 mins) 10.35am Richard Bibb -EPSRC HT Tidal Network (10mins) 10.45am Coffee break (15 mins) 11.00am Praminda Caleb-Solly about the EPSRC HT Assistive Robotics Network (15 mins) 11.15am Simon McMaster - Footfalls and Heartbeats (UK) Limited (10 mins) 11.25am Kate Walker - ExpHand Prosthetics (10mins) 11.35 Panel discussion (all speakers on the panel, possibly a couple of others) (25 mins) 12.00pm Lunch and networking 1.00pm Finish The vent was attended by around 40 researchers, industry partners and and clinicians from the East Midlands region. This event triggered interest in our project and attendees of this event went on to apply (and attend) our Grand Challenge Workshops. |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.medilinkuk.com/medilink-midlands/ |
Description | Invited Talk at AgriFoRwArdS Seminar Series |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | A research seminar was given at the EPSRC AgriFoRwArdS CDT Seminar Series. A mix of undergraduate and postgraduate students and research staff attended the Zoom seminar, which focused on shared control and roles for human-robot teamwork. The talk is followed by a discussion session, where participants displayed great interest in the subject area. The talk is streamed on youtube. |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.youtube.com/channel/UCJPcGfoLEpHH37TdbdwZUCA |
Description | Invited speaker at the Pint of Science public engagement event |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | Pint of Science is a grassroots non-profit organisation that has grown astronomically over the few years since two people decided to share their research in the pub. The aim of the event is to to provide a space for researchers and members of the public alike to come together, be curious, and chat about research in a relaxed environment outside of mysterious laboratories or daunting dark lecture theatres. The event was attended by the public in a casual environment, where our work on robotic wheelchairs and robotics in general is discussed and disseminated. |
Year(s) Of Engagement Activity | 2023 |
URL | https://pintofscience.co.uk/about/ |
Description | Invited talk at CHI-WORK Online conversations: How Human-Robot Interaction is changing the way work is done |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | An online conversation with the HCI community in the CHIWork series. A mix of professionals attended a panel organised over Zoom, which focused on how robotics will change the future of work. The talk is followed by a discussion session, where participants displayed great interest in the subject area. The talk is streamed on youtube. |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.chiwork.org/uncategorized/chiwork-conversation-with-ayse-kucukyilmaz-hosted-by-max-wilso... |
Description | National Centre for Sports and Exercise Medicine, Loughborough University - Rehabilitation research in practice event : Motivation |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Hosted by Loughborough University and facilitated and talks delivered by Prof Pip Logan and Prof Mark Lewis (Co-Investigators) This was the first in a series of NRC research events on rehabilitation into practice. The aim was to showcase the research of the NRC (including the Rehabilitation Technologies Network+) in a range of areas, this first session looked at the topic of motivation and adherence. This event was aimed at healthcare professionals but was open to anyone with an interest in the topic. Attendees: 50 (capacity & 30 on the waiting list) Talk recording views: 48 |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.ncsem-em.org.uk/events/rehabilitation-research-in-practice-motivation/ |
Description | News article published on the NRC website and various social media channels (Twitter, LinkedIn) |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Article: Technology developed by new network could be "transformative" for rehabilitation Featuring: Prof Ruth Goodridge (PI) Date: 13th April 2022 Location: The NRC website An article advertising the new Network and outlining the aims over the next three years. |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.nationalrehabilitationcentre.nhs.uk/latest-news/news-updates/1613-technology-developed-b... |
Description | Reckitt collaboration meeting |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Day visit to Reckitt where discussions around future collaboration was made. The company has agreed to fund 2 PhD studentships to start integration of robotic technologies in their factory. |
Year(s) Of Engagement Activity | 2021 |
Description | Rehabilitation Technologies Network Early Career Researcher Forum |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | The Forum was launched on 16th February 2023 and hosted by: Dr Ayse Kucukyilmaz - Co-I Dr Anna Lions - Research Associate/ECR on Rehabilitation Technologies Network+ The Rehabilitation Technologies Network+ (RTN) appealed to early career researchers (within eight years of gaining PhD award) with an interest in rehabilitation technologies to join its new Early Career Researcher (ECR) Forum. The forum launched through an in-person workshop on 16th February 2023 at The University of Nottingham's Jubilee Campus. The forum gave researchers an opportunity to benefit from RTN activities. As a member of the network, researchers will have the opportunity to create multidisciplinary connections, get access to targeted workshops, networking initiatives and awards for travel and collaborations. The Forum will become a reference point for early career researchers with an interest in rehabilitation to support them in successfully navigating and progressing their career. 11 attendees. Outputs: Identified problems/solutions for ECRs were under the following headings - funding, mentorship, from lab to patient, clinical engagement This event is intended to be the first in a series of events to support ECRs over the lifetime of this project. |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.rehabtechnologies.net/early-career-researcher-forum |
Description | Science in the Park Exhibition |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Science in the Park was organised to provide a range of exciting family friendly activities at Wollaton Park on Saturday 5th March. A robotic stand was created for the day. A total of 856 visitors joined the event on the day. Interactions with children and young people of all ages increased interest in robotic technologies, including teleoperation and social and touch-based experiences. |
Year(s) Of Engagement Activity | 2022 |
URL | https://wollatonhall.org.uk/science-in-the-park-2022/ |
Description | UKSPA Autumn Conference 2022 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | This was a UK Science Parks Association - Charnwood Campus Cluster event, part of a series of events to support the growth and success of the life science organisations clustered around Charnwood Campus Science, Innovation and Technology Park in Loughborough. Co-Investigator Prof Mark Lewis spoke at this event about the National Rehabilitation Centre and related research opportunities which included the Rehabilitation Technologies Network+. Over 100 business leaders, entrepreneurs, innovators, and stakeholders gathered to hear how local business are innovating to drive business productivity, as part of the 2023 Leicestershire Innovation Festival. The talks covered a wide and varied range of evidence-based innovations that have been deployed to improve business resilience and productivity; from supporting employee mental health, delivering innovations to improve patient wellbeing and improve NHS productivity, to business planning process changes and the importance of intellectual property protection. |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.ukspa.org.uk/ukspa-conference-charnwood-campus-2022/ |
Description | UoN / NUH National Rehabilitation Centre (NRC) Networking and Ideas Generation Event |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Introduction Professor Ruth Goodridge was awarded £10,966 by the UoN NRC Research Fund to fund the following activities: • Establish a UoN network of researchers, academics, and technicians with an interest in developing innovative technologies to accelerate and improve rehabilitation. • Organise a 1-day workshop to encourage new multidisciplinary partnerships, focusing on outlining one or more funding proposals on closed loop wearable rehabilitation devices. • Identify and liaise with healthcare and community partners to establish Open-sourced Assistive Devices (OPAD) projects for staff groups, with the expectation that this leads to REF impact studies and future research proposals. Activities completed From 1st April to 31st July the following activities were completed: • Promotion and advertising of a University of Nottingham and Nottingham University Hospitals (NUH) 'Special Interest Group for Rehabilitation Technologies' aligned to the NRC. • Survey of interested parties to understand: • Research networking event for UoN and NUH researchers held at The Nottingham Belfry Hotel on Friday 1st July 2022. Main outcomes Survey The survey was completed by 35 UoN and NUH colleagues, the outputs were shared with the NRC Project Manager and included: • 21 suggestions for possible PhD projects aligned to the NRC. • 24 suggestions for NRC laboratory facilities. • 28 colleagues interested in attending a networking event. • 33 colleagues agreeing to be added to NRC rehabilitation technologies mailing list. Networking event An event was held at The Nottingham Belfry on Friday 1st July 2022. The 23 Attendees were given the opportunity to network and discuss potential unmet needs and solutions in the area of rehabilitation technology. A number of connections were made which have already resulted in research collaborations. These include: • Dr Michael Craven (UoN) and Dr Paula Almeida (UoN) resulting in a feasibility funding application to the EPSRC Rehabilitation Technologies Network+ grant in September 2022. • Dr Samuel Smith (UoN), Dr Alison Cowley (UoN/NUH) and Dr Vicky Booth (UoN/NUH) resulting in a possible NIHR RFPB grant for early 2023. • Dr Alison Cowley (UoN/NUH) and Prof Praminda Caleb-Solly. AI, technology and walking frames, early stages and currently identifying funding streams. Those who attended the event and agreed to be part of the mailing list will now be added to the growing list of researchers interested in the area of rehabilitation technologies marketed through the Rehabilitation Technologies website. |
Year(s) Of Engagement Activity | 2022 |