and Respiratory
Research Cluster

The Rehabilitation and Respiratory Research Cluster has over 30 research active staff undertaking multi-disciplinary research in exercise and rehabilitation, and respiratory diseases and conditions. Our research is undertaken with partners in different settings including NHS/healthcare, community, schools and sporting contexts and contributes to solving real world problems.

It builds on the University of Derby’s Research Excellence Framework submission in 2021 in Allied Health Professionals (Unit of Assessment 3), where the quality of research has been externally rated as 'internationally excellent'. Our research aims to benefit local communities and a range of stakeholders across health, rehabilitation, respiratory, physical activity and sports performance contexts.

Our aims

The Clinical Exercise and Rehabilitation Research Centre has over 50 active researchers who undertake internationally excellent research. This includes our Rehabilitation and Respiratory Diseases Research Cluster.

In our research into clinical exercise and rehabilitation, we have an extensive blend of academics who specialise in rehabilitation from multiple perspectives such as elite sport performance, strength and conditioning, coaching and psychology, and sports and physiotherapy. Our research expertise also includes specific areas/conditions including viral reactivation, type 1 diabetes, neurodisability and stroke rehabilitation, strength, balance and fall prevention in adults. Our researchers have experience of orthopaedic and musculoskeletal conditions including metatarsophalangeal joint replacement with adults and running injuries and injury prevention with elite military units and exercise immunology.

Our researchers within respiratory diseases specialise in respiratory conditions from multiple perspectives with different populations. Our research expertise includes COPD, COVID-19, Long-COVID, Inspiratory Muscle Training (IMT) as well as immunology and upper respiratory infection with elite athletes.

Our collaborations in the Rehabilitation and Respiratory Diseases Research Cluster include a vast network of national and international academic institutions, industry partners, healthcare providers and organisations, third sector organisations, the military, including elite armed forces and research councils. Our research takes place in a range of health-related settings and contexts including specialist centres and healthcare settings, sports institutions, community health providers and military establishments. 

Research Cluster Teams

Our research active staff are listed below, and you can find more about their research expertise and activities by clicking on the link to their individual staff profiles: 

  • Nikki Davis 
  • Jason Feavers 
  • Sam Grimwood 
  • Rebecca Owen 
  • Lewis Spencer 
  • Linda Renshaw 
  • Catherine Ross 
  • Professor Rohan Rajan 
  • Lewis Spencer 
  • Callum Thomas 
  • Nathan Toon 
  • Shelly Walls 
  • Catalina Ioana Petrescu

Our research

Patient perceptions and understanding of pressure ulcer rusk within community settings - Dr Lisa Ledger

Pressure ulcers (PUs) are a key priority area for healthcare institutions, representing a patient safety issue, but despite global campaigns around awareness, incidence remains high. PUs are associated with ill health, poor mobility and reduced quality of life. Increasingly, patients are required to be aware of their PU risk and to self-manage their conditions, with a need to increase patient involvement in decision-making to promote adherence. To date, research is limited regarding patients’ own understanding of their risk, with majority of research focused on the healthcare professional view.

Dr Lisa Ledger's study aimed to address the following research questions:

  1. What are patient perceptions and understanding of their PU risk?
  2. What factors affect their adherence or non-adherence to prevention strategies in community settings?

The study revealed four key overarching themes related to patient understanding of PU risk and potential factors affecting adherence to advice as: Pressure Ulcer Awareness, Risk & Prevention Knowledge, Patient Factors & Adherence, The Nursing Encounter and The Nursing Approach. Novel findings included that whilst patients understood PU risk in a basic sense, this did not necessarily secure adherence due to other patient related factors, such as pain, mood affects, fatigue, fear of falling and carer dependency. The study observed two overall nursing approaches: a closed directive and a more open participatory approach. Use of an open participatory nursing approach was pivotal in securing trust and enabling acknowledgement of dynamic patient related factors as part of shared decision-making.  

The study provides important new insights for clinical practice in relation to how PU information and advice is provided and how decision-making occurs between nurse and patient and the effect of this on adherence. The findings were translated into a new conceptual risk model of PU prevention that places the patient perspective alongside the nursing perspective in partnership, with an open participatory nursing approach used to support shared decision-making.

Effects of Inspiratory muscle training on performance and health related outcomes - Dr Francesco Ferraro and Dr Mark Faghy

Inspiratory muscle training has been adopted for over two decades as a cost-effective intervention to improve athletes' functional mobility, balance, performance and enhance respiratory and quality of life-related outcomes in different conditions (such as COPD and cardiovascular diseases) (Beaumont et al., 2018; McConnell, 2013; Romer & McConnell, 2003). For this reason, IMT has been defined as a holistic intervention designed to strengthen the inspiratory muscles via specific inhalation resistances (Shei et al., 2022).
The literature and research on IMT are extremely broad, and with the advance of technology, novel and innovative forms of IMT have been developed (Minahan et al., 2015). However, there is still a lack of evidence on why improvements in inspiratory muscle strength enhance mobility and how IMT intervention should be specifically prescribed and used alone or in combination with other forms of training. There is also a lack of evidence on what mechanism links improvements in inspiratory muscle strength with higher performance results.

To answer these questions, to keep up to date with the population's needs and to further understand the role of inspiratory muscles in functions such as balance, mobility and time trial performance a series of studies and projects have been carried out within national and international collaborations, including research in diabetes patients, older adults, COPD patients and asthmatic patients. These projects included the recent publication in the European Respiratory Review (Severin et al., 2022) and the invitation to present our results at the University of Valencia (SPA) (Sheraz & Ferraro, 2022).

Join us

If you are interested in our research and would like to find out more, would like to join our research cluster or are applying for a MPhil/PhD in this research area, please contact Research Centre Lead Professor Andy Pringle ( or Deputy Research Centre Leads Dr Lisa Ledger ( and Dr Jack Parker ( for more information.


  • Ashton, R.E., Philips, B.E. and Faghy, M., (2023). The acute and chronic implications of the COVID-19 virus on the cardiovascular system in adults: A systematic review. Progress in Cardiovascular Diseases. 
  • Ashton, R.E., Aning, J.J., Tew, G.A., Robson, W.A. and Saxton, J.M., (2021). Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial. Supportive Care in Cancer, 29(8), pp.4595-4605. 
  • Ashton, R. E., Tew, G. A., Aning, J. J., Gilbert, S. E., Lewis, L., & Saxton, J. M., (2020). Effects of short-term, medium-term, and long-term resistance exercise training on cardiometabolic health outcomes in adults: systematic review with meta-analysis. British journal of sports medicine, 54(6), 341-348. 
  • Ashton, R. E., Tew, G. A., Robson, W. A., Saxton, J. M., & Aning, J. J., (2019). Cross-sectional study of patient-reported fatigue, physical activity and cardiovascular status in men after robotic-assisted radical prostatectomy. Supportive Care in Cancer, 27(12), 4763-4770. 
  • Bates, L.C., Conners, R., Zieff, G., Adams, N.T., Edgar, K.M., Stevens, S., Faghy, M.A., Arena, R., Vermeesch, A., Joseph, R.P. and Keith, N., (2022). Physical activity and sedentary behavior in people with spinal cord injury: Mitigation strategies during COVID-19 on behalf of ACSM-EIM and HL-PIVOT. Disability and Health Journal, 15(1), p.101177. 
  • Bentley, C. L., Powell, L., Potter, S., Parker, J., Mountain, G. A., Bartlett, Y. K., & Hawley, M. S., (2020). The use of a smartphone app and an activity tracker to promote physical activity in the management of chronic obstructive pulmonary disease: randomized controlled feasibility study. JMIR mHealth and uHealth, 8(6), e16203. 
  • Briggs, I., Chidley, J. B., Chidley, C., & Osler, C. J., (2021). Effects of caffeine ingestion on human standing balance: a systematic review of placebo-controlled trials. Nutrients, 13(10), 3527. 
  • Ciccarelli, S., Scuotto, C., Aruta, L., Ferraro, F.V. and Iavarone, M.L., (2023). Developing novel life skills and experiences: a pilot study with Functional Advanced Didactics. Form@ re-Open Journal per la formazione in rete, 23(1), pp.52-68. 
  • Davis, N. M., Pringle, A., Kay, A. D., Blazevich, A. J., Teskey, D., Faghy, M. A., & Mina, M. A., (2022). Feasibility, Psychosocial Effects, Influence, and Perception of Elastic Band Resistance Balance Training in Older Adults. International Journal of Environmental Research and Public Health, 19(17), 10907. 
  • Faghy, M. A., Owen, R., Thomas, C., Yates, J., Ferraro, F. V., Skipper, L., & Ashton, R. E., (2022). Is long COVID the next global health crisis? Journal of Global Health, 12. 
  • Faghy, M.A., Yates, J., Hills, A.P., Jayasinghe, S., da Luz Goulart, C., Arena, R., Laddu, D., Gururaj, R., Veluswamy, S.K., Dixit, S. and Ashton, R.E., (2023). Cardiovascular disease prevention and management in the COVID-19 era and beyond: An international perspective. Progress in Cardiovascular Diseases. 
  • Ferraro, F. V., de Ruggiero, F., Marino, S., & Ferraro, G., (2021). Social Bottom-Up Approaches in Post-COVID-19 Scenario: The AGOGHÈ Project. Social Sciences, 10(7), 274. 
  • Ferraro, F.V., Gavin, J.P., Wainwright, T.W. and McConnell, A.K., (2021). Association Between Inspiratory Muscle Function and Balance Ability in Older People: A Pooled Data Analysis Before and After Inspiratory Muscle Training. Journal of Aging and Physical Activity, 1(aop), pp.1-13. 
  • Fletcher, L. J., & Osler, C. J., (2021). Effects of mental fatigue on static upright stance and functional balance in older adults. Aging and Health Research, 1(4), 100043. 
  • Harrison, A. M., Safari, R., Mercer, T., Picariello, F., van der Linden, M. L., White, C., ... & Norton, S. (2021). Which exercise and behavioural interventions show most promise for treating fatigue in multiple sclerosis? A network meta-analysis. Multiple Sclerosis Journal, 27(11), 1657-1678. 
  • Kime, N., Zwolinsky, S., Pringle, A. and Campbell, F., (2022). Children's and young People's diabetes services: What works well and what doesn’t? Public Health in Practice, 3, p.100272. 
  • Ledger, L., & Morris, L., (2021). Pressure ulcer prevention and use of patient information leaflets. Journal of Community Nursing, 35(5). 
  • Ledger, L., Worsley, P., Hope, J., & Schoonhoven, L., (2020). Patient involvement in pressure ulcer prevention and adherence to prevention strategies: An integrative review. International Journal of Nursing Studies, 101, 103449. 
  • Nakhaee, M., Mohseni-Bandpei, M., Mousavi, M. E., Shakourirad, A., Safari, R., Kashani, R. V.,& Nakhaei, M., (2022). The effects of a custom foot orthosis on dynamic plantar pressure in patients with chronic plantar fasciitis: A randomized controlled trial. Prosthetics and Orthotics International, 10-1097. 
  • Parker, J., Powell, L. and Mawson, S., (2020). Effectiveness of upper limb wearable technology for improving activity and participation in adult stroke survivors: systematic review. Journal of medical Internet research, 22(1), p.e15981. 
  • Powell, L. A., Parker, J., Weighall, A., & Harpin, V. (2022). Psychoeducation Intervention Effectiveness to Improve Social Skills in Young People with ADHD: A Meta-Analysis. Journal of attention disorders, 26(3), 340-357. 
  • Pronk, N.P., Mabry, P., Bond, S., Arena, R. and Faghy, M.A., (2022). Systems science approaches to cardiovascular disease prevention and management in the era of COVID-19: A humpty-dumpty dilemma?. Progress in Cardiovascular Diseases. 
  • Redwood-Brown, A., Ralston, G. W., & Wilson, J., (2021). Incidence, severity and perceived susceptibility of COVID-19 in the UK CrossFit population. BMC Sports Science, Medicine and Rehabilitation, 13(1), 1-12. 
  • Safari, R., Jackson, J. and Sheffield, D., (2020). Digital self-management interventions for people with osteoarthritis: systematic review with meta-analysis. Journal of medical Internet research, 22(7), p.e15365.  
    Safari, R. (2020). Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction. Prosthetics and Orthotics International, 44(6), 384-401. 
  • Saxton, J. M., & Ashton, R., (2022). Exercise testing in breast and prostate cancer. In Sport and Exercise Physiology Testing Guidelines (pp. 258-266). Routledge. 
  • Severin, R., Franz, C.K., Farr, E., Meirelles, C., Arena, R., Phillips, S.A., Bond, S., Ferraro, F. and Faghy, M., (2022). The effects of COVID-19 on respiratory muscle performance: making the case for respiratory muscle testing and training. European Respiratory Review, 31(166). 
  • Sheraz, S., Ayub, H., Ferraro, F.V., Razzaq, A. and Malik, A.N., (2022). Clinically Meaningful Change in 6 Minute Walking Test and the Incremental Shuttle Walking Test following Coronary Artery Bypass Graft Surgery. International Journal of Environmental Research and Public Health, 19(21), p.14270. 
  • Roscoe, C.M., Pringle, A., Chandler, C., Faghy, M.A. and Barratt, B., (2022). The role of physical activity in cancer recovery: an exercise practitioner’s perspective. International Journal of Environmental Research and Public Health, 19(6), p.3600.