Survivors of major trauma can achieve a remarkable rate of recovery when given the right support, according to a new University of Manchester-led study examining a pioneering rehabilitation programme developed in response to the needs arising from the Manchester Arena bombing.
The study offers a powerful reminder that survival is only the beginning of recovery.
Published in the journal Physiotherapy, the study evaluated the Enhanced Rehabilitation Programme (ERP), a specialist multidisciplinary rehabilitation service established following the 2017 Manchester Arena attack.
The programme provided intensive, personalised support for survivors who were still struggling with the physical and psychological consequences of their injuries more than a year after the event.
The researchers from the Universities of Salford and Manchester, Manchester University NHS Foundation Trust (MFT) and Northern Care Alliance NHS Foundation Trust, found that participants experienced substantial improvements in physical recovery, confidence, fitness, mental wellbeing and overall quality of life.
Survivors described achieving goals they once thought impossible, from walking without aids and reducing pain medication to returning to work, pursuing further education and rebuilding their independence.
While advances in trauma care mean more people than ever survive devastating injuries, many continue to live with long-term physical, psychological and social consequences that can persist for years after discharge from hospital.
The ERP brought together physiotherapists, psychologists, occupational therapists, surgeons, sports scientists and rehabilitation specialists to address the complex challenges faced by major trauma survivors, at the renowned Manchester Institute of Health and Performance.
Participants consistently reported that the programme’s personalised, holistic approach, and elite sport environment, helped them regain confidence, restore function and rebuild their lives.
Patients described how the programme shifted their focus from simply coping with injury to actively “training like an athlete”, pursuing future goals and aspirations.
The study identified several important lessons for the future of trauma rehabilitation:
- Recovery after major trauma must address psychological and social wellbeing, not just physical injuries.
- Personalised goal-setting and progress tracking help maintain motivation and confidence throughout recovery.
- Multidisciplinary rehabilitation allows patients with complex injuries to receive coordinated support tailored to their individual needs.
- Despite the overwhelmingly positive experiences reported by participants, the study also highlighted concerns about what happens when specialist rehabilitation ends.
- Both patients and clinicians expressed anxieties about maintaining progress and accessing ongoing support through existing NHS services, with some describing a feeling of stepping off a rehabilitation “cliff edge” once the programme concluded.
Professor Jason Wong, Consultant Trauma Surgeon at MFT and Professor of Reconstructive Plastic Surgery and Regenerative Medicine at The University of Manchester, said:
“This study is ultimately a story about resilience. The survivors we worked with faced life-changing injuries and experiences, yet many went on to achieve things they never thought would be possible. We saw people regain independence, rebuild confidence, return to work, improve their fitness and ultimately adopt a new healthier mindset.
“What was clear from both patients and clinicians is that recovery after major trauma involves much more than healing physical wounds. Psychological wellbeing, confidence, identity and social participation are all fundamental parts of rebuilding lives after injury.”
Professor Wong, who is also a Dermatology Theme researcher at the National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC): Manchester which supported the study, added: “Our findings show that structured, multidisciplinary rehabilitation can make a real difference, but they also highlight an important challenge. Recovery doesn’t end when someone leaves hospital, and access to rehabilitation does not always provide the specialist input required.
“This is an opportunity to celebrate the extraordinary courage and determination of survivors of trauma, while recognising that many continue to need support long after their immediate injuries have healed. If we want to improve long-term outcomes, we must ensure that trauma survivors have access to sustainable rehabilitation pathways that support them throughout their recovery journey.”
The programme was funded through the We Love Manchester Emergency Fund and Greater Manchester Clinical Commissioning Groups, with support from the NIHR Biomedical Research Centre (BRC): Manchester.