Orthotic News For Doctors, Clinicians & Therapists February 2015
Introducing our new Masser™ joints
Agilium Freestep Page 6
28U90 – Thermoplastic Ankle Foot Orthosis
Page 5 Page 7
• KAFO… Cauda Equina Syndrome sufferer walks again – p.2
• FES… Anna O’Connor’s MyGait story – p.3
• C-Brace… The worlds first lower limb bionic exoskeleton – p.4
February 2015
Orthotics | Ottobock Newsletter
Traditional KAFO helps Cauda Equina Syndrome sufferer walk again. Routine spinal surgery left Katy in constant, debilitating pain. Now, a new custom fitted leg brace has ‘revolutionised’ her life. ‘After years of rehabilitation and appointments, I had thought that orthotics were the end of the line, but it’s actually just the beginning. I have so much hope and aspirations for the future now. I hope my story inspires other to trust the system and stay the course.”
For seven years Katy Duncan has suffered intense pain, muscle weakness in her legs, bladder and bowel complications and epilepsy. She has a rare condition known as Cauda Equina Syndrome (CES), a serious neurological condition in which damage to the spine causes acute loss of function of spinal nerve roots. The condition, which was caused when routine spinal surgery went wrong, has no cure and in addition to constant and debilitating pain, affects her ability to move around.
Ottobock Academy Clinician Dave Buchanan added “Katy Duncan is a true inspiration. She has shown just how far a positive outlook, kind heart and lots of effort can take you. Our orthoses are available through many NHS Trusts and we hope Katy’s story inspires others to keep up their rehabilitation and trust their clinicians. The team in North Wales are a great example of how traditional orthoses can change someone’s life and we wish Katy the very best for her future”.
“I’ve suffered with CES for seven years. The first few years I was either bed or wheelchair-bound with long periods in hospital. I relied on strong opiate pain killers which left me with additional side effects.’ ‘I’ve never been one for giving up though and with the help of the wonderful NHS teams in North Wales, I was fitted with a custom-made lightweight carbon-fibre KAFO system with the help of Ottobock in order to help me walk. Initially I was fitted with just one, on my right side. The difference it made was phenomenal – so much so, I’ve just been fitted with a second KAFO system for my left leg’. ‘Not only can I now walk, but I’ve seen a dramatic reduction in pain and have been able to come off some of the heavy pain killers I was relying on. I have found my confidence again and am feeling like myself. I’m half way through a distance learning degree in Law and am looking forward to being able to work again.’
“I have found my confidence again and am feeling like myself”
Katy’s KAFO systems are custom made for her by NHS Wales. using Ottobock bars and joints.
For more information on our KAFO please contact David Buchanan our Academy Clinician David.Buchanan@ottobock.com
‘Receiving the KAFO systems has given me hope. I still rely on my elbow crutches but without the braces, walking would be a major problem. My CES also caused a bilateral foot drop so the ankle and foot plates are excellent to steady my lower legs and feet. They’ve revolutionised my quality of life. I had expected that they might help me be able to walk, but I never dreamt that they would improve so many other areas of my condition.’
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February 2015
Orthotics | Ottobock Newsletter
Innovative MyGait stimulation cuff provides solution to Multiple Sclerosis drop foot. Functional Electrical Stimulation can alleviate the mobility problems associated with MS helping sufferers get their life back on track. Anna O’Connor, a 56 year old from Midleton in Cork, Ireland was diagnosed with Multiple Sclerosis (MS) in 2000. One of her symptoms is foot drop, caused by weakness in the leg muscles that help move the ankle, resulting in her right foot scuffing the ground at each step. As an active individual she was devastated that her mobility had suffered and her love of walking and gardening would be affected. She has since become the first patient in Ireland to be fitted with MyGait, an advanced Functional Electrical Stimulation (FES) device by Ottobock, which has allowed her to regain some of her activity levels and restored her confidence. Anna is a decorative painter, creating murals that require her to use ladders and scaffolding. She first noticed symptoms when she was out walking with a friend and her right foot was scuffing the ground. Following the diagnosis her confidence was shaken as she could no longer work at the job she loved. Simple tasks such as shopping were now difficult as her mobility deteriorated. “I love spending time outdoors, going for walks and being in the garden, and had recently learnt to ski when I got the news,” explains Anna. “Following my diagnosis, I became very conscious of my physical self and gradually my foot-drop became more and more significant. It made everyday tasks more difficult and I felt I did not want to go out as much. I began to use hillwalking sticks to help my balance.”
Anna found out about Functional Electrical Stimulation from the MS Society of Ireland, and was intrigued as to how it could help her. She visited Cappagh National Orthopaedic Hospital in Dublin where she undertook an FES trial. The pioneering device works by applying small electrical impulses to the nerves in the affected muscles, with the nerve then stimulating the muscle into movement, lifting the foot from the ground at each step. A unique advantage of Ottobock’s MyGait is that more than one muscle group can also be stimulated using a second channel. This makes it possible to provide additional support when walking.
“MS disrupts the neural communication to the muscles, causing weakness,” states Lynn Vale, clinical specialist at Ottobock. “People with MS that suffer with foot drop are more vulnerable to tripping and falling. Walking also uses more energy and people may alter their gait to compensate, commonly lifting their leg higher and swinging it to the side. In Anna’s case, FES was the perfect solution. She has adapted to it with ease and you can see the confidence it has given her to get back out there and enjoy life.” Anna continued, “When I was first fitted with the MyGait system, my foot twitched, then it raised - I was amazed how easy it was to use. I couldn’t believe there was something out there that could help me; it was a real starting point to becoming active again.” Anna adds, “Ottobock have been terrific throughout the process; the team have given me great advice and been there for me along the journey. The MyGait system just makes sense to anybody suffering from drop foot like me. MS has taken a lot from me, but I won’t let it defeat me. Gaining some of my mobility back means the world to me.”
Anna O’Connor is using a MyGait Functional Electrical Stimulation device, to help her get her life back on track.
For more information on Ottobock’s range of innovative solutions that restore mobility please visit www.ottobock.co.uk or follow @ottobockuk.
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February 2015
| Ottobock Newsletter
The World’s First Lower-Limb Bionic Leg Brace has now Launched in the UK.
John Simpson becomes the first patient in the UK to be fitted with new computer-controlled Leg Brace A new leg brace has been launched in the UK to help people living with incomplete paraplegia, spinal injury, post-stroke and post-polio syndrome walk naturally again. The C-Brace®, from Ottobock, is the only device of its kind. The intelligent, carbon fibre brace uses a built-in microprocessor and sensors which allows the knee to control all aspects of the walking cycle and can be worn on either one or both legs. John Simpson, founder of golfing charity On Course Foundation, has become the first patient in the UK to wear the device. John has been unable to walk unaided since he was a young child. Polio left his nerves so damaged he was unable to walk and despite multiple operations, physiotherapy and treatments he has relied on a locked KAFO brace to help him move around since he was 14. The C-Brace was launches to the UK media on the 4th February 2015, with John heading straight to the Royal Wimbledon Golf Club. “For as long as I can remember, I’ve had to walk with a locked-knee, which is awkward, cumbersome and puts great strain on my lower back,” explains John Simpson. “Over the years I tried new braces, supports and therapies, but nothing helped me walk and so I stuck with my original steel calipers. In all the years I’ve been wearing calipers, the most innovative development until now was the addition of Velcro, so the C-Brace is a revolution. I can walk naturally again, without fear that my leg will give way, leading to a fall. I can walk downstairs with a bent knee and without fear as the brace provides support intuitively. It’s going to change my life. With the C-Brace I’ve gone from crutches to two sticks and now only one stick, and I’m still at the early stages of learning”.
Despite his mobility difficulties, John has played golf to a high standard since his early teens – when he was taught by his father and a friend as part of his rehabilitation. John had a highly successful career as Senior Vice President of IMG, managing elite sportsmen such as Nick Faldo, Bernhard Langer, Greg Norman and Sebastian Coe and since visiting the injured military men and women at Headley Court, he has established ‘On Course Foundation’, a military charity that supports the recovery of wounded, injured and sick Service personnel through golf tuition and jobs in the golf industry. The Ottobock C-Brace can help people who have limited control of their leg/s to walk naturally, cycle, walk down stairs and descend slopes at a normal walking speed – something never before possible. Designed using worldleading prosthetic technology, C-Brace allows those paralysed through disease and trauma to benefit in the same way as amputees for the first time. “This is the most exciting development in the orthotic industry in the last decade”, said David Buchanan, Ottobock Academy Clinician and UK Stance Control expert. “This is a device designed for people who don’t have the full control of their legs or can’t bear weight without collapsing. It’s the first ‘swing-phase’ control orthosis, which means that the computer and sensors inside the device control the leg in space – just like the advanced prosthetic legs. This means that it can help people walk, cycle… even play a round of golf, naturally and comfortably”. The C-Brace is now available in the UK through Dorset Orthopaedic. For more information about Ottobock’s range of products visit www.ottobock.co.uk
For more information about On Course Foundation, visit www.oncoursefoundation.com
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February 2015
Orthotics | Ottobock Newsletter
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February 2015
Orthotics | Ottobock Newsletter
Introducing our new Masser™ Joints Streamlined and serviceable
We are proud to be launching our improved Masser™ joints at BAPO. They perform better than ever and are fully serviceable: •
Reducing the need to replace either the upper or lower joint
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Servicing can take place while the user attends clinic, avoiding the need for return visits
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No need to send the KAFO away for servicing, meaning reduced admin and cost-savings for you
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Also featuring an improved locking mechanism for better reliability and safety, reducing risk to your clinic
Come and help us celebrate, and find out more, with a free glass of champagne on presentation of this newsletter at the Ottobock stand 51-55 at 11.30am on Saturday 21st March.
Events and Exhibitions 2015 • BAPO Conference 2015 20th – 22nd March 2015 Lancashire County Cricket Club, Manchester
• Naidex Conference 28th – 30th April 2015 Birmingham NEC
For more information please visit www.bapo.com
For more information please visit www.naidex.co.uk
• ACPIN Annual Conference 20th – 21st March 2015 Hilton Hotel, Northampton
• IFESSUKI Conference 8th – 9th May 2015 Sheffield Hallam University
For more information please visit www.acpin.net
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February 2015
| Ottobock Newsletter
Introducing the Agilium Freestep – An innovative new treatment for Osteoarthritis of the knee. Osteoarthritis (OA) of the knee is a common musculoskeletal condition prevalent in adults that can cause considerable pain, immobility and disability. Patients with knee OA generally have progressive loss of cartilage and joint space commonly in the medial knee compartment, typically resulting in a varus mal-alignment, which causes the mechanical axis/ground reaction force vector to pass more medially to the knee joint centre during gait. Research suggests that mechanical load plays an important role in the disease progression. Numerous nonpharmacological interventions, such as patient education, physiotherapy, Weight management and orthoses are routinely used in the management of patients with knee OA with varying degrees of success. Orthotic treatment of knee OA normally apply a corrective 3 point or 4 point force to realign the varus/valgus mal-alignment, subjecting the user to very high interface pressures. As a result, bracing of this type is often met with poor compliance from the patient. Difficulty maintaining the brace correctly in situ throughout gait without migration or rotation, combined with the added bulk, often results in rejection from the user. The Agilium Freestep from Ottobock has been designed to provide an alternative conservative method to the treatment of knee OA. The orthosis reduces the pathological varus moment at the knee as opposed to applying corrective force directly to the user which is very different to conventional OA Knee bracing. The brace consists of a foot piece and a lateral vertical strut which influences the user’s weight bearing line on the frontal plane. The aim is to move the weight line/ centre of pressure (CoP) laterally which has the effect of bringing the GRF closer to knee axis, reducing the “distance” value and as a result the magnitude of the moment. The Centre of Pressure is moved laterally due to the preloaded vertical strut which puts the heel into a varus position. The lateral strut reduces the ankles ability to compensate for this change, making it more effective than wedging alone. The Agilium Freestep can also be used in the treatment of lateral compartment syndrome which consists of a medial strut. For ease of explanation the focus has been on the more prevalent medial side.
Key features of the Agilium Freestep • No patient weight limit • Has been tested to 3 millions steps • Discreet and lightweight • Can be worn under trousers and with most shoes • Does not apply constant pressure to the knee joint like conventional braces, meaning greater patient comfort
A recent study by Fantini et al (published in P&O International, December 2014) demonstrated a significant decrease the Knee Abduction Moment can be achieved with the Agilium Freestep. This as a For more information on the Agilium Freestep, please contact result, reduces the load on the affected knoww your Business Manager or email direct to bockuk@ottobock.com compartment, offering pain relief for the user.
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February 2015
| Ottobock Newsletter
28U90 Thermoplastic Ankle Foot Orthosis - Comfort at every step. The 28U90 Ankle Foot Orthosis from Ottobock has been designed to replace the existing 28U9 AFO. Its thin-walled polypropylene construction has been optimised for increased resilience thus offering effective support whilst remaining lightweight. The long sole provides precise foot guidance and good pressure distribution ensuring high level of wearer comfort. Replicating the support that a shoe provides, the 28U90 has a pitch rather than being flat which encourages better posture and places the knee in approximately a 10 degree angle. The micro-Velcro strap is very strong and durable and is easy to replace and wash. The 28U90 AFO is now available in a choice of transparent or black. For more information on the 28U90, please contact your Business Manager or contact bockuk@ottobock.com
Contact Us. Business Managers Tim Moore Email: tim.moore@ottobock.com Phone: 07970 629022 Larissa Cottington-Whelan Email: larissa.cottington-whelan@ottobock.com Phone: 07779 134870 Lynn Vale Email: lynn.vale@ottobock.com Phone: 07880 242463 Academy David Buchanan Email: david.buchanan@ottobock.com Phone: 07500 667122 Marketing Christina Haigh Email: christina.haigh@ottobock.com Phone: 01784 744915
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