INNOVATION FOR INDEPENDENCE
ISSUE 110 AUGUST/SEPTEMBER 2016 £6.95
Sensory device aids rehabilitation for stroke survivors By Dominic Musgrave SMALL Sensory devices could help to improve walking recovery during stroke rehabilitation in a bid to reduce social isolation.
Health researchers at Manchester Metropolitan University are leading the development of a new haptic device – technology that communicates via vibrations – to aid walking therapy for stroke survivors. They are working with the Open University and Manchester-based technology firm Lucid Innovation to develop the device. The technologies are part of a series of technical health projects at the University designed to employ new technologies to cut loneliness and isolation. The device, worn by the individual, would sense the symmetry of walking and provide vibrations, similar to that from a mobile phone, to cue the wearer to improve how they are walking. In the UK, 150,000 people sustain a stroke each year whilst 1.2 million people in the UK live with the consequences of stroke. The goal is to help these people to maintain their wellbeing and mobility. The project is led by Dr Rachel C Stockley and Glenis Donaldson, from Department of Health Professions, and Professor Josie Tetley, from the Department of Nursing. Rachel said: “Whilst advances in medical
treatment mean that many people are more likely to survive stroke and have improved outcomes, walking and specifically walking in the community, continues to be a significant problem for over half of all stroke survivors. “The increased social isolation brought about by reduced community mobility is likely to lead to a loss of sense of self, greater carer burden and can produce many significant health conditions, with associated healthcare costs, secondary to a sedentary lifestyle. “The project will provide valuable information regarding the practicality, acceptability and feasibility of wearing and using the haptic technology to alter walking and help us take the next steps in producing a commercial and useful device to help stroke survivors be more mobile in the community.” Working with computer engineering colleagues at the Open University and technology firm Lucid Innovation, the team will start to develop a wearable haptic device with funding from Greater Manchester Academic Health Sciences Network’s Technology Innovation Challenge. The project will develop a prototype device with the input of stroke survivors and clinical physiotherapists to ensure it is practical and wearable. The team will then test it in a small group of people who have difficulty walking because of their stroke.
University of Northampton student Marija Reis has used her experience of working in a care home to design and produce a sleek and modern mobility aid. The third year BSc Product Design student, who graduated this summer, wanted to create something that people with mobility issues would want to use and not shy away from, especially as her research showed there is a certain stigma attached with traditional walking aids. The RoadRoamer has multiple functions so it can be used as a zimmer frame, a rollator and can also be turned into a wheelchair.
M.4s® PCL dynamic Precise turn of the dial for effective individual therapy. Care for your posterior cruciate ligament patients using the new medi M.4s PCL dynamic knee brace. The PCL protection pad holds the tibia in the desired position. The tensioning dial enables fast and precise adjustment. medi UK Ltd. Plough Lane, Hereford, HR4 OEL, T 01432 373500, enquiries@mediuk.co.uk, www.mediuk.co.uk
00000-pmaz-220x77-M4sPCL-04-2016_85553_0.indd 1
BEFORE TENSIONING DIAL – for precise and individual adjustment
instability of the knee following rupture of the posterior cruciate ligament AFTER PCL protection pad holds tibia in the desired position
medi. I feel better. 28.04.16 10:27
A COMMUNITY hit by the devastating floods last winter has received a welcome boost after the free donation of over £1,000 of postural support equipment.
Jiraffe made the donation after being contacted by Rachel Doherty, Westmorland General Hospital Community Children’s occupational therapist, who highlighted the impact the floods had on existing equipment. She said: “When the worst of the flooding hit around Christmas time the whole area was devastated and, try as we might, we just could not save the existing equipment made
Editorial Judith Halkerston Group Editor Email: jh@scriptmedia.co.uk Dominic Musgrave Group Production Editor Email: dm@scriptmedia.co.uk Tel: 01226 734407 Olivia Taylor Reporter Email: ot@scriptmedia.co.uk
Jiraffe, the sales and distribution division of Jenx Ltd and distributors of innovative postural support equipment in the UK, has donated two Rifton Blue Wave Toilet Systems to the Community Equipment Store at Cumbria Country Council. From there, the equipment will be made available to an appropriate user from the local community as and when required.
Contacts
NEWS
Jiraffe sticks its neck out to donate kit to flood-hit area
Sales Carole Rice Product Manager Email: cr@scriptmedia.co.uk Tel: 01226 734412 Fax: 01226 734478 Tony Barry Sales and Marketing Director Email: tb@scriptmedia.co.uk
Jiraffe product advisor Joe McGovern (bottom right) presents the new equipment to representatives from the Community Equipment Store at Cumbria County Council.
available for the community.
cannot thank them enough.”
“Once the floods subsided we immediately set about trying to get our hands on replacements and this is when we had the idea of calling Jiraffe.
Joe McGovern, Jiraffe product advisor, added: “After hearing about the impact the terrible floods had on the area and the existing equipment stock we were delighted to be able to offer brand new replacement postural support systems. Everyone at Jiraffe is proud to be able to support the local Cumbrian community with this donation.”
“We were over the moon when they agreed to provide new equipment that will make such a difference to the local community and for this we
At Script Media, we try to get things right but occasionally, we make mistakes. If you have a complaint about a story featured in our magazine or on our website, please, in the first instance, contact us by email: dm@scriptmedia.co.uk We abide by the Editors’ Code of Practice as demanded by the Independent Press Standards Organisation. For details on the code and what to do should you be unsatisfied with the way we handle your complaint, please visit www.ipso.co.uk
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ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
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NEWS
Acquisition announced
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THE Thuasne Group, owner of Townsend Design, an industry leader in orthopaedic knee and leg braces, has announced the acquisition of Quinn Medical, LLC, a spinal bracing company based in San Clemente, California. Quinn Medical initiated sales of their SLEEQ Spinal Therapy System in 2011. The SLEEQ braces were the first in the industry to feature a universal one-size design, with a simplistically ingenious method for adjusting the circumferential length of the brace to accommodate virtually any size patient.
Queen’s honour for Brighton professor NICK Webborn, professor of Sport and Exercise Medicine, based in Eastbourne and medical director of Sportswise, the sport and exercise medicine clinic based at the University of Brighton, was awarded an OBE in for his contribution to paralympic medicine and the British Paralympic Association.
2015 he was named among the top 100 most influential people with a disability in the UK by the Shaw Trust. He said: “It was a huge surprise and tremendous pleasure to open the letter telling me about this honour. “It is truly humbling to be recognised in this way. It has been an enormous privilege to work with so many wonderful athletes and colleagues over this time. None of this would have been possible without the support of family, friends and colleagues.
Born in Swansea, professor Webborn studied medicine at the Royal London Hospital and, at the age of 24, he suffered a spinal injury while playing rugby when serving as a doctor in the Royal Air Force. After a year in rehabilitation he completed his RAF service and came to East Sussex in 1986 to work as a Polegate GP.
Quinn’s innovative technology is prescribed for injuries, post-surgical treatment and mobility limiters, providing comfortable stabilisation to help people get Back In Motion.
He completed his Diploma in Sports Medicine before moving full time into sports medicine and has dedicated himself to working with paralympic athletes since 1992.
“Quinn has meticulously merged product design, materials and manufacturing to create superior functionality and comfort. This is exactly our business strategy and success factor at Thuasne,” said Elizabeth Ducottet, owner of the group. “We are very pleased that Thuasne USA now includes two very respected American companies that fabricate premium orthopaedic products that enhance physical motion, daily mobility, and quality of life.”
Professor Webborn has worked tirelessly to bring sports medicine to paralympic athletes, both for the British Paralympic Association and The International Paralympic Committee.
“Thirty-four years ago I was lying in a hospital bed thinking that my life had ended and I can now look back and reflect that my own struggle has shaped my life to help advance a field of medicine for athletes with disabilities that had received little attention.
Nick Webborn
various roles.
He worked with LOCOG to bring the 2012 Games to London and was chief medical officer for ParalympicsGB during the 2012 Games.
Professor Webborn’s academic research has been focused on injury and illness prevention and he is the most widely published author worldwide in this area.
He started the IPC’s injury surveillance programme in 2002 and has attended eight Paralympic Games in
As an athlete, professor Webborn represented Great Britain in wheelchair tennis in 2005, and in
ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
“This has been such exciting news and not easy to keep quiet about it but now that the announcement has been made I can look forward to celebrating with my family and friends. “I turn 60 in October and this really is the most perfect way to mark an already significant year. It has been an honour to serve medicine, sport and my country and receiving the OBE is unexpected and thrilling. “I am immensely grateful.”
ADVERTISER ANNOUNCEMENT
Picture credit: www.panodrone.co.uk
Paralympic excitement in air By Jamie Gillespie Prosthetist, Pace Rehabilitation
TIME seems to have flown by since London was preparing for the 2012 Olympic and Paralympic Games. The build up to Paralympics was very impressive driven in part by Channel 4, as they launched their Superhumans campaign. I recall rushing from work, heading to the Olympic Park, with noticeable excitement within the crowd on the train. The atmosphere within the stadium was electric. Many stars of the Paralympics became household names and ambassadors for their sports for all the right reasons. Now, back within clinic, it is interesting to reflect on what effect the 2012 Games has had on the services we deliver. At Pace Rehabilitation, I personally felt a buzz building up to the 2012 games during day to day 8
clinical practice. We were working with a higher than normal number of amputees and their sports specific prosthetic devices. These people were not necessarily those chasing Paralympic fame, but those who were very keen to be involved in recreational sport and fitness. In the week following the games, we had six individuals phone us to discuss prostheses for sport. Of our clinical caseload, we continued to maintain and improve designs, where possible, for a committed few who were seeking greatness. However, over recent years, there appears to be a need for more diverse designs of sporting prostheses. Our support for those competing in cycling and triathlon has kept us very busy, as well as other sports scheduled to become Paralympic events, such as Badminton. In response, we have invested a great deal of time and resources into research and development efforts to optimise designs in the hope of achieving marginal gains. One area where we have seen
ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
increasing demand for our services is the supply of paediatric high activity prostheses. Restrictions within the NHS appear to prevent the supply of these devices for those looking to play, move quickly and run on lightweight and responsive designs. Often these are not sports specific prostheses, so we refer to them as play limbs. This group of children and teenagers look up to our Paralympic athletes with awe, with many aspiring to compete at the highest levels of sport. As the school summer holidays begin, my work over the next weeks will include supporting growing children, and almost all will enjoy showing me how quickly and well they can run when they attend. Another influencing factor, related to sporting prostheses, has been the Invictus Games. The fantastic coverage of our wounded veterans competing, both in London and Florida, has inspired others. We are now working with more veterans than we have previously, as we supply aids and devices to assist with sport and
fitness. We are certainly challenged when preparing unusual but effective designs to this group of athletes with multiple injuries. During the build up to the Paralympic Games in Rio, there has been a whiff of anxiety as athletes wait to learn if they have been selected. The business of Paralympic sport is apparent, the standards are extremely high, and selection cannot be taken for granted for those involved. At Pace, we share their joy when we learn, one by one, that athletes have made the team. Only this week the new Channel 4 Superhumans advert was launched and already the tune is being sung and hummed around the building. Although the Games are not as close to home this time around, there is certainly excitement in the air. We feel honoured to play a small role when helping not only the various Paralympians we support, but those of all ages who are keen to be involved in sport at all levels.
NEWS
William with his new hand (left) and with academics David Janzi and Mark Hooper from the University of Bedfordshire (right).
University 3D prints a new hand for boy By Dominic Musgrave TWO University of Bedfordshire academics have made eight-year-old William Joyner a new hand using state-of-the-art 3D printing. Will, who was born with the fingers to his left hand missing, got the chance to try out his new hand made using the University’s 3D printer. At the University’s computer science laboratory Will was able to move his new hand using signal from muscles in his arm. The ground-breaking session allowed his parents Jo and Andy Joyner to see Will hold a pen for the first time with his left hand and draw a picture. Will is left-handed. David Jazani, senior lecturer in the
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Department of Computer Science and Technology, and Mark Hooper, a technician and demonstrator who is currently studying part-time for a PhD in Computer Science at the University, were contacted by Will’s mother just over a year ago. Mark said: “Jo had found a design of a hand online made by scientist in Africa. She wanted to see if we could adapt it. “It was brilliant but we wanted to see if we could make it less clunky and more usable for a young boy. Also we wanted incorporate the use of William’s thumb to make the hand as dextrous as possible.” There are still some adaptations to the hand to be made. It needs to be able
ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
to withstand the everyday activities of an eight-year-boy, and with that in mind there are plans to insert lightweight aluminium rods and to use titanium hinges. David added: “This will be an ongoing project for the next 12 years while William grows. But we hope with the latest modifications William will be walking out of the University with a fully working hand in the next five to six months.” Will’s mum Jo said she is over the moon, adding: “It means Will be able to do the same things as other children. He’ll be able to do complex things like tie his laces but also simple activities like holding a drink in one hand and an ice lolly in the other.
“I can’t thank these guys enough. What they’re doing for William is life changing.” The new hand doesn’t just mean Will gains the use of his left hand. Now that he’s using the muscles down his left hand side they will get more developed and stronger whereas at the moment they’re rarely used. And for a budding footballer like Will that’s very important. Even better for Will, who supports Reading, the hand is going to be decked out in the club’s colours of blue and white. David added: “We’re also going make a flesh coloured one just in case he changes his mind when he’s older.”
TWO students from Glasgow Caledonian University will put their podiatry knowledge into practice when they travel to India this summer to volunteer with leprosy sufferers, with support from the University’s Magnusson Awards. Louise McCloy and Lucy Forsyth will spend a month at the Leprosy Mission Hospital in Naini, Allahabad, in the north east of India. The second year students will have the opportunity to advise patients on foot care, participate in wound management, and to observe reconstructive surgery and the manufacture of orthotics – areas both students are keen to explore. Louise said: “Not only will it enable us to see more of the world; it is a spectacular opportunity to develop our skills and knowledge, and will give us great insight into working abroad, and with people who have conditions that are less common in the UK.” Lucy added: “The chance to make a difference and enhance the lives of others while learning, adopting new
NEWS
Pair to help leprosy sufferers
techniques and enhancing clinical skills appealed to us. Hopefully what we learn can be adapted and transferred when we are back in Scotland.” The students are among 13 presented with a Magnusson Award in the name of the University’s late Chancellor, the journalist and broadcaster Magnus Magnusson KBE. Students, their families and friends, staff and invited guests attended the annual Magnus Magnusson Awards ceremony hosted by Principal and Vice-Chancellor Professor Pamela Gillies CBE FRSE and Dr Sally Magnusson, daughter of the late Chancellor and Honorary President of the Magnusson Fellowship at GCU. Professor Gillies said: “As the University for the Common Good, we are so proud of the achievements that have been made possible over the years through this incredible initiative. “The projects will enable the recipients to develop personally or professionally, giving something back to communities around the world.”
Professor Saeed Zahedi, Dr David Moser, Nadine Stech, Rob Painter and Andy Sykes.
Blatchford wins top award BLATCHFORD has been awarded the MacRobert Award by the Royal Academy of Engineering for its Linx prosthetic limb.
Established in 1969, the prestigious MacRobert Award is regarded as the leading prize recognising innovation in UK engineering. Amputees frequently experience back pain, difficulties on various terrain and require a higher cognitive and energy demand as they plan and analyse each and every step. Linx represents ground-breaking technology within the prosthetics industry as it continuously shares information between the knee and foot to adapt automatically to changing terrains and circumstances, allowing users more freedom, confidence and stability. The replication of natural motion is
at the heart of Blatchford’s design philosophy, and Linx represents the beginning of the development of intuitive and integrated prosthetic limb systems.
The Linx development team attended the award ceremony at the Tower of London and collected the gold medal and a £50,000 cash prize which is to be shared amongst them. Stephen Blatchford, executive chairman, said: “ This is the premier engineering award to win and it is a tremendous testament to all of the innovation, hard work and effort that has gone into producing the Linx integrated limb system by all of the engineers working on the project.“ Blatchford was also a MacRobert Award finalist in 2010 for the Echelon hydraulic ankle. ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
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NEW peer reviewed research published in Scoliosis and Spinal Disorders Journal has provided evidence into the positive effects of Dynamic Movement Fabric Orthoses for the management of scoliosis in children. The research paper entitled, “The Use of Dynamic Elastomeric Fabric Orthosis Suits as an Orthotic Intervention in the Management of Children with Neuropathic Onset Scoliosis: A Retrospective Audit of Routine Clinical Case Notes” was written by; Martin Matthews, Suzanne Blandford, Jonathan Marsden and Jennifer Freeman and is the first substantial clinical study to document the effectiveness of orthotic devices in relation to neuropathic onset scoliosis. The study looked at the clinical notes of 180 patients collated over 10 years from 5 separate paediatric physiotherapy departments within the NHS, which were audited independently by researchers at Plymouth University, Devon. The patients notes were divided into three categories: 1. Those diagnosed with scoliosis 2. Those with a developing spinal curve 3. Those not diagnosed with scoliosis. The 3rd group contained children with neuro-muscular conditions which would have the potential to develop into scoliosis. Of the 180 individual cases 121 were prescribed a Dynamic Movement Fabric Orthosis (DEFO), 18 were prescribed some form of rigid bracing and 41 were not prescribed an orthosis. The study has produced some very interesting results, putting forward some
very plausible evidence for the wider use of DEFO’s in the management and prevention of neuropathic onset scoliosis in children; and as a positive alternative to rigid bracing and invasive surgery. The new study showed that the use of a DEFO greatly improved the chances of patient compliance with an orthotics device with 98% of patients willing to wear them (high compliance). The data also highlighted that 42% of children who had been diagnosed with scoliosis and prescribed a DEFO, saw their condition improve or not progress further. 12% of scoliosis patients were found to no longer need any intervention after an average period of 18 months. The use of DEFO’s showed to have many other positive outcomes. The audit indicated that DEFO suits may
enhance proprioceptive feedback, improving spatial awareness provided by compression to the spine, combined with downward compression on the shoulders and control around the pelvis to provide postural stability. The suits not only provide postural support and stability but also encourages muscle use, necessary to promote isometric movement and balanced spinal muscle tone. The study also showed that 38% of cases who underwent surgery experienced complications such as; spinal rod breakage, excessive movement of fixations, infection and reduced head control. 36% of patients who underwent surgical intervention also experienced curve progression after surgery. It also noted that only 1/3 of cases who were prescribed rigid bracing continued to use this form of orthosis with 11% converting to using a DEFO. Early intervention using DEFO’s could also have a positive financial benefit to the NHS and privately funded healthcare. A recent study (Effects of bracing in adolescents with idiopathic scoliosis, Weinstein et al) estimated the cost of surgical intervention for neuromuscular scoliosis to be US $50,096 (£32,000 approx). DEFO’s, by contrast, cost a fraction of this price. Lead author and Managing Director of DM Orthotics, Martin Matthews, comments; “There is little doubt that our study has produced some very interesting results, putting forward good evidence for the wider use of DEFO’s in the management and prevention of
neuropathic onset scoliosis in children and as a positive alternative to rigid bracing and invasive surgery.” “It is also interesting to note that the use of DEFO’s has been shown to have many other positive outcomes. The audit indicated that DEFO suits may improve spatial awareness provided by compression to the spine, combined with downward compression on the shoulders and control around the pelvis to provide postural stability. The suits not only provide postural support and stability but also encourages muscle use, necessary to promote isometric movement and balanced spinal muscle tone.” The study concluded that DEFO’s could be an effective form of management of mild to moderate scoliosis in a range of neuromuscular conditions and that Cobb angle progression was typically minimal in those children using a DEFO. The results also provide some evidence for the potential for DEFO’s to be used in the future management of children at risk of developing and presenting with neuropathic onset scoliosis. The full research paper, , “The Use of Dynamic Elastomeric Fabric Orthosis Suits as an Orthotic Intervention in the Management of Children with Neuropathic Onset Scoliosis: A Retrospective Audit of Routine Clinical Case Notes” (Matthews, Blandford, Marsden, Freeman) published by Scoliosis and Spinal Disorders Journal can be read here http://scoliosisjournal.biomedcentral. com/articles/10.1186/s13013-0160073-z
ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
NEWS
New research provides evidence of positive effects of DEFO’s for the management of Scoliosis
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PRODUCT NEWS
ToeOFF Family of AFO’s Support For Better Life ! A Quantum Leap in AFO Technology: First introduced in 1997, ToeOFF is now recognized as a quantum leap in AFO technology. Today hundreds of thousands of individuals with gait impairment now enjoy an improved quality of life, thanks to the stability and dynamic response provided when wearing one of our patented carbon composite orthoses that are members of the ToeOFF Family of Products. These products can be used to manage footdrop in conditions such as stroke, Multiple Sclerosis, Post Polio Syndrome, Muscular Dystrophy, Spinal Cord Injuries, Traumatic Brain Injuries, Charcot-Marie-Tooth, Myelomeningocele, Neuropathy and Cerebral Palsy. ToeOFF and BlueROCKER are also designed to support gait in conditions such as Posterior Tibialis Tendon Dysfunction (PTTD) and toe amputations. BlueROCKER can also be used for partial foot amputations.
Improving people’s lives:
(Meet Virginia Mamone): “I am 41 years young. I live in Las Vegas, Nevada. I am a full-time home
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maker or as I like to say a Domestic Engineer, (I’ll even take Domestic Goddess). I have three children, 21-year-old Jesse, 18-year-old Marko and 9-yearold Bella. I am currently the proud branch leader for the Las Vegas Charcot-Marie-Tooth disease (CMTA) branch I was diagnosed with CharcotMarie-Tooth disease. After this initial diagnosis, I had numerous nerve conduction tests, a spinal tab that landed me in the ER, two to three blood tests every month, visits to other doctors and finally a visit to a specialist at UCLA Medical Center, who confirmed my CMT. Following this diagnosis, I slipped into depressed state, but was not going to let it take over my life. I looked into bracing for walking and running, but to no avail. The braces hurt more than the neuropathic pain. So, I hid them on top of my closet (out of sight, out of mind). In September 2012, I met Jeff (District Manager for Allard USA). He gave me the opportunity to try the Allard ToeOFF Ankle Foot Orthosis and I was sold. I received my first pair in December
ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
2012 and I was able to walk/jog my first 5K in February of 2013. I cannot describe the feeling of accomplishment as I crossed the finish line, but it was such a high”.
The Original: ToeOFF is the original carbon composite AFO and while there are many that may look similar, there is only one original. The ToeOFF family of products are manufactured in our state of the art facility in Malmo, Sweden. With our highly skilled designers and technicians and the most advanced manufacturing equipment and processes available, we are proud to maintain our position as the world leader in Composite AFO design and manufacture.
Superior Function and Design: The Anterior Design activates proprioceptive response to help the patient “feel” location of leg in space. It also avoids pressure on the calf muscles and Achilles tendon, eliminating irritation and discomfort in these areas. The Lateral Strut creates stability and function and provides more functional use for bi-lateral patients. The Carbon Fibre, Fibreglass and
Kevlar composition permits fabrication of a structurally superior AFO that is extremely Light Weight and Thin, making it almost invisible under clothing. The scientifically engineered design and shape creates a more Dynamic Footplate which results in a more dynamic and functional gait pattern. The Open Heel allows the Calcaneus to invert and evert which is biomechanically required to activate normal gait cycle.
Depth of Product Range (Graded Stability): The product groups (Ypsilon, ToeOFF, BlueROCKER) are graded in both stability and dynamic response. This same graded stability occurs also within the available sizes of each product group, thus giving an unrivalled spectrum of choice in terms of accommodating different patient needs, sizes and stabilizing properties. Enquiries: For more information on Allard UK’s range, visit www.allarduk.co.uk or contact Customer Service on customerservice@allarduk.co.uk or Free Phone 0800 051 7061 (from the UK).
WHAT DO THEY HAVE IN COMMON?
Trent, Cerebral Palsy
Billy, Stroke
Virginia, Charcot-Marie-Tooth
THEY USE THE
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CHILDREN
Introducing new range of ‘flexible, light weight and extremely thin’ inlays DeNovo Healthcare is a dynamic and progressive company focused on providing some of the most innovative products and services from around the world to the UK healthcare market. As a patient care oriented organisation, we pride ourselves in providing both healthcare professionals and patients the highest level of quality, service and choice possible. DeNovo Healthcare is proud to introduce our new range of flexible, light weight and extremely thin inlays. This range can either be made to your individual specifications or be ordered as stock. The DeNovo Inlay system includes the Daily Range, The Calca Range and Soletec custom inlays. ll Daily Series inlays are available with a range of additions including metatarsal domes and medial/lateral postings. There are five different
types of Daily Inlays available to order: Daily Men/Women, Daily Control, Daily Rigidus, Daily High Heel and the Daily Black Fiber. Features of the Daily series include: n The Daily Control inlay has a half shell heel support for improved hind foot guidance, stabilized heel with longer rear wings in the shell and the heel cup is lowered in the back for improved fit. n The Daily Rigidus inlay is made with a tough elastic reinforcement under the MTP 1. This inlay includes a levelled forefoot posture with a compensatory wedge, it’s dynamic and has a flexible heel with short rear wings in the shell. n The Daily High Heel inlay has flexibility for optimal adaptation to various heel heights, a flat heel area with padding for impacts and flexible
support of the foot’s longitudinal arch for increased walking balance. All the Daily range inlays have a shell made of glass fiber composite material, comfort padding and the bottom made out of CarboTec. The Calca Series is used for treatment of specific conditions such as plantar fasciitis and pressure relief of calcaneal spurs; long term follow up after calcaneal fractures; overuse symptoms such as with osteoporotic conditions; neurogenic related and Achilles tendon strain. There are 2 different types of inlays in the Calca Series, the Calca II and the Calca Pro X. The Calca Pro X achieves optimized relief of the plantar fascia. A molded groove extends far into the longitudinal foot arch taking the load and mechanical stress away from the painful area of the sole. The well balanced
arch support perfectly redistributes forces to reduce the patients’ level of pain. The durable polyurethane cushion material absorbs impact forces and contributes to pressure redistribution under the hind foot. Finally, the Soletec Series provides the user with a highly customized direct milled inlay which allows the quick and easy treatment of a wide range of conditions. These custom-made foot orthoses can be made from impression boxes, 3d Foot scans and plaster casts. Soletec inlays are available in a wide range of EVA or PU materials that guarantee optimal and indication specific foot care. Our simple pricing includes the inlay, top covers and any modifications or additions. All DeNovo Healthcare inlays have a 5 working day delivery time. www.denovohealthcare.com
Clos-o-Mat range evolves with the child RESEARCH shows that using functional rooms, including the toilet, is the second biggest problem for families with a severely disabled child. It also impinges on the child’s self-care skills. Yet simple, cost-effective paediatric adaptations could overcome the problems and change the family’s lives for the better. Clos-o-Mat, Britain’s leader in disabled toileting aids, has developed a range of toilet supports that, combined with its top-selling wash/dry Palma Vita toilet, give the child or young adult the ability to go
to the toilet with little or no help. The Clos-o-Mat paediatric range can accommodate children as small as 30ins/0.762m, up to young adults. All the accessories have been purposedesigned to correctly position and support the user over the Palma Vita, yet be easily removed to allow the toilet to be used by other members of the family, and changed for other support systems as the child grows, becomes an adult. Robin Tuffley, Clos-o-Mat marketing manager, said: “One child in 20 under
the age of 16 is disabled – a 62 per cent increase in the past 25 years. We go to the toilet eight times a day: no wonder – as the survey shows – that it has a huge impact on daily life, and is a growing issue for families with disabled children. “Our range has been developed to evolve with the child, so potential issues in their learning to use new equipment are kept to a minimum.” Enquiries: Visit www.clos-o-mat.com or call 0161 9691199
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ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
NEWS
Hobbs Rehabilitation receives a Royal visit HIS Royal Highness Prince Harry visited Hobbs Rehabilitation in his role as Patron of the RFU Injured Players Foundation, the official charity of England Rugby.
During the day he was able to see first- hand what the charity, in partnership with Hobbs Rehabilitation, provides for seriously injured rugby players. He took the time to meet some of them and their families and view the latest technology available in the field of neurological rehabilitation. A wide range of treatments were demonstrated and everyone was able to view the latest in neuro-technology such as the Ekso Bionics exoskeleton, the Mygait walking aid, the Litegait and the Saebo glove.
Helen Hobbs and Nicky Ellis, cofounders of Hobbs Rehabilitation, with Caroline Searight, OT and IPF client services manager, were delighted to greet Prince Harry and introduce him to all the injured players and their families.
He showed a great interest in the players’ rehabilitation stories and their lives now – there was one player injured last December while others had sustained their injury over 20 years ago. During the day there was ample opportunity for the families and patients to share stories, experiences and support others who were at different stages of their rehabilitation journey. Hobbs Rehabilitation, in partnership
with the Injured Players Foundation, provides specialist neurological rehabilitation to individuals who have been injured while playing rugby under the RFU’s jurisdiction. A team of over 60 specialist clinicians, including physiotherapy, occupational therapy and speech and language therapy, provide intensive inpatient and out-patient rehabilitation from the Hobbs centres in the south of England. Mike England, IPF director, said: “We support players with catastrophic spinal cord and brain injuries that result in significant permanent disability, to empower them to live a full and independent life. “Our collaboration with Hobbs Rehabilitation is a great success and
we are delighted to be here today to share information on new advances in technology. “Their leadership in this area is a real asset for our injured players and ensures they have access to the very best neurological rehabilitation available” Helen added: “We are extremely proud of the service we provide to the injured players, and to have Prince Harry join us was such an honour. “Our commitment to the research and development of new therapies is paramount and we hope to include some of the players in our current research study for the latest model of Ekso Bionics Exoskeleton which we demonstrated at our recent spinal cord injury conference.”
Amputation prevention and providing appropriate care for diabetic feet ... By Dan Howarth IF diabetes is poorly managed, it can lead to poor circulation, nerve damage, and reduced feeling in the feet and legs. This, in turn, can lead to serious foot problems, such as ulcers, and may result in amputation. There are over 7,000 diabetes-related amputations (leg, foot or toe) every year in England. Experts estimate that four out of five amputations could be prevented as 80 per cent are preceded by a foot ulcer, which are largely preventable. Evidence shows that foot ulcers and amputations can be avoided through improved awareness among people with diabetes about how to look after their feet, their risk status and the actions to take, and access to good-quality structured care. Diabetic foot disease is the most common cause of diabetes-related hospital admission. Everyone with diabetes is at risk of developing foot ulcers which can result in amputations, but those most at risk are smokers with diabetes, 18
people with diabetes and high blood pressure and those who have lived with diabetes for a long time. The risk of amputation can be reduced through provision of an integrated foot care pathway. Everyone with diabetes should have a quality annual foot risk assessment and, if at increased risk, referred for assessment by trained staff in community foot protection services and quick access to multidisciplinary specialist foot care teams (MDfT). The longer the delay before being seen by the diabetic foot care team, the more likely foot ulcers will be severe. Currently there is still considerable variation in outcomes and processes across the diabetes foot care pathway from the number of foot checks delivered in primary care, and the quality of them, to major and minor amputation rates. Annual foot checks NICE recommends everyone with diabetes over the age of 12 have their feet assessed at least once a year.
ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
The annual foot check is critical to ensure that people with diabetes are in the right place on the foot care pathway and this can initially be conducted in a GP surgery.
per cent) of people with diabetes had their feet checked within 24 hours of admission and only 34 per cent had feet checked at any time during their hospital stay.
People with diabetes should be told their risk of foot problems and how to care for their feet to prevent problems. For further information ‘Ten steps to healthy feet’, ‘The touch the toes test’, ‘What to expect at your annual foot check’ and ‘How to spot a foot attack’ are all available to order free from the Diabetes UK website. If anyone is found to be at increased risk of foot problems they should be referred for assessment by a diabetes foot specialist.
In addition, the number of people with diabetes recorded as having foot risk assessments whilst in hospital ranged from five per cent in some hospitals to over 75 per cent in others.
Foot care for people with diabetes in hospital People with diabetes and reduced sensation in their feet are at increased risk of developing a foot ulcer when in hospital, due to their reduced mobility. NICE guidance recommends that their feet are examined during admission to assess risk, and action taken to prevent ulcers from developing. In the 2015 inpatient audit less than a third (29
It is vital that people in hospital with foot infections or ulcers are seen by a member of the multidisciplinary foot team speedily – within 24 hours of referral. The percentage of hospitals with multidisciplinary foot care teams had been increasing, but it fell slightly to 69 per cent in 2015. This means almost one third of hospitals are without such a team and only 58 per cent of people with new or deteriorating foot disease were seen within 24 hours, by a member of the team, such as a specialist podiatrist, diabetes specialist nurse or diabetologist. n Dan Howarth is head of care at Diabetes UK.
Danish invention gives new hope and help PA NEW bodyweight-supported rehabilitation invention from Danish mobility company Ergolet offers earlier rehabilitation including gait-training, which improves motor function and strength after serious health problems such as an acquired brain injury. The Ergo Trainer linear body relief system gives patients an equal body-weight support during training, removes the risk and fear of falls or strain which can delay recovery, and props up user confidence along with their weight to let rehabilitation start earlier. Developed in collaboration with Copenhagen University, its inventors say it offers increased mobility for people recovering from acquired brain injury caused by strokes, accidents and tumours, or learning to use prosthetic limbs such as military personnel. It also gives a lift to those who are wheelchair bound, recovering from sports injuries or morbidly obese or children born with brain injuries or with cerebral palsy. “We can intensify physical training and show significantly faster, better recovery through an ergonomically designed device which makes the user feel safe and secure, and makes exercise fun and hugely motivating”, said UK sales director David Lomas. “Therapists have told us that it transforms the morale of someone who struggles to walk, by letting them stand on their own two feet, move their legs and stare
them in the eyes, all while boosting cardiovascular health and strength or just stopping muscle loss.” While other ambulatory aids exist, UK sales director David Lomas said this is uniquely versatile. “Typically, products come with a built-in treadmill which is very limiting. Ergo Trainer is used with a variety of equipment or for various floor exercise. Clients can even kick a football around”. Its design offers multiple training possibilities and lets physiotherapists mix up treatment between treadmills (BWSTT), step machines, crossfit machines, ski machines, exercise bikes or floor work. It enables 360 degree rotation, letting the user train moving forwards, sideways or backwards. Anti-fall safety devices protect staff too, who often get hurt preventing patients falling. It is designed so patients can focus on doing more challenging exercise without fear and gain confidence while staff can focus on the patient’s work-out performance, step up intensity and personalise programmes for patients. It was developed in co-operation with the Centre for Rehabilitation of Brain Injury (CRBI), Copenhagen, and used in patient studies there with dramatic results. CRBI’s neurorehabilitation specialist Jørgen Jørgensen, said stroke patients facing paralysis improved their walking speed by an average of 65% after a 12 week period.
“Traditionally it is hard to rehabilitate patients with impaired walking abilities because the fear of falling prevents an effective and continuous rehabilitation process”, said Jørgensen. “This shows you can remove that fear which will improve overall health and it is now the cornerstone of our intensive gait rehabilitation work.” For patients with impaired walking ability who need gait-training, CRBI studies show a progressive training regime of repeated movement with controlled speed and adjusted treadmill elevations is the key to a full recovery. The Ergo Trainer also lets the patient’s arms move freely so most users can develop natural gait patterns. Therapists can oversee and treat more than one patient at a time, offering health economies. Cost savings are also offered through speedier patient rehabilitation and reduced work related injuries among therapists and fall related injuries among patients. The system works with a walking harness and takes moments for the patient to start the training programme. The adjustable weight relief system is controlled by a simple hand control. It is designed for people weighing up to 200 kg (almost 32 stones) and can take up to 85kg (13 st) of individual body weight creating applications for bariatric clinics too.
OTTOBOCK has launched phase two of the new range of stylish and serviceable orthotic and prosthetic bars and joints systems for use in orthotic manufacturing.
NEWS
Patients are learning to walk again and are being given new hope and help from a Danish invention which made its UK debut recently. Assistive Techologies found out more.
Bringing 21st century design to orthotics market The new range of conventional joints offers an improved design with smoother contours for greater comfort. Benefits also include better performance and an improved locking mechanism for greater reliability and safety, bringing 21st century design to the orthotics market. The cost effective bars and joints systems are completely serviceable, meaning there is no longer any need to replace the whole callipers. All servicing can be done on-site while the user waits so there is no need to send parts away, effectively eliminating admin and postage costs. The first phase, launched back in January, saw the roll-out of the three knee joints: the Ring Lock, the 4in1 Option Lock and the Chailey Cam Lock. Phase two includes all ankle joints, the Bale Lock and the Posterior Offset Knee Joints. All customers were issued a new catalogue in the first phase in the form of a binder prior to the January launch. They have now been issued with new inserts for the phase two products so that they can replace the old contents with the new. The catalogue includes a new ‘quick reference guide’ to help customers identify the new article number for each part they previously ordered.
New contract
BLATCHFORD has been awarded the contract for the orthotic service at the Bristol Royal Hospital for Children. Opened in 2001 and part of the University Bristol Hospitals NHS Foundation Trust, the Bristol Royal Hospital for Children was the first purpose-built hospital for children in the South West and provides neurosurgery, cardiology, radiology, orthopaedic surgery and many other treatments for complex conditions.
Orthosis is fabricated to the patient’s unique model BEAGLE Orthopaedic houses a large spinal database of spinal models to suit a variety of patients. From this extensive library we can manufacture your CTLSO using measures provided from a simple measurement chart, we then adapt the relevant model to meet the specification. Each orthosis is fabricated to the patient’s unique model and your specifications, ensuring the optimum fit, support and comfort. CTLSO’s are available as; bi-valve design finished to completion (no intermediate fitting) with a
variety of liners such as cool foam, north foam 33, evazote and lambs wool. We can also provide a customised combination of products for high thoracic fractures / instabilities. The chosen TLSO is then coupled with components from the Aspen CTO, to provide the stability required for your patient in the upper thoracic and cervical region. This design offers a step-down reduction for on-going rehabilitation therapy. Available in paediatric and adult sizes. Enquiries: Call 01254 268788 ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 2016
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