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ISSUE 88 DECEMBER/JANUARY 2012/13 £6.95
Breakthrough could lead to better systems By Helen Williams RESEARCHERS from Stanford University in California have made a breakthrough in thought control of computers. They have developed an algorithm that translates neurological signals for movement with greater speed and accuracy. The system, which relies on a silicon chip implanted in the brain, has been used to allow monkeys to control computer cursors – but could one day control prosthetic limbs. Krishna Shenoy, who led the research team, said: “These findings could lead to greatly improved prosthetic system performance and robustness in paralysed people.” When a paralysed person imagines moving a limb, cells in the part of the brain that controls movement still activate as if trying to make the immobile limb work again. Even where a neurological injury or disease has severed the pathway between brain and muscle, the region where the signals originate often remains intact. Previous research has begun to develop brainimplantable sensors able to measure signals
from individual neurons, interpret them, and use them to control computer cursors with thoughts alone. But the new algorithm, known as ReFIT, vastly improves speed and accuracy of that control. And, more than four years after implantation, the new system is still going strong, while previous systems have steadily declined. The Stanford system records neural activity from an array of electrode sensors and sends data to a computer, providing key information about the direction and speed of the user’s intended movement. To test the new system, the team gave monkeys the task of mentally directing a cursor to a target – an onscreen dot – and holding the cursor there for half a second. ReFIT performed vastly better than previous systems. The path of the cursor from the starting point to the target was straighter and reached the target twice as quickly, achieving 75 to 85 per cent of the speed of real arms. Critical to ReFIT's improvement was its superior ability to stop and make adjustments ‘on the fly’ while guiding the cursor to a target.
A prosthetic hand from Touch Bionics features in a new music video with Britney Spears. The song, Scream and Shout, is the result of a collaboration between pop megastars Britney and Will.i.am. The i-limb ultra hand – said to be the world’s most advanced prosthetic hand – appears in the futuristic video, premiered on The X Factor USA television show.
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Robotics will ‘revolutionise UK economy in next 20 years’ By Helen Williams
Editorial Judith Halkerston Group Editor editorial@assistivetechnologies.co.uk
ROBOTS that can act independently of human control will revolutionise our economy and society in the next 20 years, according to the UK government.
Dominic Musgrave Healthcare Editor Email: dm@scriptmedia.co.uk Tel: 01226 734407 Helen Williams Reporter Email: helenw@scriptmedia.co.uk Tel: 01226 734694
David Willetts, Minister of State for Universities and Science, spoke about the government’s technology aims when he visited Bristol Robotics Lab. The minister wanted to see firsthand the cutting-edge technology being developed at the facility – the largest robotics lab of its type in the UK and a joint collaboration between the University of Bristol and University of the West of England. He saw work on groundbreaking projects which could revolutionise the medical industry, such as ‘robot surgeons’ and tactile robots with the potential to feel what is happening inside someone’s body. The government has identified robotics and autonomous systems as one of eight ‘future technologies’ important areas in which it hopes Britain can capitalise on current expertise to become world-leaders. In a recent speech, Chancellor George Osborne outlined his vision for science and robotics in the UK.
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David Willetts with staff and students at Bristol Robotics Lab.
He gave the BRL as an example of where such innovative research is taking place into a wide range of areas. During his visit, David Willetts met staff and students who have worked with local schools to fire up pupils about robotics, supporting the government's desire to get more youngsters interested in STEM subjects – science, technology,
engineering and maths. Mr Willetts said: “Robotics and autonomous systems have huge potential for growth. We predict that robots that can act independently of human control will revolutionise our economy and society in the next 20 years. “We want Britain to be at the forefront of these world-changing breakthroughs.”
Whilst every effort is made to ensure the accuracy of all contents, the publishers do not accept liability for any error, printed or otherwise, that may occur.
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Occupational therapists help war veterans NEWS
THE UK’s professional body for occupational therapists has been highlighting the vital role therapists play in helping former servicemen and women. During Occupational Therapy Week in November, the British Association of Occupational Therapists’ promoted projects like Active 8, a group bringing together veterans from Audley Court Treatment Centre in Newport.
From left to right: Professor Christopher James, Institute of Digital Healthcare, University of Warwick – chair of the Healthcare Technologies judging panel; Dr Stephen Taylor, UCL Institute of Orthopaedics & Musculoskeletal Science; Mark Foster, Olympic medalwinning swimmer, who hosted the Innovation Awards.
New bone healing tool wins industry award A NEW bone healing diagnostic and measurement tool has been recognised as the next step in orthopaedic surgery. The SmartNail is designed for realtime monitoring of broken bones, using wireless sensors embedded within a titanium nail. It measures biomechanical forces and temperature changes associated with fracture healing, providing a more quantitative diagnosis than traditional imaging methods such as X-ray radiography. The tool monitors the degree of fracture stability and implant loading that occurs in the critical early phases of bone healing. This gives clinicians the necessary details to provide bespoke, effective rehabilitation
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Occupational therapist David Murtagh works as a mental health practitioner for Combat Stress – the UK charity specialising in care of
He said a report by the Kings Centre for Military Health Research stated that 20 per cent of British troops who served in Afghanistan and/or Iraq will develop probable mental health disorders and four per cent Post-traumatic Stress Disorder (PTSD). He said: “On average, veterans wait more than 13 years after leaving the armed forces before seeking help from Combat Stress. It’s often family members that come to us concerned about their loved one’s behaviour or the veteran themselves finding they can no longer cope. We can work with them to turn things around and start looking at life differently.” Ex-servicemen and women face the practical challenge of finding new employment and housing, as well as coping with the psychological effects of service such as flashbacks, nightmares and feelings of guilt.
programmes, so eliminating expensive and time-consuming treatment. The SmartNail was developed by a consortium led by Smith & Nephew UK Ltd and University College London (UCL). It recently won the Healthcare Technologies and Product Design categories at the Institution of Engineering Technology (IET) Innovation Awards. Stephen Taylor, project leader and lecturer at UCL, said: “This innovation is a bridge between engineering and medical practice. It is designed to meet a real need in the future and will hopefully save the NHS money in terms of managing patients with bone fractures by providing evidence-based medicine.”
Active Assistance grows with new website ACTIVE Assistance Group, which supports people with complex and continuing care needs, has relaunched its website.
The group is taking part in activities funded by Shrewsbury Town Football Club, such as cooking and serving a three-course meal to taking part in a photography and football skills session. Veteran Paul Welton has used the experience to go on and work as a catering manager in a local school canteen.
veterans’ mental health.
www.activeassistance.com showcases services available to NHS, local authority and other commissioners.
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Captain Harry Parker, a double amputee due to an Improvised Explosive Device (IED) explosion, has created a unique range of Christmas cards. Captain Parker, nephew of Edward Parker who co-founded the charity Walking With The Wounded, painted the watercolour entitled ‘Heading South’ inspired by the upcoming 2013 South Pole Allied Challenge. Cards are available from the Walking with the Wounded website.
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Electrical stimulation therapy is a life-changer for former glamour girl By Helen Williams A FORMER ‘glamour girl’ from London who was left paralysed has regained the use of her arms – thanks to Functional Electrical Stimulation therapy. Mobility solutions specialist East Yorkshire-based Cyclone Technologies helped Lorraine Mack, from Hackney, with a FES programme used alongside physiotherapy. In March 2004, when she was 30, Lorraine – also known as Lolly – had a fledgling career as a glamour model and TV presenter. She was at a nightclub when a drunken 24-yearold man, who was also on ecstasy, fell from the balcony above and landed directly on top of her. Lying fully conscious on the floor, Lorraine knew immediately that she was completely paralysed. Previously, she had a promising career ahead of her and had featured on Sky TV and MTV, and in The Sun, News of the World, FHM and the Daily Star. Her dream job was to become a TV presenter. After ten months of rehabilitation at
Stoke Mandeville Hospital, Lorraine returned home and soon bought a standing frame to retain the muscle tone in her legs.
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She had also become aware of FES therapy and began working with founder of Cyclone Technologies, Stuart Dunne, and the Cyclone team. She obtained her own FES bike, which stimulates the lower motor neurons and evokes patterned movement of the arms and legs. She uses the RT300, which allows her to exercise her arms or legs from her wheelchair, Monday to Friday, for around two hours. This is part of a four-hour exercise regime with her physio that includes stretching by using a standing frame, and using a power plate. Lorraine could see improvements immediately after starting to use FES. The therapy works on the pulse and heart-rate – important for this type of injury.
to do simple things which we take for granted.”
supporter of spinal cord injury research.
Lorraine said: “I’ve regained some use of my arms since my accident, which has dramatically improved my lifestyle and let me regain the ability
Since returning home, Lorraine has retained her passion for travelling, fashion, music and glamour modelling, and is also a keen
She has now set herself the challenge of a sponsored sky dive on March 3, 2013, in support of Spinal Research and the Back-Up Trust.
Lolly using her FES bike and in her days as a glamour girl (inset).
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Revolutionary glove gives people a voice NEWS
By Helen Williams
Hypolite Benjamin Laurencine
Senior role for physio Laurence THE London Prosthetic Centre has appointed Hypolite Benjamin Laurencine as a new senior prosthetist at its Kingston Upon Thames facility.
Laurence – as he is known in the industry – graduated from the University of Salford with an honours degree in prosthetics and orthotics in 2000. Originally from the Seychelles, he has worked as a prosthetist at Queen Mary’s Hospital, Roehampton, for over ten years and has experience in clinical care in the NHS as well as in the private sector. His key focus will be to provide consultations for potential customers from across the UK and to create specialist clinical care packages. He will also conduct evaluations, fit a wide range of prostheses and provide follow-up care.
Analysis first for Ottobock OTTOBOCK is among the first users of a new product for gait and shoulder analysis. Released by Xsens – a specialist in 3D motion tracking – the new ‘demonstrators’ allow fast and easy analysis of upper and lower limb motion. They use a combination of completely wireless technology and scientifically validated protocols. Janos Kalmar, Ottobock programme manager for upper extremity prosthetics, said: “We supply top of the range prostheses, and now use this new technology to prove the value of our prostheses to the hospitals, insurance companies and most importantly, of course to the user.” The demonstrators have been made available to a select number of leading research institutes, hospitals, healthcare manufacturers and insurance providers around the globe. 6
A GROUND-BREAKING glove pioneered by University of Sheffield graduates is helping give a voice to people isolated by severe speech impediments. Inventors Vinoth Gurasamy, 25, Kalhana Colombage, 25, and Hossein Mohanna, 28, have produced the lightweight and low cost speech aid. It works by converting simple finger movements into gestures which control speech through a synthesised voice. The user simply wears the glove and moves their fingers in order to articulate more than 1,000 words or commands. Vinoth, who graduated from the University of Sheffield with a Masters in Aerospace Engineering, said: “Our inspiration for the invention was an eight-year-old girl who we met during our course where we observed people with communication difficulties. “She was able to do everything apart from speak and the only equipment she had was a huge keyboard which helped her say a limited amount of words. It was extremely big and she found it very difficult to carry around. Meeting her motivated us and made us determined to help others in a similar situation.” Over the past six months the team has been working closely with grandfather William Broad, 73, from Sheffield, who suffered a stroke in
A patient tries the new glove.
2010 leaving him unable to talk. The former steel-worker is now able to articulate more than 16 words and phrases including: “I am hungry', 'I am thirsty', 'my name is William', 'thank you' and 'what time is it?” William's daughter, Keeley Bellamy from Sheffield, said: “The glove is absolutely remarkable and has made such a difference for both dad and for the family. “Dad is such an intelligent and able person so it is unbelievably frustrating for him not to be able to communicate with his loved ones.” The graduates initially constructed a prototype of the device for the
University's annual Enterprising Ideas Business Planning Competition. After scooping first prize, Vinoth and Hossein launched Ecofriendly Technologies, and with the help of Kalhana, developed the gadget further to increase the glove's word bank and week-long battery life. The glove weighs approximately 100 grams, has a battery life which lasts one week and costs around £700. Although similar devices are available they are heavier and more expensive – a device with a spec of over 1,000 words or commands with a battery life of one day usually costs more than £2,000.
New measure for prosthetic devices A NEW progress tracking system could improve upper limb amputees’ ability to perform everyday tasks with their prosthetic arm. The new index – Activities Measure for Upper Limb Amputees (the AMULA) – can be used by clinicians to assess patients’ progress. Amputee patients typically work with a team of doctors, prosthetists and therapists to learn how their limbs can help them regain function and quality of life. But clinicians have had few tools to assess whether the crucial teaching and learning process is going well due to a lack of standardised measurements for adults with upper limb amputations. Linda Resnik, an associate research professor in public health at Brown University in the US, is lead author on the research.
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She said: “Patients can’t just take a prosthesis out of the box and start using it skillfully. The upper limb is used to perform so many types of tasks. Patients need training to make the most of it and we need measures to let us know if they are improving in the way we expect them to.” The new standardised methods provide criteria for clinicians to grade patients’ performance, speed and skill using any kind of prosthetic arm to do 18 everyday tasks. They include putting on and removing a shirt, opening a drinks can, combing hair, tying shoes, and using a spoon. AM-ULA will pick up aspects of movement quality that might not be revealed by the patient, such as the amount of body compensation used to perform a task. The researchers tested the metric
Activities Measure for Upper Limb Amputees can be used by clinicians to assess patients’ progress.
with 49 veterans at facilities in Tampa and New York and the U.S. Army’s Fort Sam Houston in Texas.
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An orthopaedic surgeon from Dudley in the West Midlands is helping amputees in Pakistan – where people are still struggling to rebuild their lives after the devastating earthquake of 2005. Helen Williams reports.
Dr Viquar Qurashi, of the trauma and orthopaedics department at Dudley Group of Hospitals, treats young amputees in Pakistan.
Viquar helps the earthquake amputees ON October 8, 2005, a magnitude 7.6 earthquake hit Pakistan, Afghanistan and India leaving 75,000 dead and hundreds of thousands homeless. More than 69,000 people were severely injured and an estimated 10,000 children were left disabled. At the time, aid efforts included a spinal cord injury rehabilitation facility which was set up in Islamabad for women and children. Back in England, Dr Viquar Qurashi, of the trauma and orthopaedics department at Dudley Group of Hospitals, wanted to help. He set up Naya Qadam, a non profit making charity registered in the UK, designed to support the Naya Qadam Trust, founded by Pakistani doctors in December 2005. Dr Qurashi explained: “Our aim is to provide prosthetic limbs and rehabilitation to amputees, enabling them to walk again, earn a respectable living to support their
families, and to become active participants of their local communities.” The trust devised the Naya Qadam Limb, a prosthetic limb designed for underdeveloped countries and registered with ISPO (the International Society for Prosthetics and Orthotics). The prosthesis is assembled using cost effective techniques and locally available raw materials in Pakistan, so benefiting the country’s economy. Dr Qurashi said: “Unlike their western counterparts, these limbs allow a person to squat, walk barefoot and travel across mountainous terrain – matching the rural lifestyle of the amputees. Furthermore, the prosthesis is a low cost, economical alternative to the more expensive and impractical prosthesis.” Naya Qadam’s prosthesis has been tried and tested by UK-based company SATRA under British quality
standards. To date, over 3,000 prosthetic limbs have been provided. Each year, Naya Qadam runs mobile workshops in Pakistan to continue its commitment to provide prostheses. Dr Qurashi said: “The workshops are part of the legacy we hope to create to benefit others in the future. The trust is also helping to train technicians in the manufacture of the prosthesis, so that it meets the social and cultural needs of the Pakistani community to a standard of consistency and satisfaction. So far we have trained 35 technicians.” The trust believes strongly in training women technicians as well as men, and two women have recently been sent for higher training diplomas in orthotics at a local hospital. Dr Qurashi said: “Our mission is clear – to address the needs of the poorest, transfer the technology to the local population, and get the amputees back on their feet and into
their previous profession so they are earning members of society.” The trust has also carried out a patient satisfaction audit. When the amputees have had their prosthesis for a year, they receive a telephone call about the comfort of the prosthesis. The results are so far encouraging. Data on 800 patients has been collected and analysed and will soon be published in a European medical journal, and reports about the Naya Qadam Limb are to be presented to an international congress in 2013. Meanwhile, Dr Qurashi – a member of a parliamentary group which advises the UK government on policy for disabled people – travels at least twice a year to the most remote towns and villages in Pakistan and runs limb fitting camps. He and his charity colleagues are also negotiating with Syrian doctors over plans to take a team to Syria to help civil war victims.
Engineer completes bionic climb of tower A SOFTWARE engineer climbed 103 floors to the top of Chicago’s landmark Willis Tower in under an hour with no breaks – while wearing a mind-controlled prosthetic limb. Zac Vawter, 31, who lost his right leg in a motorcycle accident, signed up to become a research subject, helping to test the prosthetic leg controlled by his thoughts. The leg works by responding to electrical impulses from muscles in his hamstring. Zac thinks, “Climb stairs,” and the leg synchronises movements in the artificial ankle and knee. A team of researchers cheered him on and noted the smart leg’s performance. When Zac returned to the town near Washington where he lives with his wife and two children, 8
the experimental leg stayed behind in Chicago where researchers will continue to refine it. Taking it to the market is still years away. Referring to the research at the Rehabilitation Institute of Chicago, Zac said: “Somewhere down the road, it will benefit me and I hope it will benefit a lot of other people as well.” Bionic – or thought-controlled – prosthetic arms have been available for a few years, thanks to pioneering work, but with leg amputees outnumbering those who have lost arms and hands, the Chicago researchers are focusing more on lower limbs. The Willis Tower climb was the bionic leg’s first test in the public eye, said
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lead researcher Levi Hargrove of the institute’s Center for Bionic Medicine. The climb, called “SkyRise Chicago,” was a fundraiser for the institute with about 2,700 people climbing. To prepare, Zac and the scientists spent hours adjusting the leg’s movements. He says that compared to his regular prosthetic, the leg is more responsive and more fluid. When his leg was amputated in 2009, the nerves that normally would carry signals to the lower leg were repositioned to to new spots on his hamstring. That was what allowed him to be able to use a bionic leg, even though the technology was then years away. The surgery is called ‘targeted muscle reinnervation’ and is like “rewiring the patient,” Levi added.
Zac Vawter climbing the 103 floors to the top of the Willis Tower in Chicago. Picture credit: The Rehabilitation Institute of Chicago.
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New Zealand companies bring Merger to benefit rehab solutions to Europe students
THREE New Zealand companies are leading the way in bringing new rehabilitation solutions to the UK and Europe.
STUDENTS will have “unrivalled opportunities” for learning in prosthetics and orthotics, thanks to a merger at the University of Strathclyde.
Rex Bionics has developed a robotic walking device, and Im-Able has created an upper arm rehabilitation system, while Chiptech, based in Christchurch, specialises in products to monitor people’s health and wellbeing in their own homes. Rex Bionics’ hands-free, independently controlled robotic walking device enables a person with mobility impairment to stand up and walk. The company was started in 2003 when fellow Scotsmen, engineers and long-time friends, Robert Irving and Richard Little, decided to use their engineering know-how to develop a robotic exoskeleton (Rex). For Robert, the drive was even more personal, as he had been diagnosed with multiple sclerosis. Rex Bionics Ltd has now launched in Europe, including the UK. It is also in discussions with UK spinal injury units about using bionic legs to help people in rehabilitation. Meanwhile, NZ company Im-Able is a biomedical engineering business
The university’s bioengineering unit has joined with the National Centre for Prosthetics and Orthotics, creating a new department of Biomedical Engineering.
A Chiptech product.
specialising in medical devices for stroke or brain injury rehabilitation. The company has now established operations in London and the first product available in Europe is the Able-X upper arm rehabilitation system. A therapeutic games computer system, it has been clinically proven to accelerate recovery from stroke and other neurological disorders for adults and children. It is designed to help improve arm movements and cognitive skills through exercise and brain stimulation.
Im-Able has partnered with the Stroke Association in the UK and will be making a donation to the association for every product sold. In telecare and telehealth, Chiptech has produced a family of Personal Response Unit (PRU) products. The combination of personal alarm functions, medication reminders, activity monitoring and the ability to work with home health monitoring devices, helps older people and those with long-term health conditions to live independently.
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It will offer learning, research and knowledge exchange in prosthetics and orthotics, and advanced postgraduate study in a broad range of bioengineering disciplines. The well-established four-year BSc Honours undergraduate programme in prosthetics and orthotics will continue. It has ongoing Health Professions Council (HPC) approval and International Society for Prosthetics and Orthotics (ISPO) recognition at Category 1 level. The National Centre retains its existing purpose-built facilities.
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Top industry award for Sir Anthony A PIONEER of occupational and environmental medicine has picked up the top award in occupational safety and health. Professor Sir Anthony Newman Taylor CBE was handed the IOSH Lifetime Achievement Award, sponsored by Santia, in London, for his outstanding work on the occupational and environmental causes of lung disease. His research has influenced much of the preventative work now taking place and has made him a key advisor to governments worldwide. Appointed consultant physician at Royal Brompton Hospital in 1977, he built, with colleagues, the largest clinical, research and teaching department in Europe for the investigation of occupational and environmental causes of lung disease. Now principal of the faculty of medicine at Imperial College London, he is also chairman of the Colt Foundation, a trustee of the Rayne Foundation, and is civilian advisor in chest medicine to the Royal Air Force.
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Scientists in spinal nerve cell discovery By Helen Williams
of the developing motor network.
SCIENTISTS from the University of Leicester have hit upon unique forms of spinal nerve activity that shape output of nerve cell networks controlling motor behaviours.
“Whilst these cells had been previously identified, their excitable properties had not been studied in detail. “We found that these cells produce age-specific activity patterns. In early life they have ‘autorhythmic’ properties that are likely to drive embryonic movements.
The breakthrough in the Department of Biology at the university follows a three-year study funded by the Biotechnology and Biological Sciences Research Council. Although the neural basis of motor control has been studied for over a century, the processes controlling maturation of locomotor behaviours – like walking and swimming – are not fully understood. The university’s research into nerve cells responsible for motor behaviours was carried out on fish. The team aimed to understand how spinal networks produce rhythmic activity from a very immature stage – and how such activity changes during maturation. The team used zebrafish, a freshwater fish native to northern India and Bangladesh, because their motor networks are similar to
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A zebrafish embryo used by the University of Leicester’s scientists.
humans. They are also fertilised outside the mother and their embryos are transparent, so scientists can readily monitor motor network development from its onset – something that is very difficult to do in mammals. Lecturer in neurobiology, Dr Jonathan McDearmid, who led the research, said: “What’s unique about our work is the observation that a group of spinal nerve cells generate unusual forms of electrical activity that adapt to meet the changing requirements
“However, as fish develop towards more mature swimming stages, they switch firing activity to generate sustained impulses that appear to be necessary for maintenance of swimming.” Dr McDearmid said the work was important because it shed light on the mechanisms by which spinal nerve cells shape activity in the maturing of motor network. He said: “This is basic research that allows us to better understand how vertebrate motor activity emerges. However, in the long term, understanding of this process might help determine what goes wrong in diseases that affect spinal cord function.”
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Hand could ‘revolutionise’ lives of amputees By Helen Williams PROSTHETICS manufacturer RSLSteeper held the official UK launch of what it describes as “the world’s most advanced bionic hand.” Bebionic3, featured in June/July’s edition of Assistive Technologies when it was shown at the Orthopadie Technik world congress in Leipzig, was unveiled in Harley Street, London. The device is the next generation of the multi-articulating, myo-electric hand and offers significant improvements over the existing bebionic. A new design and advanced new materials make it more durable, while improving the grip, strength and accuracy. In addition, the hand features aesthetic improvements, smart electronics, and all new software that enhances functionality and ease of use. Paul Steeper, managing director, Products Division, at RSLSteeper, said: “Bebionic3 is the culmination of many years of development, and has the potential to revolutionise the lives
of amputees across the world. We have been able to make significant improvements to the design of what was already the world’s most advanced myo-electric hand, making it more precise, easier to programme and more robust.”
THE Royal National Institute of Blind People (RNIB) held a ‘Switch on to technology’ last month. The organisation ran events across the UK to help blind and partially sighted people realise the benefits that technology can bring. There were how-to podcasts, beginners’ guides in all formats, and information about the Technology Support Squad – a team of volunteers who make house calls to help people set up their new products.
The new hand has been designed to help amputees tackle real-life, everyday situations, and provides a balance between advanced technology, functionality and aesthetics. Paul added: “It will be affordably priced to ensure that it is accessible to as many potential users as possible.”
The themed month tackled four key topics: finding the right mobile phone; the benefits of getting online; choosing your computer, and using eBook readers and downloadable audio books.
Most recently, Mike Swainger became the first person in the UK to be fitted with a bionic hand through the NHS. He said: “Having a bebionic hand is a complete life-changer. I’ve tried many new sports and got used to performing the everyday tasks I never thought would be possible. The best thing by far is being able to walk down the street hand-in-hand with my daughter.” Bebionic3 features naturally compliant grip patterns and a lifelike
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Mike Swainger with the first Bebionic3 binic hand in the country.
appearance. The hand also features customisable grip speed, patterns and strength that can be wirelessly programmed and tailored to suit individual requirements, via the allnew bebalance software.
People new to technology can find out about mobile phones, computers, eBooks or getting online, or order a beginners’ guide by calling the Helpline on 0303 123 9999. They can also email helpline@rnib.org.uk or download a guide from www.rnib.org.uk/technology
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University’s 3D camera characterises wounds NEWS
By Helen Williams SCIENTISTS from the University of Oxford have invented a 3D imaging camera that measures and characterises diabetic wounds.
Podiatry and physio supplier Algeos is basking in the glow of helping three times gold winning Paralympian Jackie Christiansen. The Danish athlete won gold in the men’s shot put event in London during the Paralympic Games, while wearing Centri’s Wave Activity lower limb prosthetic, Absolute Sleeve and ALP Alignment System. Algeos is UK distributor for Centri’s TFC line of carbon materials. At the Paralympics, Algeos sales manager Francis Barrett met up with Jackie, who has been competing in the competition since 2000, winning gold in Athens in 2004 and again in Beijing in 2008.
Osteogenics Centre offers bioDensity technology THE UK’s first Osteogenics Centre has opened in Leeds, offering bioDensity technology which strengthens bones, muscles and joints. Among those the technology aims to help are women who could potentially be affected by osteoporosis. The International Osteoporosis Foundation estimates that osteoporosis affects about 200 million women worldwide.
for some women the bone loss is rapid and severe. BioDensity works by stimulating the nervous system within the bone to force an increase in mineral retention, making the bone mass stronger. Clients use the device to perform a set of exercises and bone density is then measured and read by the machine and monitored each time they complete a session to capture their progress.
Women suffer more than men because they start with lower bone density and lose bone mass quicker as they age. When a woman reaches menopause, her oestrogen levels drop and can lead to bone loss and
This strengthening of joints and muscles improves balance and coordination, which in turn reduces the likelihood of falls. Bones are also less brittle and are less susceptible to being broken.
The Eykona Medical system, they say, dramatically enhances existing processes and potentially saves hospitals millions of pounds. It operates with more speed, consistency and accuracy than currently possible. Using two cameras and four highpowered flash units in a mobile, easy-to-use unit, the system builds a 3D image and uses speciallydesigned software to measure size, depth and skin tone with precision accuracy and detail at the sub-millimetre level. The 3D model can be assessed from all angles and shared with other clinicians through server or cloud-based hosting. Professor Ron Daniel and Dr James Paterson spent eight years
developing the system, which will, they say, save lives. The total cost of diabetic ulceration and amputation in the UK amounts to between £640m and £660m per year, affecting around 61,000 people in that period. The Eykona unit – priced under £5,000 including software – replaces current wound analysis techniques including naked eye assessment, tracing paper and pencil, dipstick depth measurement and relatively invasive resin casts. Through 3D models, clinicians will be able to use definitive evidence to understand if and how the wound is healing, allowing them to adjust the treatment plan efficiently. The Royal Centre for Defence Medicine is currently using the device in the field to help treat the wounds of soldiers in Afghanistan as well as mapping impacts on body armour to improve research and development.
New Year launch for site BRACE Orthopaedic is launching its new website on New Year’s Day. The independent distributor was established in April 2012 by German manufacturer Teufel, which wanted to develop its UK interests. Teufel’s lead orthotic product available on the UK market currently is the DynaCox hip abduction brace – and it is planning more product launches in 2013. National sales manager Clive Mitchell said Brace Orthopaedic was set to distribute for other manufacturers that Teufel is partnered with around the world. Brace’s role would be to source and supply products that are leading the way in innovation, new technology or enhanced patient compliance.
Firm takes on ex-Remploy staff ORTHOTICS firm Dacey Ltd has enhanced its fabric supports manufacturing by taking on skilled workers from the now closed Remploy factory in Aberdare, Wales. All Dacey’s fabric supports are made at its Merthyr factory, where it employs a team of highly skilled machinists and pattern cutters – now boosted by the Remploy workers. Dacey, which has close links with orthotists and NHS centres, specialises in products such as abdominal supports and binders, 12
lumbar sacral supports, bespoke brassieres, and gaiters. The company says it is increasingly difficult to source such products. It has expanded its premises and modernised production methods. New IT systems have been installed, including CAD CAM manufacture and bar code product tracking systems. This has led to an increase in production capacity, reduced manufacturing prices and a guaranteed lead time of ten working days, from receipt of order/goods in the factory.
ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2012/13
Clive said: “The new products are likely to have technical features that require more detailed explanation, and the website will be an important platform in communication and an invaluable tool for delivery of product launches and business developments.”
New name for Gaitway Orthoses TALARMADE has rebranded the Gaitway Foot Orthoses to be included in the Footmedics footcare range – while enhancing the offer and maintaining the price. The business has made the move in acknowledgment of changing market dynamics and the financial restraints practitioners face. The merge simplifies the brand portfolio, yet maintains a
comprehensive choice for customers. Product features have all been retained in response to their popularity and customer loyalty, and the offer has been enhanced with a 3° wedge pack to allow for simple adjustments where necessary. The range is now supplied in high gloss, retail-friendly, re-sealable packaging along with patient-friendly usage instructions.
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‘Fairytale’ prosthetics for ‘real-life Cinderella’ Olivia (LPC) – a division of RSLSteeper – in Kingston upon Thames.
A ‘REAL-LIFE Cinderella’ became the first child in the country to have specially-made prosthetics to wear to a ball.
Kim said: “The NHS & LPC working together means we get a seamless service providing all the understanding, care, attention, ability and creativity it takes to enable Olivia to do the things she really likes.”
Olivia Story, from Carlisle, nearly died when she was struck down by meningococcal meningitis, losing both limbs below the knee and an arm to the disease. Olivia’s mum Kim Brown feared her daughter would never walk or play like other children.
Abdo Haidar, consultant prosthetist at the London Prosthetics Centre, said: “A prosthesis should not just help people regain mobility in their lives – it should enable them to achieve their goals.
However, she was determined that Olivia should enjoy her life completely. With the support of the local community and the skill, desire and flexibility of medics from both the public and private sector, a special fund was set up to provide the most realistic prosthetics available.
“It’s really important that a child is as comfortable psychologically as they are physically with the prosthesis so we spend a lot of time finding the ideal solution.” The advances in technology mean follicles of hair can be added, nails and even tattoos.
Olivia became accustomed to wearing traditional flat-footed false limbs, gaining confidence and learning to walk all over again. It was during this time that a tie-up between the NHS and the private sector began to develop. Olivia is a growing child and needs new prosthetics around three times a year. She currently receives four pairs of legs a year and two prosthetic arms.
Olivia Story
The prosthetics are created at The Blatchford Centre, part of the Cumberland Infirmary, but the centre is happy to allow the legs to be covered privately with specialised skin at The London Prosthetic Centre
Olivia now loves to run, swim, horse ride, ice skate and jump on her trampoline. She has even run a mile for Sports Relief and completed a swimming event for Marie Curie Cancer. Britain’s Got Talent finalists Reconnected have also played a fundraising gig in Olivia’s honour.
Charity calls on physios’ festive help A CHARITY is calling on physiotherapy staff to help homeless people in London over the festive period. Crisis, the national charity for single homeless people, is asking physios to donate their services from Monday December 24 to Sunday December 30.
NEWS
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The charity needs physiotherapists to provide assessments, treatment and advice. It also seeks student physiotherapists and physiotherapy support workers to offer administrative and practical support. The charity’s annual ‘Crisis at Christmas’ initiative aims to provide homeless people with companionship, hot meals and essential services such as health checks. For further details visit www.crisis.org.uk/volunteerin g or call 0300 636 1000 (9am5pm).
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The year ahead is shaping up with a packed programme for assistive technologies, orthotics and prosthetics. Here are the highlights so far.
2013 promises to be a busy one SHOWS, workshops, and charity events make 2013 a busy year. Among landmarks is the 30th anniversary of the Mobility Roadshow at Telford International Centre from June 27 to 29, and The Amputee Games on May 18 and 19 at Stoke Mandeville Stadium. Naidex 2013
Naidex National is at the NEC Birmingham from April 30 to May 2. It features the latest products and services to aid independent living and brings together healthcare professionals, people with independent living needs, retailers, dealers and manufacturers. The show has over 300 exhibitors for 2013 with key brands being Invacare, Arjo Huntleigh, TGA Mobility and AKW Medicare. Healthcare professionals are invited to the free CPD conference programme, while the new Business Club features seminars and a networking lounge. Naidex Scotland takes place on September 18 and 19 at SECC Glasgow. Amputee Games
The charity LimbPower runs The Amputee Games, launched in 2008 and now an annual event introducing primary amputees to a wide range of sports.
people with disabilities to try different sports. The next clinic is on January 13 in Manchester at Sportycity, then Loughborough on February 10 and Chelmsford on March 9. Drop foot and scoliosis
Denovo Healthcare hosts a drop foot workshop in London on April 13, with a further one planned for Leeds on April 20, 2014.
2013 EVENTS
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The workshops are designed to give a better understanding of the causes of drop foot, treatment options, biomechanical implications and orthotic management. The course offers actual gait analysis of patients and discussion and evaluation of the findings. On June 15, Denovo runs a scoliosis spinal management seminar in Manchester. This is aimed at orthotists who work with scoliosis patients and are interested in updating their skills in reading and interpreting X-rays. Study day
Beagle Orthopaedic is planning its next Knee-Ankle-Foot Orthosis (KAFO) study day after its successful event in Blackburn, Lancashire, where 42 orthotists met from around the country.
Mobility Roadshow celebrates its 30th anniversary in 2013.
The day – run with Otto Bock and Becker Orthopaedic – focused on clinical and technical design considerations for patient fit and Over 400 amputees and individuals compliance of KAFO, Contracture with congenital limb loss have taken Correction Device (CCD) and Custom part over the last five years, many Knee Bracing. Erin Sinclair from over the age of 40. They have gone Newcross Hospital set the tone on to include sport into their lives and lecturing on ‘Bio Mechanical improve their social, psychological and Considerations for KAFO Design’ physical well-being. followed by a variety of other clinicians, including Dr Jim Campbell Other LimbPower events include an 84-mile walk from May 3 to 9 taking of Becker Orthopaedic. in Hadrian’s Wall, a fundraising cycle BAPO ride across Ireland from July 6-13, a After a break in 2012, the British 100km moonlit ride past London’s Association of Prosthetists and iconic landmarks and a ‘Paris night Orthotists (BAPO) is back with a fresh rider’ from September 21-22. looking conference. Learn to Run clinics
The event is at Telford International Limbpower follows its ‘Learn to Run’ Centre from March 22-24 and BAPO clinic in Sheffield with a second one in is offering an early bird discount for Manchester. the whole conference. Among highlights are an educational session The Sheffield clinic at the English Institute of Sport (EIS) was part of the on diabetes, a presentation on foot UK Athletics Talent Introduction Days. orthotics for athletes and an extensive prosthetics programme. The idea of the clinics is to allow
Beagle Orthopaedic is planning its next Knee-Ankle-Foot Orthosis (KAFO) study day.
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sponsors podiatry
PODIATRY
Ancient foot technique may ease cancer symptoms A study led by a Michigan State University researcher offers the strongest evidence yet that reflexology can help cancer patients manage symptoms and perform daily tasks. Funded by the National Cancer Institute and published in Oncology Nursing Forum, it is the first largescale, randomised study of reflexology as a complement to standard cancer treatment, according to lead author Gwen Wyatt, a professor in the College of Nursing.
The Le Chal shoe which works alongside a Smartphone.
‘Seeing’ shoe works through touch By Helen Williams AN Indian company has developed a shoe enabling blind and visually impaired people to walk around more safely. The shoe, called Le Chal, works alongside a Smartphone and is fitted with sensors, Bluetooth and Global Positioning Systems (GPS). It is the brainchild of Anirudh Sharma from the company Ducere. “For most people in India a guide dog is unaffordable,” said Anirudh. “Voice feedback devices are also not ideal as they interfere with the other primary sense of location, the person’s hearing. “This shoe with its built-in Arduino board (micro controller board) and vibrating sensors is proximity aware up to three metres. So, it can alert the wearer to upcoming obstacles.”
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She said: “It’s always been assumed that it’s a nice comfort measure, but to this point we really have not, in a rigorous way, documented the benefits. This is the first step toward moving a complementary therapy from fringe to mainstream care.”
The study involved 385 women undergoing chemotherapy or hormonal therapy for advanced-stage breast cancer that had spread beyond the breast. The women were assigned randomly to three groups and checked after five and 11 weeks. Some were treated by a certified reflexologist, others got a foot massage meant to act like a placebo, and the rest had only standard medical treatment and no foot manipulation. The study found that those in the reflexology group experienced significantly less shortness of breath, a common symptom in breast cancer patients. They were better able to perform daily tasks such as climbing a flight of stairs, getting dressed or going grocery shopping.
With Le Chal, Anirudh won MIT India’s TR35 Technology Review 2012 Innovator of the Year award. He hopes his invention will appeal to low income markets, deliver a better user experience, and be key to people’s independence and dignity. The shoe is an example of ‘haptic’ technology, a tactile feedback technology that uses the sense of touch by applying forces, vibrations or motions to the user. ‘Haptics’ have been described as doing for the sense of touch what computer graphics have done for vision. “For example, if someone sent a message saying they felt “butterflies in their stomach” it would be possible for the recipient to feel the sensation through a haptic device strapped to their body.
ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2012/13
Lee Willan has joined the team at podiatry and physio supplier Algeos, as technical sales executive. Prior to this, Lee (pictured above) was a technician for six years and believes this experience will help him interact with clinicians and patients in orthotics and prosthetics (O&P). He said: “I’m excited about the new opportunity and combining my previous skill set with the vision of Algeos progression into a wider range of O&P products.” Lee can offer product demonstrations, training events and technical support.
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sponsors sports rehab
AlterG treadmill helps patients THE AlterG Anti-Gravity Treadmill has been trialled at the NHS Royal Victoria Hospital in Belfast for three months – and in that time it has helped over 200 patients. The treadmill’s differential air pressure technology can ‘un-weight’ up to 80% of a person’s body weight, allowing for stable support while rehabilitating from injury. It is based on the ability to reduce the amount of pressure going through one’s feet and so allows for
functional improvement – meaning people have been able to walk faster and have possibly even been discharged more quickly. Louis O’Connor, clinical lead physiotherapist for the hospital’s regional trauma unit, said: “A number of patients trialled the machine who came from a trauma and orthopaedic background and with a significant amount of lower limb fractures – from ankle injuries to knee, hip and pelvic injuries.”
SPORTS REHABILITA-
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Serviceman Ricky Fergusson with his new Total Gym GTS.
Charity funds kit for injured serviceman THE Just Rifles charity has funded a new Total Gym GTS for injured serviceman Ricky Fergusson. Having lost his legs, his left eye and parts of fingers on both hands in a bomb blast, Ricky spent six months in the Defense Medical Rehabilitation unit at Headley Court. Part of his rehabilitation was performed on the Total Gym equipment at the centre. After completing the initial rehab, Fergusson contacted Just Rifles – a charity fund for helping injured servicemen and women or bereaved families – which funded the new Total Gym GTS, allowing him to continue his training on the equipment at home. Training on this kit allows for exercises that people with injuries such as Ricky’s would otherwise find challenging, or sometimes impossible. The moving glideboard and cable pulley system allow users to sit, kneel or lie either supine or prone to perform exercises targeting every muscle in the body. The incline of the glideboard is changed incrementally to match
resistance to the user’s ability. The glideboard can be kept horizontal at all inclines, keeping exercises biomechanically correct at any resistance level. Programming on the Total Gym, called GRAVITY Training, includes GRAVITY Post Rehab designed to follow on from physiotherapy treatment. Ricky said: “Working out on this equipment helps me build strength and continue working towards my goal of an everyday life most people take for granted.” Injuries sustained to his fingers mean picking up or gripping traditional equipment used for resistance training is a particular challenge. The cable pulley system on the Total Gym allows him to perform many upper body and core exercises, such as the straight arm pull down, with a variety of grip options. Ricky received the Military Cross from the Queen for acts of bravely and risking his own life to save four other soldiers, when they were injured by IED’s (Improvised Explosive Devices).
England stars Alex Corbisiero and Chris Ashton using the Compex.
Muscle stimulation for sport LONDON Irish rugby player Alex Corbisiero has been using a Compex muscle stimulator as part of his bid to get fit for the international season. Alex, who has suffered from a recurring knee injury, said: “I use Compex to fire up my quads before every training session or game. Being a front row forward, this is important as it is all about leg power.” Compex makes a range of muscle stimulation devices each with programmes that stimulate specific muscle groups and types. The concept was designed in Switzerland over 20 years ago for physiotherapists, pain treatment and
sports training. Muscle stimulation can be used during exercise to progressively increase overall strength, power, speed and endurance, and in recovery. Compex has a patented technology, ‘Muscle intelligence,’ which means sportsmen and women can manage and modify their training and recovery session by session. The Compex Mi-Sport has eight programme categories including warm up, sport, and cross-training, while the Compex Wireless, recently launched in the UK, has 50 programmes.
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PRODUCTS
Company launches footwear range REED Medical has launched its new range of diabetic footwear after two years of research and development. Healix footwear has been specifically developed to reduce the risk of plantar ulceration and re-ulceration of the neuropathic diabetic foot. Paralympian Sophia Warner joined some of the clinical team of DM Orthotics to celebrate ‘behind the scenes’ work the company did for the London Olympics and Paralympics. Sophia met with the firm at the London meeting of the Association of Paediatric Chartered Physiotherapists. DM Orthotics, known for its evidence-based work in dynamic movement orthoses (DMO) and the DM Active Sport, has been working with elite athletes over the last two years to help their performance. Sophia will be working with the company based in Redruth, Cornwall, to develop its marketing and PR strategy in the DMO and DM Active Sport range and raise the company’s profile within elite sport.
ORTHOTIX EXPANDS BASIX RANGE WITH NEW ARM/LEG GAITERS ORTHOTIX Ltd has enhanced its own Basix Range of products with a new and improved range of stock fabric arm/leg gaiters. Fabricated at its manufacturing unit in South Wales, the breathable cotton fabric gaiters are now available in either a standard or deluxe finish with an extensive variety of colours and sizes. The product: I Is used to maintain the arm or leg in extension for rehabilitation purposes. I Has full circumferential straps allowing for adjustments in size. I Comes in Standard Gaiter finished with imperial plush lining. I Comes in Deluxe Gaiter finished with a padded velfoam lining. The special introductory price for all sizes is now £18.95 standard/£19.95 deluxe (per pair), delivery typically three to five working days from order receipt.
Research shows that footwear with rigid rocker soles and specific sole geometry can significantly
or email enquiries@orthotix.co.uk
or visit www.ossur.co.uk
Enquiries: For details or a product demonstration, contact 01254 268 788.
ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2012/13
In partnership with Tekscan, Reed Medical compared in-shoe pressure measurements of eight UK commonly prescribed diabetic footwear brands with Healix. In five areas of the foot, Healix reduced pressure/time integrals by between 28% and 54%. Healix is available in three widths and two depths fittings in various styles, in UK sizes six to 11.
MANY people suffer unnecessarily from knee pain due to osteoarthritis, a degenerative joint disease characterised by the breakdown of cartilage that cushions the bones of the knee. The Unloader One from Össur is a highly effective, non-invasive solution that unloads the affected cartilage to relieve pain and improve mobility.The New Unloader One Plus is designed to optimise these features for the larger patient. The new design incorporates wider straps, thigh and calf shells to improve comfort and control of soft tissue. The adjustable hinge allows the clinician to precisely align the shells to fit the patient’s anatomy, whilst the Dual Dynamic Force straps at the core of the Unloader One design provide the offloading force. Enquiries: For further information please contact Össur on 08450 065 065
BEAGLE Orthopaedic has added another product to its growing portfolio. The Aspen Vista 464 TLSO is an allin-one system that offers patients support from S1-T8, providing versatility that accommodates the appropriate motion restriction throughout the healing process. Throughout testing, the Vista 464 was commended on its ease of application – especially to usually non-compliant patients – and the advantage of the modularity. The Sure Slot System comfortably fits waists from 26”-60” without compromising effectiveness of the brace, while the height adjustment technology means that just one TLSO fits patients ranging from 4’ 86’ 8”. There are also three styles of strap configurations, which are easy to set up, giving the user flexibility depending on individual needs. All this can be done without requiring any tools, which adds to the product’s ease of use.
Reed Medical’s contoured, removable ‘first line’ polyurethane insole system also achieves internal foot stability.
PAIN RELIEF WITHOUT MEDICATION
Enquiries: Contact customer services on 02920 370696
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A modular rigid rocker soled shoe, it is designed to reduce mechanical stresses under the foot via positioning of its patented dual axis rocker.
reduce peak pressures.
ORTHOTIX LAUNCHES HEAD PROTEX® SOFT SHELL HELMET ORTHOTIX has developed a new range of stock helmets through a joint collaboration with its market leading Spanish trade partner, Orliman. The Head Protex helmet is a comfortable and easy-to-fit soft shell stock helmet providing suitable skull protection for adults and children at risk of head injury from epilepsy, head drop syndrome, balance and co-ordination issues, self harm, hydrocephalus and post surgery. Product Information: I Superior lightweight breathable material with plush hypoallergenic lining. I Adjustable chin strap with quick release childproof clips. I Colour co-ordinated bumper adaptation available on provision of specification. I Hand wash at 30° and dry naturally. I All sizes available from 46cm-60cm in a range of funky colours (aqua, pink or black). Special introductory price £54.95 with next day delivery available on request. Enquiries: Contact customer services on 02920 370696 or email enquiries@orthotix.co.uk
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