INNOVATION FOR INDEPENDENCE
ISSUE 125 FEBRUARY/MARCH 2019 £6.95
Special wheelchair will help student achieve her dream A STUDENT from the University of East Anglia who has a genetic condition affecting her mobility is fundraising for a specialist wheelchair, so she can achieve her dream of working in the environmental sector.
for the environment, helping her to gain professional fieldwork skills and the confidence to apply for environmental consultancy jobs, which often involve site visits.
Gemma Bailey-Smith from Harlington, Bedfordshire was diagnosed in November with Ehlers-Danlos Syndrome, a connective tissue disorder causing spasms and dislocations of her joints, affecting her mobility.
“I recently undertook an internship as an environmental advisor which cemented my career aims and this month I’m starting a part-time research position working on a Highways England project.”
“I’ve lost my former active self and I now suffer daily with chronic pain and fatigue,” said Gemma. “But I’m determined not to let my condition hold me back in life, especially in my academic studies and career. “Coming to terms with having to use a wheelchair at the age of 21 has been really difficult, especially as I was previously really active and sporty. “I used to love hiking holidays, I volunteered in Borneo, was an avid gymnast, and even competed with the university stunt cheer team, UEA Angels.” The student, who is completing a Masters in Environmental Assessment and Management, needs £12,000 for an all-terrain electric wheelchair which will allow her to collect data while on a fieldwork trip to Devon in April. She will also be able to pursue her passion
The specialist wheelchair will give Gemma power and stability while tackling environments such as woods, beaches and fields, prevent muscle wastage, reduce inflammation to her ribs caused when she uses crutches, and limit long-term damage to her joints. She continued: “I’ll be able to go on walks with my family and join my friends on strolls round the UEA broad, which I’ve been missing out on for the last four years I’ve been at University.” Other students from UEA have been helping Gemma with her fundraising and the UEA Students’ Union Environmental Sciences Society recently held a quiz for students and staff. “Having the support from other students at this challenging time has been overwhelming,” she added. “It feels like everyone is rooting for me and wants me to succeed in my fundraising goals.”
The UK is set to train many more highly-skilled prosthetists and orthotists after the announcement of a global centre of excellence at the University of Salford. Worldwide demand for artificial limbs, braces, footwear and other devices which help people recover from injury is mushrooming, but the people who make, fit and monitor prosthetics require a rare combination of clinical, medical and engineering skills. The new centre is set to train 60 individuals to doctoral level over the next four years, and coordinate new Masters courses and research to address the skills gap at home and abroad, particularly in low and middleincome countries such as Cambodia, Uganda and Jordan. The £11m project, funded by the Engineering & Physical Sciences Research Council, unites 27 industry and clinical partners.
whilst this approach is prevalent, there is little evidence of its effectiveness.
AN interdisciplinary team of researchers from Robert Gordon University has secured funding for a project to investigate if an app that uses voice conversations can encourage physical activity in older adults.
After receiving its funding from the Engineering and Physical Sciences Research Council GetAMoveOn Network+, the study will explore how contextually relevant conversational dialogue can be used as a digital health intervention. The team, from RGU’s School of Computing Science and Digital Media and the School of Health Sciences, will work closely with Professor Ehud Reiter, natural language generation expert from the University of Aberdeen. Nirmalie Wiratunga, Professor of Intelligent Systems Research at RGU, said: “Conversation appeals to all age groups, but might prove particularly appropriate for older adults, who can have difficulties with new technologies and may be more likely to appreciate the natural interaction
“As a means of one-way communication, text notifications provide no opportunity for interaction and research has shown that fewer than 30 per cent are typically viewed by users – with average delays of close to three hours.”
Professor Nirmalie Wiratunga.
offered through conversational dialogue. “Therefore, delivering behaviour change interventions using digital conversation provides an opportunity for achieving higher levels of adoption and adherence, compared to traditional approaches.” Professor Kay Cooper, Clinical Professor Allied Health Professions at RGU and NHS Grampian, added: “Currently, digital behaviour change interventions are delivered as text notifications on mobile phones, and
Dr Sadiq Sani, Research Fellow at RGU, concluded: “Our vision is to develop a natural, ubiquitous and proactive system, which can improve the physical activity of older adults. “To do this, we need to answer a number of questions, such as whether wearable sensors can be used to contextualise digital conversations and whether this type of experience can ensure full engagement.” The project will run until June and will involve monthly workshops with a group of 10 older adults, who will work with the research team to cocreate the app. Participants will also be entered into a prize draw to win an Amazon Kindle Fire tablet.
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Technology to encourage exercise in older adults
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ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2019
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3D-printed robot hand ‘plays’ the piano SCIENTISTS have developed a 3D-printed robotic hand which can play simple musical phrases on the piano by just moving its wrist. And while the robot is no virtuoso, it demonstrates just how challenging it is to replicate all the abilities of a human hand, and how much complex movement can still be achieved through design. The robot hand, developed by researchers at the University of Cambridge, was made by 3D-printing soft and rigid materials together to replicate of all the bones and ligaments – but not the muscles or tendons – in a human hand. Even though this limited the robot hand’s range of motion compared to a human hand, the researchers found that a surprisingly wide range of movement was still possible by relying on the hand’s mechanical design. Using this ‘passive’ movement – in which the fingers cannot move independently – the robot was able to mimic different styles of piano playing without changing the material or mechanical properties of the hand. The results, reported in the journal Science Robotics, could help inform the design of robots that are capable of more natural movement with minimal energy use. Complex movement in animals and machines results from the interplay
between the brain (or controller), the environment and the mechanical body. The mechanical properties and design of systems are important for intelligent functioning, and help both animals and machines to move in complex ways without expending unnecessary amounts of energy. “We can use passivity to achieve a wide range of movement in robots: walking, swimming or flying, for example,” said Josie Hughes from Cambridge’s Department of Engineering, the paper’s first author. “Smart mechanical design enables us to achieve the maximum range of movement with minimal control costs: we wanted to see just how much movement we could get with mechanics alone. “Piano playing is an ideal test for these passive systems, as it’s a complex and nuanced challenge requiring a significant range of behaviours in order to achieve different playing styles.”
is a massive research challenge. Most of today’s advanced robots are not capable of manipulation tasks which small children can perform with ease. “The basic motivation of this project is to understand embodied intelligence, that is, the intelligence in our mechanical body,” added Dr Fumiya Iida, who led the research. “Our bodies consist of smart mechanical designs such as bones, ligaments, and skins that help us behave intelligently even without active brain-led control. “By using the state-of-the-art 3D printing technology to print humanlike soft hands, we are now able to explore the importance of physical designs, in isolation from active control, which is impossible to do with human piano players as the brain cannot be ‘switched off’ like our robot.”
(staccato) or smooth (legato) notes, achieved through the movement of the wrist. “It’s just the basics at this point, but even with this single movement, we can still get quite complex and nuanced behaviour,” said Josie. Despite the limitations of the robot hand, the researchers say their approach will drive further research into the underlying principles of skeletal dynamics to achieve complex movement tasks, as well as learning where the limitations for passive movement systems lie. “This approach to mechanical design can change how we build robotics,” said Fumiya. “The fabrication approach allows us to design mechanically intelligent structures in a way that is highly scalable.”
Over the past several years, soft components have begun to be integrated into robotics design thanks to advances in 3D printing techniques, which has allowed researchers to add complexity to these passive systems.
The robot was ‘taught’ to play by considering how the mechanics, material properties, environment and wrist actuation all affect the dynamic model of the hand. By actuating the wrist, it is possible to choose how the hand interacts with the piano, allowing the embodied intelligence of the hand to determine how it interacts with the environment.
“We can extend this research to investigate how we can achieve even more complex manipulation tasks: developing robots which can perform medical procedures or handle fragile objects, for instance,” said Josie. “This approach also reduces the amount of machine learning required to control the hand; by developing mechanical systems with intelligence built in, it makes control much easier for robots to learn.”
The human hand is incredibly complex, and recreating all of its dexterity and adaptability in a robot
The researchers programmed the robot to play a number of short musical phrases with clipped
The research was funded by the Engineering and Physical Sciences Research Council.
Orthopaedic project delivers vital help to Kenya TWO academics from the University of Plymouth recently returned from a trip to Kenya as members of an orthopaedic surgical partnership to help patients get back on their feet. Alongside health professionals from around the south west, and working with Kenyan hospital practitioners themselves, Alice Inman and Dr Matt Ward from the University’s Global Health programme travelled to Nyahururu District Referral Hospital with Kenya Orthopaedic Project. The project performs vital surgery and treatment on people who are unable to access the specialist services they need, working 4
alongside the local team to “share skills and transform lives”. Alice, senior physiotherapist for the project and programme lead for MSc Global and Remote Healthcare, said: “This project has been running for several years now, but it never fails to amaze me how many people and the variety of problems we see. “The partnership continues to develop. This time we ran a pilot of an electronic notes and referral system, which was enthusiastically adopted by the local team who could see real potential for sustainable change in the future.
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“On this trip, a 10-year-old boy’s hip was dislocated after he was sat on by a cow he was tending for the family. “This had been left untreated for four months, leaving him unable to walk, and he needed a complex surgical procedure to relocate it. “It’s our help alongside the professionals in Kenya that has got him mobile again. It’s events like this that show the unmet need of trauma consequence around the world – and since arriving back in the lead up to Christmas, it’s really made us all think about the value of ‘people’ over ‘stuff’.”
The project was initiated by Dr Lucy Obolensky from the University of Plymouth 10 years ago and, on average, two to three camps have taken place each year. It is now led by Christoph McAllen, trauma and orthopaedic surgeon from University Hospitals Plymouth NHS Trust, but the full team consists of multidisciplinary practitioners from across the south west. They assess in excess of 200 patients at a time, performing surgery on around 25 and providing conservative management or advice to the others.
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TGA is congratulated by Simon Weston CBE for winning the 2018 BHTA Independent Living Design Award. Pictured from left to right: Simon Weston CBE; Daniel Stone, TGA managing director; Justin Bone, TGA service manager; Dom Walbanke, marketing co-ordinator; Tim Ross, national sales manager and Eric Cooper, wheelchair specialist.
Powerchair claims prestigious award WHILL Model C, the multi awardwinning powered wheelchair from TGA, has triumphed again with another prestigious accolade – the BHTA Independent Living Design Award 2018. Now in its 23rd year, the Independent Living Design Award is recognised by members of the healthcare trade as the flagship title that highlights the very best in innovation. Manufacturers, designers and retailers were invited to nominate products they believed to have significantly enhanced independent living. TGA entered its pioneering WHILL Model C with clear justification regarding how and why it has excelled in all award criteria. TGA’s success was announced at the BHTA’s annual black-tie awards dinner which was held at the Alton Towers Hotel, Stoke-on-Trent. Simon Weston CBE, the inspirational host for the evening, presented the award to Daniel Stone, TGA managing director, alongside key members from the team. Working on behalf of the BHTA, an expert panel of judges deemed WHILL Model C exceptional in terms of: Enabling independence, improving quality of life, innovation, price accessibility, ease of use and aesthetic appeal. Exclusively supplied by TGA in the UK, WHILL Model C is unlike any other electric wheelchair. It can be dismantled into three manageable components for easy 6
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transportation and its omni wheels provide the tightest feasible turning circle for ultimate versatility. Combined with touch-sensitive ‘mouse style’ steering, remote control app and appealing aesthetics, the WHILL Model C delivers a new level of self-assured independence. Daniel said: “2018 was a remarkable year for our customers, WHILL Model C and TGA. WHILL Model C has now won seven prestigious awards but more importantly, it has empowered style-conscious people with disabilities to achieve more from life through pioneering practicality and aesthetics. “Our remarkable powerchair focuses on enhancing self-esteem and confidence whilst delivering levels of inclusion and accessibility never seen before in the UK. “We are delighted as a business to have won the BHTA Independent Living Design Award for the third time as it reiterates our commitment to innovation. This latest accolade is testament to WHILL Model C’s exceptional Japanese design and proven ability to change people’s lives.” This BHTA Independent Living Design Award is the latest addition to WHILL Model C’s collection of awards which includes: the CES 2018 Innovation Award, If Design Award, International Design Excellence Award, Japan’s Good Design Award, ‘Best of the Best’ Red Dot Award (healthcare category) and TIME Best Innovation.
Oxygen insole may help ulcer healing NEWS
PURDUE University researchers in Indiana have developed a shoe insole that may help diabetics with foot ulcers heal more quickly, by supplying more oxygen to them. A key feature of the insole, which is made from silicone-based rubber, is the installation of reservoirs of oxygen that release the gas to the very point where the ulcer is located, due to each insole being tailor-made. “One of the ways to heal these wounds is by giving them oxygen,” said Babak Ziaie, Purdue professor of electrical and computer engineering. “We’ve created a system that gradually releases oxygen throughout the day so that a patient can have more mobility.” Diabetic ulcers commonly result from
“If we could test how well this insole delivers oxygen to the wound site from within the cast, then this could be a way of aiding the healing process.”
high blood sugar damaging nerves, which takes away feeling from the toes or feet. Without the ability to feel pain, hits and bumps tend to go unnoticed and skin tissue breaks down, forming ulcers. A lot of sugar in the bloodstream, along with dried skin as a consequence of diabetes, further slow the ulcer healing process. Desmond Bell, a podiatrist in wound management and amputation prevention at the Memorial Hospital in Jacksonville, Florida, and the founder of the Save a Leg, Save a Life Foundation, said: “The gold standard for treating an ulcer is a patient wearing a total-contact cast, which provides a protective environment for the foot. “If we could test how well this insole delivers oxygen to the wound site from within the cast, then this could be a way of aiding the healing process.” Purdue researchers used lasers to shape silicone-based rubber into insoles, and then create reservoirs that release oxygen only at the
A new shoe insole technology could help diabetic ulcers heal better while walking. (Purdue University image/Kayla Wiles)
part of the foot where the ulcer is located. According to the team’s simulations, the insole can deliver oxygen at least eight hours a day under the pressure of someone weighing about 53-81 kilograms (117-179 pounds). But the insole can be customised to take on any weight, the researchers
say. The researchers now want to create a way to 3D print the whole insole, rather than printing a mould first and then laser-machining a pattern. They also plan to test the insole on actual diabetic ulcers, to further gauge how well they advance the healing process.
Bristol Robotics Laboratory supported start-up Open Bionics raises £4.6m A START-UP developing bionic limbs in the style of superheroes for children and adults has successfully raised $5.9m (£4.6m) from investors including F1’s Williams Advanced Engineering Group.
“We look forward to offering the Hero Arm in multiple international markets and continuing the development of great products that solve challenges within mobility and independence.”
Open Bionics, which developed in Bristol Robotics Laboratory, creates advanced multi-grip bionic hands called ‘Hero Arms’ for amputees.
Open Bionics has won awards for engineering and innovation including the £1million prize for the AI and Robotics for Good award, the James Dyson award for engineering, and two British Engineering Excellence awards.
The company uses 3D technologies such as 3D scanning and 3D printing to radically reduce costs. Open Bionics has achieved a price point that means its multi-grip bionic hand is the only advanced device affordable enough to be covered by national healthcare systems in major western markets such as the UK, France, Germany, and the USA. The company launched private sales in May 2018 with the ‘Hero Arm’ already becoming the best-selling multi-grip bionic hand in the UK. Open Bionics has worked closely with the NHS for two years under a product development contract with the joint goal of being able to offer these life-changing devices through clinics. The team has already sold devices in France and Spain with goals to serve more European countries this year. Open Bionics is the first company to create multi-grip bionic hands small 8
enough to fit children as young as nine years old. The Hero Arm enables amputees to choose between different finger speeds and movements enabling the wearer to pick up small objects like marbles with a fine pinch to carrying shopping baskets with a full hand grasp.
Samantha Payne, co founder and COO, said: “This funding enables us to serve multiple international markets and we’re thrilled to finally be able to deliver bionic hands to amputees and people with limb differences in the USA later this year.
Samantha Payne and Joel Gibbard, named by The Europas start-up awards as the ‘hottest founders’ in Europe, founded the ‘tech for good’ company in 2014.
“We’re exceptionally excited to receive this support from such high calibre investors who not only offer financial backing but incredible experience in commercialisation, measuring impact, and engineering high performance hardware.”
The multi award-winning business developed its technology at BRL’s Hardware Incubator before relocating to the neighbouring Future Space innovation centre at the University of the West of England’s Frenchay campus.
Joel Gibbard, co founder and CEO, added: “This investment provides crucial capital to help Open Bionics deliver on its vision of making advanced prostheses available to a much wider audience of limbdifferent users.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2019
The company also secured multiple licensing agreements from entertainment creators Eidos Montreal and The Walt Disney Company to create bionic limbs inspired by its most popular characters. Matthew Burke, head of technology ventures, Williams Advanced Engineering, said: “Williams Advanced Engineering is excited to work with the team at Open Bionics and share our expertise in product development systems. “Alongside the Fund’s investment, Open Bionics will benefit from the engineering and technology experience at Williams and the investment management and growth experience of Foresight’s team of investment professionals. Together this aims to be an ideal combination to deliver for the sector, its customers and the wider UK economy.”
Advertiser’s announcement
Reed Medical Ltd make a fresh start NEWS
WE are delighted to confirm that the company has now relocated to its larger “new home” in Blackburn, representing the final stage of the ‘fresh start’ following the management buyout last July. The move was completed between Christmas and New Year to ensure minimum disruption to production.
There continue to be many exciting developments taking place within the company as the construction of new offices, canteen facilities and training room near completion. Our new adults and kids catalogues, released in Summer 2018 have provided a “spring board” to further enhance our product offering. This has included working with several of our customers, over the course of the last few months, assisting in developing very complex footwear requirements to satisfy the needs of patients with acute foot conditions. We are happy to extend this service to all, at no additional cost: “Just ask” and we will work with you to assist with fulfilling the needs of your more complicated footwear patients to ensure they receive footwear which both fits and is functional. We continue to look at new product development to keep us at the forefront of UK orthopaedic, surgical
and diabetic footwear manufacture and we look forward to sharing these with our customers at BAPO in Harrogate in March. We have now extended our offering of active Podartis footwear to include additional everyday styles of footwear. Podartis shoes are clinically designed to prevent, reduce and stop the pain due to foot pathologies and incorporate the clinically proven Biomechanical WellWalk® outsole which is effective, in particular, for people with limited joint mobility and moderate diabetic risk in active life. Please visit us at BAPO this March and our team will be delighted to discuss our product ranges, including new styles and materials, and any requirements specific to you. Enquiries: Telephone 01254 503333, email wendyb@reedmedical.co.uk or visit www.reedmedical.co.uk
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Orthopaedic Research Institute features in national campaign patient recovery and clinical practice. By delivering multi-disciplinary support from the beginning of a patient’s journey, we can improve quality of care and reduce the length of hospital stay needed.”
THE Orthopaedic Research Institute at Bournemouth University features in a national campaign looking at how university research is improving everyday life. A Universities UK national campaign, ‘MadeatUni’, will see a host of UK universities celebrated for their contributions to society and everyday life – including the work of Bournemouth University’s Orthopaedic Research Institute. The list, which has been compiled by UUK, aims to celebrate significant inventions, discoveries and social initiatives made by academics over the years which have had a transformative impact on people’s everyday lives. ORI, which was set up in 2015, was founded with the intention of working across the university, local hospitals, and industry partners to carry out research that will improve patient care and develop clinician practice in the UK. Headed by consultant orthopaedic surgeon, Professor Rob Middleton,
and Associate Professor of Orthopaedics, Tom Wainwright, the Institute has seen its services in high demand due to the higher proportion of orthopaedic surgeries required in the Dorset region. As a result, ORI’s research is making a significant difference to clinical practice and patients in the local area. The Dorset Local Enterprise Partnership has provided funding to enable the purchase of worldleading equipment to support ORI’s work, including the procurement
of virtual reality surgical training equipment and creation of a GRAIL gait laboratory – one of only 23 in the world – which allows medical professionals to see how new devices and surgical techniques can improve outcomes for patients. Professor Middleton said: “Establishing ORI stems from our passion for improving the quality of care for orthopaedic patients. Our previous research has demonstrated that enhanced recovery pathways can make a significant difference both to
Commenting on future projects, and a new community-based exercise programme, Associate Professor Tom Wainwright, added: “ORI is conducting a NIHR funded clinical trial to compare standard NHS physiotherapy treatment for hip arthritis to an innovative, eightweek community based exercise and educational programme focused on using cycling to reduce hip pain. “The outcomes of this trial are set to influence the treatment of hip arthritis globally. Furthermore, ORI will also carry out one of the first studies in the world to evaluate the outcomes of robotic hip surgery using the facilities at its world-class facility.” Professor Dame Janet Beer, president of UUK, said the list is “a testament to the difference that universities make to people’s lives.”
Advertiser’s announcement
New design addresses the ‘forgotten joint’ A RECENTLY published article in The Journal of Functional Morphology and Kinesiology highlighted the prevalence of patellofemoral osteoarthritis and its underemphasised role in contributing to knee pain in patients with osteoarthritis.
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Crossley, professor of physiotherapy at La Trobe University in Brisbane Australia, to refer to the PF joint as “the forgotten joint in knee osteoarthritis.”2
correct varus or valgus in the knee joint. The result is a brace that is effective for both major sources of knee OA pain, is easy to put on, and is comfortable for all-day use. 1. R. C. Duncan, E. M. Hay, J. Saklatvala, P. R. Croft; Prevalence of radiographic osteoarthritis—it all depends on your point of view, Rheumatology, Volume 45, Issue 6, 1 June 2006, Pages 757–760,
According to a radiographic analysis of 777 patients over the age of 50, presenting with knee pain, 68 per cent exhibited observable knee OA.
and another 35 per cent had isolated patellofemoral OA.1
With clear evidence of the frequent coincidence of patellofemoral OA and tibiofemoral OA, BioSkin is pleased to announce the launch of the OA Spiral, a revolutionary new brace that addresses both tibiofemoral and patellofemoral pain.
Of the patients with OA, only six per cent had isolated tibiofemoral OA, while 59 per cent had combined tibiofemoral and patellofemoral OA
It is surprising then, that so many treatments and so much discussion focus exclusively on tibiofemoral OA. It was this incongruity that led Kay
To make the OA Spiral, we integrated the clinically validated technology in the BioSkin Q Brace3, with a new design that uses a dynamic strap to
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2. Crossley, K.M. et al. The patellofemoral joint: the forgotten joint in knee osteoarthritis, Osteoarthritis and Cartilage Volume 19 Issue 7, 765 – 767 3. Callaghan, M et al. Beneficial effects of a brace for patellofemoral OA: results of a randomised trial Osteoarthritis and Cartilage Volume 21 (2013); S23
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A ‘step change’ in prosthetics SOUTHAMPTON researchers are working with clinicians, academics and policymakers in Cambodia to develop digital tools to improve access to prosthetic and orthotic services. The team will also be training clinicians in the use of these digital tools, and undertaking their own research. These results should ensure that funding allocated for prosthetic services is spent more efficiently. Dr Alex Dickinson, lecturer in Engineering and Physical Sciences, is leading a multidisciplinary team of engineers and health scientists from Southampton to assess how useful a range of digital technologies could be to prosthetic limb provision in Cambodia. “The legacy of landmines in Cambodia and, more recently, road traffic accidents because of limited infrastructure in booming cities, means there is an urgent need for improved provision for prosthetics and orthotics,” said Alex. “This is coupled with an increasing
incidence of diabetes and vascular disease, both of which are leading causes of amputations.” Creating a prosthetic limb is a highly skilled process that takes many years to master, and in many countries the supply of qualified prosthetists isn’t keeping pace with the growing numbers of people who need their services. To address this issue, the team is working alongside prosthetists in Cambodia to investigate whether portable 3D surface scanners and computational shape analysis techniques could help them share good practice, measure a person’s adaptation to their prosthetic device and enable more people to access them. Alex added: “Prosthetists like our expert partners at Exceed Worldwide and the Cambodian School of Prosthetics and Orthotics are highly trained, and their practice is based on huge experience; their expertise certainly can’t be replaced by a computer. “However, these technologies could help them interpret what they have
done before, learn faster and engage with their clients. This could help speed up provision of prosthetics and orthotics to people who really need it.” In collaboration with the University of Salford, the project will also conduct physical activity measurement research, to assess how people use their prosthetics in community settings. Health psychologist Dr Maggie Donovan-Hall is providing a key element in the team’s approach; she is working closely with the groups of people in Cambodia that use prosthetics, to create technologies that meet their technical, social and cultural needs. To achieve this, Maggie and social affairs researchers in the Cambodian team are carrying out preliminary focus groups with prosthetic service users to ensure the technology will be of benefit to them. In collaboration with University of Southampton digital spin-out company, BluPoint Ltd, the team is developing a secure method of collecting the scan and activity data
in the community, and disseminating information. They will also trial the use of digital versions of clients’ case notes to enable prosthetists to provide treatment to people in remote communities who can’t afford to travel to a clinic, removing the risk that paper-based notes could get lost or damaged in transit. “My hope is that they will give people better and faster access to a more personalised prosthetic and orthotic service, and devices that are better suited to their everyday lives,” concluded Alex. “Portable scanners and digital case notes could have the added benefit of patients requiring less time off work for appointments because clinicians are more able to travel to remote locations to visit them in their homes.” The project is a result of the Institute for Life Sciences’ FortisNet initiative, which brings together experts from different disciplines across the University, and is funded by the Engineering and Physical Sciences Research Council’s Global Challenges Research Fund.
Smartphone technology will use AI to help patients RESEARCHERS at CAMERA are helping to develop an app that allows arthritis patients to monitor their symptoms on a smartphone. A partnership between the healthtech company Living With, the Royal United Hospitals Bath NHS Foundation Trust and the University of Bath has been awarded a major grant to develop a Rheumatoid Arthritis Flare Profiler.
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excellence for rheumatic conditions, and CAMERA at the University of Bath, a leader in developing and evaluating new digital technologies such as the use of video, sound and motion for clinical applications. “We’re thrilled to have won an Innovate UK grant,” said Living With’s CEO Chris Robson.
The award, from Innovate UK, will allow rheumatoid arthritis patients to use new methods capturing key disease activity data from smartphones, which will support clinicians to be able to classify and optimise care pathways.
“This will transform the way patients with rheumatoid arthritis can be monitored intelligently between appointments and hopefully help the NHS reduce the cost of treating patients with RA. It also adds a transformational new capability to our existing Living With Rheumatoid Arthritis product.”
Living With is developing the Flare Profiler in partnership with the RUH Trust’s Royal National Hospital for Rheumatic Diseases, which is the internationally leading centre of
Jane Carter, research and development manager at the RNHRD, added: “The Trust has an established international reputation for our research and expertise
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in rheumatology. We are always looking at ways to further improve the care and treatments we can offer patients. “Using the latest technology and artificial intelligence is an exciting development. We are very excited to be part of this innovative project.” CAMERA was created to help further and transfer the knowledge developed within computer science, often targeting the technology developed for the entertainment industries, to other sectors such as healthcare. CAMERA director, Professor Darren Cosker, said: “This is a great project. Being able to take some of the computer vision techniques we developed for hand tracking for animation and transferring them into a condition monitoring platform that can operate in a person’s home is a
very positive use of technology and exactly the kind of work we should all be doing.” The Flare Profiler will test a unique range of patient data sources including video and thermal imaging technology. The project will then analyse patient data using cutting edge artificial intelligence and machine-learning technology to group patient disease activity patterns and identify the most effective treatment pathways for them. The aim of the Flare Profiler is to demonstrate how better monitoring can provide earlier detection of issues, allow earlier clinical intervention and over time reduce need for costly acute treatments. It also aims to reduce the stress and need for patients to travel to hospital during treatment for specialist tests.
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The power prosethetic knee that researchers from North Carolina State University, the University of North Carolina and Arizona State University have developed. Photographs by Helen Huang.
New powered prosthetic knee users able to walk in minutes RESEARCHERS from North Carolina State University, the University of North Carolina and Arizona State University have developed an intelligent system for “tuning” powered prosthetic knees, allowing patients to walk comfortably with the prosthetic device in minutes, rather than the hours necessary if the device is tuned by a trained clinical practitioner.
The system is the first to rely solely on reinforcement learning to tune the robotic prosthesis. When a patient receives a robotic
“A computer model adapts parameters on the device and compares the patient’s gait to the profile of a normal walking gait in real time.”
prosthetic knee, the device needs to be tuned to accommodate that specific patient.
The new tuning system tweaks 12 different control parameters, addressing prosthesis dynamics, such as joint stiffness, throughout the entire gait cycle. Normally, a human practitioner works with the patient to modify a handful of parameters. This can take hours. The new system relies on a computer programme that makes use of reinforcement learning to modify all 12 parameters. It allows patients to use a powered prosthetic knee to walk on a level surface in about 10 minutes. “We begin by giving a patient a powered prosthetic knee with a randomly selected set of parameters,” said Helen Huang, co-author of a paper on the work and a professor in
the Joint Department of Biomedical Engineering at NC State and UNC. “We then have the patient begin walking, under controlled circumstances.
“Data on the device and the patient’s gait are collected via a suite of sensors in the device,” Helen added. “A computer model adapts parameters on the device and compares the patient’s gait to the profile of a normal walking gait in real time. “The model can tell which parameter settings improve performance and which settings impair performance. Using reinforcement learning, the computational model can quickly identify the set of parameters that allows the patient to walk normally. “Existing approaches, relying on trained clinicians, can take half a day.”
While the work is currently done in a controlled, clinical setting, one goal would be to develop a wireless version of the system, which would allow users to continue fine-tuning the powered prosthesis parameters when being used in real-world environments.
Helen said researchers hope to make the process even more efficient. “For example, we think we may be able to improve the process by identifying combinations of parameters that are more or less likely to succeed, and training the model to focus first on the most promising parameter settings,” she added. The researchers also note that, if the system does prove to be effective and enter widespread use, it would likely reduce costs for patients by limiting the need for patients to make clinical visits to work with practitioners.
App a step in right direction for patients’ fitness current assessment practice and, unlike some other apps for walking, it measures fitness using a wellvalidated test developed for medical patients.
A WALKING app designed to assess and support physical activity in medical patients – in a simpler and more accessible way than many current methods – is being developed at the University of Strathclyde.
“The findings of our study will lead to the development of a tool that could improve levels of fitness and physical activity in healthy people and people living with illness alike.
The app will enable patients to assess their own fitness by measuring the distance they can walk in six minutes.
“Clinicians have expressed interest in using the app as a tool for presurgery assessment and they see the potential for it to be a motivator for physical activity beyond clinical intervention.”
It is also based on a validated fitness test which is used to measure effects of exercise interventions in medical patients. In addition to measuring and monitoring physical fitness, it can act as a facilitator and motivator which can offer patients an incentive to boost their physical activity. Initially, the app – named 6MW-app (Six-Minute Walk) – is being tested in trials with cancer patients but could potentially be used for those with other conditions. The study is being led by Dr Liane Lewis, a Research Associate in 14
Strathclyde’s Department of Computer and Information Sciences. She said: “Measuring patients’ levels of fitness has many benefits in a clinical environment, such as assessment of pre-surgery fitness, a baseline measure for monitoring progress and facilitating conversation about physical activity.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2019
“However, making these measurements is either resourceintensive, and therefore not easily accessible, or too subjective to be meaningful. “We developed the Six-Minute Walk app for self-assessment of fitness using a mobile phone. Its simplicity could lead to it replacing
The app has been tested with healthy participants, who performed two fitness tests and completed a short survey. While the sample size was small, the results were found to be highly reliable and indicated that the app would be suitable for use in a nonsupervised environment. Further tests are planned with a clinical population.
Advertiser’s announcement
PEACOCKS Medical Group is proud to support a national campaign which promotes engineering and technical trades to youngsters across the UK.
of people are fascinated by what we make here at Peacocks and I spend a lot of my day talking about my role and the techniques we use to create the end product.
Peacocks – a custom-made orthotics and clinical service provider, based in the North East of England, are very proud to have participated in the Royal Academy of Engineering’s This is Engineering campaign (a national campaign which also formed a key part of the government’s Year Of Engineering). Aimed at changing the perception of engineering amongst young people, 16 inspiring young people were chosen and 16 resulting films have been created to show that getting in to engineering can provide an exciting, varied and rewarding career. The national campaign released its second series of films, one of which features Alan Proud, Peacocks’ senior orthotic technician – as a ‘Walk Wizard.’ The film has received nearly 150,000 views online and shows how Alan uses technology, hand-held tools
NEWS
Peacocks’ ‘Walk Wizard’ features in new national film campaign “I’m excited to be a part of the campaign and it’s great how well the original film is doing.” Alan also features in the Gatsby Foundation Technician’s Make it Happen campaign and the Year of Engineering’s More Heroes Needed campaign with Marvel. and skills learned over time to create Ankle Foot Orthoses to improve patients’ lives. Alan has attended events in Birmingham and London to promote the campaign and the work he does for Peacocks, showcasing and discussing technical careers with youngsters while raising the profile of the orthotics industry. Peacocks employs engineers in a variety of roles across the business and is delighted that Alan was chosen to participate in this campaign.
The film highlights the benefits of engineering as a career, apprenticeships, learning on the job and working within the orthotics industry to – in Alan’s words – “help people who have difficulty walking get back on their feet.” He added: “It’s an honour to be involved in such an amazing campaign. It’s great to see the impact it can have on a lot of children who are looking to go into careers which involve engineering or technical skills. “When I go to the exhibitions a lot
Alan is practically minded and has progressed his career at Peacocks to senior orthotic technician through studying NVQs in manufacturing and an apprenticeship in industrial applications. All of the campaigns are aimed at promoting technical trades to youngsters and Peacocks are proud to help raise the profile of engineering and technical trades, but also the orthotics industry. Find out more by visiting www.thisisengineering.org.uk/ www.technicians.org.uk/
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A new exercise and education programme is helping patients avoid surgery and supporting their improved fitness. The programme is also saving the NHS money and freeing up valuable bed space by putting patients at the heart of managing their conditions. Assistive Technologies found out more.
Cycling boosts outcomes in patients with hip pain and helps to avoid surgery life changing results.
THE CHAIN (Cycling Against Hip Pain) programme is a six-week exercise and education treatment pathway for people with hip pain.
“It is an excellent example of how working across organisations in partnership can bring benefits to our patients.”
The programme was first piloted in 2013, and was created by Professor Robert Middleton and Associate Professor Tom Wainwright, of the Orthopaedic Research Institute, Bournemouth University in partnership with the Royal Bournemouth Hospital and BH Live. Professor Robert Middleton said: “CHAIN is a great success for both patients and the NHS. More than 70 per cent of people completing the CHAIN programme have less pain, are able to do more activities and have avoided surgery. It is the go to first line treatment for hip pain.” With a hip replacement costing the NHS almost £7,000, this represents a big saving to the tax payer, while ensuring other patients requiring surgery do not have to wait as long. It provides better outcomes for the patient, as depending on their job role, they generally take at least six weeks off work to recover, in addition to time off needed for any follow up appointments and aftercare. Neil Cowan, director of operations for surgery at the Royal Bournemouth and Christchurch Hospitals, added: “This fantastic collaboration between Bournemouth University, BH Live, ActiPath and The Royal Bournemouth and Christchurch Hospitals is helping
The programme is designed to promote the self-management of hip pain and is based on the latest NICE guidelines for the treatment of osteoarthritis. These guidelines recommend local muscle strengthening, aerobic exercise, and education as a core part of the treatment. Cycling strengthens muscles around the hip, helps to reduce pain, and is an excellent form of aerobic exercise. people to manage their hip pain and avoid complex surgery. “Furthermore, patients are supported in the longer term with lifestyle and wellbeing help, alongside all the marvellous benefits that increased exercise brings. “We are very excited about the results of this programme and look forward to developing it further for the benefit of more NHS patients both locally and nationally.” So far, more than 100 people have been referred onto the CHAIN programme out of 500 who have been commissioned by the Royal Bournemouth and Christchurch Hospitals. The results for those patients who
have completed the programme have been extremely positive, with 100 per cent of participants reporting that they would recommend the programme. A small minority of patients have returned for a clinical intervention where appropriate, and while the programme is not mandatory, most people referred for CHAIN are taking up the opportunity to improve their health and well-being. Associate Professor Tom Wainwright, also of Bournemouth University, added: “We continue to be delighted with the results of the CHAIN course. Participant feedback is excellent, with 100 per cent recommending the course to others, and many achieving
The CHAIN programme is securely digitally managed through an innovative online platform from local software experts, ActiPath Limited. Their secure portal provides endto-end lifecycle management of patients throughout the programme, including real-time outcome analysis and patient communication via email and text. Tom concluded: “The deployment of ActiPath has allowed us to increase efficiencies within the CHAIN programme whilst ensuring consistency of delivery and future scalability.” With the ongoing success of the CHAIN programme, other health conditions are being considered for the opportunity to be included in future CHAIN programmes
Active Hands launches new hook aids overhead or when your arms are forward.
ACTIVE Hands – the go-to place for people with hand function disabilities – had designed a new gripping product to improve workouts.
This makes the hook aids more versatile than existing hook devices, which only perform well when lifting upwards from the ground.
Its new hook aids are designed to enable a user to independently grab and release a close ended bar to perform exercises such as chin ups, as well as allowing use of some previously inaccessible types of gym kit such as lateral pulldown machines, seated rowing and hand crank machines.
The position of the hook is adjustable to suit hand size, positioning of item gripped and personal preference.
They will also work to grip the handlebars on many types of hand bikes.
manufacture a unique new hook design, not available anywhere else, specifically for this product.
It comes with four silicon tubes, for optional use, to increase grip on an object.
The design incorporates a strong stainless steel double, which gives stability when under tension and mimicks a “real grip” feel when in use, with a clever adjustable wrist strap.
The metal hooks have a thin v-shaped section as part of their design with an elastic loop attached.
The hook aid can be used without these and this may be the preferred way when gripping some items such as rubberised, foam covered or padded bars.
Active Hands had to invent and 16
The aids are adjustable and can be personalised to suit the user.
This innovative elastic loop is placed around a finger and prevents the hook from flopping down under its own weight when grabbing a bar
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2019
Director Rob Smith said: “As a regular user of the products we
manufacture at Active Hands, I am always on the look out for the times there is an item I struggle to use or cannot access due to my limited hand function. “I have been using our Gym Pack Deluxe range of products for my workouts for many years and they have really helped me train for wheelchair racing. “However, when doing workouts, I have always struggled to grip closed ended bars with both hands without needing assistance. “The hook aids have a uniquely designed hook with elastic retainer system allowing the user to reach and grab overhead with both hands and also release fully independently. “They have really expanded my gym workout options which has given me a great boost mentally as well as physically.”
EXPERTS at the University of Winchester have set up a new community clinic to help improve the health, wellbeing and quality of life of stroke victims through exercise and education.
to take part in community exercise and educational programmes. The HELP Hampshire Stroke Clinic will fill this gap, offering a new community service that will help patients, carers and the healthcare system.
The Health Enhancing Lifestyle Programme Hampshire Stroke Clinic will work with stroke survivors to help them find new forms of exercise that might suit them and will also run exercise sessions in-house.
“The programme is unusual in that it will utilise academic research and expertise to make a real impact in the local area while generating further insight to hone our understanding of stroke recovery, improving future treatments.”
By helping stroke survivors to return to exercise, the clinic aims to improve their motor and sensory skills, promote their independence and raise their quality of life more broadly.
Dr Faulkner will manage the clinic with Ariyan Alimadadi, HELP Hampshire programme manager at the University of Winchester.
Strokes are a major cause of death and disability internationally. The physical effects of a stroke can be debilitating, varying from weakness or paralysis on one side of the body to muscle spasms or weakness and balance problems. Exercise can help improve an individual’s health and wellbeing, reducing the risk of a future stroke. The not-for-profit HELP Hampshire clinic will build on research carried out by Winchester academic Dr James Faulkner, who is the HELP Hampshire Programme Lead and an exercise physiologist, to
Ariyan Alimadadi; Louis Martinelli, Hobbs Rehabilitation; Dr James Faulkner, and Professor Simon Jobson, Dean-Designate of the Faculty of Health and Wellbeing, University of Winchester.
provide tailored treatment to each patient. In partnership with collaborative research partners in the UK and abroad, Dr Faulkner has worked with more than 100 stroke patients in hospitals and their own homes to find out how to best support their recovery since 2015. James said: “Although 1.2 million people live with the effects of stroke in the UK, there are surprisingly few opportunities for stroke survivors
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Experts launch exercise-based stroke rehabilitation clinic in Hampshire
The clinic team will treat patients referred by local GPs and Hampshire Hospitals NHS Foundation Trust, in particular consultant physicians Dr Lucy Sykes and Dr Nigel Smyth at Hampshire Hospitals NHS Foundation Trust. Clinic sessions will take place in the Carroll Centre, Stanmore; St Mark’s Church, Oliver’s Battery; and other locations in Winchester and wider Hampshire. In addition to benefiting patients, the programme will create learning and teaching opportunities for students at the University, particularly those on physiotherapy and sports and exercise programmes. The clinic opens in March.
Student goes ‘back to DARCO’s ‘Allrounder’ shoe school’ for OT lesson is designed for ease of use AN occupational therapy student has returned to her roots to help demystify the profession by giving workshops at her former high school.
Chloe Holmes, who is in her final year of study for the three year BSc course, visited her alma mater Ormiston Bushfield Academy in her home town of Peterborough to help shine a light on a sometimes misunderstood and misrepresented discipline. The idea for the workshops came about following a discussion by members of the Occupational Therapy Admissions Tutor Forum of which Debbie Hewson, senior lecturer at University of Northampton, is the chair of. The aim is to encourage occupational therapy students across the UK to go back to the classroom and help explain the role of the ‘OT’, what they get out of their studies and raise awareness of the profession, how it helps people and how invaluable that help is. Chloe said: “Occupational therapy covers so much more than just helping people get back into work, but few high school students know anything about it. This is what I wanted to tackle with my presentation. “By ‘occupation’ we mean a daily task or activity – like getting up in the morning or undressing to go to bed and everything else in between
that you do to keep busy or for fun – basically, the whole of your day.” Chloe felt that doing this at her former school was especially important.
“I’m one of very few students from Ormiston who have gone on to study occupational therapy in the past few years and was the only one from my year group,” she added. “In fact, there was a bit of headscratching and background research needed by my tutors – they had no idea what occupational therapy is. “This is why I signed up to giving the presentation – to talk about what I do and why it’s a much needed profession.” Chloe found herself further developing her public speaking skills in the process. She added: “I gave two presentations, the first to 60 year 12 students about university life – so I was a bit nervous. “The second was to a smaller group of health and social care students across years 12 and 13 and was specifically about occupational therapy. “Despite my initial nerves, my passion for the profession took over and I was able to talk about what occupational therapy is and the up to date ‘OT suite’ and learning equipment we have at Northampton’s new Waterside campus.”
FROM post-op to wound care, the “Allrounder” is a comprehensive healing shoe, a relief shoe and a rehabilitation shoe, an all-in-one design for comfort and ease of use. The AllRound® shoe is the perfect, versatile option; with a wide opening for easy access and plenty of room for bandages.
The slip resistant sole, offers stability and good shock absorption due to two different shore densities. Indications
Features n Stable and easily adjustable. n Shock absorbent, anti-slip outersole. n Spacious boot design for custom Insoles or bulky bandages (can accommodate diabetic foot insoles).
n Post-operative care. n Wound care. n Arthritis. n Foot in risk category 0, 1 or 2 according to the German Diabetes Association Guideline. Purpose n Sole allows for easier mobility without compromising stability. n Sandwich sole construct combines firmness for stability and a cushion sole for softer landings. n Shoe upper is a light-weight, breathable nylon fabric that repels water and soil. n Multi-layered closure for protection and a secure fit. n Removable insoles plus ample space to accommodate individual needs.
n Soft breathable fabric with adjustable hook and loop closure. n Long ridged internal plate promoting weight distribution. n Extra wide opening – seamless comfort-zone. n Low profile sole – no height compensation necessary. n Also for bandaged or swollen feet, arthritic feet and feet with deformities. n Can be worn on the right or the left. Call or email V-M Orthotics Ltd for further information or for details of how to buy the product through any one of our UK distributors. Telephone 01986 798 120 or email info@vmorthotics.co.uk
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