01
29/1/15
15:49
Page 1
INNOVATION FOR INDEPENDENCE
ISSUE 101 FEBRUARY/MARCH 2015 £6.95
Amputee makes history with two prosthetic limbs By Olivia Taylor A COLORADO man recently became the first bilateral shoulder-level amputee to wear and simultaneously control two of Johns Hopkins University Applied Physics Laboratories’ modular prosthetic limbs. Les Baugh, who lost both arms in an electrical accident 40 years ago, was able to operate the system by simply thinking about moving his limbs, performing a variety of tasks during a short training period. Before putting the limb system through the paces, Les had to undergo a surgery at Johns Hopkins Hospital known as targeted muscle reinnervation. Johns Hopkins Trauma Surgeon Albert Chi, M.D explained: “It’s a relatively new surgical procedure that reassigns nerves that once controlled the arm and the hand. “By reassigning existing nerves, we can make it possible for people who have had upper-arm amputations to control their prosthetic devices by merely thinking about the action they want to perform.” After recovery, Les visited the Laboratory for training on the use of the Modular Prosthetic Limbs. First, he worked with researchers on the pattern recognition system, and by the time
the socket was finished, Les said he was more than ready to get started. When he was fitted with the socket, and the prosthetic limbs were attached, he said: “I just went into a whole different world.” He moved several objects, including an empty cup from a counter-shelf height to a higher shelf, a task that required him to coordinate the control of eight separate motions to complete. APL’s Courtney Moran, a prosthetist working with Les, added: “This task simulated activities that may commonly be faced in a day-to-day environment at home. “This was significant because this is not possible with currently available prostheses. He was able to do this with only 10 days of training, which demonstrates the intuitive nature of the control.” The next step is to send Les home with a pair of limb systems so that he can see how they integrate with his everyday life, and he’s looking forward to that day. “Maybe for once I’ll be able to put change in the pop machine and get pop out of it,” he said. He’s looking forward to doing “simple things that most people don’t think of. And it’s re-available to me.”
British disabled skier Heather Mills is attempting to break the Guineess World Record for speed skating – wearing a prosthetic leg that has been a year in development. Heather – who lost her leg in a collision with a motorbike in 1993 – only started her professional sporting career in 2011 when she was approached by the head of the Slovenian Masters while on a skiing holiday in Austria. She has a host of medals under her belt and now has a permanent position with the British disability skiing team – but she’s now in training to become the fastest disabled female speed skier in the world. Full story, Page 8
02
29/1/15
10:05
Page 1
29/1/15
10:05
Page 1
Microprocessor-controlled leg puts Jim’s life back on track
Contacts Editorial Judith Halkerston Email: jh@scriptmedia.co.uk
Group Editor
By Nicola Hyde
Glasgow.
A MAN who lost his leg after it was crushed in a forklift has spoken about the challenges of getting the right prosthetic that worked for him.
He said: “I was lucky to be able to try it out and I was immediately impressed and knew it would improve my lifestyle significantly and let me get back to some of the activities I enjoyed prior to my amputation.
Dominic Musgrave Group Production Editor Email: dm@scriptmedia.co.uk Tel: 01226 734407 Nicola Hyde Reporter Email: news@scriptmedia.co.uk Tel: 01226 734715 Sales
“I can be active again; I’m back at the gym and have a bluetooth remote control that lets me change the settings to use the treadmill or the rowing machine. I’m also having gait training which is helping me build up speed and pace and improve my walking pattern.”
Email: cr@scriptmedia.co.uk Tel: 01226 734412 Fax: 01226 734478
Jim Bruce, from Glasgow, was a keen gym-goer, football supporter and gardener, but a freak acccident in 1995 saw him injure his knee and shin so badly that he had to be amputated above the knee – despite the fact that his foot was uninjured. He said: “When they told me they were going to amputate my leg, it felt strange but didn’t really hit me until afterwards. It was only after the amputation that it dawned upon me that this would change my life forever. I was in hospital for three months which gave me time to reflect and then it was another seven weeks until I got my first NHS leg. “The amputation had a huge impact on my day-to-day life. It left me unable to do the small things I didn’t even realise that I would miss, like using a step ladder and doing DIY.” Jim’s first NHS leg used a hydraulic system which he found very tiring and often stumbled and fell. Later on
Jim now volunteers on the prosthetics course at the University of Strathclyde. He regularly participates to help aspiring prosthetists learn. Jim Bruce with his C-Leg microprocessor knee from Ottobock
in life, Jim found out about the CLeg microprocessor knee from Ottobock from his active involvement in the amputee patient community and was given the opportunity to try it at the University of Strathclyde in
Jim added: “I really hope that in the future the NHS will be able to provide microprocessor knees. It has helped me to continue the active lifestyle I led before my injury, and I believe that if a patient had a C-Leg as their first leg it would help greatly with healing and lead to faster recovery times.”
Carole Rice
NEWS
03
Product Manager
Tony Barry Sales and Marketing Director Email: tb@scriptmedia.co.uk Circulation circulation@wharncliffepublishing.co.uk 24 hour hotline: 01226 734695 Design/Production Stewart Holt Studio Manager Email: sth@scriptmedia.co.uk Laura Blackburn Graphic Designer Email: lb@scriptmedia.co.uk
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.
www.assistivetechnologies.co.uk
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
3
29/1/15
INDUSTRY NEWS
04
10:27
Page 1
Is your orthotics service meeting your customers’ requirements? By Simon Dickinson, clinical director, TalarMade
deliver the care required for their consumers (i.e. patients).
I HAVE always found it interesting to ask any clinician working in the NHS who their customers are?
Over the last year I have been asked to do some work for the Parliamentary and Health Service Ombudsman. This organisation is the final step in the NHS complaints system and is independent of the NHS. One of the questions posed to me by the Ombudsman was specific to timescales relating to orthotic service delivery.
The immediate answers are always patients, but are patients really the customers of the NHS? The Oxford English dictionary’s definition of a customer is “a person who buys goods or services from a shop or business”. The obvious question therefore is, do patients buy goods and services from the NHS? Although the NHS is funded by taxation, the transfer of cash to the providers of NHS services is not paid directly by patients (although a contribution may be made by prescription charge in some circumstances). So if patients are potentially consumers of NHS services who are the customers? Ultimately any customer has the right to decide whether to buy your services or not. Therefore the customers of NHS orthotic services must ultimately be commissioners and finance/procurement managers/directors in the NHS. These people essentially hire services and people (NHS or contracted) to
discover that local orthotic service specification documents existed. Dialogue with the BAPO chairman confirmed this was the case and BAPO are trying to influence this. Therefore orthotic services are in the rather bizarre position that its customers, i.e. commissioners, have no national framework for commissioning orthotic services to deliver and monitor consistency in timely access and treatment. Could this possibly mean therefore that commissioners are uncertain of exactly what they are commissioning regarding orthotic services? What is certain is there are currently no quality standards for orthotic services nationally except the 18-week RTT target.
As a result I investigated national guidelines relating to orthotic provision timescales. I was more than surprised by the result. The only timescale target that exists nationally that is applicable to orthotic services relates to the 18week RTT (Referral to Treatment) target that 95 per cent of all patients in England should receive their first definitive treatment within 18 weeks of being referred by their GP. This treatment could be delivered by any professional on the patient’s journey through NHS consultant led services. “Stopping the clock” for orthotic services is achieved at the first fitting of the orthosis or by a decision “not to treat”.
Simon Dickinson
In my previous role I was more than aware of this target but I was incredibly saddened to discover that there is no national service specification for orthotic services in England. Further investigation led me to
Fortunately patient groups like the Orthotics Campaign are now engaging with the NHS and commissioners to inform them of what patients want. Neil Churchill, director of patient experience for the NHS, has grasped the nettle and his listening event in Salford on March 2 will hopefully become the start of a brighter and more consistent future for orthotics services, its customers and its consumers.
Nigel chosen to be doctor for England rugby union team A SPORTS medicine consultant has been chosen to be the official doctor for the England Rugby Union Team. Nigel Jones, who works at Spire Liverpool Hospital, will be working with the English senior team, as official sports medicine consultant and doctor as they take part in this year’s Autumn Internationals and next year’s Six Nations and World Cup. Nigel said: “It's an immense honour. I have acted as official doctor for the
4
under 19s and under 21s before but this is a different level of workload and intensity. I intend to enjoy every moment.” Nigel's role will involve handling all medical issues for the team but in particular issues related to sports injury, diagnosing problems, and developing rehabilitation plans and treatments. He has extensive experience in this area from his work at Spire Hospital Liverpool and also from previous
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
posts with Liverpool Football Club and British Gymnastics. Dr Jones will balance his commitments with England Rugby with his patient work at Spire Hospital Liverpool. Alison Peake, Hospital Director at Spire Liverpool Hospital said: "It's great news for Nigel and really shows Spire's leadership in sports medicine with our consultants being appointed to some of the top medical roles in UK sport."
Nigel Jones
05
29/1/15
10:06
Page 1
29/1/15
INDUSTRY NEWS
06
11:44
Page 1
Using physios could reduce A&E waiting times, says Society Firm gives tech-savvy provider a bionic boost at HQ opening A TECH-savvy care and housing provider enjoyed a bionic boost at the launch of its new headquarters.
status quo every bit as creatively as our founder, Dr Margaret Blackwood, did in the 1960s and 70s.”
Staff at Blackwood took part in a ribbon cutting ceremony with a difference, thanks to experts from Touch Bionics.
Dr Blackwood was a renowned disability rights campaigner and founded the organisation which still bears her name in 1972.
Representatives from the hi-tech Scottish prosthetic limb pioneers joined Margaret Burgess, Minister for Housing and Welfare, to officially open the new Blackwood HQ in Edinburgh.
Touch Bionics demonstrated some of their latest designs and innovations, showing how prosthetic technology can enhance the lives of those with impairments.
Colleen Robertson, Communications and Marketing Manager for Blackwood, said: “Having both Margaret Burgess and the team from Touch Bionics at our official launch was a fitting testament that we are still innovating and challenging the
Sally Bowie, International Marketing Manager at Touch Bionics, said: “We were thrilled to help Blackwood celebrate the launch of their new headquarters as we are very likeminded companies who believe in the advantages of technology for this sector.”
PHYSIOS say they could ease pressure on accident an emergency departments if more was done to help patients with musculoskeletal conditions. The Chartered Society of Physiotherapists said that up to a fifth of A&E patients have conditions, which can be treated by physios. Chief Executive Karen Middleton said: “Today’s new statistics highlight the urgent need to look harder at how NHS A&E departments are staffed and to properly utilise the skills of health professionals trained in reducing the number of patients going to casualty in the first place. “Proper consideration must be given to straightforward solutions that could make a real difference to waiting times and the quality of service patients receive, including making physiotherapists available in every A&E department. “Physiotherapists are experts in diagnosing and treating MSK problems and other long-term conditions. They are also highly skilled in managing patients who
Karen Middleton
have fallen and can support them to self-manage and return home safely, often without needing to be admitted to hospital. “Too few A&E departments routinely make physios available on the front line. Those which do are seeing improvements in waiting times and helping vulnerable older people to feel more secure about their health when they leave. “An established workforce of physiotherapists is already available to the health service and must be given greater opportunity to assist the work done by medics to help ease the pressure on the system as a whole.”
Bionic leg gets Laurence back on the water AN 18-year-old from Plymouth who lost his leg in a sailing accident has had his ability to get back on the water restored with the help of the world’s most advanced bionic leg developed by mobility experts Ottobock. The Genium X3, originally designed for military personnel, is the only completely waterproof microprocessor prosthetic knee and has a Bluetooth remote control to switch between sailing, walking, jogging and cycling modes. Laurence Greenough was just 10 years old when he lost his leg in a tragic accident in the sea. Sailing in Plymouth harbour, a routine capsize drill and subsequent incident with a safety boat went terribly wrong. The injuries Laurence sustained resulted in an above the knee amputation of his left leg. Only two months after the accident, Laurence was back on the water, choosing to use crutches to get around as there were no suitable waterproof prosthetic legs on the market; using a normal prosthesis in the sea would cause it to corrode. Carrying on with his sailing dream, he was honoured with the prestigious Raymarine Young Sailor of the Year award in 2007, following in the footsteps of past winners including Olympic Gold medallist Ben Ainslie OBE and world class yachtswoman Dame Ellen MacArthur. As time went on, Laurence stopped sailing as the difficulties of sailing and doing other activities without a prosthetic leg became apparent. After three years on crutches he was referred to and fitted by Richard Nieveen of ProActive Prosthetics with a computer controlled prosthetic ‘C-Leg’ which provided him with improved mobility 6
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
but could not be worn on deck due to the risk of water damage. When Ottobock’s Genium X3 was released Laurence was keen to find out more about the bionic leg which was designed for people who lead an adventurous lifestyle. He was recently fitted at the ProActive Prosthetics clinic in Surrey. Lawrence said: “The first thing I planned to do was to take it sailing! It also has a ‘walk to run’ feature and bespoke running mode; I had not run since 2006 and it was the most exciting thing to be able to do it again. “It makes walking feel so natural – I trust it and don’t have to use so much energy. I feel safe and can just relax and let the leg do all the work.” The Genium X3 is the world’s most technologically advanced prosthetic leg and features activity modes that will allow Laurence to take part in everything his friends do: sailing, grass boarding, running and football in the park. The bionic technology can be programmed from a laptop and can be switched manually between different modes using bluetooth. Sensors, a gyroscope and in-built computer mean the Genium X3 can be programmed to perfectly match Laurence’s lifestyle. Richard Nieveen, Laurence’s prosthetist at ProActive Prosthetics, added: “The set up and fitting of Laurence’s new leg is tailored to get him back doing all of the things he enjoyed before his accident. We’ve also programmed a special sailing mode in the knee to allow him to move around the boat with ease – and of course he’ll be safe in the knowledge that he can get it wet without any problem”
Laurence Greenough with his Genium X3 leg.
07
29/1/15
10:06
Page 1
29/1/15
10:35
Page 1
INDUSTRY NEWS
08
Heather has been working with Abdo Haidar of The London Prosthetic Centre on her prosthetic leg for the past year.
Heather hopes to break Guinness World Record for speed skating By Nicola Hyde BRITISH disabled skier Heather Mills is attempting to break the Guinness World Record for speed skating – wearing a prosthetic leg that has been a year in development. Heather – who lost her leg in a collision with a motorbike in 1993 – only started her professional sporting career in 2011 when she was approached by the head of the Slovenian Masters whilst on a skiing holiday in Austria.
more than 200km/h – a feat that will involve a vertical of drop of between 300 and 340 metres. Heather said: “Skiing is a high-octane sport and I knew the risks when I first set about training. For me though, the most frustrating thing was that my initial prosthesis only offered very limited movement which was neither natural nor comfortable and tended to hinder my performance somewhat.”
She has a host of medals under her belt and now has a permanent position with the British disability skiing team – but she’s now in training to become the fastest disabled female speed skier in the world.
She is using a specialist prosthetic skiing leg designed and built by Abdo Haidar of The London Prosthetic Centre. A painstaking, year-long project which involved over 15 appointments, the prosthesis has been designed to withstand the harshest of racing conditions.
She will need to reach speeds of
Abdo said: “I have been a prosthetist
Key diary dates for 2015 March 19: Kidz in the Middle, Coventry. March 20-22: BAPO, Manchester. April 28-30: Naidex National, Birmingham NEC. May 29-30: IOCP, Southport. June 4: Kidz South, Reading. June 9-10: Foothealth, Kettering. June 22-25: IPSO World Congress, Lyon, France. June 25: Mobility Roadshow, Donington Park, Derbyshire. July 12-16: ISB, SECC, Glasgow. September 17: Kidz Scotland, Edinburgh. November 20:Kidz Up North, EventCity, Manchester. 8
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
for many years and made limbs for cycling, horse riding and Paralympic running challenges, but nothing compares to skiing – it is without doubt the most difficult sport for an amputee. “A below the knee amputation, such as Heather’s, causes reduced knee control due to the loss of the ankle joint, so the limb must compensate for this. In this instance, the key lies in the design and fit of the socket – it’s responsible for reducing movement, which consequently enhances control and precision.” Heather is also confirmed to appear in the next series of Channel 4’s reality TV show, The Jump, where she will train alongside 15 other celebrities to master various winter sports.
OTs and ward play key role OCCUPATIONAL therapists and the use of activity as a treatment mode has played a key role in the opening of a temporary ward designed to speed up patients’ recovery and free up beds at the Royal Free Hospital. The reablement ward will give up to 25 patients at any one time the chance to socialise and start looking after themselves in preparation for discharge to their home or a community-based rehabilitation centre. Since the ward opened in November, OTs have been working alongside nurses and other members of the multidisciplinary team to encourage patients to do more for themselves.
09
29/1/15
10:07
Page 1
10
29/1/15
10:08
Page 1
29/1/15
10:08
Page 1
Dave Buchanan, Ottobock Orthotics Academy Clinician, explains the science behind stance control and how the imminent launch of a new intelligent leg brace is about to change the future of orthotics.
C-Brace: The future of orthotic technology ORTHOTIC bracing is changing. As new technology, extensive research and new light-weight materials emerge we can expand the way we practice.
limbs and contains a computer and sensors so that it moves and adapts intuitively to any circumstances. People living with partial paralysis, spinal injury, post-stroke and postpolio syndrome will be able to walk without having to concentrate on every step.
For people with problems ranging from isolated quadricep weakness, to polio, post-polio, multiple sclerosis, unilateral paralysis, incomplete spinal cord injury and some traumas, walking can be a challenge. Technology is helping us overcome this challenge and a new wave of orthotic bracing is pushing the boundaries of orthotic care. In recent years, Stance Control Orthoses, and now Stance and Swing Control (SSCO®) have changed the way we approach bracing – from static, always-locked or alwaysunlocked approach to new dynamic systems that unlock only when needed. Compared to walking with a locked leg brace, a stance-control orthosis is a brace that helps create a more natural stride. Stance control means that instead of stability coming from a locked knee joint, the brace is able to lock and unlock at just the right time while walking.
So what does this new technology mean for the user? You may have seen or experienced a hip hike or other unnatural motions that come from walking with a locked knee brace. A Stance control brace helps avoid the physical strain and damage these abnormal movements can cause over time. Stance control braces closely mimic natural gait (or walking), and help the wearer cover the variable terrain they face every day, from carpet and grass to uneven, rocky ground. This all means more energy can be spent moving forward with a great deal less wear and tear on the body.
New Technology
This year, the world’s first intelligent, electronic orthosis is being launched, allowing people who were previously wheelchair-bound, to walk again. The C-Brace, the world’s first Stance and Swing Phase Control Orthosis (SSCO), is a custom orthosis controlled by a computer and sensors. The C-Brace® mobility system is made by manufacturer Ottobock and is the culmination of their advanced prosthetic technology and orthotic expertise. The C-Brace mobility system can be considered for all neurological indications of the lower
INDUSTRY NEWS
11
Unlike conventional orthoses, the CBrace (SSCO) reacts intelligently to its environment. The unique combination of sensor technology and an integrated microprocessor make it possible to control hydraulic stance and swing phase in real time. This means the patient is supported in every position throughout their gait pattern. The microprocessor in the brace allows it to be completely customised for the individual and additional settings can be tailored to activities such as bike riding. Custom built, light-weight, strong and stable, the future of orthotics is most certainly in stance control orthotic braces and it will be exciting to see how the technology continues to evolve to benefit those with limited mobility. For more information on Ottobock’s range visit www.ottobock.co.uk
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
11
29/1/15
INDUSTRY NEWS
12
10:09
Page 1
Algeos to partner with Podiatry Hive in the UK A LEADING medical products distributor is to partner with a business mentoring service to help podiatrists in the UK grow their practices.
A company that provides rehabiliitation services to amputees has opened the doors to its third UK clinic. Pace Rehabilitation has a new clinical facility in West Moor (Newcastle Upon Tyne) and resident physiotherapist Tracy Millar was joined by her prosthetist/orthotist colleagues Toby Carlsson and Paul Richardson for the official opening. One patient who is already benefitting from the new facility is local inspirational above the knee amputee Glenn Johnstone, 46, from nearby Stanley. Using his bespoke cycling prosthesis, Glenn (pictured above) demonstrated his riding prowess and shared his personal patient experiences since becoming an amputee, including recently taking part in his first ever triathlon.
Algeos will be working with Podiatry Hive to market its services to podiatrists across the UK. Podiatry Hive is already proving popular with podiatrists in Australia where the organisation is headquartered and where Algeos has an office. The first major Podiatry Hive event in the UK will be held at the ibis London Earls Court hotel in London on March 6-7.
‘Renewed focus’ on health needed
The Business Reset event will show podiatrists how they can:
STATISTICS on work-related injury and illness show the need for a 'renewed focus' on employee health, according to the Chartered Society of Physiotherapy.
Become more profitable without sacrificing work-life balance.
Natalie Beswetherick, director of practice and development at the CSP, said: “The increase in the number of people with a work-related musculoskeletal disorder bucks the long-term trend and demands a renewed focus on employee health.
“Supporting staff health and wellbeing to cut sickness absence is good for individuals, employers and the economy. “We need employers to recognise this and take immediate action to get sedentary staff more active and provide fast access to rehabilitation services for those who need it. “We must do more to stop so many people from suffering what is often entirely avoidable ill-health.”
Automate their marketing. Learn about leadership and delegation. Move from being a podiatrist to a podiatry business owner. Podiatry Hive is led by leading Australian podiatrist Troy Parsons and experienced business mentors Jonathon Heath and Greg Gunther.
Through its workshops and conferences, Podiatry Hive also provides members with access to numerous other business leaders. Hugh Sheridan, CEO of ALG International Holdings, which includes Algeos, said: “ALG is proud of its reputation for not only providing medical professionals with industry-leading products, but also as an innovator and provider of education to improve the lives of millions of patients. “Our partnership with Podiatry Hive fits neatly with our desire to educate by providing podiatrists in the UK with business support to help them develop their practices, enhance the services they offer and become more profitable.” Fast growing ALG now distributes its products to more than 70 countries through its offices in the UK, Australia, United States and United Arab Emirates. Among the leading podiatry brands it distributes are Diaped, Podotech, Nova and Slimflex. To book your place on the Podiatry Hive “Reset Your Business” event go to www.podiatryhive.com/expo
Sam Jones puts the DMO E-Step hybrid neuro-stimulation unit through it paces during a game of squash as part of the clinical trials.
Company works with university on new product A UK company is launching a new product that has been developed in partnership with Southampton University. DM Orthotics have worked with Rod Lane, from the university, for the DMO E-step – a pioneering new product which combines Dynamic Movement Orthoses (DMO) and Functional Electrical Stimulation (FES) technology to aid the management of adult and child Dropfoot.
12
of being able to develop an innovative solution that would address the specific problems experienced by other products on the market.
utilising Bluetooth technology, which monitors the movement of the user’s leg swing, to determine when it should activate itself in order to produce a more natural walking pattern.
“Research suggested that although many stimulators were able to provide an improvement to the gait of people with Dropfoot, they required to set the foot in an unnatural position in order to improve stability in their foot.
The DMO E-step is a hybrid neurostimulation unit, which improves users walking gait, whilst providing greater ankle stability.
“Our orthosis allows a much improved walking pattern which reduces the un-natural loading on the knee.”
Managing director Martin Matthews said: “I have wanted to incorporate FES technology into our products for quite some time – but it was the case
The DMO E-step combines DM Orthotics’ highly successful DMO Dorsiflex Sock, which provides active dorsiflexion to people with low
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
DM Orthotics have also developed a specialist conductive silicone polymer electrode through which the electrical current can pass to the user’s skin.
Sam Jones has already seen the benefits of the E-step.
muscle tone, with a neuromuscular stimulator. The stimulator offers a number of benefits including a wireless footswitch and motion sensor
The DMO E-step has undergone its own clinical and field testing showing positive results. One patient involved in the clinical trials, Sam Jones has already seen the benefits of the E-step. The DMO E-step will showcase at this year’s BAPO Conference held at The Point, Lancashire Cricket Ground on March 20 to 22.
13
29/1/15
10:09
Page 1
29/1/15
INDUSTRY NEWS
14
10:10
Page 1
DeNovo provides many innovative products from around the world These orthoses are also available in mix and match, custom versions and made to cast.
DeNovo Healthcare is a dynamic and progressive patient centred company focused on providing some of the most innovative products from around the world to the UK healthcare market.
Atlantic Rim Spinal Brace Corp. manufacture bespoke high quality spinal orthoses produced and delivered into clinic within a week from measurements, cast or scan offering an unbeatable option for meeting your clinic deadlines.
As distributors for some of the best known and reputable suppliers in the world we have a lot to offer.
Basko Healthcare’s SPL 2 articulating KAFO is a light weight reliable orthoses aimed at users who have quadriceps insufficiency and need to retain articulation while walking.
New for 2015
Our new and highly competitively priced range of DeNovo Daily Orthotic inlays offer unique solutions for your inlay requirements. Initial reaction to these has been excellent. The slimline profile and wide range of options make these a good choice where space is an issue in footwear. A handheld 3D scanning system for under £1,000 was a dream up until the introduction of our new scanning solution. Using our easy digital system, which is designed to offer a fast and reliable way of collecting data for the manufacture of all types of orthotic devices and footwear, give the practitioners the ability to capture accurate and detailed images which
can be used to collect accurate measurements, create foam models and store digital data which can be used to monitor clinical changes easily. Arriving soon is a new solution for managing ankles and feet. This new development will bring an exciting option to the clinic and more will be revealed soon so keep an eye on our website! Our successful Nimco Made4You footwear with children and adult ranges has now been enhanced with many exciting additions including
children’s shoes with a new light weight flexible sole option from size 16 and new stylish adult footwear options. We are also introducing additional lasts which make this collection the most comprehensive to date. The Centri Dynamic Walk orthoses is manufactured with ultra-light weight thermo formable carbon fibre to give the clinician the option to make adjustments for better fit and relief of pressure that has not been an option with other carbon fibre materials.
This unique system can be used in various design configurations depending on the users’ needs, single or double sided with or without ankle joints making this the most versatile option in the market. A wide range of prosthetic and orthotic products manufactured and supplied by the Fillauer group including the RGO and TRS terminal devices. thousands of products to choose from to meet any prosthetic and orthotic need. A full list of products available can be viewed at www.denovohealthcare.com
Amputee’s Marathon world record goal AN ISRAELI runner has used a UK company to create him a running blade to help him smash the leg amputee Marathon world record. Below-the-knee amputee distance runner Eitan Hermon was first referred to Pace Rehabilitation in 2013 by the Tikbot charity who funded his first dedicated running prosthesis. He has already achieved a personal best time of just over three hours, for the gruelling 26-mile race but – after hearing of a new world record of 2:57:06 set by fellow amputee Kim De Roy – Eitan decided to try to claim the world record for himself. Accompanied by Tikvot chairman and founder Rocky Muravitz, within hours of landing in the UK Eitan was cast for a new prosthesis by prosthetist Jamie Gillespie.
14
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
Eitan Hermon
Buckinghamshire countryside.
Jamie said: “Eitan has already achieved a very impressive Marathon time, but like any athlete, he wants to improve upon his personal best.”
Having optimised the socket, the Pace technicians produced the definitive prosthesis, enabling Eitan to take it back to Israel to train on just ten days after his arrival.
A series of diagnostic sockets were produced, incorporating an Ossur Cheetah blade, to fine tune the fit and comfort, with Eitan embarking on test runs around the
Eitan plans to return to Europe this year to compete in the Berlin and London Marathons, where he hopes to achieve the fastest ever time by a below-the-knee amputee.
15
29/1/15
10:10
Page 1
29/1/15
10:11
Page 1
NEWS
16
The AMBER lab in the Mechanical Engineering Department at Texas A&M University has constructed a number of robots, including the AMPRO, DURUS and AMBER series robots.
Texas lab moves forward with bipedal robotics research By Nicola Hyde A MECHANICAL engineering lab in Texas is moving forward with experimental research in bipedal robotics that could change the face of the prosthetics industry. AMBER Lab, established in 2008 in the Mechanical Engineering Department at Texas A&M University and led by Prof. Aaron Ames, is devoted to both theoretical and experimental research in prosthetic design. Prof Ames has been trying to describe the complex challenge of walking into a mathmatical solution that can be written into software that
would be understood by robotic limbs. By developing robots that mimic human movements, Ames and the students who work with him aim to gain a deeper understanding of human walking to develop exoskeleton and smart prosthesis that will assist individuals afflicted with amputations and other human body limitations. The AMBER lab has constructed a number of robots, including the AMPRO, DURUS and AMBER series robots. “We’ve beefed up the AMBER robot series and are focused in trying to get
human-like walking,” Ames said. “A lot of the structural elements are similar from AMBER II, so it too has articulated feet and had chain drive but you can tell the scope is a little bit different. “AMBER II did some great things but the maximum torque was about 10 newton meters and AMBER III will have over 100.” AMBER II was the second robot in the series and the first to use a heeltoe movement in order to walk. This differed from AMBER I, which did not have articulated feet and instead possessed long stubs. That small difference made AMBER II more
human-like, but because of it, AMBER II was unable to conquer obstacles like binders or folders placed in front of its path. Ames has also developed a smart prosthesis known as AMPRO – sensory feedback is taken from an individual’s healthy leg and information is fed to a controller, which then tells the algorithms what to do. Prof Ames said: “I think down the line we shouldn’t need wheelchairs at all,” Ames added. “Instead of getting a wheelchair you would get a frame that you step into and it takes you where you have to go.”
TVS Brace – the ‘knee support you can rely on’ The TVS Knee Brace is designed to hold a medially or laterally unstable knee from moving into a painful position of deformity while the knee is in extension and weight bearing. While the patient is wearing the TVS Brace the knee will be re-aligned to its original gait and long term use will stop the knee from sagging to a more extreme position preventing the need for a surgical solution. The TVS has helping relieve arthritic knee pain to over 25,000 patients in the UK alone for over 40 years. Varus (bow-legged) and Valgus (knock-kneed) deformation support. Helps relieve arthritic knee pain. NHS approved and clinically proven for over 35 years. Easily attached and removed in seconds. Ultra lightweight (200grams/8oz). Greatly increase stability and security for the wearer. Comfortable to wear and unobtrusive (can be worn under clothes). Suitable for both legs. Children’s size available. For more information call 02380 643402,
16
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
email sales@stclare-engineering.co.uk or visit www.tvskneebrace.co.uk
29/1/15
10:11
Page 1
Promedics expands its bracing portfolio PROMEDICS has been appointed as the official UK distributor for Bledsoe bracing products following its recent merger with BREG in the USA.
training cannot completely eliminate the symptoms of ACL deficiency. The dynamic nature of the Bledsoe braces works with the patient to help manage these symptoms.”
Adding the Bledsoe bracing range to the existing range from BREG allows Promedics to offer an unparalleled portfolio of bracing solutions in the UK.
Dynamic Braces use quadriceps power to push the tibia posterior with increasing force as the knee extends to help stop anterior tibial translation before foot strike.
CEO David Baxendale said he was delighted Promedics had secured the distribution rights for the Bledsoe range.
Dynamic braces have several benefits:
He added: “Adding the Bledsoe products to those of BREG will allow us to offer our customers an unparalleled choice that will continue to meet the needs of their patients in all areas of bracing ”
Protect ACL reconstructions.
Understanding the demands on busy clinics and hospital departments is something Promedics takes very seriously, and all bracing products are shipped on a same day basis. Customer service manager Anne Ford said: “My team fully appreciate the demands placed on today’s clinicians, and we ensure we always meet and exceed the expectations of our customers. “We do everything possible to make sure the goods are delivered on time, every time.”
Eliminate ACLD symptoms. Limit further damage. The benefits can be quickly proven by actual brace use on symptomatic knees. Totally Dynamic
OA Bracing
The Bledsoe range brings a novel concept to the field of knee bracing and products such as the Axiom D & Z-12 D ligament support braces apply dynamic forces against tibial translation like no other brace.
In the treatment of osteoarthritis the Bledsoe DUO and Legacy Thruster are welcome additions.
National bracing manager Chris Everett added: “ACL deficient and reconstructed knees share common problems that may not be recognised. “Static bracing, muscle strengthening, and other forms of
The DUO (Dynamic Unloading Osteoarthritis) is the only dualupright DYNAMIC OA brace on the market. In extension, the brace provides a load across the knee to open the joint surface and as the knee goes into flexion, the load turns off. The reduction of pressure when sitting eliminates the skin irritation
associated with a constant pressure exerted by many other braces available. This makes the DUO ideal for patients that wear the brace all day for activities of daily living and is ideal for a patient with an active lifestyle who may need additional support from a dual upright brace due to ligamentous instability. The Legacy Thruster hinge is on the affected side of the knee creating relief by pulling on the strap system to open the joint space vs. pushing against the opposite side of the knee.
INDUSTRY NEWS
17
Chris added: “These are only a few of the extensive range of products available from Bledsoe and they will complement the already successful and market leading BREG products already available from Promedics. “To support our customers we will continue our commitment to bracing awareness and education by extending our already successful accredited regional study days throughout the UK.” For information on the Bledsoe and BREG range of products, or to arrange a product demonstration, contact Promedics customer services on 01475 746400, national bracing manager Chris Everett on 07768 833416, visit www.promedics.co.uk or email enquiries@promedics.co.uk
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
17
3/2/15
10:37
Page 1
Innovative product eases Anna’s mobility problems
INDUSTRY NEWS
18
AN INNOVATIVE piece of equipment is helping a woman with drop foot caused by Multiple Sclerosis ease her mobility problems. Anna O’Conner, 56, was diagnosed with MS in 2000 – it has caused drop foot in her right foot, meaning she scuffs the ground when she walks.
Candice Carter has put an initially heart-breaking experience to practical use.
Ex-gymnast turned physio gets patients on their feet A GYMNAST whose career was cut short by injury is helping patients back on their feet as a physiotherapist at Hillingdon Hospital. Candice Carter, 30, took gymnastics up as a five-year-old and competed for Great Britain before having to retire from the sport at 16. The physical demands of training more than 20 hours a week took its toll but Candice later put an initially heart-breaking experience to practical use. Candice said: “It was tough at the time because gymnastics was my life but I went on to gain a sports science degree and then chose to focus on physiotherapy. “It’s a hands on profession but you
can see the positive results of what you are doing which is rewarding and enjoy the interaction with patients. “It does involve some detective work getting to the root of the problem but that’s what makes it interesting and patients are often surprised about how the body compensates for an injury by making another part work harder.” Candice sees around 20 patients a day in the hospital’s rehabilitation gym for everything from whiplash and fractures to back pain and foot injuries. She is part of an 18-strong outpatient team whose wider department includes inpatient physiotherapy, occupational therapy and outpatient physiotherapy.
She has become the first person in Ireland to be fitted with MyGait, an advanced Functional Electrical Stimulation (FES) device by mobility experts Ottobock, which has allowed her to regain some of her activity levels and restored her confidence. Anna is a decorative painter, creating murals that required her to use ladders and scaffolding. She said: “I love spending time outdoors, going for walks and being in the garden, and had recently learnt to ski when I got the news. “I became very conscious of my physical self and gradually my footdrop became more and more significant. It made everyday tasks more difficult and I felt I did not want to go out as much. I began to use hill-walking sticks to help my balance.” Anna found out about Functional Electrical Stimulation from the MS Society of Ireland, and was intrigued as to how it could help her. She visited Cappagh National Orthopaedic Hospital in Dublin where she undertook a FES trial. The pioneering device works by applying small electrical impulses to the nerves in the affected muscles,
Anna O’Connor is using a MyGait Functional Electrical Stimulation device to help her get her life back on track.
with the nerve then stimulating the muscle into movement, lifting the foot from the ground at each step. Lynn Vale, clinical specialist at Ottobock, said: “MS disrupts the neural communication to the muscles, causing weakness. Walking also uses more energy and people may alter their gait to compensate, commonly lifting their leg higher and swinging it to the side.”
Piedro LTD acquires Gilbert and Mellish Ltd PIEDRO Ltd has acquired Gilbert & Mellish Ltd. The merger has resulted in the companies being renamed to form Piedro & Gilbert & Mellish Ltd, who are now the only suppliers for all Piedro adult and children’s orthopaedic footwear in the UK and Ireland. Piedro & G&M Ltd is a subsidiary company of Piedro Verkooporganisatie B.V. (based in The Netherlands). Piedro Verkooporginsatie B.V. are the designers and manufacturers of Piedro high quality fashion and orthopaedic footwear for both adults and children, and have been operational since 1957. Piedro is a well-known brand both here in the UK and internationally for its design of high quality and high performance orthopaedic footwear. Design, style and functionality has always been at the forefront of Piedro’s drive to provide products that help people increase their quality of 18
life daily, and will remain to be at the forefront and driving force behind them moving forwards.
already received by our customers, with faster order processing and delivery times.
Until December 2014 Gilbert & Mellish Ltd were the sole UK distributor for Piedro footwear, and for over 50 years they worked together developing a close and strong working relationship.
This really is an exciting time for both companies and for the UK market, with customers already seeing the improvements and benefits from the merger.
Moving forwards Piedro & G&M Ltd will continue to build on their strong partnership, with the company retaining the sole distributorship for the UK and Ireland of Piedro adult and children’s orthopaedic footwear collections. Ideally located in Castle Donington, Piedro & G&M Ltd will continue to provide a first-class customer service, processing all orders and dealing with any enquiries and accounting practices at theUK office. All orders will be processed here and shipped directly from our head office and extensive warehouse in The Netherlands. This new, streamlined organisation will significantly improve the high level of customer service
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
new and innovative products for our market.
Emil Van Swaal is the owner and director of Piedro Verkooporganisatie B.V and was heavily involved in the smooth establishment and merger of both companies.
Work has already started on new orthopaedic footwear collections for 2015, and we are also looking to extend our orthotic soft goods/bracing range. 2015 brings us a wealth of new opportunities and ways to enhance and build upon the good relationships we have with our customers and we look forward to continuing to provide you with a excellent, high quality product range and service.
John Meadows (previously Managing Director for G&M Ltd) has joined Emil in this new venture and is the managing director for Piedro & G&M Ltd.
2015 is a year of change for Piedro & G&M Ltd with many challenges and exciting things to come, we already have a few new products lined up ready to launch.
The pair have extensive experience in the orthopaedic footwear and medical bracing market, both here in the UK and internationally.
Some of which will be unveiled at this year’s BAPO exhibition in March. We look forward to seeing a lot of our customers at the show and making some new ones.
They look forward to building a stronger, more efficient and streamlined organisation, with continual development and service improvements along with developing
For any further information on the changes at Piedro & Gilbert & Mellish Ltd call our new office number on 0845 617 1976 for further information.
19
29/1/15
10:12
Page 1
20
29/1/15
10:12
Page 1
INDUSTRY NEWS
Lisa dances again after seven years of pain AN amputee who lost her leg in a car accident says years of poorly fitting prosthetics made her depressed and in pain. Lisa Eagleton, 40, from Wigan, had a below-the-knee leg amputation in 2007 and for seven years struggled with the physical and emotional challenges in accepting her new life. She said: “Even months after my amputation I was in pain every day, living on morphine. The socket on my prosthetic leg rubbed, causing blisters that resulted in me being barely able to walk. I had lost my life as it was. “I thought I had to accept my limitations. I was told that I would never be as I was before my accident. Everyone was telling me what I couldn't do, what I no longer was. I was depressed and in pain.” Lisa was eventually referred to an independent rehabilitation provider to try and address her prosthetic limb issues. Howard Woolley at Pace Rehabilitation in Cheadle (Cheshire) picked up the case. He said: “The discomfort Lisa was experiencing with her existing prosthesis and lack of mobility was understandably negatively impacting on many other aspects of her life.” She underwent several months of
bespoke prosthetic and physiotherapy support, and began to make progress. She began to walk again and then decided to focus on body image issues. She was invited to take part in a photo shoot by David Draken becoming an alternative model called Lady Lush Lisa. She’s appeared in magazines and has even been on the Nation Geographic Channel talking about her modelling work and her prosthesis.
She said: “I felt unattractive, had low confidence and was uncertain of what the world thought of a limb less woman. However I felt that it was time to accept that this is me and rebuild myself.” It was at this point she decided to return to dance – a sport she had loved but never thought she could return to. She added: “I missed it so much, but decided a route to return to it was pole dancing, as that is low impact
on my leg and offered me support. “My teachers helped me to learn moves, some of which took a long time to master, but I was determined to dance again. After lots of practice, I eventually managed to compete in some competitions and became Britain’s only below knee amputee pole dancer. “There is always a way to do something that makes you happy. The hardest thing to do is take the first step to try.”
Family-run firm moves to new site in Suffolk 2015 sees exciting changes for V-M Orthotics Ltd, who have recently moved to new premises. A beautiful modern workspace and warehouse has been created within a converted barn with wonderful views of the surrounding countryside. Situated in the heart of beautiful Suffolk, V-M Orthotics Ltd started out as, and remains, a family run business. They have been operating since 1985 and have accrued a wealth of expertise within the Orthotics industry over the years. V-M Orthotics manufacture and supply their own series of Multifit products and source a variety of innovative products to complement their existing catalogues. Their customers are drawn from across the healthcare spectrum, ranging from community and hospital based NHS establishments, trade companies, care homes as well as members of the public. 20
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
The company prides itself on its excellent customer service with welltrained staff, responsive to customer needs. They carry comprehensive stock levels enabling them to offer a prompt and efficient delivery service with competitive prices that are available to all. As well as their own range of orthopaedic goods, V-M is a long established distributor of both the DARCO and HEELIFT range of products and enjoy a very close working relationship with both companies which continues to develop. The company continues to grow from strength to strength, finding new products and ways to enhance their service. They regularly attend national conferences and organise workshops and training events with valued customers. Please just get in touch if you have any questions about where they are exhibiting or if you have a query about possible study/training days.
29/1/15
10:13
Page 1
Researchers awarded funding to develop 3D printed foot orthotics RESEARCHERS in Glasgow have been awarded grant funding to design and manufacture innovative foot orthotics using 3D-printing technologies.
Peacocks have already produced the world’s first 3d printed one piece foot orthoses (podfo) and have spoken about their work at global conferences.
Glasgow Caledonian University (GCU) researchers, in partnership with the University of Newcastle and Newcastle-based Peacocks Medical Group have been granted a £77,000 Small Business Research Initiative (SBRI) Healthcare development contract. The funding was awarded following a call to address challenges in improving diagnosis, selfmanagement and prevention of musculoskeletal disorders. The GCU team, led by Dr Gordon Hendry and Professor Jim Woodburn, will work with Peacocks Medical Group and researchers from Newcastle University on the ‘FootFEMan’ project, which will utilise a computational engineering tool called finite element analysis to improve the functional design of orthotic devices for individual patients. The improved personalised design will then be printed layer by layer using 3D-printing techniques
NEWS
21
A team of five full-time engineers and one technician from Peacocks are working on this latest project which builds on their previous achievements.
Professor Jim Woodburn
Peacocks’ operations director Steve Cook said: “This latest collaboration looks to further optimise the design of orthoses by combining detailed engineering processes with the benefits of 3d printing.”
developed previously in the team’s award-winning EU-funded project, AFOOTPRINT.
Disabling foot and ankle conditions affect approximately 200 million European citizens.
Dr Hendry said: “We are confident that we can successfully 3D print new orthotic insole devices. This project will now enable us to improve each orthotic tailored to the individual patient according to whatever foot problem they have.
Over 300 million Euros per annum is spent treating many of these people with orthoses and splints, often relying on hand-crafted manufacturing techniques which are slow, costly and difficult to reproduce.
“We will test the new products in controlled clinical studies here at GCU to see if we can improve foot function during walking and further lessen disabling foot symptoms.”
With an increasingly ageing population and a growing health burden in long-term conditions, the global market for custom foot orthoses continues to grow.
A new area manager has been appointed for the South and West by Radcliffe Rehab. Matthew Sanders, from Somerset has a background in assessment in all aspects of postural and pressure care with vulnerable patients, recommendations of accurate seating to Occupational Therapists and Physiotherapists, the training of Occupational Therapists, Physiotherapists and Care Teams in postural care and pressure management. Matthew has had strategic involvement in product development and the design process of product portfolios both current and future. Matthew has previously worked for Kirton Group, Ottobock and Ottobock Prosthetics.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
21
22
29/1/15
10:18
Page 1
NEWS
Advertiser’s announcement
Davies Odell exclusively distributes Vibram in the UK DAVIES Odell has been manufacturing and supplying precision footwear components for over 150 years and is proud to be the exclusive distributor of Vibram to the footwear manufacturing industry in the UK. Vibram has been making the most advanced heels, soles and finishing materials for more than 75 years and its instantly recognisable yellow octagon logo has become the sign of gold standard quality and
22
performance in the footwear market. Based in Rushden Northamptonshire, Davies Odell manufactures and stocks a large range of products that are suitable for the orthopaedics footwear industry with a variety of top quality EVA, cork & rubber sheeting available in numerous densities, thicknesses and colours with many materials and products available from stock while others for more specific applications can be made to order onsite.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
Also available exclusively is the classic ITSHIDE range of rubber soles and heels which are known for their hard wearing dependability. ITSHIDE soles and heels are long lasting, proven, trusted and favoured by a large number of prestigious and world class welted shoe manufacturers and are now available with a brand new for 2015 pattern, the BRITGRIP, which incorporates the design of the Union Jack flag into the
pattern on the heel and sole for a truly unique look. Available in a number of different colours the BRITGRIP has proven so popular that a lightweight option made from EVA has been added to the range. To find out more about Davies Odell and its range of products either visit stand 50 at the BAPO Conference or contact sales manager Tim Soloman directly on 07894 423891 tim.soloman@daviesodell.co.uk
29/1/15
10:19
Page 1
Brains of people with one hand adapt well to disability, new research finds By Nicola Hyde A RESEARCH project is breaking new ground on how the brain controls hand and arm movements when a limb is missing in a move that could help amputees with prosthetics. The project sheds new light on what happens to the large parts of the brain that control hand and arm movements when a hand is missing and how the brain adjusts to find new ways to complete everyday tasks like tying shoelaces. The study was led by the University of Oxford in collaboration with Oxford University Hospitals NHS Trust, supported by the Wellcome Trust and the artificial limb provider Opcare. The researchers used functional MRI brain scans to measure the brain’s response in people missing a hand who attend the Oxford Centre for Enablement, a specialist rehabilitation unit at the Nuffield Orthopaedic Centre. Study co-author Dr David Henderson Slater, Consultant in Neurological Disability and Rehabilitation Medicine, based at the Nuffield Orthopaedic Centre, Oxford, said: “We have always known that some
people adapt to the loss of a limb very soon, and start to make changes in the way they use other parts of their body to compensate for not having a hand.
NEWS
23
“This study helps us to understand the neuronal basis for this, and shows us that the brain adapts and learns how to supplement for the hand loss. “It is encouraging to see that there is hope for improvement even after devastating injuries, and to understand better what is going on inside the brain to make these behavioural adaptations. We may be able to incorporate this knowledge into the therapy we offer to new amputees.” Study leader Dr Tamar Makin, of Oxford University's Centre for Functional MRI of the Brain (FMRIB), which is based at the John Radcliffe Hospital, Oxford, added: “This study tells us a lot about the science of how the brain works and how it adapts really flexibly to compensate for a disability. “Whichever body part is being used to compensate for a hand loss takes over the brain territory of the missing
Researchers used functional MRI brain scans to measure the brain’s response in people missing a hand
hand – and this happens in a different way depending on whether the individual is an amputee or has congenital limb loss. "One of the key findings was that the brain doesn't care if you are born with only one hand. The brain is not fussy about whether there is a hand at the end of the arm, a prosthetic or a ‘stump’ – so long as it is used in a similar way." “There has been quite a lot of
investigation into phantom limb pain in people who have had amputations but much less into people born without a hand who face a different set of challenges. “We now understand this a little more and are excited about the implications for rehabilitation and further research, particularly into how it might be possible to take advantage of the brain’s adaptability.”
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
23
29/1/15
INDUSTRY NEWS
24
10:19
Page 1
Growing need for protection as prosthetics make great leaps The former is being trialled at two specialist orthopaedic units and according to one recipient is a lifechanger. Mark O’Leary enthused to The Guardian: "It's like they've given me my leg back. I know that sounds a bit trite. With this thing I just click the stump on in the morning and I can walk as far as I like, do anything I want within reason. There's no limit.”
are great news, the devices don’t come cheap: Gregg’s costs £70,000. In addition, with many amputees funding prosthetics through insurance settlements they frequently opt not for one, but several devices to match their lifestyles.
“It feels fantastic, well balanced and comfortable. I can now walk up and down stairs, backwards and it's waterproof which is really important.”
“The price ceiling for an above-theknee prosthesis a few years ago was around £25,000. The cost now is nearing treble that figure,” added Scott Richardson of leading independent rehabilitation providers, Pace Rehabilitation. “At PACE we also find a typical provision would be three prostheses, one for everyday use, a cosmetically covered device, perhaps for ‘Sunday best’ and a water activity limb.”
Whilst such technological advances
One patient, he reports, has no fewer
Former soldier Gregg Stevenson is equally enthusiastic about his Ottobock Genium X3 knee, which offers pre-programmed modes such as walking, jogging and running.
24
amputees to own a number of prostheses meant they were in danger of being left woefully exposed. Not many people can easily afford to replace a device costing tens of thousands of pounds – and that means they’ll lose their independence.”
AMPUTEES’ lives are being transformed by the latest generation of prosthetics with Itap (intraosseous transcutaneous amputation prosthesis) and multi-mode laptop programmable devices among revolutionary new technologies.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
than 12 devices. The move away from reliance simply on NHS provided (and owned) prosthetics does however raise an important question: what happens if your expensive, life-enhancing prosthetic is lost, damaged or stolen? It was a question disability insurance specialist Fish Insurance addressed last year when it responded to demand by introducing the UK’s first dedicated prosthetic insurance policy. “There was this huge gap in protection because insurers had failed to recognise and respond to the changing needs of amputees,” said Fish’s managing directo, John Garrard. “The rapidly increasing cost of devices and growing trend for
His response was to develop and launch a policy which protects, as standard, devices worth up to £55,000 and offers bespoke cover for prosthetics that breach that figure. Annual premiums kick in at £99 with the policy able to protect multiple prostheses as well as orthotic devices such as braces for the spine, upper and lower limbs, feet, knees and ankles. Scott added: “To be honest, it was incredible that there wasn’t insurance for prosthetic cover available before the Fish policy. We feel a lot more reassured that our clients now have access to a policy to specific cover their considerable investment in their prosthetic devices.” For more details visit www.fishinsurance.co.uk or call 0500 432 141
29/1/15
10:20
Page 1
Jobskin re-launch Orthowrap range JOBSKIN are delighted to announce the re-launch of the Orthowrap range of garments.
NEWS
25
The range includes bracing to support hands, wrists, legs, ankles back and abdomen. We also have a range of garments suitable for support during pregnancy. Garments are available in traditional beige with the addition of most items now being available in black with a range of trims as desired to jazz up these traditional garments for sportswear and other activities. The materials used are of the highest quality breathable fabric for wearer comfort with easy to secure Velcro strapping for patients with poor manual dexterity. Garments are available in a range of sizes and many include removable steels for added comfort and support. Please contact our customer service team should you have any questions or request a new catalogue Tel: 0115 973 4300 or email orders@jobskin.co.uk www.jobskin.co.uk
A rehabilitation company has joined together with a former footballer to raise cash and donate items to Birmingham Children’s Hospital. Radcliffe Rehab have donated equipment and former Wolves defender Jody Craddock handed over a cheque for £20,000 as it is the hospital where his youngest son Toby has been treated for leukaemia for the last two-and-a-half years. Equipment worth over £3,000 was donated by Radcliffe Rehabilitation Solutions (RRS). This includes two paediatric wheelchairs – one a ‘Tilt in Space’ comfort wheelchair accommodating children with special needs and the other an easy clean ‘Sanichair’ for paediatric toileting and bathing. They have also donated some light weight paediatric walking aids.
Sensors measure patients’ physicality A COMPANY has developed a set of wearable fabric sensors that will measure patients’ physicality – including bend, rotation, angle and torque. The BeBop Sensors are developed by musical instrument inventor Keith McMillen and KMI, who claim the BeBop Wearable Smart Fabric Sensor
could become a major benefit in the development of prosthetic limbs. Unlike other wearable sensors on the market today that only measure physiology (EKG, EMG), electrical conductivity or breathing, BeBop measures actual physicality to sense and display 3D maps of data.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
25
29/1/15
INDUSTRY NEWS
26
11:52
Page 1
Amputee Jack fitted with Linx prosthetic limb with motion integrated intelligence A WORLD first. Jack Eyers, role model, walks on the Linx prosthetic leg, the first ever prosthetic limb with integrated computer control of knee and foot, a system in which the parts talk to each other like a human leg. Jack’s story is about someone whose dream is something the fashion authorities often dismiss as irrelevant but which each of us can applaud and delight in seeing in action. Jack is a model. He was born with a disorder called proximal femoral focal deficiency (PFFD) that meant sections of his right leg didn’t form properly and eventually at 16 he needed an amputation to enable him to walk effectively. Prosthetic technology helped him achieve the level of fitness he strives for on a daily basis. A year after his amputation Jack got involved in the Paralympic Association and did some trials and won a scholarship that resulted in his becoming a member of the GB Juniors Basketball Team. The training schedule and seemingly aggressive nature of Wheelchair
26
Basketball required a fitness regime that turned his body from that of a normal fit teenager into that of a honed athlete with a physique that enabled him to spin a wheelchair round the maelstrom of court action with speed, agility and a certain level of fearlessness. Jack grabbed a number of opportunities to work in the film industry with agencies that promote the use of people with disabilities. This led to a number of gory roles as an injured battle casualty in films like Gladiator and in real life on military training exercises. One highlighted role was being part of the trapeze team in the 2012 Paralympic opening ceremonies. This year he is booked to appear on the cat walk in fashion shows in Milan which start in February, success will mean that Jack is breaking new ground in introducing people with disabilities into an area of life that has always had stringent views on perfection. The fashion industry isn’t particularly forgiving of differences to the ‘body beautiful’ as defined within its own ranks so it is quite some achievement.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
The nature of Jack’s limb loss, PFFD, means that his right hip joint hasn’t formed properly and this has an impact on his balance and the way he walks. The prosthetic limb he has been using is designed for athletic activities and allows him to train and train others in his job as a personal trainer but it doesn’t give him the type of subtle control required to show fashion off on the catwalk. The new Linx Limb system monitors his movement and activity constantly and adjusts to every nuance of his gait. When he stands still it locks so that he can relax and conserve energy, even when the knee is bent at a relaxed angle. The Linx is different to all previous systems because it has a new software called MiÇ (Motion integrated intelligence) which monitors software from the sensors throughout the system, this means that the foot and knee are effectively sharing information about the environment Jack is walking in and together they make subtle control adjustments so that he can confidently move around knowing
Jack Eyers walks on his Linx prosthetic limb.
that the limb will be at the right speed and support level at all times. Previous systems shared the power supply between the knee and foot but didn’t actually talk to each other. The Linx, therefore, is a whole new level in lower limb prosthetic technology.
29/1/15
10:21
Page 1
Delcam to showcase updated version of its OrthoMODEL software at BAPO DELCAM will demonstrate the 2015 version of its OrthoMODEL software for the design of custom orthotic insoles at the BAPO conference to be held at the Point, Manchester, from March 20-22. The new release includes the ability to design three-quarterlength rigid orthotics and an extended range of corrections for rigid orthotics, plus other enhancements. Those not attending the conference can see further details at lz.orthotics-cadcam.com OrthoMODEL offers ‘real-time design’ of both accommodative orthotics, ideal for patients with diabetes and for those requiring comfort insoles, and corrective orthotics, to address problems with the patient’s foot orientation and gait cycle. The software has a direct interface to Delcam’s iQube range of scanners, all of which are able to scan the patient’s foot, foam boxes or casts.
As an open system, OrthoMODEL can also import scan data from most other systems as well as create NC code for orthotics generated in other CAD systems. The main addition to the 2015 release is the new option to create three-quarter-length rigid orthotics.
INDUSTRY NEWS
27
The new style can be selected from the existing menu of orthotic types, with the same options to specify the size and width required for the patient. The range of corrections that can be made to rigid devices has been extended in OrthoMODEL. Options available to be added now include extrinsic and intrinsic forefoot and rearfoot posts, as well as heel lifts and raises. In addition, all rigid orthotics can now be designed with constant thickness across their width, even in areas with steep walls, thereby maintaining rigidity. Other enhancements in
OrthoMODEL 2015 include support for orthotics with flat heels, dynamic reporting of the pad height as a pad is adjusted, and an easier method to set up a new library of orthotics with improved error reporting if details are entered incorrectly. As with all of Delcam’s products for the orthotics industry, the new software has been developed in association with Delcam customers
from laboratories, podiatrists and orthotists around the world, coupled with Delcam’s knowledge of footwear design and manufacture gained from its relationships with leading brands. For further information on Delcam’s solutions for orthotics design and manufacture, please contact Peter Dickin, Marketing Manager, on 0121 683 1081 or email marketing@delcam.com
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
27
28
3/2/15
10:38
Page 1
OTs warned to expect extra responsibilities NEWS
OCCUPATIONAL therapists have been told to expect extra responsibilities when changes to Blue Badge assessments come into force. Assessments will move from GPs to ‘independent mobility assessors’ following government reforms of the Blue Badge scheme. The College of Occupational Therapists say the change represents an ideal opportunity for OTs to take on additional responsibility particularly those working in local authorities as budgets begin to transfer from the NHS to social care. The scheme which allows people with long term mobility problems to park for free or on yellow lines is undergoing a staged programme of reform.
Rebecca Hopkins
rely on it most. Peggy Frost, head of professional practice at the College of Occupational Therapists, said: “OTs are the best and most appropriate choice to assess eligibility for Blue Badges and it’s important we seize this opportunity. “Occupational Therapists are experts at assessing the impact of disability and illness on all areas of a person’s life – mental, physical and social – and the skills to understand the complex needs of those with disabilities as a result of a long term condition, illness or accident.” The College of Occupational Therapists has been closely involved in Blue Badge Reform Consultation since it was launched in February 2010.
Active Hand gripping aid helps Rebecca to return to the water Foot drop stimulator beneficial for stroke rehabilitation, claim Changes seek to provide a consistent and uniform approach to administration and delivery of the scheme, preventing abuse and greater sustainability for those who
By Nicola Hyde
A WOMAN who was partially paralysed after suffering a brain tumour has been able to return to the sport she loves – waterskiing.
Rebecca Hopkins has always loved sports and outdoor activities – she was a keen soccer player, ran her first road race aged 12 and came first in her age group just three weeks after brain surgery to remove a tumour. But her greatest love is water skiing a sport she had to give up when her brain tumour returned.
In 2012, she began experiencing severe headaches – she had brain surgery and radiation therapy. These left her partially blind in her right eye and partially paralysed in her right leg and arm. But – although Rebecca joined the YMCA “Live Strong” programme that helps to rehabilitate people
recovering from cancer - she did not have enough gripping strength to hold her hand onto the different exercise equipment.
Now, after finding Active Hands, Rebecca water-skis with a specially adapted system. She is attached to the training pole by her Active Hand gripping aid, a mountain climbing harness attached via a heavy duty karabiner and a cord: providing her with a three-point connection. This protects her from an uncontrolled fall yet still gives her the responsibility for controlling the ski. Mark, Rebecca’s father, said: “I can't tell you how much Rebecca looks forward to skiing, it makes her feel normal and the joy it brings her is priceless, without the Active Hand she would just be another kid sitting on the side-lines with only memories about what life was like before cancer.”
College launches apprenticeship NEW College Durham is one of the first colleges in the UK to launch a brand new podiatry apprenticeship. The Advanced Apprenticeship in Clinical Health Care Support has been specifically tailored to the role of a Podiatry Assistant and started in January. Apprentices will spend half a day studying at New College Durham and will spend the rest of the week based with an employer. Claire Kelly, curriculum manager at New College Durham, said: “This exciting new apprenticeship, which we think is a first for the UK, will 28
An expert panel of OTs was also formed to discuss issues and concerns around the assessment and take part in the pilot programme.
offer a fantastic opportunity to those employed in a clinical setting, to gain the qualifications and experience to be a qualified Podiatry Assistant. “This programme has been developed in conjunction with NHS managers to meet the demands of the industry.” The apprenticeship is free and will last for approximately 18 months. Apprentices will learn to support a Podiatrist in all aspects of patient care including the preparation of the clinical environment, both in the NHS and private practice.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
RESEARCHERS have discovered that a foot drop stimulator is beneficial when it comes to stroke rehabilitation. The Kessler Foundation say the application of it during task-specific movement for four weeks can retrain neuromuscular system and that its use as a rehabilitation intervention may facilitate recovery. “EMG of the tibialis anterior demonstrates a training effect after utilization of a foot drop stimulator" was published online by NeuroRehabilitation – the authors are Rakesh Pilkar, PhD, Mathew Yarossi, MS, and Karen J. Nolan, PhD, of Human Performance & Engineering Research at Kessler Foundation. Dr Nolan said: “Compensatory strategies have a negative effect on gait pattern.
Dr. Nolan is a research scientist in Human Performance & Engineering Research at Kessler Foundation. She conducts clinical studies of new technologies in the rehabilitation of people disabled by stroke and brain injury.
“While use of an ankle-foot orthosis can improve speed and function, it is not designed to restore muscle function. We looked at whether stimulation of the peroneal nerve during walking would retrain the temporal activation of the tibialis anterior muscle.”
She added: “We found a potential training effect in all participants. These results indicate that use of the stimulator may facilitate recovery of muscle function.”
Four participants more than three months post right-sided stroke completed ten walking trials (five with and five without stimulator) at baseline and after four weeks of using a commercial device.
This study was funded by Kessler Foundation, a major nonprofit organisation that is considered a global leader in rehabilitation research that seeks to improve mobility issues.
Credit: Kessler Foundation
3/2/15
10:38
Page 1
sponsors podiatry
Following the foot care pathway to avoid diabetic amputations By Margaret Stubbs, clinical advisor at Diabetes UK EACH week in England there are around 100 amputations in people with diabetes. People with diabetes are up to 30 times more likely to have an amputation compared to the general population. The fact is that an estimated 80 per cent of amputations are potentially preventable, through improved awareness among people with diabetes about their risk status and access to good quality structured care. The risk of amputation can be reduced through provision of an integrated foot care pathway, with trained staff in community foot protection services and quick access to multidisciplinary specialist teams. The percentage of hospitals with multidisciplinary foot care teams has been increasing – from 61 per cent in 2010 to 72 per cent in 2013. However, more than a quarter of hospitals have no multidisciplinary foot care team. Amputations have been reduced by
over 50 per cent where hospitals have introduced multidisciplinary footcare teams and promoted rapid access to them. In addition, through the reduction of costly amputations, such teams can save over four times their cost.
presentation.
There is currently considerable variation in amputation rates across England. All Clinical Commissioning Groups (CCGs) should be looking at how they can improve foot care for people with diabetes, and those CCGs with a higher than average amputation rate compared to the England average should take urgent action to reduce it. Footcare for people with diabetes should not be a postcode lottery.
It is also important to ensure that those at high risk of foot problems can be identified through good quality annual foot checks and regular review by a specialist podiatrist or a member of the Foot Protection Team. In addition, people with diabetes who are at high risk of foot problems, and their carers, need to know what to look out for and where to go in the event of a problem.
All people with diabetes need to receive a high-quality foot check each year. They should be told their risk of foot problems and be offered advice on how to care for their feet. In addition, poor-performing CCGs need to take action to increase the availability and uptake of foot checks – particularly in people with Type 1 diabetes, younger people, and any
The integrated footcare pathway highlights the importance of rapid referral to, and management by, a member of the MDT if someone has active ulceration or infection in their foot.
Margaret Stubbs
hard-to-reach groups. CCGs also need to ensure an integrated foot care pathway is being delivered across primary, community, and specialist care services. This includes having a multidisciplinary foot care team (MFT) and a foot protection service in every area. The MDT also plays a crucial role in being able to assess outpatients with active foot disease within one working day of
PODIATRY
29
In order to reduce the number of amputations, everyone with diabetes should have an annual foot check, understand their risk score and know how to look after their own feet. People in all areas should have quick access to Foot Protection or Multidisciplinary Foot Care Teams, which have been shown to significantly reduce levels of risk.
Podiatry services can prevent diabetes related limb amputations A STUDY has revealed that around 125 lower limb amputations are carried out every week in England alone on people with diabetes due to complications caused by their condition. Amputations currently cost the NHS between £600-700million every year – but 80 per cent of these amputations are avoidable through improved integrated foot care pathways. The report by the National
Confidential Enquiry into Patient Outcome and Death (NCEPOD) has shown that fewer than half of patients that needed lower limb amputation received good care. More than half of the patients included in the study had diabetes but the report highlighted that there had been little involvement in their care by diabetes specialists and care was often poorly co-ordinated with a lack of multidisciplinary team working.
In a statement on its website, Lawrence Ambrose, lead policy officer for The College of Podiatry, said: “Podiatrists have a vital role to play in the prevention and treatment of lower limb amputation associated with diabetes. Ensuring rapid access from podiatrists to vascular teams for all people recognised to be at risk of or in need of amputation, needs to be made key in all amputation care pathways.
diabetes patients are not being provided access to podiatrists and while cases of diabetes are increasing by approximately five per cent per annum, podiatry staff are planned to reduce by one per cent. This report demonstrates that the care pathway is not being rolled out effectively and we’d like to work more closely with the government and NHS to ensure this happens and that adequate podiatry services are in place.”
“However more funding and better pathways need to be in place. Many
The report can be read on the NCEPOD website.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
29
29/1/15
12:02
Page 1
medi UK celebrates launching 20 products in last two years
INDUSTRY NEWS
30
A UK company is celebrating after launching over 20 new orthopaedic products in the last two years.
Beagle unveils Urban Collection of orthoses WITH so many shapes, sizes of feet together with numerous muscles, bones, joints and ligaments affecting the way we move, can a standard off-the-shelf or modular device really be the optimum treatment plan for your patient and may even lead to false economy.
A custom-made foot orthoses from Beagle Orthopaedic is fabricated by skilled technicians completely by hand to individual prescriptions, casts and foot impressions. Correctly prescribed these handmade devices can give optimum correction
and/or pressure relief for effective outcomes.
To keep ordering simple we have designed a small range of products which can be tailored to suit a variety of indications. Named after Lancashire towns; Lytham, Blackburn, Bolton, Accrington, Lancaster and Whalley any one of the “Urban Collection” will provide a unique threedimensional orthoses to suit your patient pathologies. For further information please contact 01254 268788
medi UK said the products include a selection of specific knee, lumbar and children’s fracture products developed through close partnership working with clients. A spokesman said: “Products such as M4s Comfort and Genumedi PT have been well accepted by clinicians and patients alike, while KIDZ epico ROM for the elbow, clavicle support and medi ROM for the knee have helped children through their recovery and rehabilitation. “Innovative designs as seen in our medi Humeral Fracture Brace, Protect ROM telescopic have helped patients recover through fracture or post-op conditions while Manumed active and Lumbamed Thermopad have
provided support and relief for patients with chronic conditions.” The company now aims to add a further ten product launches this year and add to the lumbar and knee portfolio and Genumedi family of products.
Össur to exhibit new and interesting products and have clinical specialists on hand at BAPO ÖSSUR are pleased to be supporting BAPO again in 2015, returning to The Point, Lancashire County Cricket Club on March 20-22. As last year, Össur will be exhibiting some new and interesting products as well as having clinical specialists on hand to take questions and join in discussions about amputee rehabilitation and orthotic practice. Innovation has always been a key part of the Össur Values. Not afraid to bring new concepts to the sector, there have been many new products that are now embedded in modern clinical practice. The original Iceross (Icelandic Roll On Silicone Socket) liner, developed by Össur Kristinsson himself back in the early 1990’s, has changed the landscape of prosthetic socket fitting globally, bringing new levels of comfort and function to users as well as ease of fitting for clinicians. Since then, many new iterations of the iconic silicone interface have led the way for solutions offering greater comfort and personalisation. The new Iceross Seal-In X TF offers
30
the benefits of previous transfemoral suspension methods, but now allows the user to adjust where he or she places the Seal-In® membrane. This not only adds greater comfort opportunities, but also helps users manage small daily and longer term volume fluctuations, minimising the risk of losing socket suspension during normal use. The new liner is also significantly longer. A recent addition to the socket solutions portfolio is Össur’s new Unity® Vacuum Suspension System. A small pump, hidden within the architecture of the Flex-Foot range, uses normal deflection of the foot module to draw a class leading vacuum from within the socket via a new tri-functional valve. Used in conjunction with either the transfemoral or transtibial Seal-In® liner range, the system offers enhanced socket fitting along with the convenience of sleeveless and self-suspending socket solutions. Adding vacuum to the socket system can help manage residual
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2015
limb volume fluctuations, and by doing so ensuring an already excellent socket fit remains so for longer periods. Össur have also worked closely with innovators in other fields of expertise, culminating in projects like RHEO KNEE® for example. Now in its 3rd generation, this Microprocessor Knee is rapidly being acknowledged as a genuine alternative among experienced clinicians and amputees alike. With its unique feel, ease of use for patients and simple set-up for the clinician, the RHEO KNEE 3® is suitable for new and experienced users alike. RHEO KNEE 3® is now stable enough for less experienced and lower activity users, and yet allows more dynamic and active amputees to walk their own way! At BAPO this March, Össur will be demonstrating these and other new products, including the new Unloader Fit and Rebound PCL, making a meaningful contribution to what everyone hopes will be a great conference.
31
29/1/15
10:22
Page 1
32
29/1/15
10:22
Page 1