INNOVATION FOR INDEPENDENCE
ISSUE 119 FEBRUARY/MARCH 2018 £6.95
Balloon Buddies boosts patients’ rehabilitation PATIENTS at Charing Cross Hospital, part of Imperial College Healthcare NHS Trust, are benefiting from playing a newly developed video game which boosts rehabilitation.
Researchers from Imperial College and clinicians at Charing Cross Hospital have designed a video game called Balloon Buddies, which is a tool that enables those recovering from conditions such as a stroke to engage and play together with healthy volunteers such as therapists and family members as a form of rehabilitation. Balloon Buddies uses animation, sounds, and vibration-feedback, similar to conventional video games. It is played with a wireless handgrip called GripAble, enabling people with arm weakness to control video games on any standard tablet device. Balloon Buddies has been trialled by getting patients to play it on their own in single user mode and then with healthy volunteers in dual player mode. Researchers found that the performance of the patient was boosted when they competed against a healthy volunteer, compared to if they were playing the game on their own. In addition, they found that the poorer a patient’s single player performance was, the greater the improvement seen when they competed against another during dual-player mode. Dr Paul Bentley, Honorary Consultant Neurologist
at Imperial College Healthcare NHS Trust, said: “It’s great to see our patients benefitting from playing this video game, enabling them to engage and interact with the game and another player to aid their rehabilitation. It also allows caregivers and patient to be involved with a patients care in a less conventional but positive way.” The findings suggest that by increasing engagement with healthy volunteers, compared to playing alone, patients may be more likely to increase the effort they put into training, which could ultimately lead to greater gains in physical performance. Dr Michael Mace, lead author from the Department of Bioengineering at Imperial College London, said: “Video games are a great way of providing repetitive exercise to help patients recover from debilitating illnesses. However, most games are designed for users to play on their own, which can actually discourage and isolate many patients. “We developed the Balloon Buddy game to enable patients to train with their friends, family or caregivers in a collaborative and playful manner. “The technology is still being developed, but we have shown that playing jointly with another individual may lead to increased engagement and better outcomes for patients.”
Teenage racing driver Billy Monger has fulfilled a remarkable promise to return and walk back on to the hospital ward he left in a wheelchair just months ago. The 18-year-old was badly injured in a racing accident and was airlifted to the East Midlands Trauma Centre at Queen’s Medical Centre in Nottingham where despite the best efforts of specialist teams he had to have both his legs amputated. He left the ward in May saying when he returned he’d be out of his wheelchair. He was good to his word when he came back to see staff and present them with a special thank you gift. Full story on page 10.
A week after completing his fellowship in America he joined NLaG.
A NEW consultant has come full circle in his career after taking on the role of an orthopaedic surgeon at Northern Lincolnshire and Goole NHS Foundation Trust.
Specialising in upper limb surgery, he is working at Scunthorpe and Goole hospitals, providing care for patients with shoulder and elbow problems, including sports injuries and trauma to the upper limbs.
Mustafa Javed is no stranger to Scunthorpe hospital having walked the wards when he accepted his first ever surgical junior doctor post here.
Mustafa comes from a long line of doctors.
He said: “It is a very dynamic organisation in many ways, and I have an emotional attachment to the place after my junior doctor days. It is great to have come full circle.” “I thoroughly enjoyed my time at Scunthorpe when I was a junior doctor. I learned from a great team and had no hesitation in taking up my first consultant post here. “I have received a great welcome back from all of the team, and I really look forward to working with them to develop services for the future.” Mustafa completed his Certificates of Completion of Training from the Yorkshire Deanery. He has since been all over the
He added: “I guess it was just natural that I would follow in their footsteps. However, none of them have specialised in orthopaedics.
Mustafa Javed
world with a Trauma Fellowship in Hungary and back to the UK for Upper Limb Fellowships in Cardiff and Chesterfield. He has also completed his fellowships at the Mayo Clinic, Rochester; Johns Hopkins, Baltimore and The San Antonio Orthopaedic Group, San Antonio, USA.
“Shoulder and elbow surgery has caught up with the rest of orthopaedics at an amazing pace in terms of innovation and up-to-date technology. “Keyhole surgery for shoulder and elbow is now being used more and more and I do a lot of it. “I also do joint replacements of the shoulder and elbow for arthritis and trauma which improves the patients’ quality of life and their functional outcome.”
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New consultant Mustafa’s career comes full circle
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Graduate awarded prestigious travel fellowship by Trust NEWS
TEESSIDE University physiotherapy graduate Dr Victoria Butler was among a handful of health professionals to be awarded a travelling fellowship by the Winston Churchill Memorial Trust.
Pictured with the sock collection are community podiatrist Karen Eason, podiatry assistant Amanda Holler, community podiatrists Amanda Scotland and Claire Slee.
Podiatrists donate socks to homeless people in Derby A TEAM of NHS foot care experts working across southern Derbyshire, Amber Valley and Erewash donated over 100 pairs of new socks for people attending the Padley Centre in Derby city centre over Christmas. The idea came from podiatrist Amanda Scotland and podiatry assistant Amanda Holler, who run a regular clinic session every eight weeks at the Padley Centre to offer foot care to homeless people.
Their podiatry colleagues at Derbyshire Community Health Services NHS Foundation Trust quickly adopted the idea as their Christmas charity and bought new socks to add to the bumper selection, with a final tally of 108 pairs donated. Amanda Holler said: “When people are homeless they are on their feet all the time and can be in wet shoes for long periods of time so their feet really suffer.”
As a Fellow, Dr Butler was among those invited to investigate overseas approaches which have had a positive impact on a range of healthcare issues, with the aim of returning with new solutions to benefit their working practice and communities across the UK. Dr Butler travelled to Australia to investigate exercise programmes to prevent falls in stroke patients. She graduated from Teesside University’s MSc Physiotherapy preregistration in 2013 and now works as a physiotherapist on the stroke ward at North Tees and Hartlepool NHS Foundation Trust. Dr Butler said: “I am incredibly proud to be a Churchill Fellow and feel privileged to be able to have travelled and meet incredible individuals dedicated to stroke and falls and bring that knowledge back to the UK.” Since returning from Australia, where she spent six weeks along with three days in New Zealand, Victoria says she has already implemented some of the ideas taken from her travels. “During the trip I travelled to Melbourne, where I visited acute and community hospitals and research institutes to meet individuals working in stroke. I also travelled to Sydney to visit stroke rehabilitation units and meet developers of a state-wide falls programme for the over 65s called Stepping On.
“I then travelled to Queensland to meet clinicians delivering the Otago exercise program in the community and visited the Burnie Brae centre and Healthy Connection, a community gym based exercise service delivered by exercise physiologists for individuals with multiple health issues including stroke.” She was chosen as a Fellow after identifying that some individuals who had experienced a stroke were more at risk of falls. Victoria added: ‘I wanted to investigate how falls services were implemented on a large scale and if there were any programmes or initiatives which could be used for stroke individuals. “I identified that Australia and New Zealand had developed state-wide falls programmes and there was a strong physiotherapy research background in falls and stroke,” she added. “‘The application for the Winston Churchill Trust Fellowship involved outlining why I wanted to investigate falls programmes, followed by a second application outlining where I wanted to travel and a panel interview.” Julia Weston, chief executive of the Winston Churchill Memorial Trust, said: ‘Churchill Fellows travel globally and return with innovative ideas and a commitment to sharing their findings to help others in the UK. “Our hope is that exposure to practical, positive practices overseas will enable the individuals we fund to contribute to the delivery and leadership of an effective healthcare system in the UK.”
Infirmary’s physiotherapy department on the move
THE physiotherapy department at the Cumberland Infirmary in Carlisle is moving to The Sands Centre. The musculoskeletal (MSK) outpatient physiotherapy appointments that would have previously been held at the Cumberland Infirmary will now be held in The Sands Centre in Carlisle.
Patients will receive the same level of service but from the new location which will offer more space and greater convenience. The move is one of the first steps towards ambitious goals of offering more services in the community, those which don’t need to be in an acute hospital environment. The move also means there are 4
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closer links with The Sands Centre in the hope people will continue their own physio and exercise programmes once they have been discharged from the service.
Helen McGahon, head of physiotherapy at North Cumbria University Hospitals NHS Trust, said: “This move is fantastic news for our patients. It means they’ll receive the same excellent treatment they’re used to in a venue where they can access exercise and leisure services to support their recovery. “We also want our patients to undertake exercise and keep up their physio once they have finished their treatment with us and this move will really help to encourage them.”
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“By wearing the brace, the pain on exertion was reduced and the pain-free distance extended.” Watch our 3D video by searching «Action Reliever» on COST The price for the Action Reliever is just £195 plus VAT. BOOK A DEMONSTRATION To book a demonstration of this product or to find out more, please contact Thuasne’s Customer Services team on 01295 257 422 or email orders@thuasne.co.uk and they will arrange for one of the team to visit. 6
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Students testing apps to educate stroke and brain injury patients STROKE and brain injury patients are being guided on the best choice of digital help thanks to students in the School of Health Professions at the University of Plymouth, in collaboration with a national network of healthcare professionals.
the apps’ effectiveness for people at various stages of rehabilitation.” Amanda Denton, lecturer in Neurological Rehabilitation, said: “It’s great that the University is collaborating on this project and we’re pleased to be able to help and guide patients’ choices.
Alongside organisations including Northern Devon Healthcare NHS Trust and Livewell Southwest, students are clinically testing apps to see if they are suitable to be part of the mytherappy website – a database of clinically recommended health apps developed by the stroke and neuro rehab team at NDHT. The mytherappy website is an app review website that helps patients, carers and clinicians find the best apps to help with rehabilitation and recovery following a neurological disorder, such as a stroke or brain injury. Now the collaboration will see undergraduate and postgraduate students test new apps on a monthly basis. They are joining mytherappy’s national network of app testers, which includes clinical specialists in stroke, neurology and head injuries, therapists, nurses, psychologists, patients and carers. Apps that have been tested by the network and meet mytherappy’s robust set of testing criteria are featured on the mytherappy website, which anyone can access. Occupational therapy and physiotherapy students were the first students to be trained in how to test apps, with Ruth Siewruk, advanced practitioner occupational therapist for neuro and stroke, and
Ruth Siewruk, NDHT; Louise Holmes, Kim Algie, MSc Advanced Professional Practice Neurological Rehabilitation; and Sophie Maynard, BSc Occupational Therapy.
Louise Holmes, both from NDHT, attending to deliver the session. Louise, who is also a student on the University’s MSc Advanced Professional Practice Neurological Rehabilitation, said: “There are a host of apps available to help patients through their rehabilitation after they’ve suffered a stroke or other brain injury – and our patients often ask us which ones are the most effective. “So colleagues at the Trust set up mytherappy, where patients can see which apps are recommended by clinicians and other users. This is where the students come in – by using their theoretical and practical skills they can help analyse
“The training session was really helpful for our students and, as well as learning more about the technology available to help patients, they can also understand how the technology can help those delivering rehabilitation. The students are looking forward to testing apps over the course of the year.” The mytherappy website is having a global impact – with more than 20,000 users worldwide. Following a six-month audit of neuro patients at NDHT, 93 per cent of the patients who used apps said they would recommend mytherappy and app usage as part of their treatment. When comparing patients who used apps with those who didn’t, the outcomes of those who used apps were improved by 10 per cent. Ruth Siewruk, occupational therapist at NDHT and founder of mytherappy, said: “I am delighted that students from the University of Plymouth have joined our testing network after training with us. “We want to empower patients to manage their health in the way that is right for them, and the mytherappy website helps those who are recovering from a stroke or brain injury to do exactly that.”
Invictus Games and Paralympic medal winner and Hertfordshire Alumni David Henson MBE, with Paralympian Sophia Warner, senior lecturer and physiotherapist Danielle Ramsey, and University of Hertfordshire students.
Student volunteers grease Winter Wonderwheels ... THIRTY physiotherapy student volunteers from the University of Hertfordshire in Hatfield were key cogs in the first Winter Wonderwheels event, which attracted more than 500 disabled sports enthusiasts and was held on the International Day of Disability.
Created by Paralympian Sophia Warner, Winter Wonderwheels is part of the Superhero Series which has been created specifically to allow anyone with disabilities and an interest in sport the chance to cycle, walk, run, push, or anything in between on 1km, 5km and 10km 8
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challenges.
“There are no cut-off times and all types of gadgets and gismos are welcome, from day chairs, handcycles, walking frames and trikes to tandems, race runners, blades and bikes,” said Sophia. “Key to the success of the event is an army of volunteers to help our everyday athletes with their kit. The physiotherapy student volunteers from the University of Hertfordshire, by far the largest group we had, were invaluable as their specialist training meant they understood how to lift and best help our athletes.”
NEWS
Billy steps up to fulfil a promise TEENAGE racing driver Billy Monger has fulfilled a remarkable promise to return and walk back on to the hospital ward he left in a wheelchair just months ago. The 18-year-old was badly injured in a racing accident and was airlifted to the East Midlands Trauma Centre at Queen’s Medical Centre in Nottingham where despite the best efforts of specialist teams he had to have both his legs amputated. He left the ward in May saying when he returned he’d be out of his wheelchair.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2018
He said: “It’s absolutely fantastic to see Billy back on the ward he’s an amazing young man and he’s done incredibly well. To see him walking on his new prosthetic legs with a smile on his face is brilliant.”
He was good to his word when he came back to see staff and present them with a special thank you gift.
Billy was back in Nottingham as a guest of honour at NUHonours Awards, the Trust’s annual staff awards event. He nominated staff involved in his care and was invited to join the team on the night.
Billy said: “That was the goal when I came back – to be able to walk up along the ward and say hello to everyone on my own two feet which I managed to do which is good.
Billy’s courage and strength following the Formula 4 accident has inspired thousands of people and he continues to keep busy and look toward the future.
“It was awesome to come back on the ward and see the team. It’s been six months which is a long time but when you come back on the ward it kind of feels like it was yesterday that I was in here wheeling around in the wheelchair causing havoc. It’s good to see everyone.”
He said: “I’ve been busy had another couple of hospital checks, doing physio, learning to walk, had an F1 weekend with Lewis Hamilton that was cool, I’ve been busy.
Tony Westbrook, consultant
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orthopaedic surgeon at Nottingham University Hospitals NHS Trust, and Billy’s named consultant during his care, said it was brilliant to see him back and that his visit would lift staff and other patients on the trauma unit.
“I’m hopefully going to be back in a race car competing again soon, learning to walk and racing hopefully just as well.”
NEWS
Photographs by Andrew Cook.
Project goes on display in New York A UNIVERSITY of Dundee project that incorporates everyday materials in the design of prosthetic hands, to better suit disability, has gone on display at a prestigious New York museum. Hands of X, an initiative led by design researchers from Duncan of Jordanstone College of Art & Design (DJCAD) at the University of Dundee and University College London, design made-to-order prosthetics that come in a choice of materials including leather, woods, wools and metals. Their work will be on display in ‘Access+Ability’ at the Cooper Hewitt, Smithsonian Design Museum in New York until September 3. The hands are co-created by wearers and challenge the dominant prosthetic material palettes of ‘realistic’ skin-coloured silicone, cyborg-like carbon-fibre and
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3D-printed plastics, offering a greater sense of ownership for users. The project team, including Graham Pullin and Andrew Cook from DJCAD; Mark Miodownik and Sarah Wilkes at the Institute of Making have developed a Spring Summer collection of designs that include materials ranging from beech and cedar woods to leathers and stainless steels. Graham Pullin, reader in disability and design at DJCAD, said: “We are challenging the polarisation between cosmetic hands that attempt to replicate human skin and sensational cyborg robotic hands. Hands of X is more nuanced, and draws on a deeper culture of materials worn and handled, which feels appropriate given that disability is part of the fabric of our everyday lives. “Our 2018 collection features a
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2018
palette that includes tortoiseshell acetate, the material that spectacle frames are made of, felted wools, leathers and woods. Familiar, everyday materials, which in their own way are both beautiful yet unremarkable. “Hands of X has already been prototyped by wearers. An in-store service for browsing, trying on and selecting materials was staged in Cubitts eyewear shop in London and in a makerspace in Glasgow. Being featured in ‘Access+Ability’ is a fantastic acknowledgement of the work we are doing with those who use prosthetics.” Hands of X now features as one of 70 innovative designs exhibited in Cooper Hewitt’s ‘Access+Ability’. Other objects on display range from adaptive clothing and eating
implements that assist with daily routines to apps and “smart” technologies that aid in social interactions and navigating the environment. Caroline Baumann, director of the museum, added: “The diversity of works on view in ‘Access+Ability’ embrace the latest developments in digital technologies and fabrication methods, along with a user-driven focus on enhancing what people can do when given the opportunity. “In partnership with the New York City Mayor’s Office for People with Disabilities, the exhibition will be accompanied by our first-ever Cooper Hewitt Lab, a two-week-long series of programmes this February in the Barbara and Morton Mandel Design Gallery to further the dialogue about inclusive design.”
Donation will help stroke patients with rehab and recovery NEWS
STROKE patients will be helped in their rehabilitation and recovery thanks to a £30,000 new machine donated by two Lincolnshire charities.
Sara Payne MBE cuts the ribbon to open the I Can Therapy Centre in Andover.
Innovative new therapy centre opens in Andover AN innovative new therapy centre designed to encourage exercise participation in older adults and to support the rehabilitation needs of those living with long term health conditions has opened in Andover. Operated by Valley Leisure, the new ‘I Can Therapy Centre’ boasts 10 specially adapted power assisted exercise machines from UK manufacturer, Shapemaster, as well as a full-time on-site physiotherapist to screen, assess and deliver exercise programmes for users with varying conditions and abilities. Liz Murray, community health development manager, Valley Leisure, said: “We are extremely excited to be opening the new and innovative I Can Therapy Centre in Andover. “Valley Leisure’s sole aim is to enable people to move more and feel better and through the operation of our new Power Assisted Exercise facility, powered by Shapemaster, we are certain that we can make a real difference to help many people live as well as they can for as long as they
can.” The centre was officially opened by stroke survivor and child protection campaigner Sara Payne MBE in attendance of healthcare professionals, local council representatives and specialist interest groups. The specialist equipment adopted by the centre enables users to exercise passively or actively, depending on their abilities. Powered by Shapemaster, the equipment has also been customised for optimum accessibility. Liz added: “We are absolutely staggered by the interest we have received from local healthcare providers and their patients. “The launch event itself attracted many people with varying long term health conditions such as Fibromyalgia, MS and those living with the physical effects of a stroke some of whom have already signed up and are very enthusiastic to move more and feel better.”
Award entries invited ENTRIES are currently being invited for The Cosyfeet Podiatry Award 2018.
The £1,000 award is open to any podiatrist or podiatry student planning to engage in voluntary work, take up a work placement or carry out research, either in the UK or abroad. The winner’s application should demonstrate that their chosen project will develop their professional knowledge and skills while being of benefit to others. Former winners have undertaken a wide range of initiatives including those relating to the treatment of the diabetic foot, the podiatric needs of the homeless and preventative foot care in the elderly. Others have travelled to Africa, Asia, 14
South America or Eastern Europe to help with conditions resulting from diseases such as Diabetes and Leprosy.
Ying Peng, a qualified podiatrist and final year honours student at Queen Margaret University in Edinburgh, won the 2017 Cosyfeet Podiatry Award. She is using the £1,000 award to help fund her ground-breaking podiatry work with dementia patients who display challenging behaviour. To apply for the award complete an online application form by the closing date of April 21. The winner will be requested to submit a report and photographs of their experience, and to be included in Cosyfeet publicity relating to the award.
ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2018
The PENTAX nasendoscopy machine has the ability to look up the nose and down the back of the throat. This helps specialist speech and language therapists to assess, treat and manage swallowing disorders of people resulting from a stroke. It also has the ability to record and play back images to help with swallowing therapy and training purposes. The inspiration for securing a machine for Lincoln County Hospital’s stroke unit was Naomi Wentzell, who suffered a stroke on August 20, 2015. The 46-year-old was at work when she collapsed and was rushed to Lincoln County Hospital. She said: “When I woke up I was told I had suffered a stroke, but I was suffering from locked-in syndrome. I could hear and understand everything, but the only part of the body I could move were my eyes. It was so frightening and also frustrating.” Naomi made a remarkable recovery thanks to the treatment and care at Lincoln County Hospital. She was on
the stroke unit for seven weeks and five days, but the team believe she could have gone home even sooner if a machine similar to the one donated had been available. She added: “I was so stubborn and wasn’t going to be beaten by the stroke. When I left I was able to walk out and I was talking. It just took a while to get my strength back.” Naomi now volunteers on the stroke unit for the Stroke Association, talking to other patients and helping to reassure and advise them. Physiotherapist Alwyn Sproul from United Lincolnshire Hospitals NHS Trust said the new machine is going to help patients in their recovery. She added: “By having this new machine on the stroke unit it will improve outcomes, reduce length of stay and improve quality of life for our patients. It really is going to make a huge difference to patients. “This impacts on more than just swallowing. Patients are able to participate in other rehabilitation, for example with the occupational therapists and physiotherapists more easily if they are not tethered to a feeding tube and a drip.“
Head UpTM Brace – see the World in a new dimension INNOVATION is critical to enabling the NHS to achieve the very tough objectives that have been set, and Beagle are excited to launch our latest product innovation to all those in the relevant field. We have worked closely with the innovations team at Musgrove Park to design and deliver the Head UpTM Brace – a daily living aid to assist those with motor neurone disease or other relatable diseases. Patients suffering with irreversible weakness of the posterior cervical spinal muscles are the ones that are going to benefit most from this product. Most of the current designs available are based on the concept of a collar, but neck weakness is only part of the condition and it is usually accompanied by weakening in the shoulder region and long back muscles. These can cause chafing of the skin under the chin and clavicles, while surgery is associated with a very high complication rate of in excess of 30 per cent. The Head Up BraceTM is a unique, non-surgical method that allows the patient to passively correct their chin
on chest deformity, improve posture and comfortably hold the head in neutral position while preventing skin problems from occurring. Visit www.beagleorthopaedic.com or call 01254 268788.
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Orthotist plays part in creation of industry-first national guidelines AN orthotist who works at The Robert Jones and Agnes Hunt Orthopaedic Hospital is celebrating after reaching the end of a two-year project to help create guidelines that will standardise clinical practice nationally.
out to help orthotists with decision making regarding patients with spinal injuries. “The initial study that we carried out really demonstrated the need for such guidelines as many Orthotists’ practice was based on anecdotal evidence, as opposed to actual hard evidence.”
Emma Bonnick, senior orthotist at RJAH, was one of three orthotists commissioned by the British Association of Prosthetists and Orthotists to run a series of spinal bracing surveys to reveal spinal bracing clinical practice across the UK, with the aim of improving current practices for patients.
As it stands the guidelines are currently going through copyrighting ahead of them being published, which is likely to take place in the near future, according to Emma.
The main findings of the study were that practice was not consistent between orthotists across the country.
Jane Dewsbury, principal orthotist at RJAH, added: “I’m immensely proud of the dedication Emma has shown to helping produce these guidelines.
Following on from this, the aim was to develop national trauma spinal bracing guidelines using evidence-based findings to give recommendations as to the type of spinal brace to use to stabilise each level and type of spinal injury.
“Emma has spent copious amounts of her own time, energy and passion into this. She’s spent many evenings and many days of her annual leave on this, and all of it is to make current practices better for the patient.
Emma has spent the past two years on the project, alongside Helen Walker, lead orthotist at Wirral University Teaching Hospital – formerly an RJAH member of staff – and Jonathan Tebbutt, lead orthotist
Emma Bonnick, senior orthotist, and Jane Dewsbury, principal orthotist, with a spinal brace. Emma was one of three orthotists commissioned by BAPO to run a series of spinal bracing surveys to reveal spinal bracing clinical practice across the UK, with the aim of improving current practices for patients.
at Hywel Dda – the health board for Carmarthenshire, Ceredigion and Pembrokeshire. Emma said: “I feel incredibly proud that we’ve completed these guidelines, it’s been two years of
extremely hard work but I always knew how worthwhile this would be because it would mean there would be a gold-standard of standardised practice and that’s important because there are no guidelines currently set
Workshop held as part of Diabetes UK’s ‘Putting Feet First’ campaign DIABETES UK hosted a foot care workshop in Portsmouth recently as part of its ‘Putting Feet First’ national campaign. Aiming to halve the number of diabetes-related major amputations in the area, Diabetes UK, together with Solent NHS Trust, organised the local education session to advise on how diabetes can cause potential problems for feet. Over 75 people from the area attended the event which focused on prevention and was designed for people with diabetes who currently have healthy feet and are not seeing a podiatrist. During the workshop at the Langstone Hotel, attendees heard from expert podiatrists in the Portsmouth area: Anna Littlejohn, James Tomkins and Victoria Bonham about how diabetes can affect your feet, the importance of good foot wear and how to look after your feet. Yian Jones, a podiatry patient, also gave a personal account of the impact that developing a diabetes-related foot complaint has had on his life. Yian, a former social worker from Havant, was diagnosed with Type 2 diabetes aged 21. 16
“All day, every day our clinics are full with ulcerations. Our aim is to prevent these resulting in amputations that can be life threatening.” He said: “In 2010 I had a gastric bypass to help me with my weight. I lost half my body weight and started exercising soon after my surgery. Once I became more mobile, however was when my foot problems started. I suffered from foot ulcers and then a Charcot appeared. “Treated by the excellent foot care team at Solent NHS Trust, unfortunately, after five years of care, it’s now at a point that they will need to amputate below the knee in the near future because there’s no more they can do. “It’s devastating but I really want people to know the importance of foot care. I hope that by relaying my personal story, people with diabetes in the Portsmouth area will understand how important it is to take care of your feet. Don’t ignore any problems.
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“Please get them checked immediately.” In Portsmouth, according to recent research, there were 131 diabetesrelated amputations between 2013 and 2016, 43 of which were major amputations, resulting in an individual losing a limb. South Eastern Hampshire had 162 diabetesrelated amputations and 43 major amputations in the same period. Anna Littlejohn, an advanced practitioner podiatrist from Portsmouth who spoke at the event, added: “Portsmouth and the surrounding area have very high amputation rates and by putting this workshop on, we really wanted to raise awareness of the risks of diabetes-related amputations. “All day, every day our clinics are full with ulcerations. “Our aim is to prevent these resulting in amputations that can be life threatening. “We work within the diabetes multidisciplinary team at Queen Alexandra hospital and have close links with the vascular team. Prevention is better than cure and this is the main message that we wanted to get across.”
“These guidelines are also brilliant for RJAH because this is where this all started from as Helen Walker used to work here. It’s brilliant to see RJAH leading the way and playing a crucial part in improving practice in orthotics.”
Recovery is a fun game at hospital
JENGA, skittles, dominoes and draughts are the name of the game for a forward-thinking rehabilitation team based at Sevenoaks Hospital. The team, run by Kent Community Health NHS Foundation Trust, has introduced a series of garden games to the therapy room to make recovery fun for their patients. Over-sized traditional games encourage patients to stand, work on their balance and support their posture at the same time as enjoying themselves during their time in hospital. The brainchild of occupational therapist Judith Strudwick, the games were bought thanks to a generous £300 donation from the Sevenoaks League of Friends. Ward Sister Kiran Dhillon said: “We are really grateful to the League of Friends for its donation. The games are fantastic and are really making a difference to the experience our patients have when they are with us. We are here to help them physically recover, but it’s also important to support their mental wellbeing too and the games make sure they are socialising and interacting with one another.”
NEWS ASSISTIVE TECHNOLOGIES I FEBRUARY/MARCH 2018
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NEWS Kevin Shaw fits Procarve at Dorset Orthopaedic’s Ringwood Clinic (left) and Emma and Kathleen prepare to hit the slopes (right).
Dorset Orthopaedic and Ottobock join forces for BBC sports technology special PROSTHETICS experts at Dorset Orthopaedic and Ottobock have been featured in an episode of the BBC’s flagship technology programme, BBC Click.
who has over 30 years’ experience in prosthetics. Emma added: “This is a wonderful opportunity to showcase the kind of product that can help someone achieve their dreams, whether that’s to be a Paralympian or just get out on the slopes for a few hours.
Available on BBC News Channels and on iPlayer, the programme focuses on the technology behind the upcoming Winter Paralympics.
“This is exactly why Ottobock are constantly investing in research and development, to be at the cutting edge of prosthetic technology used for sports and everyday life.”
BBC Click reporter and double belowknee amputee Kathleen Hawkins had the chance to try out the groundbreaking ski and snowboarding prosthesis, the Ottobock ProCarve which helps Paralympic skiers and snowboarders compete at the highest level. The programme follows Kathleen during a fitting with Dorset Orthopaedic Clinic prosthetist Kevin Shaw, who explained the unique advantages of the ProCarve for snowboarders. Kathleen was then joined by Ottobock head of prosthetics Emma Gillespie for the ultimate test: using the ProCarves on the slopes. The ProCarve can fit into a snowboarding boot, and has a pneumatic spring and a large, airfilled cylinder at the ankle joint that act as a shock absorber.
Emma Gillespie and Kathleen Hawkins on the slopes.
In addition to creating specialist winter sports prostheses such as the ProCarve, Ottobock is the official prosthetic, orthotic and wheelchair technical service provider for the PyeongChang 2018 Paralympic Winter Games.
This increases the rider’s comfort and also contributes to a better body position whilst boarding.
about the independence these feet could give to amputees wanting to get on the slopes with confidence.
The air pressure inside the cylinder can be tailored to suit the individual’s riding style and type of terrain.
“It’s the best aspect of technology for me. Now I just need to save my pennies.”
These Paralympic Winter Games will be the biggest to date, with 80 medal events in six sports: Para alpine skiing, Para biathlon, Para crosscountry skiing, Ice sledge hockey, Para snowboard and Wheelchair curling.
Kathleen said: “Getting to try out the ProCarve feet for BBC Click was such a fun and interesting experience.
“I hope that this programme will give people some insight into the work that goes on behind the scenes to help para-athletes at every level to perform at their best, from fitting and alignment to making sure you have a good socket,” said Kevin,
With 670 athletes from 42 nations expected to compete, Ottobock technicians will be busy repairing wheelchairs, sit-skis, and any other equipment athlete or members of the Paralympic family rely on for competition and everyday life.
“I’ve snowboarded (badly) in the past and it was great to feel a different sensation on the snow and think
Appeal for return of loaned equipment launched KNOSWLEY’S Integrated Community Equipment Service is running a campaign to encourage patients to return all NHS loaned equipment that they no longer need, so it can be cleaned, recycled and put to good use again. The service, which is delivered by the North West Boroughs Healthcare NHS Foundation Trust, provides free NHS equipment to support patients across Knowsley and Sefton. ICES is asking that everyone takes 18
the time to check if they have any NHS community equipment they no longer need and to get in touch as soon as possible to arrange a free collection, as part of their equipment amnesty.
could be saved by returning any unused NHS community equipment include:
Every year around 20,000 pieces of equipment are loaned out in Knowsley, but less than half of these are returned.
n Each bath lift returned saves the NHS around £200.
This costs the local NHS over £300,000 a year to replace. Some examples of how much money
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n Each wheeled zimmer frame saves the NHS around £17.
n Each pressure mattress returned saves the NHS between £140 and £550. n Each kitchen trolley returned saves the NHS around £40.
Sara Harrison, head of service for the Centre of Independent Living, said: “We need to make best use of our resources and ask anyone who has any equipment such as walking aids, kitchen or bathroom aids, supportive seating, specialist mattresses or cushions to kindly return them. “Everyone will be aware of the financial pressures currently facing the NHS, and the Community Equipment Amnesty is one way to help save some money locally.”
Wheelchair website for Gloucestershire launched by Service The new website provides an online source of information about how referrals can be made to the service via a GP or healthcare professional, as well as guidance on the wheelchair assessment process, personal wheelchair budget, and support plan. The site is also BrowseAloud enabled, which provides speech and reading support tools, whether you are using a smartphone, computer tablet, PC or Mac. Dan McAleavy, a local wheelchair user who helped co-produce the new website, said: “For people with complex, long term conditions, being able to access the right wheelchair, with appropriate support is of paramount importance. “The new website is easy to navigate and will help educate local people on what services are available, how you choose a suitable wheelchair, as well as giving useful links to local community organisations.” Head of speech and language therapy, Gloucestershire Wheelchair Services, Integrated Community Equipment Services and Telecare Services, Jane Stroud said: “There are currently around 10,000 wheelchair
users in Gloucestershire. Two thirds of them are regular users. “Wheelchairs provide a significant gateway to independence, well-being and quality of life for thousands of adults and children. They play a substantial role in facilitating social inclusion and improving life chances through work, education and activities that many people who do not need wheelchairs take for granted.” GWAS is part of Gloucestershire Care Services NHS Trust and provides wheelchairs and wheelchair accessories to those with medium to high specialist needs and to those who will need the equipment for long term use of more than six months. If you have not visited the service before, an initial referral needs to be made via a healthcare professional. After the initial referral GWAS accepts self-referrals from individuals registered with the service. The team based at the GWAS comprise of specialist clinicians (occupational therapists and physiotherapists) and technical instructors. They are supported by rehabilitation engineers and a rehabilitation technician. The whole team can provide specialist advice about posture and wheeled mobility.
Line-up of speakers confirmed for annual Foothealth Seminar
THE Healthy Footwear Guide is to provide the industry with a footwear and foot health seminar. The event takes place at Kettering Conference Centre on June 20, and tickets are already being sold.
There are usually around 500 GPs/ podiatrists at the Foothealth Seminar and it attracts a large number of companies year on year – in fact many of the stands were sold over a year ago. The shared event will be a half-day of speakers and you can choose morning or afternoon to listen to some amazing speakers. There will be a representative from Diabetes UK who has some staggering up-to-date statistics of how this disease is on the increase and how many more weekly amputations (usually leading to death within two to three years), Other speakers include Stephanie Sweetmore from De Montfort University (3D cad/cam design), Terry Mitchel from the US (Vasyli – now Vionic) .
There will also be lots of stands to discuss footwear, orthotics, etc.
This is a great chance to network with health and footwear professionals, learn more about feet and our industry (including some financial planning advice from associate member Alex Ziff) and get together with one another for a coffee and snack. The SSF has been given a small number of stands at a reduced price, so if you are not an existing exhibitor and would like to display your footwear or accessories (or even if you are a retailer and would like to encourage health professionals to visit you), then please contact Jackie or Karen from Professional Events and say you want one of the SSF special price stands. For a ticket book online at www. professionalevents.co.uk or email info@professionalevents.co.uk for more information. Don’t put it off, book now, there are only a limited number of tickets available.
NEWS
THE Gloucestershire Wheelchair Assessment Service has launched a new website – http://www. gloswheelchairservice.nhs.uk/
Kadeena Cox cuts the ribbon at the BRC at Chapel Allerton Hospital.
Key musculoskeletal research centre’s future is secured A MULTI-MILLION pound investment has secured the future of a joint Leeds University and NHS research centre specialising in rheumatology, musculoskeletal diseases and joint replacement.
The research facility at Chapel Allerton Hospital has been recognised as a Biomedical Research Centre by the National Institute for Health Research – and comes with £7million of research funding from NIHR. There are 20 NIHR Biomedical Research Centres in the UK, and the Leeds team is the only one specialising in musculoskeletal research. The centre is led by professor Paul Emery, whose research publications in the field of rheumatology are the most cited in Europe. At the launch, Professor Emery explained the centre’s priorities, and how its research would support patients. He said: “In the future our research will focus on two very important areas, namely preventing autoimmune diseases, with rheumatoid arthritis as the prime example, and improving treatments and outcomes for osteoarthritis. This should improve the lives of millions in the UK and beyond.” Professor Emery said through increased research, academics would develop and evaluate individually targeted, cost-effective therapies which would improve quality of life for musculoskeletal patients. In the longer term, Professor Emery said the goal was the early diagnosis and prevention of musculoskeletal disease and reduction of risk factors to improve outcomes. The centre was officially launched by 2016 Paralympics gold medal winner
“In the future our research will focus on two very important areas, namely preventing autoimmune diseases, with rheumatoid arthritis as the prime example...” Kadeena Cox MBE. She said: “It is good to see this life changing research getting the recognition it deserves. “The Leeds Biomedical Research Centre is a great asset to my home town of Leeds and will bring discoveries which achieve real long term benefits to patients locally, nationally and across the world.” Global impact on patient care
A precursor to the new centre, also funded by the NIHR, secured more than £100million in external funding since 2008, instigated more than 140 research projects and published over 1,000 peer-reviewed papers. The team’s output has had considerable global impact on patient care through developing innovative joint replacement technologies and in championing the importance of early intervention in rheumatoid arthritis. The £7million funding from the NIHR will allow the team to continue the much needed research well into the future. Musculoskeletal conditions, estimated to affect one in six people in the UK, are the single most common cause of chronic pain and disability. These include inflammatory arthritis (such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis), connective tissue diseases (such as scleroderma and lupus), and osteoarthritis.
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NEWS
Students helping care home’s elderly residents avoid falls UNIVERSITY of Brighton sport and exercise science students are visiting a care home to help tackle one of the most serious health issues facing older people – falls.
helped put into practice ideas and theories we cover at university. I can honestly say I will never forget these residents and have grown so fond of them and all their individual ways and humours. It has been a privilege to observe improvements in every single resident throughout the weeks and to know that we have positively impacted on their lives.”
Every year, one third of older people fall and in London alone these account for a 10th of ambulance call outs. Falls result in injuries, some serious and occasionally fatal, and besides the misery caused, they result in a £2billion financial burden to the NHS. The students, Sophie Thomas and Megan Groombridge, studying BSc(Hons) Sport and Exercise Science at the university’s Eastbourne campus, are visiting St Margaret’s Care Home in Eastbourne with their exercise programme ‘Fitness Fights Falls’ which improves strength and balance. Sophie said: “Our lecturer Robert Harley mentioned the opportunity to set up a falls prevention programme in one of our first year lectures. “We started to realise the magnitude of the problem and this inspired us to apply for a grant and apply our knowledge from our degree into a real life setting with the potential to
After graduating, both students plan to take an MSc in Rehabilitation Science before taking up careers as physiotherapists. Sophie Thomas gives personal tuition to a resident.
better our local community.” Grants are awarded by the university’s School of Sport and Service Management to students involved in work that promotes excellence and supports the community. Sophie and Megan were awarded £2,500. They sent out questionnaires to all 28 care homes in Eastbourne which revealed a need for stability fitness programmes. The two completed a course to qualify as postural stability instructors
and are now using their programme as part of their dissertations. The one-hour fitness classes, twice a week, have proved so popular at St Margaret’s that more residents are joining in. Megan said: “We would love to offer this to more care homes because we’ve seen first-hand the positive impact it’s had on the residents, but this is not manageable yet with the workload from our studies.” Sophie added: “The project has
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Megan added: “The best thing about being part of this project is being able to give back to the community and do something that I am passionate about, and for that I feel very fortunate. “It’s been an amazing experience through which I’ve learnt so much, not just education wise but also about myself, as my confidence in working with vulnerable people has greatly increased. Teaching these residents has been an absolute pleasure as they never fail to put a smile on my face and it’s been so rewarding to see the improvements they have made.”
OdrA: The most technologically advanced solution to knee osteoarthritis THE dynamic custom-made OdrA knee brace, available at Ortho Europe, offers a unique mechanical solution for the pain caused by medial compartment osteoarthritis (OA). Rather than applying pressure to three points like other OA knee braces, OdrA introduces a twin “distraction-rotation” action to relieve knee pain. A medial hinge lengthens the brace when the leg is extended, creating a distraction between the femur and tibia, and reducing pressure on the painful knee joint. Simultaneously, a lateral hinge shifts the joint back along its midline, rotating the foot outwardly to block the abduction that causes painful pinching in the knee. With a 3D breathable lining, OdrA consists of a flexible polypropylene thigh band and rigid lower band, connected by the two metal joints that provide the pain relief. This design, with both above knee and below knee joint uprights, provides more stability than other braces, whilst remaining low-profile at 30cm in length, and weighing just 500g. The mechanical effect of OdrA is immediate and comfortable, with many existing users wearing the brace for upwards of eight hours per day, and with one study finding that a third of OdrA wearers no longer needed to take pain medication after 12 months of use. OdrA can be used by a wide range of patients 22
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suffering from OA in the knee: since they are custom-made to a cast of the patient’s lower limb, the brace can be adapted for all body shapes, and may be worn on both knees at once if care is taken to ensure the knees do not rub together. Although OdrA was specifically designed for the treatment of painful medial compartment OA, it is also indicated for use by: patients who suffer from pain daily during physical activity and when using stairs, those who are on a surgery waiting list, and those who no longer tolerate anti-inflammatory drugs. The brace may also be worn when practicing sport, and by patients who have undergone meniscus surgery. Ortho Europe supplies a variety of alternative knee braces for a full range of indications, as well as many other orthotic products.
If you would like further details about the OdrA knee brace, or to learn more about the full Ortho Europe product range, please get in touch: Andy Cooper 07770 948592 andy.cooper@ortho-europe.com Ian Walker 07786 378515 ian.walker@ortho-europe.com You can also find more information on the Ortho Europe website, www.ortho-europe.com
How connectivity will change health and social care ...
A NUMBER of trends are spurring the NHS to create ‘connected care’ based on internet-linked devices that will contribute to the transformation of primary and secondary care across Britain.
The race to meet the three-year timetable for the move to paperless, integrated digital health and care records and a new NHS ‘Innovation and Technology Tariff’ is driving the introduction of smart devices to collect and share data instantly, from robot-assisted surgical instruments to AI-driven ‘virtual GPs’. Globally, investment in a healthcare ‘Internet of Things’ is projected to reach $117 billion by 2020. Rising patient demand for personalised healthcare is incentivising investment in technologies such as wearable health tech to enable remote monitoring of patients from any location, and connected pacemakers that send information about a patient’s heartbeat to a doctor. Connected health is now becoming part of the NHS healthcare landscape, with connected medical devices routinely being used for patient surgery, care and monitoring. Increasingly, data analytics will be used to harvest the data from this medical ‘Internet of Things’ network and generate personalised, predictive healthcare treatments. The ultimate vision is to create a ‘smart’ reactive and personalised
see inside an operating theatre and view procedures or equipment from different angles and receive remote training through a tablet. Remote access technology could even be used to ‘remote in’ to future portable X-ray machines, enabling scans to be analysed from hundreds of miles away.
healthcare system, which proactively reduces demand by using technology to aid prevention and efficiently target resources. At the heart of this revolution is the need for a constant, real-time exchange of information between an array of devices.
For this to be achieved, it is imperative that these devices stay functioning correctly on a 24-hour basis. Connected healthcare will not only enable healthcare organisations to adapt services in response to live data feeds but will also enable healthcare bodies to remotely intervene if any medical equipment becomes faulty, avoiding costly, lengthy call-outs and downtime. NHS Trusts and US Medical Boards are now using screen sharing software to allow specialists to ‘remote in’ to everything from X-rays and MRI scanners to medical instrumentation from any location to make urgent upgrades or diagnose and fix faults. Fujifilm is deploying the technology to help technicians remotely monitor and manage vital medical imaging equipment across far-flung hospitals, veterinary practices, small clinics and even cruise liners, without needing to send out engineers, creating a high-speed ‘IT help desk’ for medical equipment. The Medical Board of California has even created an app to allow a small IT team to remotely maintain, manage and upgrade healthcare devices
NEWS
Adam Byrne, chief operating officer at RealVNC, discusses the trends driving a ‘connected care’ revolution where much monitoring and care will happen beyond the hospital walls
As patients and carers become mutually dependent on a growing Internet of Things ecosystem of health monitors, scanners and medical instrumentation, real-time interchange of information will become essential. Adam Byrne
across 15 locations 500 miles apart. One pioneering US medical centre even uses connected technology to resolve issues ranging from a faulty system at a patient’s bedside to a medical research lab, from a faraway helpdesk. This is particularly imperative as organisations such as the NHS begin to build healthcare decisions on the data from connected medical devices, which means the software inside the devices must be trustworthy and free of bugs or vulnerabilities. Yet the connected revolution also opens up other possibilities, such as speeding up healthcare training and diagnosis. Remote connectivity could in future be used to allow trainee surgeons to
We could see the NHS adapt remote access technology to facilitate the live sharing of everything from images to audio between a multitude of devices. This will create a care system that operates like ‘smart cities’, linking live data together from different sources to predict and prevent health problems before they arise, easing pressure on services through proactive prevention and targeted intervention. Information from wearable technologies, apps, hubs and mobile scanners could be remotely transmitted, enabling more care to take place outside hospitals in care homes and other settings, reducing pressure on hospital places. The growth of a medical ‘internet of Things’ will ultimately create a smart health and social care ecosystem that adapts and responds to real-time information.
Podiatry team help homeless at Christmas A TEAM of podiatrists from Queen Margaret University gave up their time on Christmas Day and Boxing Day to look after the foot health of homeless people in Edinburgh. When the rest of Scotland was celebrating Christmas with family at home, podiatry lecturer and lead podiatry volunteer for the charity ‘Crisis’, Evelyn Weir, along with 10 Queen Margaret University podiatry students, will run a specialist foot clinic for people who live on the streets of the capital. The Queen Margaret University podiatrists were volunteering with the ‘Crisis at Christmas’ project. The event was run by the charity Crisis which helps single homeless people. The ‘Crisis at Christmas’ project provides companionship and support to tackle loneliness and isolation, and
helps people take their first steps out of homelessness.
offered to support the Crisis event.
The project ran for the first time in Edinburgh in 2013 on Christmas Day.
She added: “Many people who are homeless tend to walk for miles each day in all kinds of weather.
It was such a great success, with incredible support from a wide range of volunteers, that the event has continued to expand each year.
“However, they often don’t have access to foot health care or good quality footwear, and probably don’t have a change of shoes.
As well as offering some much needed foot care over the winter period, the Christmas Day and Boxing Day events offered homeless people services such as hairdressing and massage, as well as providing breakfast, a hot Christmas meal, and supper on each day.
“All of these issues combined with the fact that they may stand around on hard pavements in the cold and damp, and have nowhere to store dry shoes and socks, can lead to significant foot problems.”
Evelyn Weir, programme leader for the BSc (Hons) Podiatry programme at Queen Margaret University, has spent the last 26 years volunteering with homeless charities and was delighted that a team of enthusiastic university podiatry students again
Evelyn added: “I am thrilled that students volunteered again to support this important project on Christmas Day and Boxing Day, and I’m also overwhelmed by the generosity of our sponsors – Algeos, C&P Medical and support from senior management at Queen Margaret University. “We were well equipped with essential medical supplies and instruments and can also supply people with new winter socks, donated by QMU staff.
Evelyn, and her student team from the BSc (Hons) Podiatry course at QMU, provided a podiatry service for over 100 homeless people on both days.
“The project also presented an excellent opportunity for our students to develop their clinical and interpersonal skills whilst making a positive contribution to the community.
Homeless people benefited from relaxing foot baths, general foot care treatments and advice, and the supply of new warm socks.
“Using your specialist skills to benefit others seems to make Christmas more meaningful.”
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