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INNOVATION FOR INDEPENDENCE
ISSUE 105 OCTOBER/NOVEMBER 2015 £6.95
Team successfully fits prosthesis that sends feelings By Dominic Musgrave AN Austrian team of researchers has successfully fitted a human being with a leg prosthesis that sends feelings to its wearer for the first time The study results indicate that it greatly increases safety when in motion. The new prosthesis is perceived to be much more similar to the original limb and helps to let torturous phantom pains subside. Prosthetics expert Dr. Hubert Egger, a professor at the FH Upper Austria (University of Applied Sciences), has, for the first time, fitted a human being with a sensory-enhanced prosthesis. Due to the neural interface, the patient has feeling on the sole of the prosthetic foot, and therefore manages much better to recognise the nature of the ground he/she is walking on. There is also more awareness of obstacles, which reduces the risk of falling. The re-established transfer of information also contributes to a more natural integration of the prosthesis into the body concept of the patient and, in this case, has led to the complete disappearance of previous long lasting pains. The patient also underwent “Targeted
Sensory Reinnervation”, a selective transfer of nerves, by OÄ Dr. Eva-Maria Baur and OA Dr. Thomas Bauer at the University Clinic for Reconstructive Plastic and Aesthetic Surgery in Innsbruck, which is a cooperation partner of the FH Upper Austria. During this procedure the sensorial nerve endings of the sole of the original foot were reactivated to serve as an indicator for pressure on the sole of the prosthetic. Another goal of the operation was to decrease pain from neural scarring (neuroma) by redirecting the nerves. The study results show that amputees and their lives can greatly benefit from all this. The method of “Targeted Sensory Reinnervation” will also be used on future patients at the University Clinic in Innsbruck to potentially bring an end to their phantom pains by allowing the artificial limb to resemble the original one more closely and naturally. The initiator of the research project, Hubert Egger, also headed the development of a prototype of a mind-controlled and sensory-enhanced arm prosthesis. The mind-controlled prosthetic arm was approved by the Food and Drug Administration in 2014.
An ex-soldier who lost a leg in Afghanistan has recently completed a gruelling Tough Mudder assault course. James Cairns, 26, from Yorkshire completed the challenge in four hours and 42 minutes, despite suffering pain caused by the moisture rubbing on his leg. He said: “Tough Mudder is a big challenge for able bodied people let alone disabled people, it was even harder than I imagined it would be, but I didn't train at all, I got off a lads holiday a few weeks before.” James, who was shot in Afghanistan in October 2011, hasn’t stopped there. Next year he hopes to compete in the Orlando Invictus Games – a sporting event for wounded and ill service men and women. He also hopes to compete in the 1,500 metres at next year’s Paralympics.
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Robotics researchers star at MediaCityUK industry event ROBOTICS engineers from the University of Salford were prominent players at a major industry day at MediaCityUK. Led by professor Samia NeftiMeziani, Dr Steve Davis and Dr Adham Atyabi the team showcased cutting edge research in ‘soft robotics’ industrial automated systems and robotics for healthcare and assisted living. Their work featured on the BBC, Sky News and Granada and Professor Meziani – a key player in regional research and development – was interviewed by the broadcasters. Salford University is part of the Northern Robotics Network – which launched at the event at Salford’s MediaCityUk campus at the beginning of September. The Network brings together research institute and universities and high tech businesses in the region and grew out of the GAMMA project to revolutionise manufacturing
processes in the aerospace industry.
Editorial Judith Halkerston Email: jh@scriptmedia.co.uk
Professor Nefti-Meziani said: “Prime Minister David Cameron described robotics as one of the eight great technologies of the future and one, we believe, will emerge as a powerhouse for the North.
The event, opened by DVC (for Research Professor Nigel Mellors and entitled Powering Productivity included speakers and exhibitors from Siemens, Rolls Royce, ABB, Festo, the National Nuclear
Group Editor
Dominic Musgrave Group Production Editor Email: dm@scriptmedia.co.uk Tel: 01226 734407 Olivia Taylor Reporter Email: ot@scriptmedia.co.uk
“To fulfil this potential, we need a forum in which to work together and that is what we hope to achieve with the Northern Robotics Network.” The University has been at the forefront of Robotics since 1987 when it was chosen as the site of the United Kingdom's National Advanced Robotics Research Centre and has led projects for DEFRA and the Engineering and Physical Sciences Research Council.
Contacts
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Sales Carole Rice
Product Manager
Email: cr@scriptmedia.co.uk Tel: 01226 734412 Fax: 01226 734478 Tony Barry Sales and Marketing Director Email: tb@scriptmedia.co.uk Circulation circulation@scriptmedia.co.uk 24 hour hotline: 01226 734695
Dr Steve Davis and professor Samia NeftiMeziani.
Laboratory and more than 30 SMEs. Alan Norbury, central technology officer at Siemens UK, who was paying his second visit to Salford university said: “We hope to work closely with Samia and the Salford engineering team.”
At Script Media, we try to get things right but occasionally, we make mistakes. If you have a complaint about a story featured in our magazine or on our website, please, in the first instance, contact us by email: dm@scriptmedia.co.uk We abide by the Editors’ Code of Practice as demanded by the Independent Press Standards Organisation. For details on the code and what to do should you be unsatisfied with the way we handle your complaint, please visit www.ipso.co.uk
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Directory of Evidence Based Orthotic Practice (DEBOP) is released NEWS
By Simon Dickinson ON October 4, 2014 a group of proactive orthotists met in Buchanan Orthotics boardroom in Glasgow to form a working group to answer the question; “What is the evidence for orthotic treatment for MSK conditions?” The driving force to put this group together initially came from the MSK lead for Orthotics in NHS Scotland, Chris Rowley. As discussed in the last edition, NHS Scotland is undergoing a review and transformational change of its MSK pathways in order to reduce the strain on orthopaedic services. Other AHP professions already claimed to have an evidence base and orthotics was sadly lacking. Chris managed to secure some funding from Scottish Government and successfully coerced some professional colleagues to join a working group. At our first meeting Chris challenged the group to attempt to document the evidence for successful orthotic treatment for MSK conditions. Foot and ankle was identified as the initial priority with knee, hip and upper limb to follow. We were given a deadline of nine weeks to produce a draft document on the evidence for orthotic intervention for foot and ankle.
As a group we used Sign 50’s methodology (see www.sign.ac.uk/methodology for more info) in order to ensure we followed the correct procedures as we attempted this mammoth task.
only could we have the “algorithmns” live on the web, we could also link them directly to the Evidence. By mid-December we had the draft version complete for foot and ankle. Hip, knee and upper limb then followed also using Sign 50 guidelines.
As a group we created a Mutually Exclusive Collectively Exhaustive list in order to identify every possible MSK foot and ankle condition.
The one final question related to what exactly had we created. Was it a protocol, a pathway or something else?
We then merged these conditions into groups representing regions of the foot and ankle. Our methodology then led us to formulate our literature searches for each group using a PICO chart. In one day we achieved a great start and five of us were identified to carry the project forward. The five people were Nicola Munro, Fiona Monaghan, Chris Cox, Lynne Rowley and myself. With some support from the library we then performed level two and three literature searches to gather the evidence. All too often I have heard people say “there is no evidence for orthotics!” The level two forefoot literature search returned over 1,700 abstracts of studies and articles! As a group, continuing to follow Sign 50 methodology, we proceeded to filter the literature search and ultimately critically appraise the relevant papers producing a systematic review of the literature with all of the studies classified and
appraised.
After much discussion we agreed that we had created a “directory for evidence based orthotic practice” and DEBOP was born! DEBOP is now live and can be accessed by anyone with the link below:
This was an exhausting and time consuming process which took many hours.
http://www.clinicalknowledgepublish er.scot.nhs.uk/Published/PathwayView er.aspx?fileId=1422
The group then discussed how to present the information we had collated. We wanted to ensure it was clear and accessible but also did not detract from clinical skills or provide “the idiots guide to orthotics”.
DEBOP is the first of its kind. It will need regularly updating and refining as the evidence base increases. BAPO have agreed to assist with its maintenance in the future.
Simon Dickinson
Nicola Munro was instrumental in discovering and creating the wed based platform we intended to use, clinical knowledge publisher, and was ably supported by Fiona Monaghan in setting up what we referred to at the time as the “algorithms”. Not
There is a great deal of evidence for successful orthotic treatment of MSK conditions. Our collective ongoing challenge is to maintain DEBOP and do the studies to add to the evidence. Simon Dickinson is a clinical director at TalarMade.
Physiotherapists save department thousands with recycling mission WEST Cumbria physiotherapy services have been on a recent ‘recycling’ mission in order to save costs within their department.
homes within Copeland and Allerdale were contacted and asked to return any unused or unwanted equipment.
Their campaign has saved the NHS thousands of pounds. The team, based in the West Cumberland Hospital, noticed that a significant amount of the walking aids such as zimmer frames, elbow crutches and the like were not always returned when patients no longer needed them.
“We were able to retrieve and reuse many unwanted walking aids. These homes now have contact details of their local physiotherapy department should they have any more unused equipment to return in the future.”
Kathryn Mitchell, clinical lead physiotherapist at Cumbria Partnership NHS Foundation Trust, said: “A significant amount of nonpay budget is spent on walking aid equipment in the Trust largely down to a decline in the number of aids returned. “In order to both reduce budget spend and improve appropriate ‘recycling’ of walking aids, all care 4
The campaign even took to social media to raise awareness within the community as well. Fiona Temple, specialist physiotherapist at CPFT, added “I decided to launch an appeal using social media to create more awareness on returning walking aid equipment. “We received a very positive response and a large amount of equipment has been returned due to this, which is fantastic to see.”
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
West Cumbria physiotherapy services staff with some of the recycled walking aids that have been returned.
Both of the above actions, as well as changing equipment suppliers, have led to a significant budget saving of more than £4,000 and also an increased awareness of recycling of walking aids.
Kathryn added: “As a team we are thrilled with the response we have had from people returning equipment and hope, due to more individuals being aware of this, we can continue to save our budget costs and recycle more equipment.”
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Northumbria Health Trust paves way for first OT service in Ghana A NORTH East health trust is helping to set up a much-needed service which will improve the quality of life for thousands of people in West Africa.
North Tyneside and Wansbeck general hospitals and in the community, gaining valuable skills that they can use to benefit patients back home.
Due to its clinical expertise and track record for developing international partnerships, Northumbria Healthcare NHS Foundation Trust is working with The Ministry of Health in Ghana to introduce the first occupational therapy service in the country.
While in Northumberland and North Tyneside, the students are focussing on areas of OT that will help to address major health challenges in Ghana, such as stroke, which is a significant cause of mortality and morbidity, and an area in which Northumbria Healthcare excels.
Three years ago, a team from the trust visited Ghana to witness firsthand the health challenges people face. Now six students, who will be among Ghana’s first occupational therapists when they graduate next year, have worked with the University of Ghana to design and implement the first OT course. They are experiencing for themselves how an OT service can help patients overcome or adapt to an illness, such as a stroke, and regain their independence with advice and the assistance of specialist equipment and adaptations for the home. For six weeks, the students are working alongside experienced OTs at
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In Ghana, like many other African countries, patients who have had a stroke, or other debilitating illness, have to stay in hospital for long periods because there is little or no support to help them when they go home.
The OT students with representatives of Northumbria Healthcare NHS Foundation Trust.
on their feet and often regain their independence.
Barbara Kemp, head of occupational therapy at Northumbria Healthcare, said: “Welcoming the students to our trust has been another step towards our goal of helping to set up the first OT service in Ghana.
“The students have been surprised to see how by working as a team, and joining up care delivered in hospital and the community, patient can quickly leave hospital following major trauma, such as a stroke, with the right support in place.
“It’s been an absolute pleasure to have the students here and to show them how a well-run and established OT service can help patients get back
“The differences between the NHS here and the health service in Ghana are stark, however, the students will be able to take valuable learning
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
home with them to help set up an effective service and improve the quality of life for thousands of patients. “We look forward to following their progress and returning to Ghana to attend their graduation next year, for what will be a real celebration of what has been achieved.” Northumbria Healthcare’s OT team plan to keep in touch with the students via Skype and follow their progress with interest.
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Woman is first in UK to be fitted with computer-controlled prosthetic leg NEWS
AN East Sussex woman has become the first UK patient to be fitted with the new and improved CLeg 4. It was fitted on Lorraine Pooley by Matthew Hughes, clinic manager at Dorset Orthopaedic. The C-Leg 4 is the fourth generation of the first ever computer controlled prosthetic leg, and boasts additional features compared with its three predecessors. Lorraine lost her right leg above the knee shortly after her 21st birthday when she was struck by a motorbike in 1991. Shortly after her accident, Lorraine was given her first prosthetic leg but found it to be heavy and cumbersome. Throughout all the challenges she has had to face, Lorraine has remained focused on reclaiming her determination and getting back to the active lifestyle she enjoys. Since being fitted with C-Leg 4, Lorraine is now eager to get back to her active lifestyle, which includes trekking through the Nicaraguan jungle for the BBC2 programme Beyond Boundaries and competing in half marathons. “Ever since the accident I have always kept up to date with the latest technology”, said Lorraine. “I want to make sure I have technology that can support what I want to do; I thought that way, I can do more and be more active. Without the technology I’ve used, I would not have achieved what I have done in my life so far. I was thrilled when Matt told me about the C-Leg 4.”
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The new C-Leg 4 is available in two colours and enters a new era with its additional features, including real time swing phase control fuelled by 3D motion analysis and strengthened stumble recovery support. Another highly beneficial feature for amputees is the new standing function. This recognises when the wearer has stopped and dampens the knee in a slightly flexed position to provide maximum stability and comfort. Walking backwards has also never been easier than with CLeg 4. “Lorraine is a great candidate for the new C-Leg 4,” added Matthew. “She is an active amputee and will really benefit from the additional features such as intuitive locking. “We’ve also created a new bespoke silicone socket complete with a pre-preg carbon fibre frame. This will greatly increase comfort and reduce bulk and weight". The new and improved weatherproof prosthesis helps people master everyday life more confidently with two additional modes. The knee can be adjusted to meet an individual’s specific requirements for unique activities such as cycling, dancing or playing sports. For the first time, users can quickly switch between modes and monitor battery life using the new ‘Cockpit’ app for Android smartphones. The optional remote control also supports this functionality and both options integrate Bluetooth technology.
Lorraine Pooley shows off her new C-Leg 4.
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The London Prosthetic Centre led by consultant prosthetist Abdo Haidar is promising change for people with prosthetic limbs...
NEWS
Group to develop new medical tool IN RECENT years technical innovations have combined to make prosthetic limbs much more functional and lifelike than earlier versions. SocketMaster is a complete rethinking of the most crucial prosthetic component: The socket. The aim is to bring modern technology and innovative design to bear on a long-ignored pain point. Less glamorous, but the most fundamental element in the prosthetic industry are prosthetic sockets. The main interface that connects those sophisticated prosthetics to peoples’ residual limbs.
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“Achieving comfort for amputees and improved quality of life will be possible with the SocketMaster.
amputees and offer the adjustability to improve the fit. As a result, the design of a prosthetic socket is still basically an art, which is highly dependent on the experiences and skills of the prosthetist.
“This is one of the most innovative scientific project ever attempted to improve amputee comfort,” said Abdo.
This is a time-consuming process, involving the production of multiple check sockets before a well-fitted socket can be achieved, during which each check socket is modified according to the feedback of the patient.
The prosthetic limb may be fitted with the highest advancements of electronic or bionic knees or feet, but the socket remains the real point of contact. It’s the interface where the hardware meets the human.
Abdo Haidar, lead prosthetist at The London Prosthetic Centre, together with six leading European organisations: TWI, Innora Proigmena Technologika, Fondazione Bruno Kessler, Polkom Badania SP Zoo, Sensing Future Technologies, Veneto Nanotech SCPA and the University of Surrey are working on a three-year project called The “SocketMaster”.
Different measuring techniques are used in the prosthetic industry at present to capture the size and shape of residual limbs.
Their aim is to develop a new medical tool and a procedure to achieve fast and optimised design of a prosthetic socket for an above knee amputee.
These techniques remain limited and are unable to identify the infrastructure of residual limbs and pressure tolerance of individual
The SocketMaster medical tool will be developed by integrating mechanical and micro electronic sensors such that the parameters
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
He also says the final stage will be the clinical trials of 50 lower limb amputees. These trials will be carried out at LPC to validate the SocketMaster Abdo added: “The project is in its first stage and we expect to be completed within 36 months. Abdo Haidar
relevant to the comfort of an amputee such as pressure, friction between the socket and the residual limb can be measured during a walking cycle. This data will then be used to design an optimised socket by the SocketMaster software. With a rapid prototyping machine it is envisaged that the design and fabrication of a well-fitted prosthetic socket can be completed within a few hours in the same day.
“I envision a remarkable outcome for SocketMaster.” The SocketMaster project has been awarded funding worth €4m from the European Commission’s newly launched Horizon 2020 Research and Innovation programme, under the theme of ICT-2: Smart Systems Integration. The project officially started on February 1 and will last for three years. For more details, please visit project website www.socketmaster.eu or www.thelondonprosthetics.com
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DM Orthotics remove need for medication for cartoonist ... DM Orthotics has given a new lease of life to cartoonist Hannah Ensor. Hannah, who has Hypermobility Type EDS and POTS, has been using a combination of the company’s products to alleviate the symptoms of her conditions helping her to become more independent and less reliant on a wheelchair. She was also able to stop taking prescribed medication for her POTS only a few weeks after using her DMO’s, something she was really pleased to do. Speaking of the changes that she has undergone, Hannah said: “I discovered DM Orthotics three years ago and I can honestly say being introduced to their products completely changed my life. “The enhanced proprioception means I have awareness of the whole of my body – it’s awesome! The improvement in sensation was instantaneous – it was really quite unbelievable. “With my full DMO outfit I can walk a few metres and talk at the same time – trust me, this is totally
awesome!”
couldn’t do the exercises essential to managing my EDS. I often missed out on things because they happened at the wrong point in my medication cycle.”
Hannah uses a DMO Vest, DMO Leggings and DMO Socks as an alternative to a full DMO Suit for greater flexibility of use.
Within three weeks of using her DMO’s she was able to come off the medication she was taking for her POTS. This also led to cost benefits for the NHS where the prescription of DMO’s led to a 75 per cent saving versus the cost of medication.
DM Orthotics clinician Liz Betts explains her choice of prescription. “Ehlers Danlos Syndrome means without aid Hannah is very unstable and is prone to a number of symptoms,” she said. “This adds to her POTS, increasing its pre-potency. The use of multiple DMO’s would not only improve her stability and proprioception but also improve her blood circulation, alleviating some of the blood pooling and low blood pressure symptoms. “We opted for single items as opposed to a full suit as it would give her greater versatility and flexibility of movement.” Before using DMO’s Hannah was tied to a rigid management programme for her conditions involving; injections every three weeks, a specific diet, wearing conventional compression stockings and a cooling vest, specific exercises and lying
down frequently to try and manage the blood pooling issues. Hannah explains the difficult effects this had on her everyday life, Hannah added: “Although this [the programme] helped it was not ideal. The injections were painful and the medication could take a week to become fully effective, peaking for about a week and then wearing off again. “My symptoms varied hugely and I struggled to ‘pace’ my activities – it was like the goalposts were constantly moving, and I often
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Now, Hannah is able to plan her time so she can get the most out of her DMO’s and consequently, the most out of life and running her illustration business, Stickman Communications. She added“The use of the DMO’s has given me so many more possibilities in life. I am stronger and fitter, and can cope better with being out of my house for several hours at a time. “I’m still reliant on my wheelchair, and have to manage a complex set of symptoms, but my DMOs are a tool I wouldn’t be without – I no longer have to plan my life around a medication cycle, I can socialise and work to my own schedule; my DMOs have given me back control.”
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Firm wins award for third consecutive year By Olivia Taylor
day week.
LEEDS based Physio Med has been recognised at a prestigious awards ceremony for the third year in a row – this time alongside its client John Lewis Partnership.
This is estimated to have saved JLP 41,010 working days in total, delivering excellent ROI of 5:1. Physio Med’s managing director Phil Clayton said: “We’re absolutely thrilled that Physio Med’s service has been able to achieve such fantastic results for the John Lewis Partnership.
JLP was awarded the Employer’s Rehabilitation Initiative of the Year at the Rehabilitation First Awards having worked with Physio Med to increase productivity and reduce sickness absence rates amongst its staff.
“Being recognised in the rehabilitation industry for three years in a row for providing an excellent service is a strong achievement and we’re proud of our great team that helped make it happen.”
The company employs more than 90,000 staff across its UK sites, including John Lewis and Waitrose stores, distribution centres and group sites. Many of the job roles at JLP – from retail sales to warehouse operatives, office workers to security workers – can be physically demanding and JLP found that employees suffering musculoskeletal disorders were often absent for extended periods or less productive at work while waiting to access NHS physiotherapy, which can take up to 14 weeks. JLP Partnership Health Services worked with Physio Med to implement its innovative and award winning Physiotherapy Advice Line service, providing fast access to a blended approach of fast-track telephone triage, remote multimedia self-management and on-site face-to-
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Physio Med has previously been recognised at the Rehabilitation First Awards for its work with public sector organisations St Helens and Knowsley Teaching Hospitals NHS Trust and North East Ambulance Service.
Nick Davison, head of partnership health services at JLP, with Phil Clayton, managing director at Physio Med.
face treatment/advice. Over a 12-month period 2,324 appropriate referrals were made to Physio Med. 89 per cent of those off sick at the point of referral returned to work following treatment and overall 96
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
per cent of all who used the service were safely maintained at or returned to work. Physio Med’s treatment resulted in a 24 per cent improvement in productivity and function – equating to 1.2 days per person working a five
Recognising the achievements of JLP and Physio Med, Stephanie Denton, editor of Post magazine and head judge at the Rehabilitation First Awards, said: “This entry stood out as it showed a good solid commitment from a progressive employer using a simple practical solution to aid musculoskeletal disorders.” The awards ceremony took place at the Royal Garden Hotel in London.
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A professional singer was devastated by severe back pain before specialist intervention at the Royal Orthopaedic Hospital changed his life for the better. Assistive Technologies found out more.
NEWS
Getting rid of back pain without surgery GAVIN Newman was diagnosed with a prolapsed disc which stopped him singing, working or even doing basic tasks like shopping.
We used the latest research to design the programme, and patients find that after the four-week programme they are much less disabled, in less pain and much more confident.
At one stage he was taking 30 painkillers a day and was told he’d need spinal surgery if he was to recover.
“They are getting back into work and enjoying their leisure time more. “Until 10 years ago people with severe long term back pain would find themselves having a spinal fusion operation, which is major surgery.”
That was when he met Dr Grahame Brown and extended scope physiotherapist Dave Rogers at the Royal Orthopaedic Hospital in Northfield.
The programme involves education, relaxation techniques and graded exercise and encourages patients to use a toolkit of techniques to help improve function.
They introduced Gavin to the functional restoration service they run, which provides support to people living with back pain, and helps them recover without the need for major surgery. Gavin said: “I owe everything to the team at the Royal Orthopaedic Hospital. Everything has changed. I hold them responsible for my recovery. Without them I dread to think what I’d be doing now.” The service was set up with the aim of improving patients’ confidence,
There is support from physiotherapists, a doctor and a pain counsellor. Gavin Newman
reducing disability and pain, making them less reliant on medication and better able to cope when back pain flares up.
For Gavin, it was life changing. He spent six months going back and forth to his GP who provided painkillers which gave him many unpleasant side effects.
Extended scope physiotherapist Dave Rogers added: “This is all about putting the patient back in control.
Gavin said: “Everything I touched gave me pain. I couldn’t even do the shopping. I came into the
programme really dismissive of it. I didn’t think it was for me. I was the worst possible patient. “Then something just clicked. I listened to the functional restoration team and together we set a goal that I would come off one of the most powerful painkillers. In a couple of weeks, the pain I was taking the tablets for had almost gone away. “As soon as the pain began to reduce and the exercise took effect I got into it more. I started volunteering to do extra, took on board everything they were saying. “I used the breathing techniques to help me and I still use them. In four weeks I was pain free. It was absolutely amazing.” Having been out of work due to his debilitating back pain, Gavin was finally able to get a new job. And now he is IT Service Desk team leader at the Royal Orthopaedic Hospital. He married his fiancée in August and is looking forward to taking up singing once again.
Opening ceremonies Samantha fitted with new mark completion of carbon fibre wheelchair walking gardens AN OPENING ceremony has taken place at Colchester General Hospital to mark the completion of a £59,000 scheme to create two walking gardens. The gardens, which are located in courtyards next to the hospital's Gainsborough Wing, will be used to help patients who have been fitted with prosthetic legs learn to walk and also in the rehabilitation of many more types of patients, including patients who are recovering from stroke. Tracey Williams-Macklin, head of occupational therapy at Colchester Hospital University NHS Foundation Trust, said: “They are the vision of the Colchester Prosthetic User Group, which has worked in partnership with us on the design and funding. “The gardens will encourage many individuals to gain confidence walking on everyday surfaces, for example, individuals with a prosthetic limb or those who have had a stroke. ‘Patients can try the varied surfaces in a safe and controlled environment, which will lead to them being able to have an independent lifestyle within their local community. "It's a great place for the prosthetist, 14
physiotherapist and occupational therapist to assess an individual’s outdoor mobility.” The work has involved new planting, laying down artificial turf, improving the drainage, replacing all handrails, putting down new surfaces (including some special non-slip surfaces), and installing a bespoke parasol. A plaque was unveiled in one of the gardens by Frances Collins, of Colchester, who was a founder member of the Colchester Prosthetic User Group (PUG) in 2009 and who still serves on its committee. Among the guests at the opening was Kiera Roche from LimbPower; Gordon McFadden, chairman of the United Amputee Community Charity; PUG committee members; representatives of various user groups around the UK, including Roehampton, Luton and Dunstable, Wrexham and Stanmore; and Alan Rose, chairman of Colchester Hospital Trust. The project cost £59,162 to complete. Colchester Hospital Trust, which runs Colchester General Hospital, secured almost two-thirds of that amount – £38,462 – by applying to a government fund set up to improve prosthetic services.
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SAMANTHA Kinghorn, one of the UK’s most successful wheelchair racers, has become the first person in the UK to be supplied with a new ‘every day’ carbon fibre wheelchair from mobility specialists Ottobock. Provided by Bromakin Wheelchairs, the Voyager Evo wheelchair is made to the highest quality, designed for active wheelchair users and is nearly indestructible.
Perfect for her busy, active lifestyle, the Voyager Evo is made entirely to suit Samantha’s size, weight and individual style. Built in Germany on a modular system, her Voyager Evo has been designed to suit her lifestyle and is enabling her to travel with ease around the world as she trains for the upcoming Doha World Championships later this year. Samantha Kinghorn broke her back when she was 14 years old in a tragic farming accident at her home in the Scottish Borders. Airlifted to hospital in Glasgow, she underwent six months of rehabilitation before returning to the farm with the knowledge that she would never walk again. “As part of my rehabilitation I got the chance to attend the Stoke Mandeville Spinal Injury Games and caught the bug,” she said. “Three weeks after I got my first racing
Samantha Kinghorn
chair I competed in the London Mini-Marathon and came second – I didn’t realise you weren’t supposed to stop and spent the race thanking everyone who stopped to wish me well.” “I’ve always been active, and spent my childhood outdoors on the farm. I used to horse ride, and enjoyed gymnastics at school. As soon as I tried wheelchair racing I knew it was what I wanted to do. I now compete in the T53 racing category”. “Off the track, I have used a number of different wheelchairs – I have a farm chair for the mud and puddles and have now opted for a new carbon fibre active wheelchair from Ottobock. It’s lightweight, easily manoeuvrable and is really comfortable due to its custom design.”
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®
The WalkAide System THE WalkAide® system was introduced to the UK functional electrical stimulation (FES) market by Trulife in 2008, after many years of development at the University of Alberta, Canada.
flex cuff is designed to make donning of the system easy for the user, and it is also designed for one-handed application. The WalkAide® unit is applied directly to the leg below the knee – not implanted underneath the skin – which means no surgery is involved. It can be worn discreetly under most clothing.
WalkAide® provides movement and function to those with drop foot of central neurological origin. It is a significant technological advance in neuro-orthotics.
Accessories
A device that can be used by adults and children
There are a range of standard, hypoallergenic and cloth electrodes that can be used, depending on the individual needs of the patient.
WalkAide® stimulates the common peroneal nerve to send signals to the muscles that lift the foot. The WalkAide® system is suitable for those with drop foot due to central neurological origin, including patients with: Stroke Multiple Sclerosis Cerebral Palsy Acquired head injury Hereditary spastic paraparesis Incomplete spinal cord injury Advanced Unique FES Technology
WalkAide® uses tilt sensor technology to analyse the movement of the leg during walking and
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A WalkAide® clinician will be able to assess which is most suitable. A silicone cover is also available to add further protection to the WalkAide® unit. stepping. The system is programmed by a clinician to stimulate muscles at the correct time during the walking cycle for each individual.
This results in simplicity of use and allows the patient complete freedom of footwear choice. They can even go barefoot!
This provides a smoother, more natural and safer stepping motion.
Easy to use
Advanced tilt sensor technology makes the WalkAide® system a onepiece design without requiring any other parts to be placed in footwear or pockets.
Patterned material can be added to the ribbon of the WalkAide® system to customise the Bi-flex cuff. WalkAide® clinicians
Although highly-advanced, WalkAide® is small and easy to use.It is powered by one alkaline AA battery. The two electrodes are housed within the Bi-flex cuff with Velcro. The Bi-
Trulife train and support clinicians throughout the UK and Ireland. For more information please contact info@trulife.co.uk or to speak to our customer services team, call 0800 581 596.
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
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Family’s high-tech help for stroke patients NEWS
STROKE patients at Morriston Hospital in Swansea have been given some high-tech help with their recovery thanks to the grateful family of one patient. After Keith Lewis suffered a stroke in December he was able to use his own iPad during his therapy and recuperation. It not only provided access to information and useful apps but also helped him recover his dexterity and coordination. Now other patients who are experiencing difficulties with communication will be able to enjoy similar benefits after Keith’s family handed over a new iPad to the speech and language therapy team. The money for the device was raised by Keith’s step-daughter Hannah Jones who took part in a sponsored 10k run in Bristol in March. She also managed to collect £600 for the Stroke Association to spend on its work with patients in Swansea. Speech and language therapist Nia Jenkins said: “We are so grateful for the kind gift Keith and his family have donated to the speech and language therapy team. “It was a pleasure working with Keith and his wife Anne, they were so motivated and engaged in therapy each week and worked tirelessly in between sessions working on his targets and goals. He has made remarkable progress.”
Hannah Jones with her mum Anne Hodge-Lewis, speech therapist Nia Jenkins and step-dad Keith Lewis. Hannah, along with her mum Anne and Keith, returned to the hospital to hand over the iPad to speech and language therapist Nia who had worked with him during his recovery. Hannah, who is a junior doctor in Bristol, said: “I’m not a runner and although a short distance, I enjoyed the challenge especially to support something close to my family’s heart. Mum and Dad were both there
cheering me on, it was an emotional finish to say the least.” Keith has made such a good recovery that he has now been able to return to work as a partner in a landscape gardening firm three days a week.
calculation are very necessary skills,” added Hannah. “We were so happy with the care that dad received we wanted to thank the team for all their hard work and positive encouragement.”
“He is so much better now, it is great to see how much progress he has made and is now back at work where things like negotiation and
Nia added: “The iPad is already up and running and we have utilised it for both assessment and therapy purposes on the ward.”
US stroke robot pioneer visits patients and staff at hospital A LEADING scientist from Massachusetts in the USA who has pioneered the stroke robot technology recently visited staff and patients at North Tyneside General Hospital. Dr Hermano Igo Krebs, principal research scientist and lecturer at Massachusetts Institute of Technology, has led the development of stroke rehabilitation robots over many years and is widely recognised by peers around the world for his leading edge research into rehabilitative robotics. Just over a year ago, North Tyneside General Hospital became the first in England to house two of his ‘rehabilitation robots’ which are now being used as part of clinical trials using robot assisted training to help NHS stroke patients regain movement in their affected arm. Now, the hospital is leading clinical trials in the North East with Newcastle University, working with stroke patients from across Tyne and Wear. During his visit to North Tyneside General Hospital, Dr Krebs met public 16
governors of the trust, staff from the hospital’s dedicated stroke unit, as well as patients who have been cared for by the expert stroke team in North Tyneside. He was also joined by Dr Helen Rodgers, professor of stroke care at the Institute of Neuroscience at Newcastle University and consultant stroke physician at Northumbria Healthcare NHS Foundation Trust, who is leading the UK research. Commenting on his visit, Dr Krebs said: “It is fantastic to visit the UK and the North East of England in particular, where great things are happening with stroke research using robotic rehabilitation. “The technology we have developed at MIT is already helping many stroke patients and people with other neurological conditions in the US on their road to recovery and we hope to see similar results here in the UK over the next five years thanks to the NHS research now taking place. Dr Krebs was in the North East as part of a week-long visit to the region being hosted by Newcastle University and was a keynote speaker
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
at The Society for Research in Rehabilitation’s annual conference – ‘Rehabilitation in the 21st Century: Using Robots & Computers to Promote Recovery’.Helen added: “Since launching our UK clinical trials just over a year ago we have recruited almost 200 patients to take part in the robot research and are well on track to meet our target of working with 700 patients over the course of the research programme. “We have been working closely with colleagues in Massachusetts over many years and if the UK research is shown to be effective, it has the potential to revolutionise how we provide rehabilitation in the NHS for people who have suffered a stroke.” A clinical trial of robot assisted training in the USA has shown that this approach to rehabilitation may improve upper limb recovery for some stroke patients. Now, the NHS is conducting a much larger study to see if robot assisted training using Dr Kreb’s technology leads to improved clinical outcomes for patients and more efficient use of valuable NHS resources.
NHS Trust wins top accolade CAMBRIDGESHIRE Community Services NHS Trust has won first place in the CommunityTrust category of the prestigious Best Places to Work awards 2015. The results were revealed at the ICC in Birmingham, where the healthcare industry elite came together for an afternoon of recognition and celebration. The Top 100 list of NHS providers includes 42 acute trusts, 31 mental health trusts, 16 specialist trusts, 11 community trusts, plus 20 clinical commissioning groups. The winner and runner-up in each of the five categories were commended as the top 10 organisations across the country for their outstanding performance. Matthew Winn, chief executive, said: “I am incredibly proud that the Trust has been recognised as the best Community Trust in the country to work for. “Research demonstrates a proven link between engaged staff and positive patient outcomes and this award recognises the passion and commitment of every member of staff within the Trust.”
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sponsors podiatry
Putting an integrated service at the heart of foot care ... By Nikki Joule FOOT ulcers and amputations have a catastrophic impact on quality of life for people with diabetes and lead to early mortality. Latest figures show that each week in England there are around 135 diabetes related amputations. The figures continue to rise – but this is not inevitable. The recently published NHS Atlas of Variation in Healthcare finds that the 3.9-fold variation in amputation rates may be due to differences in the organisation of care for people with diabetes. An estimated 80 per cent of amputations are potentially preventable, through improved awareness among people with diabetes about their risk status and the actions to take, as well as access to good quality care. When people with a foot attack (active foot disease) get rapid access to treatment by a specialist multidisciplinary footcare team, there has been faster healing and fewer amputations, saving money and lives. Integrated foot care services
The risk of amputation can be reduced through provision of an
integrated foot care pathway that ensures access to the right care at the right time.
hospitals with multidisciplinary foot care teams has been increasing – from 61 per cent in 2010 to 72 per cent in 2013, more than a quarter of hospitals still have no MDT at all.
Everyone with diabetes should have an annual foot check and be referred to trained staff in community foot protection services if they are at increased risk.
What needs to happen?
Clinical Commissioning Groups need to ensure an integrated foot care pathway is being delivered across primary, community, and specialist care services as set out in recent NICE guidance.
However, the most recent National Diabetes Audit (2012/2013) showed that 28 per cent of people with Type 1 diabetes and 13 per cent of people with Type 2 diabetes are still not receiving their annual foot check. Access to foot checks and the quality of the check varies widely across the country. In a recent foot care survey conducted by Diabetes UK nearly half of respondents said they had not been advised (32 per cent) or did not remember (nine per cent) if they had been made aware of their risk of foot problems. This is unacceptable. Ensuring that patients get a quality annual foot review and have a good understanding of how to look after their feet is essential. Our free leaflets, ‘10 steps to healthy feet’, ‘What to expect at your annual foot check’ and ‘How to spot a foot attack’ offer clear and useful advice
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Nikki Joule
to patients. Healthcare professionals can order them from our online shop to help them empower people with diabetes to understand more about how to look after their feet, to understand more about the care they should be receiving and what to look out for and who they should contact if they notice any changes with their feet. The integrated pathway should also ensure quick access to multidisciplinary specialist teams for those who need it. However although the percentage of
This includes having a MDT and a foot protection service in every area. In addition, people with diabetes who go into hospital, for whatever reason, should have their feet checked on admission and regularly throughout their stay. If they are at increased risk their feet should be protected when in hospital. All healthcare professionals should be aware of the local diabetes foot care pathway and how to refer appropriately to ensure that people with diabetes access the right care at the right time and avoid the devastating impact of foot ulcers and amputations. Nikki Joule is policy manager at Diabetes UK.
Sue braves the shave in aid of national cancer campaign A PODIATRIST at South Warwickshire NHS Foundation Trust has taken inspiration from her family and patients to ‘brave the shave’, a national campaign which involves shaving all of her hair off. Sue Pike has worked at the Trust for 16 years, and faced the
shavers to raise money for Macmillan. She said: “My inspiration for taking part in brave the shave is, first and foremost, my auntie who lost her long battle with cancer in 2013. “She always faced her hair loss
with such strength and dignity, and always looked fantastic despite the drawn out cancer treatments that she endured.” So far, Sue has raised around £200 for Macmillan. You can support Sue by sponsoring her at https://bravetheshave.org.uk/ shavers/sue-pike/
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
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NEW PRODUCTS
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TheraBand® CLX™ – Consecutive Loops All-in-one product delivers versatility and value. Does the work of four products band, loops, tubing, handles, and door anchor. Integrated App engages users (patients and practitioners). TheraBand is breaking new ground with its latex free, patented CLX – Consecutive Loops. Never before has resistance training been so versatile, so simple and so inspiring (effective). The TheraBand CLX with Easy Grip Loops™ provides multiple unique grip options that enable exercises like open and closed hand grips, holding objects with resistance, no-griprequired exercises and never before possible exercises such as simultaneous upper and lower body work. The TheraBand CLX delivers unparalleled versatility and ease of use that may increase exercise compliance to improve patient outcomes.
Bolton Bros work with Klaveness to offer wide range of styles BOLTON Bros are delighted to work with Klaveness shoes to offer a wide range of styles for men and women. A FREE integrated CLX App provides a CLX exclusive exercise library with unique support tools to enhance any rehab or training programme. Enquiries: For more information or to order call Patterson Medical today on 08448 730 035 or visit www.pattersonmedical.co.uk
Models to suit a variety of patients BEAGLE Orthopaedic houses a large spinal database of spinal models to suit a variety of patients. From this extensive library we can manufacture your CTLSO using measures provided from a simple measurement chart, we then adapt the relevant model to meet the specification. Each orthosis is fabricated to the patient’s unique model and your specifications, ensuring the optimum fit, support and comfort. CTLSO’s are available as; bi-valve design finished to completion (no intermediate fitting) with a variety of liners such as cool foam, north foam 33, evazote and lambs wool.
We can also provide a customised combination of products for high thoracic fractures / instabilities. The chosen TLSO is then coupled with components from the Aspen CTO, to provide the stability required for your patient in the upper thoracic and cervical region. This design offers a step-down reduction for on-going rehabilitation therapy. Available in paediatric and adult sizes.
APRB added to portfolio TalarMade are pleased to announce the launch of their new Ambulatory Pressure Relief Boot.
Soft, breathable, washable liner. 18
Have a look at this short slideshow to see some of the styles we currently have on offer with Klaveness shoes. You can also download the new catalogue to see the huge range of options available. Enquiries: Contact us for more information on 0191 2732012 or email info@klaveness.co.uk
Elite orthotic designed to maximise foot function THE Talarmade Elite Foot Orthotic incorporates superior biomechanical design to maximise foot function.
‘Designed by clinicians for clinicians’, utilising the latest biomechanical theories, Elite allows improved clinical outcomes when treating pronated feet. Its full length design is focused on improving first ray function while providing enhanced biomechanical control to the hind and mid foot. Features and benefits: EVA construction. Three densities – soft, medium and firm. Intrinsic four-degree medial heel post. Robust heel cup.
Antimicrobial top cover. Replaceable heel and first met head cushioning. Plantar surface can be easily customised using TM ‘Microgrip’ surface additions. Multiple extrinsic wedge options for further customisation. Enquiries: For more information and pricing call 01246 268456, email info@talarmade.com or visit www.talarmade.com
Short course suggestions wanted
It is designed to allow patients to transfer and ambulate short distances whilst offloading the posterior heel and can also be used to offload the heel and prevent contractures at the ankle whilst the patient is in bed.
Easily removable sole plate to prevent contamination of bed sheets following ambulation without the need for tools.
In collaboration with Bolton Bros, prescription shoes are available for many individuals with a requirement for footwear modifications due to a
Mild metatarsal support.
The APRB is a welcome addition to TalarMade’s pressure care portfolio and can be used for the prevention and treatment of heel ulcers.
This highly cost-effective product has the following key features:
Klaveness Skofabrikk are Scandinavia's best known shoe company with a wide range of fashionable, comfortable shoes.
medical condition.
The BAPO Education Committee work hard to create the short course programme each year.
Adjustable length toe support. Anti-rotation bar. Available in two sizes. For more information and pricing call 01246 268456, email info@talarmade.com or visit www.talarmade.com
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2015
The Committee are keen to consider the needs and views of the profession as whole and would like to encourage individuals to contact the BAPO Secretariat with topic suggestions for short courses, specific locations you would like a short course to be run, or perhaps to volunteer to present a course. We hope that together we can
address the educational needs of the profession. This year we launched a series of MSK (Assessment Diagnosis and Treatment of Musculoskeletal Foot and Ankle Problems for Orthotists) courses in Scotland which have been a great success. Send your ideas/suggestions of courses to education@bapo.com and look out for more information on the upcoming 2016 programme at www.bapo.com
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