INNOVATION FOR INDEPENDENCE
ISSUE 117 OCTOBER/NOVEMBER 2017 £6.95
New trial for prosthetic hip joint infection
THE first randomised trial to investigate why some patients develop infections after their hip or knee replacement surgery, and which type of surgical revision treatment, is best is being run by the University of Bristol and members of the public are being asked to consider taking part. Periprosthetic joint infection affects approximately one per cent of patients following total hip replacement and often results in severe physical and emotional suffering.
Current treatment options include the removal of damaged or dead tissue, antibiotics and implant retention; revising (re-doing) the joint replacement; removal of the joint; and amputation. Revision surgery can be done as either a one-stage or two-stage operation. Both types of surgery are well established in the NHS and appear to result in similar rates of re-infection, but little is known about the impact of these treatments from the patient’s perspective. The NIHR-funded INFORM (Infection – Orthopaedic Management) trial compares one-stage with two-stage revision for hip PJI and is co-ordinated by the University’s
Musculoskeletal Research Unit, based at Southmead Hospital. The trial’s primary focus is on patient reported outcomes: pain, stiffness, function and wellbeing in the longterm. The trial also compares the cost-effectiveness, complications and re-infection rates between these surgical interventions. Finally, an interview study explores patients’ and surgeons’ experiences, including their views about trial participation and randomisation. Ashley Blom, Professor of Orthopaedic Surgery in the School of Clinical Sciences and joint head of the Musculoskeletal Research Unit, said: “Over 160,000 primary hip or knee replacements were carried out in England, Wales and Northern Ireland in 2016. About one person in 100 develops a bacterial infection at their new, artificial joint. “Patients with infected joint replacements have described the experience as ‘devastating’ and ‘associated with unbearable suffering’. “If untreated, these infections can result in severe pain, persistent dislocation and death. It is important that we establish which form of treatment is best from a patient’s perspective.”
Invictus Games and Paralympic medal winner and fundraiser David Henson MBE has been presented with a Fellowship by the University of Hertfordshire for his services to sport and the local community. He was conferred with the award, which recognises his outstanding achievements, at a ceremony held at St Albans Abbey. Just five years after losing his legs after standing on an IED while serving with the British Army in Afghanistan, David competed in the 100m and 200m sprints at the 2016 Paralympic Games, winning a bronze medal in the latter. He is now setting his sights on Tokyo 2020.
A LEEDS-based physiotherapist is attracting clients from all over the world thanks to her innovative treatment techniques.
Bachelor of Physiotherapy Shalini Sapru has been qualified for more than 10 years and her growing reputation has attracted clients from overseas to Physio Med’s Leeds clinic. One patient was so impressed by the treatment she received from Shalini for her slipped disc, she has since travelled across the globe – from Pakistan and New Jersey – three times in just 15 months, in order to be treated. Now, Shalini is looking to lead an expansion into specialist treatments to support women’s health at the Leeds clinic, specifically targeting pregnant women and new mums. Pre-and postnatal physiotherapy treatments offer numerous benefits to women both during and after pregnancy, helping them to strengthen vital muscles before giving birth, reducing the risk of miscarriages, and to also help them
recover and return to full fitness after giving birth. Occupational physiotherapy provider Physio Med offers the treatments but with a lack of available information about the benefits the company is now hoping to raise awareness of their effectiveness.
Editorial Judith Halkerston Group Editor Email: jh@scriptmedia.co.uk Dominic Musgrave Group Production Editor Email: dm@scriptmedia.co.uk Tel: 01226 734407 Olivia Taylor Reporter Email: ot@scriptmedia.co.uk Sales Carole Rice Product Manager Email: cr@scriptmedia.co.uk Tel: 01226 734412 Fax: 01226 734478
Phil Clayton, managing director at Physio Med, said: “We’re incredibly proud of Shalini and the fact that she inspires her patients to travel from overseas to receive treatment from her is testament her incredible ability.
Tony Barry Sales and Marketing Director Email: tb@scriptmedia.co.uk Circulation circulation@scriptmedia.co.uk 24 hour hotline: 01226 734695
“Furthermore, her knowledge and experience of working in the field of pre-and postnatal musculoskeletal physiotherapy is second to none, and we hope that we can raise awareness of the benefits such treatments can deliver.” Physio Med, launched in Leeds in 2000, provides cost effective occupational [hysiotherapy and ergonomic solutions to major national businesses including Waitrose, John Lewis and the Department for Work & Pensions.
Contacts
NEWS
Innovative treatments attract overseas patients to clinic
Design/Production Stewart Holt Studio Manager Email: sth@scriptmedia.co.uk Ben Thornley Graphic Designer Email: bt@scriptmedia.co.uk
Shalini Sapru
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ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2017
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£1.5m study looks at patter of tiny feet By Dominic Musgrave
Professor Chris Nester, research programme leader at the University of Salford, said: “Buying your child’s first pair of shoes is such an important moment, but there’s a huge gap in our knowledge about how children’s feet develop during this crucial time.
NEWS
RESEARCHERS are looking for parents of babies to take part in the first study its kind aimed at transforming our understanding of how young children’s feet develop as they learn to walk. The five-year Great Foundations scheme, led by research teams from the Universities of Salford and Brighton and funded by £1.5m from the William M Scholl Endowment Fund, will look in detail at how the foot develops as children start to walk independently, as well as parents’ attitudes and beliefs around infant foot health. It consists of two studies – Small Steps, which will for the first time establish an understanding of foot development as children learn to walk, and Little Footnotes, which will build up a picture of how people get their information about children’s foot health. Small Steps is the most ambitious study of its kind to date. Parents of babies who are just beginning to crawl and pull themselves up are now being invited to purpose-built ‘baby spaces’ in the University of Salford’s Brian Blatchford Building and at the University of Brighton which have been designed to look as much as possible like nurseries.
“When it comes to answering fundamental questions like when people should buy their child’s first shoes and how feet should be measured, a lot of people base their decisions on word of mouth or turn to potentially misleading web forums because the official advice might be difficult to access.
For the next three years research teams will be looking for parents of children aged around three to five months and not yet standing who can visit the lab to help them carry out this work. The team will invite parents to return over the course of a year to look at how their children’s feet continue to develop as they grow and begin to walk with more confidence.
“This research will enable us to build up a detailed understanding of children’s foot development and our findings could have huge implications in the future – by providing parents with accurate advice, helping footwear manufacturers design better products, and enabling health professionals to give appropriate support. “Decisions made during infancy can have an effect on people for the rest of their lives, and being able to provide evidence based information to parents could help us prevent future problems for a generation which hasn’t even been born yet.”
Researchers will measure how the babies move using a series of 3D cameras to film them as they crawl or toddle across a short area.
As part of Little Footnotes, the team will talk to groups of parents and carers, as well as looking at data from online forums and mum chat rooms to find answers to questions such as what factors influence decisions around buying shoes.
Dr Stewart Morrison, of the University of Brighton, added: “There are some fundamental gaps in our understanding of where parents get their knowledge on foot health, what concerns them, and how health professionals might provide appropriate support.
Information gathered from the cameras will show how the children move during this critical stage of their development, while a pressure pad below their feet and some tools placed on the skin will help scientists understand how their foot muscles work.
They will also be talking to major footwear brands and health professionals such as health visitors and podiatrists. The outcomes may be used to inform parents and carers about issues such as how and when they should buy their children’s first shoes.
“This is very timely because of the increasing emphasis on prevention rather than cure of diseases in adulthood. Getting evidence based public foot health messages to parents should be a great way to prevent future problem.
Talarmade celebrates awards successes
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TALARMADE is currently celebrating success having been awarded ‘Best Orthotics Product Provider 2017 and ‘Award for Innovation in Podiatry Products’ by SME News in the Midlands Enterprise Awards 2017.
He added: “This is a great achievement by the entire Talarmade team, and demonstrates our continued development as an organisation in both product development and customer service.”
This is an award that is voted for by customers using the services and products of companies in the sector which, as Talarmade managing director Ian Leddy stated: ‘makes it all the more important that we have been recognised and nominated for the award in the first place.
Talarmade hope to emulate this success having been further ‘customer nominated’ and have been selected as a finalist in ‘The NHS in The North West Excellence in Supply Awards 2017’, and will be attending an awards dinner in Blackpool later in October.
Advertiser’s announcement
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Assistive Technologies partners with Naidex NAIDEX is Europe’s most exciting event dedicated to the disability, independent living and healthcare professional sectors.
In the wake of the huge success of the most recent instalment of this esteemed and long-established event, Naidex will return for its 44th year to the Birmingham NEC on April 25 and 26. Since taking over this powerhouse event in mid-2016, PRYSM Media Group have injected diverse content, expert speakers and 20 years of experience in event organisation, and it hasn’t gone unnoticed. Attracting thousands of public, trade and healthcare professional visitors, Naidex has regained its momentum and is back on the map as the event for the disability sector. And it’s absolutely free to attend! With an increased floor plan, and running alongside the Dementia Care and Nursing Home Expo, there is no limit to the reach of this incredible event. PRYSM Media Group will be resolutely nurturing and developing Naidex over the coming months, to ensure that old favourites such as the Mobility Test Track and Sport Demo Arena are 6
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2017
refined and focused, and brand new, never before seen components such as the Moving & Handling Lab and Home, Design & Build Summit will impress and amaze a cross section of forward thinking, international delegates. As well as this, Naidex will also boast a comprehensive seminar schedule of 200 expert speakers, as well as over 300 diverse suppliers. Naidex is the hub of innovation for the disability sector. Assistive Technologies magazine and Naidex have partnered for the 2018 event to ensure that its readership is aware of the unparalleled opportunities available for healthcare professionals, clinicians, therapists, equipment suppliers and associated businesses who have an interest in assistive technologies and mobility improvement. Register for your FREE ticket at www.naidex.co.uk. For exhibiting and sponsorship enquiries please email paige.lewin@prysmgroup. co.uk or call 01179 902092.
A quarter of children wear wrong sized shoes, new research finds NEWS
MORE than a quarter of UK children are wearing shoes which could permanently damage their feet, new research has shown. A staggering 29 per cent of British children could be wearing shoes which are completely the wrong size, according to new research.
According to a survey of 2,000 parents by The College of Podiatry, 55 per cent of British children have suffered damage to their feet, such as blisters, bruises and calluses, by wearing shoes which are either too small or unsuitable for young feet. In addition to the risk of wearing the wrong size shoe, the research also showed many parents are inadvertently dressing their children in shoes which podiatrists would not recommend for everyday or frequent wear. These include flip flops (25 per cent) and ballet pump, slip-on style shoes (20 per cent). In fact, the survey revealed the nation’s daughters are at the greatest risk of long-term damage. Nearly a quarter of parents (22 per cent) say they feel pressure to buy their daughters fashionable shoes such as ballet pumps, flip flops and even high heels, which experts warn against. Almost one in 10 young girls are wearing shoes with a heel of 2cm or higher and, on average, young British girls are wearing these types of shoes as young as six years. This could put young feet at greater risk of developing foot problems. The survey showed that 56 per cent of parents admit they have bought their children shoes without having the children’s feet measured or the shoes properly fitted.
Dr. Stewart Morrison, a podiatrist from the College of Podiatry and The University of Brighton, said: “It is worrying that so many children are wearing shoes which either don’t fit them properly or are not suitable for everyday wear.
Even when it comes to school shoes, 47 per cent of parents do not buy their children’s school shoes in a shoe shop which offers a proper fitting service, opting for cheaper supermarket and high street options.
“Wearing the wrong size or type of shoe in the short term causes blisters, rubbing, bruising and calluses, but in the long term it could affect foot development and result in musculoskeletal issues in the future.
More than a third (38 per cent) of parents also admit to handing down shoes to younger children without being sure they fit properly. In fact, one in 10 parents (13 per cent) confess they have no idea
“Children’s feet are still growing and are more susceptible to damage than adult feet, so it’s really vital to ensure they are wearing shoes which fit them well – in width as well as length – and that are suitable for age, as well as the task they are wearing them for.”
“Wearing the wrong size or type of shoe in the short term causes blisters, rubbing, bruising and calluses, but in the long term it could affect foot development and result in musculoskeletal issues in the future.”
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of their children’s current shoe size.
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2017
“Children often won’t say if their shoes are too tight or are hurting, which is why it is important that we raise more attention about children’s foot health and encourage parents to check their children’s feet regularly. “We recommend parents have their children’s feet measured and their everyday shoes fitted by a professional. For a young child (aged 1-3), foot
changes can happen very quickly and parents should have their feet measured approximately every eight weeks, and for older children, we would advise every 3-4 months. This would be particularly important during growth spurts.” 44 per cent of parents say they have not had their children’s feet measured because they insist they can tell by checking themselves, while 8 per cent blamed busy lives and hectic schedules. More worryingly, 40 per cent of parents have put off buying a new pair of shoes for their child - even though they have complained about their feet hurting. One in 20 (five per cent) said they couldn’t get their child to stay still long enough for a shoe fitting. A further one in 20 (five per cent) didn’t know there were shops that offered a shoe measuring and fitting service. Budget is also an issue for modern parents, with 34 per cent saying they struggle to find the cash for new pairs of shoes – while 18 per cent said they were too busy to sort it straight away. Nearly one in six parents (15 per cent) confess that they don’t like shoe shopping for their children because their kids don’t want to wear what their parents would like them to wear.
LimbPower releases videos for amputees
The tutorial style videos feature a range of strength and movement exercises, designed to improve people’s general fitness and encourage more amputees to lead an active lifestyle. Created in partnership with Sport England and filmed by Square Daisy, the series of 22 short exercise videos support LimbPower’s ongoing work to support people with limb impairments to reach their full potential through sport and exercise. Each video is between one and three minutes long, and features a voiceover and on-screen graphics to guide individuals on how to perform the exercise with the correct technique. Exercises featured in the video series cover five main areas: n Introduction to exercise and warm up. n Dynamic exercises. n Circuit training and stretching. n Strength and conditioning.
n Agility, balance and coordination.
Jack Eyres, an amputee and personal trainer, said: “LimbPower created these videos to help inactive amputees to improve their fitness, build confidence, strength and stability, empowering them in the early stages of their lives as amputees to engage in physical activity. “These exercises focus on core stability, coordination, strength and balance, along with dynamic stability and mobility exercises, to promote increased fitness. “We want to encourage amputees to take an active role in their rehabilitation and general well-being and to equip them to take part in more dynamic activities and sport.”
Astounding response to leg amputee study A UNIVERSITY of Dundee PhD student has been inundated with people volunteering to take part in her study.
All exercise videos are available to watch on the LimbPower website and YouTube channel.
Giulia Zedda from the Institute of Motion Analysis and Research at Ninewells Hospital put a call out to leg amputees who use a prosthetic unaided. Her study aims to find out if the patients are using the correct prosthesis.
Kiera Roche, LimbPower CEO, added: “We know that being active can have a positive impact on a person’s physical, mental and social wellbeing.
She has now had to close the study to new patients as she has received an overwhelming number of people coming forward to take part.
“We hope that these videos will give people with limb impairments more confidence to take part in regular exercise and improve their fitness levels.”
Giulia said: “The response has been amazing. Within two hours of the press release going out I had enough patients to complete the study. I’m still continuing to get requests, but
NEWS
LIMBPOWER has released a series of short exercise and fitness videos for amputees.
now unfortunately I’ve reached my quota.
“I’m really grateful to all those who have got in contact. Without the help of patients we wouldn’t be able to carry out this sort of research. The public, particularly in Tayside in Fife, always show us tremendous support. The people who will be part of the study have already told me they’re excited to get started.” Guilia will be using special software to check if the patient’s prosthesis is fitted correctly, the study will focus on the distribution of force during everyday activity. This could lead to adjustments to the prosthetic that aims to improve the overall comfort of the patient.
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NEWS
Experts develop computer hand model to improve finger joint surgery
CLINICIANS and researchers in Southampton are leading a pioneering study into the use of computer-generated hand models to help improve the success of joint surgery for patients with arthritis.
either stiffening the joint, known as fusion, or replacement using artificial spacers made of metal or plastic, is considered.”
As part of the study, funded by the Engineering and Physical Sciences Research Council, the team will also collect the same data of the PIP joint from patients with arthritis both before and after joint replacement. This will allow greater understanding of the effects of disease and how to improve the reliability and predictability of surgery.
Currently, surgery to replace the proximal interphalangeal (PIP) joint – the second joint in the finger from the finger tip – is not as reliable or predictable as surgery to replace the hip or knee. Although it usually reduces pain, the range of movement does not improve and, in some instances, the joint can dislocate, stiffen or wear out. Now, surgeons at University Hospital Southampton NHS Foundation Trust and researchers from the University of Southampton are using data taken from CT scans and MRI scans, together with motion-tracking technology, to build a precise computerised model of the PIP joint containing billions of pieces of information. The computational engineering team in the University’s Faculty of Engineering and
“By using data from patients’ existing MRI and CT scans to construct advanced computer models of the hand, we will be able to view the motion of the joint and how a simulated joint replacement will look before surgery.”
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the Environment – Dr Chris Phillips, Dr Alex Forrester and Dr Alex Dickinson – have applied sophisticated mathematical methods developed in aerospace engineering to correlate the data from the scans and the motion-capture. Dr Cheryl Metcalf, a specialist in biomechanics at Southampton’s Faculty of Health Sciences, is also part of the research team. Study lead and consultant hand surgeon Professor David Warwick is joined by consultant radiologist Dr Leonard King from UHS on the project. “Our finger joints can naturally wear out with age and, although symptoms are often manageable, pain can become so troublesome that treatment is considered,” said Professor Warwick. “Initially, we can try one or two steroid injections and, if unsuccessful, surgery, which includes
“By using data from patients’ existing MRI and CT scans to construct advanced computer models of the hand, we will be able to view the motion of the joint and how a simulated joint replacement will look before surgery,” said Dr Metcalf. “This will give hand surgeons access to levels of specific and detailed information they have never had before.” Prof Warwick added: “Although most people are pleased with pain relief following surgery, their range of movement in the fingers does not improve and, in many cases, worsens – in which case the intervention is disappointing. “One of the main reasons for this is that when the joint is diseased, it is technically very difficult to get the artificial joint components to fit precisely with the ligaments and tendons which surround the joint and, to improve that, we need to obtain more information.” He concluded: “Then we can design better surgical techniques and better joint replacements to help patients in the future, so we are extremely excited about the possibilities this work presents.”
NEWS
Paralympian Andrew Lewis awarded Honorary Degree ANDREW Lewis was awarded the Honorary Degree of Master of Technology by the University of the West of England in recognition of his contribution as a Paralympian and elite sportsman alongside his commitment to inspiring others to overcome adversity and to developing new technology. After leaving school in 1999 he made the decision to serve Queen and country by applying to join the Parachute Regiment, in the British Army. Andrew said: “Because of my determination to excel when applying for the army I was super fit as I
“Getting the blade changed my life dramatically and I competed in and won many events including Stoke Mandeville stadium and I registered for England Athletics.”
frequently ran for Gloucestershire in cross country events across the UK. “I was about to begin my P Company training when I had a motorcycle accident that left me hospitalised for over four months. After waking up in a hospital bed at just 16 years old the reality of exactly what had happened to me set in, I thought both my life and career were over.
“Getting the blade changed my life dramatically and I competed in and won many events including Stoke Mandeville stadium and I registered for England Athletics.”
Andrew Lewis
“The next couple of months were very hard for me as I didn’t lose my leg straight away. Bristol Royal Infirmary did everything they could to save it and for a short time they managed to do so.
to achieve something incredible and something that would change my life forever.
“However, due to continual complications, in December 2005 I made the extremely difficult decision to have my leg amputated.”
“I had a burning desire to run after watching the 2012 Paralympics. Watching those inspirational athletes ignited a flame in my heart that for years had just been a small ember.
This was a hard time for Andrew as he struggled with his decision as he had wanted to join the British Army and it was particularly difficult as his brother was in Iraq at the time. Andrew added: “I made the decision that my amputation was not going to be my disability but in fact my ability
“I knew there would be obstacles and I knew that I would have to learn to get over them.
“With a fresh resolve I started looking into getting a running blade so I could run again and my employer Airbus UK incredibly part funded the cost of this new leg, as it is not available on the NHS, and we managed to fund raise the rest, raising a total of £8,000.
Not content with running alone, Andrew entered a triathlon as its multi-faceted disciplines were extremely appealing to him. Three years later he is now part of the Great Britain World Class Performance Programme competing all over the world. After many hours of training he is now Paralympic champion after bringing home gold in Rio 2016, and during the same year secured world and European champion status for GB. Only recently Andy returned from Austria to be crowned European champion once again to regain his title. He was awarded the Honorary Degree of Master of Technology (Hon DTech) at the awards ceremony of the Faculty of Environment and Technology at Bristol Cathedral
Innovative fastening system for Genudyn® CI NOVEL Brace THE new Genudyn CI NOVEL Knee Brace from Sporlastic, now available exclusively at Ortho Europe, uses a unique fastening system to ensure reliable orthotic support for your patients. Unlike most knee braces which rely on hook and loop fastenings that can shift with movement, the Genudyn NOVEL Brace uses an innovative twist-lock system, enabling you to permanently set the strap position, whilst at the same time allowing for: n Adjustment of flexion (45°, 60°, 75°, 90°) and extension (0°, 10°, 20°, 30°, 40°, 50°). n Adjustment of strap tension, with a simple button to release tension as needed. n Adjustment via tactile and audible check, even through clothing. n Motion compensation with the Living Hinge. Additional strapping can be used to control and stabilise the posterior drawer, and incongruent joints support the knee’s physiological movements. 14
The NOVEL system is very easy to use, and application for the user is simple without having to step through. The brace is particularly suitable for active orthotic patients. The Genudyn brace has a frame made of aluminium which can be individually shaped, guaranteeing an accurate anatomical fit for the user. Indications for use include injuries and reconstructions of the anterior and posterior cruciate ligaments (ACL and PCL), rupture of the PCL, and instability in the posterior drawer. Ortho Europe also supplies a variety of alternative knee braces for a full range of indications, as well as many other orthotic products. If you would like to find out further details about the Genudyn family of knee braces, or learn more about the full Ortho Europe product range, please get in touch directly: Andy Cooper – 07770 948592 andy.cooper@ortho-europe.com Ian Walker – 077863 78515 ian.walker@ortho-europe.com You can also find more information on the Ortho Europe website, www.ortho-europe. com
ASSISTIVE TECHNOLOGIES I OCTOBER/NOVEMBER 2017