Assistive Technologies December/January 2017/18 by Script Media

INNOVATION FOR INDEPENDENCE

ISSUE 118 DECEMBER/JANUARY 2017/18 £6.95

Professor set to measure results of technology

A BOURNEMOUTH University professor will undertake the first in-depth analysis of using robotic-assisted technology in hip replacements.

The Mako robotic-arm technology started to provide hip replacements to Nuffield Health Bournemouth Hospital’s patients from October, led by leading orthopaedic consultant Professor Robert Middleton, who is the head of the Orthopaedic Research Institute at Bournemouth University. The partnership is the result of a £200,000 grant awarded to BU by the world’s leading medical technology company, Stryker, and it is the first time worldwide that an indepth analysis of the physical and economic benefits of using robotic-assisted technology in hip replacements will be undertaken. Professor Middleton said: “I was first trained in robotic-assisted surgery 20 years ago. The Mako technology is now at a level where patients are seeing a true benefit of receiving robotic-assisted surgery. “As a Professor and an orthopaedic consultant, not only did I want to perform hip replacements using robotic technology to the highest standard, but I wanted to prove the benefits of using this technology over current

standard practices, so all can benefit in the future”

In partnership with Nuffield Health, Professor Middleton will see patients before operating and then up to one year after at Bournemouth University’s ORI BU Gait Lab. This facility has state-of-the-art equipment available including a 180-degree screen where medical professionals can take a deeper look at a patient’s gait or walk, as they swerve, jump and kick animated objects that will appear on screen. Professor Middleton added: “Patients in the UK and Bournemouth will see a multitude of benefits from receiving robotic-assisted arm surgery including a quicker, less painful recovery and a longer lasting implant. A hip replacement is the most common surgery conducted in the UK and by improving this procedure patients will have the opportunity to get back on their feet and back to work quicker, as well as competitive sport.” John Fletcher, BU’s Pro-Vice Chancellor of Research and Innovation, added: “This partnership will bring real benefits, not just to Dorset and the UK, but globally, as we work together to drive forward innovation and improvements in medical science.”

LimbPower has announced that Richard Whitehead, four-time world champion and two-time Paralympic gold medallist, is the charity’s new patron. Richard has been a dominant force in men’s para-athletics in recent years. He holds the world record for athletes with a double amputation in both the full and half marathon. He won gold in the T42 200m sprint at both the London 2012 and Rio 2016 Paralympic Games, and is a fourtime world champion over the same distance. In 2013, he was appointed MBE for his services to athletics. As patron, Richard hopes to support LimbPower’s mission to improve the provision of sport and leisure opportunities for amputees and people with limb difference.

A THIRD year Journalism student has been awarded a £2,500 grant to go towards a new mobility scooter to help him complete his course at De Montfort University Leicester.

students to complete their academic studies at DMU. “The team’s objectives are to ensure that the disabled student is offered opportunities to fully engage with the student experience.

Simon Sansome, who became disabled after injuring his spine three years ago, was having difficulty getting around campus and turned to DMU’s Disability Advice and Support team for assistance and advice. With their support, Simon completed an application to the Snowdon Trust and was awarded £2,500 for a new mobility scooter which is already giving him much more freedom around campus and the community as a whole. “To be awarded the grant was amazing,” he said. “I am very grateful

“I simply would not be able to finish my university course without the assistance of the scooter.”

“Disability is not a barrier to learning so approach the team and see what they have to offer to you!”

Simon Sansome

to the university and the Snowdon Trust. I lost some of my independence and was struggling to get around campus and Leicester. “Now I am free to go anywhere, it is going to improve my quality of life tremendously. “I simply would not be able to finish my university course without the assistance of the scooter.” DAS manager Tina Sharpe added: “Our aim is to provide an accessible and inclusive environment for

DAS offers a range of innovative strategies such as quiet rooms in halls; dyslexia screenings and other neurodiversity assessments; low sensory matriculation and many others including assistance in applying for Disabled Students Allowances. The service consists of the central Disability Advice and Support team based in Gateway House and Faculty Disability Officers, who are based in the faculties. Simon added: “It was important for this to be reported as the Snowdon Trust is not a well-known organisation for disabled students here on campus, but they can offer support to any disabled student applicant.”

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Wheelchair grant praised by disabled DMU student

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ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2017/18

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Funding to explore how virtual reality can help children through rehab RESEARCHERS from Sheffield Hallam University have received a grant to help them lead on revolutionary work looking into how virtual reality can help injured children through painful rehabilitation. The Medical Research Council awarded funding to a Sheffield consortium made up of University of Sheffield, Sheffield Children’s NHS Foundation Trust, Sheffield Hallam University and Sheffield Teaching Hospitals NHS Foundation Trust. This funding is designed to “accelerate the transition from discovery research in any healthcare area into translational development projects by supporting preliminary work or feasibility studies to establish the viability of an approach”. It forms part of the MRC’s strategic aims to turn fundamental discoveries into improvements in human health and economic benefit. From this funding, a Sheffield Hallam University team has received a grant of just over £50,000 to carry out the project, which is a partnership between Hallam, the University of Sheffield and Sheffield Children’s NHS Foundation Trust. The team, led by Ivan Phelan from Hallam University, also comprises Professor Paul Dimitri, director of research and innovation at Sheffield Children’s Hospital NHS Trust and Professor Penny Curtis, professor of child and family health and wellbeing, at the University of Sheffield. Children who have injuries to their upper limbs and hands often have to undergo complex repetitive therapy exercises that may be painful to help them regain functionality. This project, currently dubbed ‘VR Rehab PlayRoom’, aims to develop interactive VR scenarios which will require the children to perform the required exercises for them to progress through a game. 4

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It is hoped that the patients will be so engrossed in the VR game that they become unaware of the pain associated with the exercises. Ivan Phelan, research associate game developer in Hallam’s Cultural Communication and Computing Research Institute (C3RI), said: “Depending on certain injuries, it can be necessary for children to have to perform exercises to help them recuperate – which can sometimes be painful. It can also be very difficult to motivate some children to perform these vital exercises. “Using VR, patients would perform the exercises recommended by their therapist, and would receive in-game rewards to progress to the next level at the correct pace - either over time, by movement or both. “The system would monitor how they cope with the exercises and progress made. Repeated sessions would enhance the prospect of good or complete recovery with optimal restoration of function. “The developed system could be made available for patients to use at home, by them using existing computers or games consoles and VR headsets. Different scenarios would be made that would appeal to children’s different motivations to engage.” Professor Paul Dimitri, Director of Research and Innovation at the Sheffield Children’s NHS Foundation Trust, added: “Children will be really excited about the prospect of using VR to play, and we think it will yield real clinical benefits in terms of their rehabilitation. This is obviously the tip of the iceberg when it comes to the potential VR has to contribute to innovation in children’s healthcare, from training to treatment.” The project started this summer with patient trials likely to begin in April 2018.

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Racerunner Ellie is one step closer to Paralympic dream By Dominic Musgrave

National Paralympic Committees will be able to license RaceRunning athletes with World Para Athletics from January 1.

DOUBLE world champion RaceRunner and Sheffield Hallam University graduate, Ellie Simpson, is celebrating after it was announced that her sport was to become an official World Para Athletics event.

Ellie added: “When I first started RaceRunning, I was a little disappointed to learn that it wasn’t a Paralympic sport.

The sport development and coaching graduate who has cerebral palsy, has worked hard to promote the benefits of RaceRunning for people with the condition and has longed for it to become a Paralympic event. This latest development, supported by the International Paralympic Committee, means Ellie is one step closer to achieving her dream. “I feel on top of the world for RaceRunning to finally be recognised as a World Para Athletics event,” said Ellie, 22. “RaceRunning is incredibly special as athletes who have the more severe levels of Cerebral Palsy/brain injuries, who would normally just sit on the side lines and spectate, are able to get out there and compete – and they’re

“But my sheer love for it very much overwrote this and I knew it was the sport for me as I loved the fact that I was able to run around a running track and compete.” Ellie Simpson

running! It is incredible that athletes like me are now going to be given the chance to compete on a world stage and at a world class level. I feel like all my craziest of dreams have come true.” The Cerebral Palsy International Sports and Recreation Association recently announced that the World Para Athletics will introduce a selective RaceRunning programme at the 2018 World Para Athletics European Championships in Berlin.

RaceRunning is a form of assisted running and provides athletes with high support needs, who cannot compete in a racing wheelchair and/ or ambulant run with the opportunity for aerobic competition on the athletics track. RaceRunners are supported by a frame on wheels which allows them to successfully ambulate. At the moment, RaceRunning is promoted internationally by CPISRA, it features on the athletes’ programme at their World Games and has its own

World and European Championships. It has been included at various IWAS World Games since 2011. But now Ellie, who is the UK’s number one race runner and is the founder of CP Teens – a charity that connects young people with disabilities to support, advice and opportunities, is confident that her sport will make the 2024 Paralympic Games in Paris. “It is unlikely at this stage that RaceRunning will be added to the programme for Tokyo 2020, although it’s not entirely impossible. However, I am really confident it will make Paris 2024 and I’ve already got this goal in mind when training. “To be a Paralympian would be my ultimate achievement. Just the thought of it sends me into a whirlwind. Also, to be one of the first ever RaceRunning athletes at the Paralympics would be incredible. It is a sport that I’ve been a part of and put my heart and soul into developing, so to see it in Paris will be phenomenal.”

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Retired professional footballers at higher risk of knee osteoarthritis The study concludes that the ‘repetitive microtrauma’ of professional football, regardless of significant injury, is likely to be the main cause of increased risk of knee osteoarthritis. The reported degree of increased adjusted risk (at least doubled) is in the order required by many national bodies to recognise knee osteoarthritis as an industrial disease for professional football.

The research was led by academics at The University of Nottingham and funded by the charity Arthritis Research UK with collaborative support from FMARC (FIFA’s Medical and Research Centre), the Professional Footballers Association (PFA) and SPIRE Healthcare Group. The study reported that male exfootballers were two to three times more likely to suffer from knee pain and knee osteoarthritis and require a total knee replacement, even after adjustment for other risk factors including significant knee injury. Ex-footballers reported more knee pain, structural knee osteoarthritis on x-ray and total knee replacements across all age groups in the study and especially in younger age groups (4054 years). The research also revealed that although former footballers presented with more musculoskeletal pain, they were less likely to suffer with and report other conditions or diseases such as diabetes, heart attacks and cancer. The study was led by Dr Gwen Fernandes and Professor Michael Doherty who are part of the Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis and are based in the department of Academic Rheumatology in the University’s School of Medicine.

Professor Mark Batt, Director of the Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, and part of the research team, said: “This was a well-conducted study powered to investigate both the positive and negative effects of playing professional football. The research will allow us to more accurately communicate both the associated benefits and risks to those involved in the industry.” This is the largest and most comprehensive study conducted in the UK and internationally on establishing how common knee pain, osteoarthritis and knee replacements are among ex-professional footballers when compared with the general population and to look specifically at whether this was influenced by other factors such as previous knee injury. More than 1,200 ex-footballers with an average age of 59 years were recruited via the PFA and from individual league clubs and

professional football associations in the UK and compared to more than 4,000 general population men from the East Midlands region with an average age of 62.8 years. Other novel findings include: exfootballers had more osteoarthritis in the end joints of their fingers (nodal OA), were more likely to have an index finger shorter than their ring finger — also known as a pattern three-digit ratio, which has been previously linked to osteoarthritis risk; and reported significantly more body pain, knee misalignment and use of painkillers. The research suggested that there could be modifiable risk factors such as obesity management and not engaging in other high-risk occupations post-retirement from professional football. Reducing the number of significant knee injuries in professional football would also have an important

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impact on the development of knee pain, knee osteoarthritis and the requirement for a knee replacement.

RETIRED professional footballers are far more prone to develop knee pain and osteoarthritis and face problems with their knees earlier in life than the average person, a study has revealed.

Dr Stephen Simpson, Director of Research & Programmes at Arthritis Research UK, added: “Osteoarthritis is the most common cause of joint pain and affects over eight million people in the UK. “Studies that focus on elite athletes, such as professional footballers, are useful in understanding the longterm impact of specific movements on musculoskeletal health, especially those associated with sports. Ultimately, this can help pinpoint links and risk factors for osteoarthritis leading to effective ways to treat it and to prevent its development. “It’s worth reminding people who take part in regular sports or physical activity, such as football, that regular exercise is important for all ages and the long-term health benefits are immense. “If you are injured, we would advise that you take care and consult a health professional as soon as possible, to get advice to enable the best recovery.”

Rugby league captain shares inspirational story SCOTLAND’S Wheelchair Rugby League captain has urged people with disabilities to realise the positive impact sport can have on their lives.

The Sports Centre – designed to be inclusive for users of all physical and sensory ability – also allowed Blackwood customers to sample various machines in the gym as well as watch and participate in displays.

Graeme Stewart told a special sporting themed AGM of specialist housing and care provider Blackwood how sport helped him overcome challenges associated with his injury.

Graeme added: “It’s great that Blackwood chose to have a sportthemed AGM as it gives everyone a chance to try things they might not have known existed, meet new people and just generally get out and about and have some fun.

Graeme, from Balloch, West Dunbartonshire, was just 16 years of age, and two days away from joining the RAF, when a tragic accident left him paralysed in the legs. The 50-year-old is now not only the proud captain of his country at rugby league, he has also been cox of a rowing team, regularly plays basketball and has climbed Ben Nevis. In his inspirational speech, Graeme said: “In 1983, I fell off a rope swing that was over a cliff and I broke my back in three places which led to paralysis. It was a bit of a shock at the time, I had my life planned out

and it threw it into disarray. “I was two days from starting with the RAF and was training at the time of the accident to compete for Scotland at rowing. “Everything had changed but sport really helped me through and now I’m proud to say I’ve climbed Britain’s

highest peak and I’m captain of my country.” The Blackwood AGM was held at the National Sports Centre in Largs, North Ayrshire, and offered the organisation’s customers the chance to try various sports and activities such as wheelchair basketball, dance and archery.

“It’s so important what Blackwood are doing because people need to know what their options are as I’ve experienced first-hand the positive impact sport can have. “Sport has helped me so much and I’m still learning. I just took up basketball three weeks ago. I’m so proud when I go out and represent my country so my message to all the customers is to just go out and enjoy it because you never know where it might take you!”

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‘FootSnap’ app helps in fight against diabetic foot ulcers “It was embedded with image processing algorithms to enable standardisation of data capturing.

UNIVERSITY researchers have developed an app to help medical professionals capture consistent photographs of the underside of diabetics’ feet in order to better detect foot ulcers and monitor treatment.

“With Lancashire Teaching Hospitals NHS Foundation Trust, we collected a large-scale dataset with ground truth annotation of the ulcers.

The Manchester Metropolitan University academics – Dr Moi Hoon Yap, a senior lecturer in Computer Science, and Professor Neil Reeves, professor of Musculoskeletal Biomechanics – created FootSnap to run on an iPad tablet device. With the aid of a tripod and a portable LED spotlight, FootSnap assists clinicians to capture uniform images of the bottom of someone’s feet no matter what time or place. It therefore allows changes in a patient’s physiology to be more easily tracked and compared over time, with the aim of leading to a timely diagnosis of abnormalities or disease. Prof Reeves said: “A diabetic foot ulcer is an open wound on the foot and represents a major problem for people with diabetes, being very difficult to heal and in some cases leading on to amputation. “The app that we have developed at the moment standardises foot photographs. “Feet may not necessarily be photographed by clinicians at the moment. If they are, the pictures are not standardised for distance, orientation and lighting as we do with this app. “The standardisation feature of the app is however, only the first stage of what we will go onto achieve with this app. “We are now incorporating more sophisticated

“We introduced an end-to-end solution using a deep learning approach for the detection of diabetic foot ulcers with high accuracy.

algorithms as part of the app, which allow for state-of-the-art monitoring and prevention of foot ulceration over time. “This will be a very useful clinical tool for healthcare professionals to monitor ulcer healing and is a major advantage over the current approach, which is mainly based on subjective judgement.” FootSnap, developed with the help of PhD researchers Katie Chatwin and Manu Goyal, guides medical professionals to orientate and align the patient’s foot in such a way as to build up a portfolio of uniform images for comparison to assist diagnosis and prognosis.

“In the near future, the optimised light-weight deep learning model will be integrated into FootSnap to enable early prediction of diabetic foot ulcers.” To test the reliability of FootSnap, Prof Reeves and Dr Yap conducted a successful proof of concept study, as reported in a recent paper published in the Journal of Diabetes Science and Technology. They compared and analysed how two operators photographed the feet of 15 people with diabetes, aged between 43 and 74, and 15 non-diabetic control volunteers.

The app should be available to download in the near future and the developers envisage further evolution of the programme will enable it to be used on smartphones and other devices and by less well-trained operators.

The authors concluded: “Standardisation of plantar foot photographs with FootSnap will allow the future implementation of advanced computer vision algorithms with these images, which can be used for monitoring changes in diabetic foot shape, texture, and colour during longitudinal clinical trials or as part of state-of-the-art clinical monitoring procedures.

Dr Yap added: “FootSnap is a mobile application based on the concept of data-driven research and Internet of Things.

“This technology may represent the first stage toward a meaningful step forward in the prevention and management of diabetic foot pathologies.”

Simon launches ambassador programme accessing.”

CUMBRIAN wheelchair athlete Simon Lawson is reflecting on his season and hopes support from the University of Cumbria will lead to even more success in his 2018 campaign.

Students too will make the most of the relationship offering practical as well as theoretical experience has set the University of Cumbria’s course ahead of rivals.

Winning the Great North Run and setting a British marathon record were undoubtedly highlights; crashing out of the London marathon and getting a puncture just two miles from the finish while lying third were events he’d rather forget. “There’ve been real ups and downs – not the best season overall although I’m happy where I was physically,” Simon said. “Now I’m training all winter to see if I get selected for the Commonwealth Games in Australia.” Helping him towards peak fitness both physically and mentally will be students and staff from the University of Cumbria’s Sport and Physical Activity department. Simon is the first UoC Sport ambassador and in return for a package of support from the university will help out with various marketing events and school trips, sharing a wealth of knowledge and life experience from his inspirational story. The team already has a track record in helping Cumbrian sportsmen and women reach their potential – M Sport, Carlisle United, GB triathletes and many more are among athletes who have already benefitted from the Fusehill Street fitness laboratory. Now it’s hoped Simon too will be able to make the 10

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“We offer weekly rehab clinics each Tuesday evening which mean students get work with real people – with some clients at the top of their sport – which is fantastic for students,” Jeff added.

Jeff Thrope with Simon Lawson and Vice Chancellor Prof Julie Mennell.

most of the kind of expertise in Cumbria that will help him succeed on the other side of the world. “It’s the start of a journey where we hope to be able to support Simon in whatever way we can,” senior lecturer in coaching and sport performance, Jeff Thorpe, said. “I think it’s an area that is lacking around here and we hope to help out with the additional elements that make a difference to top level performance like strength and conditioning, sports rehabilitation, blood testing, and sports psychology. “We’re hoping this will be the start of a relationship where we can maximise Simon’s training and offer this kind supplementary support that athletes in our region typically find difficult

Winter training along the coastal paths and hills of west Cumbria may be a daunting experience, but Simon says knowing he has a supportive team of experts backing him up makes the dark days of winter more bearable. “Jeff’s already helped a lot with the psychological side of things after niggles and injury and now the sports science testing should help show where I am physically to show a base line and indicate where we need to work to really reach my potential,” Simon said. The University has also launched a talented junior athlete programme, supporting five of the Cumbria Sports Awards Rising Star winners from the recent awards ceremony in Ambleside. “What this shows Cumbria and the wider region is that the university is very serious about helping our local athletes achieve at the highest level and we hope this will be the start of a long and successful period for Cumbrian athletes and teams,” Jeff said.

Cardiff Met launches Stroke Research Hub

Strokes are one of the top three causes of death and the leading cause of adult disability in Wales. Around 7,400 individuals will have a stroke in Wales each year, with 66,000 currently living with the after effects of a stroke. It is estimated however, that 70 per cent of stroke cases could have been avoided, which is why the Welsh Government has proposed a five-year delivery plan to tackle strokes in individuals of all ages. The plan, which was recently refreshed, is a comprehensive, cross-sector, collaborative research strategy. The aim is to highlight all opportunities on offer in Wales, and create and fund an ambitious research environment. Since it has been implemented there has been an improvement in the treatment of strokes, but treatment options are still limited, which is why stroke research is vital. The research will help medical professionals understand the causes of strokes, resulting in the development of new treatments and a reduction in the number of individuals who suffer from strokes and the after effects. Dr Phil Jones, Clinical Research lead for Wales, said “The stroke implementation group has recognised the importance of research into stroke and the need to support a robust,

inclusive and productive environment for this to happen.

“Investing in stroke research and joint working with Cardiff Metropolitan University have been significant steps forward in realising these objectives.”

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CARDIFF Metropolitan University has launched Stroke Hub Wales – a resource facility that will support and coordinate research, innovation and education programmes across the country.

Associate Dean for Research at the School of Sport and Health Sciences at Cardiff Met, Professor Philip James, Academic lead and part of the team that helped devise and develop Stroke Hub Wales, said: “Our aim is to create and sustain a collaborative, robust research infrastructure in Wales and help facilitate world-leading research and innovation in the prevention, diagnosis and treatment of stroke, thus saving lives and ultimately reducing the debilitating impact on stroke patients.” The aim of SHW is to achieve a step-change in high-impact stroke research for the benefit of the health, wellbeing and prosperity of people in Wales. The hub is hosted by Cardiff Metropolitan but will act as a resource for researchers, clinicians and allied health professionals across our NHS Trusts, University Health Boards and Universities. Dr Abdul Seckam, SHW Manager at Cardiff Metropolitan University added: “In essence, the Stroke Hub Wales endeavours to develop a coordinated approach to attain funding support for excellent practice and world leading research.” Stroke Hub Wales will build on established relationships with Stroke Cymru and the British Heart Foundation.

Ice hockey player joins course NEW signing for Edinburgh Capitals, Mike Cazzola, has committed to a two-year physiotherapy programme at Queen Margaret University, Edinburgh. Part of the appeal of coming to Scotland from Canada was the chance to enrol with Queen Margaret University on its two-year MSc Physiotherapy (pre-registration) course. He said: “Combining my passion for ice hockey with the chance to study physiotherapy at QMU is a once in a lifetime opportunity. “Scotland is renowned throughout

the world for the quality of its higher education and I feel privileged to have the chance to experience and benefit from the country’s education system. By studying physiotherapy at QMU, Mike will benefit from a wellequipped School with specialised teaching facilities and state-of-the-art laboratories where practical skills can be honed before clinical placement. QMU also has a range of research laboratories, and a suite for the measurement of human movement using three-dimensional motion analysis, human performance and neuromuscular analysis.

App reaches 20,000 downloads OTTOBOCK has revealed that 20,000 people worldwide have downloaded the Fitness for Amputees App following its launch three years ago.

“It’s a fantastic tool for both existing and new amputees who want to improve their independence and mobility.

The App comprises a wide range of fitness and rehabilitation exercises for lower-limb amputees. The exercises were created by Ottobock’s leading physiotherapists and are easy to follow, with videos and guides to ensure users get the most from their rehabilitation and exercise.

“We hope to help many more people with our comprehensive approach to health for amputees as the App continues to develop and improve.”

In September 2017, the App reached the 20,000 users mark, meaning that more people than ever before have benefitted from the speciallydesigned exercises. While the App cannot replace a professional course of physiotherapy, the exercises are designed to help maintain fitness for amputees. It was launched with two sets of eight exercises to cover strength and endurance and coordination and balance.

The Fitness App has the potential to become even more popular in the UK as an increasing number of amputees are benefitting from recent NHS England Funding for Microprocessor Controlled Knees. Strength and endurance exercises are designed to strengthen the upper body muscles and so stabilise the spine and improve gait, while the coordination and balance exercises demonstrate how to stand securely on a prosthetic leg, resulting in greater comfort for the patient and a more natural way of moving. Earlier this year an additional stretch

and relax mode was incorporated into the App to help users cool down after each workout. These new exercises help to promote a faster regeneration and improve flexibility. :We are delighted to hear that so many people worldwide are now able to benefit from the Ottobock Fitness App” said Emma Gillespie, head of prosthetics at Ottobock UK.

The state-of-the-art MPK, Ottobock’s C-Leg 4, was previously only available to veterans and private healthcare patients, but as more and more amputees receive the C-Leg 4 and similar MPKs via their NHS Limb Centres, the App can provide vital training to individuals looking to maximise the benefits of their new prosthesis.

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NHS funding for advanced prosthetics may lead to lower patient injury rates and aid technology development SINCE the NHS England Clinical Commissioning Policy for microprocessor controlled knees came into place it has meant MPK’s can be prescribed to patients at specialist rehabilitation centres giving prosthetists the opportunity to prescribe amputees with the best solutions the market has to offer. So far, in all of the NHS limb centres across England combined, over 200 qualifying amputees have been assessed for a micro-processor controlled knee joint. With all of these patients having been vetted against the commissioning policy, the number of patients that have rejected the chance to transfer onto this life-changing equipment has been very low. Access to microprocessor-controlled knees continues to be hugely beneficial to those suffering with above knee, knee disarticulation and hip disarticulation amputations, particularly what are referred to as K3 walkers. These are patients that are able to walk outside at a range of walking speeds and traverse obstacles. These users face both the potential of injury caused by falls and long term health issues associated with uneven weight distribution caused by lack of confidence with their current devices. Use of the old systems available on the NHS meant amputees often struggled to even stand still comfortably as their knees have limited stability. A lack of trust in their prosthetic limb often means that the user will shift 80 per cent of their weight on to the none-amputated limb. This has a detrimental effect on other joints. Users of microprocessor-controlled knees also therefore benefit from stability on different terrains, slopes and steps, as well as being able to walk more naturally and efficiently at either single or varying speeds.

One of the leading examples of such a knee joint would be UK Company Blatchford’s Orion 3. This knee adapts hydraulic resistance in real time, providing the wearer with support when moving in any environment or standing still.

medical problems often experienced by amputees with conventional prosthesis and joints, such as lower-back pain, arthritis and hip replacements.

For example, while standing still, the Orion 3 will lock allowing the issue of uneven weight bearing mentioned above to be significantly reduced. Along with this, it also has stumble recovery technology, ensuring that the knee remains stable should the user trip or falter.

If patients wearing microprocessorcontrolled limbs are less likely to injure themselves thanks to the advanced technology, this has the potential to reduce costs and waiting times at clinics. If fewer amputees have to visit GPs or hospital wards due to prosthetic issues or injuries, NHS time and money can be spent on other areas.

This further reduces the risk of amputees falling or injuring themselves when walking or changing environments, and is another feature that provides users with the confidence and stability needed to move without fear.

The decision to make microprocessor knees more readily available to NHS patients in much larger numbers will act as a catalyst to accelerate the development of even more advanced technologies to improve patients’ lives further.

Such benefits not only make a huge difference to patient safety and quality of life; they also reduce the lifelong care needs of amputees.

Already the larger volume of users having access to the technology has encouraged Blatchford to offer hydraulic ankle technology into the clinical offering at no extra cost.

Prevention of falls was one of the key drivers for the NHS in creating this new policy – reducing the chances of acute injuries – but effective stabilisation can also cut the knock-on

The use of hydraulics in the ankle provides proven benefits to the wearer including efficient roll-over, for optimal alignment, greater clearance of the toe during swingphase extension and reduced socket pressure. Hydraulic foot technology such as Blatchford’s Echelon foot which self-aligns to terrain and remains dorsiflexed for swing provides a smooth, safe and natural walking experience for the user. When you combine both hydraulic foot and knee technologies together across the two joints the outcomes are further improved. In fact, such is the effect of the foot that many users notice the

ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2017/18

improvements from the foot more during their daily lives than the microprocessor knee – it’s almost as though the effect at the foot is felt on every step whereas the knee acts like a silent guardian quietly monitoring and keeping the user safe at all times. Previously, the technology was only accessible to a small market, hindering developer’s potential to grow and expand whilst also limiting the amount of user feedback and supporting research evidences available. Now that the treatment will be available on the Health Service, the amount of people who have access to these devices has become far broader. This will provide a much larger user group whose experiences and feedback can help to steer further future technological advances in this area. It’s refreshing to see that NHS patients will now have access to advanced microprocessor technology that is already widely available in other countries. In a world where technology continues to improve the lives of patients, it is a positive step to see NHS England harnessing what the market has to offer to benefit amputees, as well as investing in preventative measures to reduce the need for future treatments. This is a positive step forward for patients, the Health Service and the industry alike, that stands to only get better as the technology is developed further now it has at last become accessible. For more information on Orion3 and free Orion3 training courses you can visit www.blatchford.co.uk

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Digital experts look to get beyond ‘auditions’ in international project AN X-Factor style audition process will see some of Europe’s top developers compete to create products using virtual reality and digital technology to aid rehabilitation for people with a range of health concerns.

Shaun Wellburn and Professor John Dixon, all from the University’s School of Health & Social Care, as well as Professor Zulf Ali, Director of the University’s Healthcare Innovation Centre, through which the project will be operated.

Professor Denis Martin

The international project is being funded for three years, with the first year spent setting up the ‘hackathons’ across Europe, the second year seeing the ideas developed at ‘game jams’ across North West Europe, and the third year dedicated to the winners working with the VR4Rehab team to fully develop their ideas.

Researchers at Teesside University are part of the ambitious international project which will look towards digital technology and virtual reality to help provide support for people with a variety of health conditions. Funding of 2.4 million euros has been awarded for the VR4Rehab project, which comprises Teesside University’s Centre for Rehabilitation Sciences, along with partners from universities, hospitals and industry in the Netherlands, UK, France, Germany and Belgium. A series of ‘hackathons’ will take place across Europe bringing together developers in VR and digital technology with research and clinical experts from the various partners. The health experts will detail the issues and challenges faced with helping patients deal with various health problems, such as managing pain, controlling movement and encouraging physical and social activity.

theme and they will then work with the VR4Rehab team to bring their idea to market.

The developers will then come up with ideas for digital and VR solutions, which will help address these issues and concerns.

Professor Denis Martin is Professor of Rehabilitation at Teesside University and also Director of the Centre for Rehabilitation Sciences. His research specialises in the assessment and management of chronic pain and he has worked on several high profile projects, including The North of England Regional Back Pain Programme, which aims to help people with back pain self-manage their own condition, as well as Pain Garden, a website which uses the concept of gardening to illustrate more complex concepts about pain.

Those who come up with the best ideas will be invited back to develop prototypes and pitch their solutions to a panel of experts in a number of ‘game jams’. A winner will be chosen in each

Denis is the lead for Teesside University for this latest project and will be one of the experts heading-up the chronic pain theme. He will work alongside Dr Sam Harrison, Dr Cormac Ryan, Dr

Denis said: “I am delighted that Teesside University is able to be involved and provide expertise for such an exciting and innovative international project which should have a significant beneficial effect on a wide range of health issues. “Digital technology and virtual reality can provide so many different opportunities within healthcare and rehabilitation and I’m looking forward to seeing what ideas and solutions the developers come up with. “In terms of chronic pain, one of the problems people have is getting access to the right kind of advice and support – that is where things like interactive education and games can help people to better manage their lives while living with pain. “This will be a tough process and we have likened it to the X-Factor – with auditions, a kind of digital boot camp, and the finalists working with expert mentors.”

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Indego from Parker Hannifin POWERED exoskeletons are generally either therapy devices or assistive technology for personal use.

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