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INNOVATION FOR INDEPENDENCE

ISSUE 67 June/July 2009 £6.95

Firm turning to spider’s web science

By Dominic Musgrave AN Oxfordshire company is aiming to use the science behind spiders' webs to help rebuild people's joints.

Orthox has developed a silk biomaterial that can regenerate damaged cartilage and bone tissues.

The company's CEO Nick Skaer told Assistive Technologies that the technology, which imitates the strength and resilience of spiders' silk, could save the NHS hundreds of millions of pounds.

He added: “Spider's silk is one of the strongest substances known to man and, combined with being extremely elastic, it is not only very strong but also very robust. We are looking at developing a material based on this to fix cartilages because more operations of this type to repair them are taking place each year.

“Once inside the human we hope the material will repair the damaged tissue and encourage new cartilage to grow around it and replace it."

The company has been studying the silk produced by a poisonous species of spider from Australia, but because

each spider can only produce about 20 metres of silk in one go, silk worms, which are more prolific spinners, are used instead. The company plans to turn liquid silk into silk sponges, which will be used to replace the damaged cartilage.

Based on a decade of research by Oxford University scientists, the absorbable implant takes over the function of the damaged tissue, removing the need for permanent plastic or metal prosthesis.

Nick added: “The model is working how we would want it to and we are pretty close in the development stage.

We received £1.6m from the Wellcome Trust to fund the development and design process. This is a three-year project and in two-and-a-half we hope to be in a position where we are using the materials in humans. In future we hope to develop products for other serious orthopaedic problems such as spinal disc repair and bone regeneration.”

Knee replacements now cost the NHS more each year than total hip replacements, estimated at nearly £1 billion by 2010.

Five-year-old Ellie Challis made headline news when she became the youngest person to be fitted with Flex Run feet, after losing her limbs to meningitis.

Inside, Bob Watts of fitters Dorset Orthopaedic shares his experience of the project with Assistive Technologies. Picture: www.worldwidefeatures.com Full story, Page 14

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Hand operation drugs study set to begin in US

By Dominic Musgrave AN American hospital is beginning a new study which aims to reduce the amount of drugs given to patients undergoing hand transplant operations.

Although surgeons from around the world have performed hand transplants successfully for almost 10 years, they have used multiple medications to prevent rejection of the grafts, increasing the risk of diabetes, hypertension and other disorders.

Researchers and surgeons at the University of Pittsburgh Medical Center hope to use antibody therapy, donor bone marrow cell infusion and treatment with a reduced amount of immunosuppressive drugs to reduce toxicity for patients.

Andrew Lee, chief of the division of plastic surgery and professor of surgery, added: “We will be offering another, potentially safer alternative for those who have lost a hand.

“With our focus on reducing the multiple drugs typical of this procedure, we believe that we can restore what many amputees have

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lost without the risk of devastating side effects.”

Surgeons at UPMC will adapt a twophase protocol that involves initial antibody treatment followed by bone marrow cell therapy. The goal is not only to suppress the immune system but to change the way it functions.

Transplant patients will receive antibodies to help overcome the initial overwhelming immune response. That will be followed by a bone marrow infusion. The bone marrow cells target specific cells that could reject the hand and help “reeducate” the immune system into thinking that the transplanted hand is not a foreign object.

Dr Lee added: “Unlike a solid-organ transplant, which is needed to prolong life, a hand transplant improves only the quality of life. We take very seriously the long-term health of our patients. We have devoted many years of research to developing a protocol that will reduce the risks of the procedure.

We believe this will achieve this goal, allowing more amputees to be considered for hand transplants in the future.”

Paralympian Marc Woods is swapping water for walking and using prosthetic technology to help him climb the seven highest mountains in the world. He is working with Dorset Orthapaedic to trial the Blatchford Echelon foot and the next stage is to attach it to a Brio adjustable heel height unit, to help him climb down steep slopes.

Device ‘rewires’ the brain for MS patients A NEW device could help people with Multiple Sclerosis improve their balance and walk normally again by ‘rewiring’ the brain.

The GaitAid virtual walker being developed in Israel by professor Yoram Baram consists of a mobile phone-size, lightweight control unit and a set of goggles that provide sensory feedback of visual images and sounds in response to the patients’ movements. Worn for

practice-walking for between 20 and 30 minutes a day, the device aims to 'rewire' the brain to follow a healthier walking pattern- an effect that often continues even when it is not being worn.

Yoram said: “Along with the ability to walk normally again, the GaitAid Virtual Walker restores the Multiple Sclerosis patient's capacity to get the most enjoyment from life.

“It gives the feeling that the user can take control of the illness, get their confidence back and enjoy going out for a walk without the fear of falling down."

Yoram , a computer science professor, developed the GaitAid Virtual Walker in collaboration with several neurologists specialising in treating Multiple Sclerosis and other movement disorders.

Contacts Editorial Andrew Harrod Group Editor editorial@assistivetechnologies.co.uk Dominic Musgrave Healthcare Editor Email: dm@whpl.net Tel: 01226 734407 Sales Ellen Sharpe Email: es@whpl.net Tel: 01226 734412

Sales representative Fax: 01226 734478

Circulation circulation@wharncliffepublishing.co.uk 24 hour hotline: 01226 734695 Design/Production Judith Halkerston Group Deputy Editor Email: jhalkerston@whpl.net Stewart Holt Studio Manager Email: sth@whpl.net Sales and Marketing Director Tony Barry Email: tb@whpl.net Whilst every effort is made to ensure the accuracy of all contents, the publishers do not accept liability for any error, printed or otherwise, that may occur.

www.assistivetechnologies.co.uk

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Skeleton demonstrates new joints A SKELETON was put through its paces on an exercise bike to demonstrate the next generation of artificial joints at an event where businesses were shown some of the UK’s most cutting-edge research.

The cycling skeleton was the star of an interactive display at Pioneers 09 by biomedical engineers from the universities of Leeds and Glasgow, who are developing longer-lasting joints that cause less wear and tear, taking people well beyond retirement age as life expectancy grows.

The aim is to improve people’s quality of life, while also reducing the economic burden on the NHS. Its movements were powered by a second bicycle, which visitors could hop on and ride.

Research fellow Dr Sotirios Korossis, a member of Leeds’ Institute of Medical and Biological Engineering, said: “In the past artificial replacement joints have been largely developed on a ‘one size fits all’ basis.By creating personalised implants, precisely tailored to the needs of the individual, we want to give patients the best possible chance of a more active, healthy old age – so people can enjoy their longer lives as actively as possible.”

Helping kids to walk again

By Dominic Musgrave A NEW piece of equipment at an American rehabilitation hospital is helping children with neurological conditions to walk again.

The Rehabilitation Institute of Chicago is offering Pediatric Lokomat therapy or robot-assisted walking therapy for children with cerebral palsy. The condition is the leading cause of disability in children, which affects the motor control portion of the brain, often accompanied by secondary orthopaedic conditions affecting a child’s voluntary muscle activation, tone, reflexes, coordination, balance and ability to walk and be independent.

Deborah Gaebler-Spira, MD, director of the cerebral palsy programme at RIC, said: “The institute is committed to discovering new treatments that maximise the abilities of kids with cerebral palsy allowing them to achieve their goals in life.

“There is an immense need for research in this area, and we are dedicated to examining the vast opportunities and discovering new treatments that advance ability for those who are living with the

The panel also heard that she displayed poor time management, planning and prioritisation skills and exhibited poor communication with 4

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Deborah added: “Currently, this type of physical therapy is conducted with the aid of two or more therapists who manually move the patient’s legs in a walking pattern.

The patient is suspended in a harness over a treadmill, and an exoskeleton robotic frame, attached by straps to the outside of the legs, moves the legs in a natural walking pattern.

A computer controls the pace of walking and measures the body’s response to the movement. The pediatric model also has an interactive gaming interface which, through cartoon characters and challenges, motivates children and

“The strenuous nature and variability of the manual method can limit the frequency and duration of therapy. In the Lokomat, the robotic device does most of the heavy work, the pattern and pace are consistent throughout the session, and the exercise can be sustained over longer periods of time, making it more effective.”

A SPECIALISED podiatry service in North Tyneside is being extended following a successful pilot programme.

The podiatry biomechanics service – provided by the region’s Primary Care Trust – provides assessment and treatment for a wide range of issues that can develop as a result of biomechanical problems in feet.

Physio suspended for year over standards of proficiency The HPC conduct and competence committee heard that Rachel K Bird displayed poor clinical reasoning, used inappropriate handling techniques and allowed patients to perform inappropriate exercises.

provides them instruction.

Robot-assisted walking is a form of physical therapy that uses a robotic device to help a person improve his or her ability to walk.

Podiatry pilot to be extended

The Polytol PU resin kit from Otto Bock has received two design awards.

The equipment, which is used to fabricate flexible inner sockets has won the iF material and the Design Plus awards. For the iF awards, the jury evaluated a total of 98 entries from 13 countries, according to the criteria of material selection, processing, innovativeness, environmental compatibility, design quality, functionality, ergonomics and safety. The Polytol PU resin kit and four other submissions received the iF material award in gold during the Hanover trade fair, while a total of 36 products received the Design Plus award.

A PHYSIOTHERAPIST has been suspended for a year for failing to meet the HPC standards of proficiency while working for the East Cheshire NHS Trust.

disease.”

patients, carers and her multidisciplinary team.

Chair Derek Adrian Harris said: “The shortcomings of Ms Bird’s practice are wide ranging and serious.

“She appears to lack fundamental knowledge of some basic physiotherapy techniques.

“In addition to protecting the public, a suspension order will allow her time to reflect on her shortcomings and also give her the opportunity to take steps to remedy the deficiencies in her practice.”

Previously the service was only available at the podiatry department’s base in North Shields, but now patients are referred by their GP to their nearest biomechanics base, enabling them to be seen closer to their own home.

Principal podiatrist in biomechanics Steve Hannant, who has overseen the development of the new service, said: “Being able to offer the service at locations across North Tyneside means that we can provide the specialist care patients need in a community setting, ensuring that the problems they’re experiencing are identified and treated at the earliest opportunity. In this way early foot problems are prevented from developing into potentially more serious issues requiring surgery.”

When a patient gets referred to the service, staff carry out an initial biomechanical assessment to establish the exact nature of the problems they are experiencing. This can involve watching the way a person walks, stands and moves in

Steve giving advice

order to correctly identify the cause of their problems. Along with the treatments, which can include foot orthoses and stretching and strengthening exercises, advice is given on the best type of footwear to opt for.

Steve added: “Human feet are a marvel of biomechanical engineering, giving us stability and balance, providing grip and strength, and acting as shock absorbers as we walk and run. The majority of the time our feet do their jobs and everything stays in balance, but when part of the biomechanical system in our feet stops working correctly that’s when problems arise. By assessing and treating problems early we’re able to reduce the number of people needing to receive hospital based treatment for more serious problems” The new service is being rolled out across the region over the next year.

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Hip devices ‘extremely durable’ RESEARCHERS at Rush University Medical Center have found that total hip replacement devices are extremely durable, even 20 years after surgery.

Clinical and radiological evidence showed that 96 per cent of the 124 cementless metal components assessed remained securely fixed in place 20 years post surgery, according to a study published in the May issue of the Journal of Bone and Joint Surgery.

These components, which fit into the cup-shaped hip socket, were among

the first implants designed with a porous structure to allow bone to grow into the surface in the hope of achieving long-term fixation.

Dr. Craig Della Valle, an orthopedic surgeon and principal author of the study, said: “Our results confirm earlier work done at Rush and at other institutions: that cementless acetabular components work very well and that long-term biological fixation can be obtained.

“With time, the number of repeat surgeries due to wear and osteolysis has increased, as have the numbers

of cases of osteolysis we identified radiologically. But with the newer, more wear-resistant bearing surfaces we are now using, we believe that fewer patients today will need revision surgery for these reasons.”

Over the last two decades, the researchers have been studying the results for 204 total hip replacements performed at Rush in the mid-1980s in a group of 184 patients ranging in age from 20 to 84 years. Findings were previously reported at 10 and 15 years.

In the present study, the researchers

analysed results for 124 hip replacements in the 111 patients who were still alive 20 years or more after surgery. Since the previous report at 15 years, two metal cup implants, in addition to the three noted earlier, were found to be loose. Of the original 204 hip replacements, five cases had failed.

Two of these five implants were revised, but three were left intact because the patients did not suffer significant symptoms.

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The study was funded in part by Zimmer, which supplies orthopedic devices.

Rik tames Mount Kilimanjaro A BELOW the knee amputee has successfully climbed Mount Kilimanjaro in aid of his local children’s hospice.

Rik Bennet decided to attempt the climb together with fellow hikers after completing a ‘four peaks’ challenge, a 30-hour climb of Britain’s highest peaks: Ben Nevis, Snowdon and Scarfell Pike and their local hill on Bodmin Moor.

Rik told Assistive Technologies that the group self funded the trip so all the money raised went to supporting the creation of a children’s hospice in the south west.

He added: ‘The difficulty is mental as well as physical. You’re always needing to push yourself onwards and make yourself keep going. It’s easy to lose the will and give up, and that’s why so many people fail to complete the climb.

“The great thing about the Modular III foot I used from Ossur is that it moves me forward rather that the other way round.”

The trek involved a four-day ascent and two-day descent, and Rik used the foot in conjunction with the Iceross Seal-In X5 liner.

Rik and friends at the top of Mount Kilimanjaro

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Surgery to replace worn-out joints could become a thing of the past following a discovery by two professors in Wales. Dominic Musgrave found out more.

Professors reveal knees can heal themselves JOHN Fairclough and Charlie Archer have shown for the first time that the knee has the ability to heal itself, which could transform the treatment of arthritic conditions.

They believe the breakthrough could eventually mean that instead of patients undergoing major surgery to have their knees resurfaced or replaced with artificial joints, the knee could be encouraged to heal itself internally with help from orthopaedic experts.

John, who is based at the University of Wales Institute Cardiff’s school of sport, said: “Growing old is not easy – the athletic body of our youth

transforms, no longer able to tolerate the vigorous exercise of our early years.

“We get stiffer, we slow down we begin to ache. For many our joints begin to become painful and start to first reduce our ability to exercise easily and then cause pain and limit function.

“Each year in the UK there are more than five million consultations related to knee pain and the Holy Grail for all medical and sports participants is to be able to measure joint wear and to stop its progression and as a goal re-grow any damaged part of the joint surface.”

The research, conducted at Uwic and at Cardiff University, found

John Fairclough

that once the joints have rubbed away that the bone, instead of being completely dead, still contained living pieces of cartilage.

John, who is also a consultant orthopaedic knee and sports surgeon at the University Hospital of Wales, added: “Through a combination of work at Uwic and Cardiff University, we have discovered these cells can regrow the surface that was lost.

“We now know that it is possible that joints which are wearing away have the potential to recover. This is the first time that we have shown that a knee can do this.”

Instead of growing these cells in a laboratory and implanting them back into the knee, it is thought

that the joint will be able to reheal itself, provided that the bones and muscles are properly aligned.

He added: “We have been able to look at the muscles and have shown that the problems seem to start with the way that the bones are angled.

“The object of the research that we are undertaking is to show that these cells can regrow if we can alter the environment in the knee.

“We are now aware how important the muscles and the bone angles are in the wearing process of the knee; hopefully we can now show that we can resurface the knee by altering the angle of the bone.

Horse treatment to be trialled on humans A TECHNIQUE which is being successfully used to return horses with tendon injuries to top levels of performance is going to be trialled in humans.

The pioneering stem cell treatment, developed by VetCell Bioscience in Cambridge, has been so successful in horses it will now be trialled on humans with similar injuries by a team led by Dr David Glover, former medical director of Cambridge Antibody Technologies, professor Nicola Maffulli, one of the most wellknown sports medicine and orthopaedic consultants in the UK and Roger Smith, professor of equine orthopaedics at The Royal Veterinary College.

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rest, icing and anti-inflammatory drugs.

Nicola said: “The move from clinical veterinary to human medicine is inspiring and unusual; we normally see the translation happening the other way around.

“I am very excited to be involved in the human studies and hope that the results will herald a new era in the treatment of musculoskeletal soft tissue injuries.

“At present the management of human tendinopathy is more an art than a science but this approach could potentially reverse that situation.”

It is anticipated that the initial pilot study, which is planned to start within 12 months, will focus on the treatment of Achilles injuries.

A larger trial, involving several centres across Europe, is planned for 2011.

Nicola Maffulli

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US soldier in prosthetic world first

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By Dominic Musgrave AN American soldier who had both legs amputated following an accident in Iraq has been fitted with the world’s first commercially ready prosthetic knees.

Lieutenant Colonel Greg Gadson was serving in Baghdad in May 2007 when the truck he was riding in was struck by a bomb, leaving him on the side of the road bleeding and in and out of consciousness. Ten days later he was at Walter Reed Army Medical Center with both legs amputated.

He has now been fitted with the second generation of Ossur’s Power Knee - the first technology to use sensors, power, artificial intelligence and actuators to provide amputees with the ability to walk naturally and safely without even thinking about it.

Greg said: “I didn’t know what to expect. But the first time I put them on I thought, this is an engineering win.

“When you are wearing a passive (unpowered) prosthetic, you have to kick that leg out and you're listening or feeling for a secure lockout before you put that foot down.

“This is much more natural. You know that whatever position the leg's in, whether it's in or locked out, it's going to be stable. That

really gives you a more natural motion."

Used mostly within the Department of Defense and the Veterans Healthcare Administration, the Power Knee marked a new milestone in amputee mobility, safety and advancing natural motion through a powered gait process when it was first launched.

Three years later, working closely with the Walter Reed Army Medical Center (WRAMC), the next generation has been developed, which is now smaller, sleeker, quieter, lighter and even more intelligent than before.

Hilmar Janusson, vice president of research and development for Ossur, added: “Ossur is committed to the men and women of the armed forces to provide them with the most advanced technology available.

“Their sacrifice and dedication to their country has inspired us to work even harder to optimise their mobility.”

“The result will be that the entire amputee population will eventually realise a more natural and safe form of walking.”

The second generation is now in early commercial release at Walter Reed Army Medical Center. A full commercial release is expected by 2010.

New modern wet rooms benefit orthopaedic patients ORTHOPAEDIC patients at West Suffolk Hospital are benefiting after their ward's bathrooms were replaced with modern, easily accessible wet rooms.

The two separate male and female wet rooms allow patients to walk straight in and can be used by people with any type of disability.

It comes after frontline hospital staff were encouraged to suggest ways in which £100,000 could be spent to improve everyday life at the hospital during a Staff Conversation event.

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extremely high standard and are easy for everyone to access.

“As well as providing our patients with the best possible facilities, their design makes them easy to clean, which in turn supports our ongoing work to control and prevent infection.

“Feedback from patients so far has been extremely positive – especially from those with mobility problems, who find the wet rooms much easier to use than traditional bathrooms.”

The new wet rooms were one of a number of projects brought forward as a result of the Staff Conversation, which took place last summer.

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Light switches, TV remote controls and even house keys could become a thing of the past thanks to technology that lets users perform every day tasks with thoughts alone.

Dominic Musgrave reports.

Perform tasks by thoughts alone ...

THE brain-computer interface (BCI) technology provides an innovative way of controlling the interconnected electronic devices that will populate the smart homes of the future, granting increased freedom to people with physical disabilities.

Christoph Guger, the CEO of Austrian medical engineering company g.tec that has developed the application, said: “The BCI lets people turn on lights, change channels on the TV or open doors just by thinking about it,” “It has a kitchen, bathroom, living room – everything a normal home would have. People are able to move

The new house being designed by g.tec

through it just by thinking about where they wanted to go.”

flicking on a light switch or turning up the radio.

The company teamed up with a group of international universities and research institutes as part of the EU funded Presenccia project to incorporate its BCI technology into virtual environments. As part of the project a fully functioning smart home was created in virtual reality.

The new technology could also help amputees learn how to use a prosthetic limb, or allow people confined to a wheelchair to experience walking in virtual reality, as one experiment conducted by the Presenccia researchers showed.

Electroencephalogram equipment is used to monitor electrical activity in a user’s brain via electrodes attached to their scalp.

After a period of training, the system learns to identify the distinctive patterns of activity produced when they imagine walking forwards,

Having been tested in virtual reality, g.tec’s smart home application will soon be deployed in a real smart home being built as part of the SM4all project, which has received funding under the EU’s Seventh Framework Programme.

Project co-ordinator Mel Slater added: “A virtual environment could

be used to train a disabled person to control an electric wheelchair through a brain-computer interface.

“It is much safer for them to learn in VR than in the real world, where mistakes could have physical consequences.”

One application developed by g.tec lets people control a small robot with their thoughts, though the same system could easily be adapted to control a wheelchair instead.

Four lights on a small box set to flicker at different frequencies provided the control mechanism using a method known as Steady State Visual Evoked Potentials (SSVEP).

Bright future as family firm moves to bigger premises AN INDEPENDENT family-run firm of mobility specialists is looking forward to a bright future after relocating to bigger and better premises.

Dophin Mobility (East Midlands) Ltd has moved to a large consolidated site in Lincoln where it hopes to continue to expand.

The firm specialises in the supply, installation, maintenance and relocation of stairlifts and other mobility products such as ramps and specially designed chairs.

In just eight years Dolphin Mobility (East Midlands) Ltd has grown from just three employees to 15, and it now operates across Lincolnshire, Nottinghamshire, Derbyshire, South Yorkshire and Hull.

Judith Hambrook, who became a director of the company in 2006 after the death of her husband Steve, told Assistive Technologies the new premises will open up a range of possibilities for the firm.

She said: “Our new base is much bigger than our old premises, and it’s brought everything together under one roof.

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“At our old site we had three separate units, but now all our staff are together which means improved efficiency, better communication and a real boost for staff morale.

“We’re certainly getting a lot of positive comments from people and our visitors are really noticing the difference in quality when they come in.”

Judith says the larger premises will allow the company to supply a wider range of lifts and other products, and provides an opportunity for the firm to branch out into other areas such as mobility aids, adaptations and bathroom equipment.

She added: “We’ve been looking for new premises for four or five years and this location is perfect.

“We wanted to be to the south of the city on a main road with passing traffic but where there is also easy access for people with mobility difficulties.”

“Our aim is to improve people’s quality of life and help them to remain in their own home for as long as possible.”

Dolphin Mobility (East Midlands) directors Michael Hambrook and Judith Hambrook.

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Win gives people ‘more faith in company’ NEWS

By Mary Ferguson THE winners of last year’s BHTA awards have revealed to Assistive Technologies how the accolade has affected their businesses.

As nominations open for the 2009 ceremony, Barbara McCallum of Albion Mobility – who picked up the Mobility award – said the win has given people more faith in the company. She said: “Winning the award had a big effect on our business. People are more keen to come to us because they see we have won a prestigious award.

“We have only been in business just over two years and are a small company so it was quite a coup for us to win.

“I think it gives hope to other small, young businesses out there

Remploy Healthcare’s Steve Jones and Robert MacKenzie Smith receive the Orthotics award from Marc Woods and Angela Rippon.

that it’s not just the big companies that can win the big awards.”

Bob Watts, managing director of Dorset Orthopaedic, claims their win in the Prosthetics category was the highest accolade they could get, because it was voted for by customers. He said: “The BHTA award has made us look at how we deliver our service and to focus on

where our customers are finding the link to us. Is it from magazines such as Assistive Technologies? Or is it from our web site? The award has helped us to analyse and focus our marketing efforts.”

Remploy Healthcare received the Orthotics award and Chris Ford said displaying the award on their stand at BAPO helped them raise their

profile and attract more visitors – resulting in a record number of enquiries from the show.

“We had won the Mobility award for the last three years so it was a really pleasant surprise to win the Orthotics award last year. This year, we would love to win both categories.”

Bob added: “We did not expect to win last year so we are certainly not expecting another win. If our customers vote for us again then we will be grateful for their continued support and regard it as an endorsement of our continued efforts to improve our prosthetic services.”

Careflex were the winners of the Rehabilitation award at last year’s ceremony.

Award search for companies that go the extra mile ...

ASSISTIVE Technologies magazine is once again searching for the companies that have gone that extra mile in providing excellent service and innovation in the last year.

The Excellence Awards, open to everybody, recognise companies in four main categories: Mobility, Rehabilitation, Prosthetic and Orthotic. Entries for the Mobility award include any supplier of pow-

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ered or manual wheelchairs, scooters, walking aid or any other product to aid and assist mobility.

The Prosthetic and Orthotic awards are given to any product manufacturer or supplier who professionals within the industry believe has demonstrated either unrivalled customer service or product development.

The Rehabilitation award will

include suppliers across the broad range of equipment available for people with special physical needs.

Readers have until Friday, July 24 to get their nominations in, and a period of voting will then follow which will decided who picks up one of the coveted trophies at the annual awards ceremony in December.

You can vote by either texting 07825 264211, stating your name,

position and contact number or email plus the category and name of the company for nomination (texts will be charged at your service provider’s standard rate).

You can also follow the instructions on the website www.assistivetechnologies.co.uk or by completing the form on Page 8 and sending it to Assistive Technologies, 47 Church Street, Barnsley, S70 2AS.

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Complex knee surgery done in a day COMPLEX knee surgery can be done in a day at the hospital in Eastbourne.

Lancashire cricketer Mel Loye with the impression taken of his foot.

Best foot forward for sports stars

By Dominic Musgrave LANCASHIRE County Cricket Club batsman Mal Loye and Salford City Reds rugby league player Willie Talau have launched a £1.5m partnership between the University of Salford and a global foot company.

The sportsmen demonstrated the University’s cutting-edge podiatry research to highlight its three-year research and innovation partnership with Scholl – which is owned by Manchester-based healthcare company SSL International.

The foot-themed event officially launched the collaboration – called Feet Matter – which will enable the university to work towards its goal of

being the world’s number one foot health and well-being education and research centre.

said: “I am extremely proud that we have been able to secure this prestigious partnership with SSL.

Feet Matter will include numerous key areas of partnership, including knowledge investment, research and innovation, and new product development – all with a potential global impact on foot health.

“The benefits for both partners will be evident at local, national and international levels. Through our collaboration on this initiative in India, we hope to raise awareness of problems relating to foot health, and improve education and specialist training in that area.”

Following a donation by SSL, the project will include a team from the University’s School of Health Care Professions working with foot health specialists at Sri Ramachandra Clinic in Chennai to improve foot health care assessment and treatment.

Head of the school of health care professions, professor Sue Braid,

During the launch cricketer Mal had an impression taken of his foot in the hi-tech new podiatry clinic, and was later presented with a plaster cast replica, while Willie demonstrated the University’s biomechanical foot pressure analysis technology.

Patients needing reconstruction of the anterior cruciate ligament can undergo the most advanced surgical techniques but be discharged to go home on the same day as their operation.

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Tearing of the ACL is a common injury suffered by sportspeople, particularly footballers and skiers.

Medical advances mean tendons from the hamstring can be used to reconstruct the knee ligament, providing a stable knee and preventing secondary damage to the joint.

The first patient to be discharged within a day of the operation was Dr David Lipscomb, a consultant endocrinologist at East Sussex Hospitals Trust.

He left the hospital seven hours after orthopaedic surgeon Sam Rajaratnam had operated on him.

Dr Lipscomb said: “I am very pleased with how it all went – I was expecting much more discomfort than I have had.

“The multidisciplinary team has been top class."

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When five-year-old Ellie Challis had running feet fitted, she made history for being the youngest ever amputee to use the technology.

Mary Ferguson spoke to Bob Watts, managing director of Dorset Orthopaedics – who fitted the feet – about what the project meant to them.

How young Ellie ran into the history books ...

OSSUR, the manufacturers of the Flex Run feet that Ellie now uses, had them specially made because they had never made them for someone so young before.

Bob said: “Ellie had been coming to us for a while and it was on one ‘check up’ visit when Paul, Ellie’s dad said that she had something to ask me.

“So we all sat down and listened to what she had to say. After finishing her second cup of hot chocolate she turned to me and said, ‘I would like some feet that I can run in’.

“Well we like a challenge here so I phoned Paul Jamieson of Ossur UK and asked if the company would make an exception and produce some tiny blades for Ellie.”

Top: Ellie Challis and, above, Ellie with her sister.

Pictures: www.worldwidefeatures.com

At the age of 16 months, Ellie lost her arms and legs to meningitis and Paul convinced his bosses in Iceland that her story and determination was justification enough for a pair of tiny running feet to be specially made.

those children who cooperates and that made the job so much more straightforward and accurate.”

Bob said the biggest challenge when fitting a child so young is compliance. “It can be hard to get them to appreciate that if they sit still during casting then a much more comfortable socket can be developed.

Dorset Orthopaedic have fitted a number of bilateral transfemoral children with Flex Run feet and Bob said it enables them to walk much faster and with less effort than conventional feet.

“But young children don’t necessarily understand this and so for the prosthetist it is a balance between ensuring that the child is having fun and an interesting time against getting the job done.

“But Ellie has always been one of

Ellie had specially made bright pink sockets and now uses the feet to run around with her sisters.

He added: “I hope that more children will be given the opportunity to try the feet and if we get the chance to fit them here then that’s great. We relish the opportunity to increase our experience further with cutting edge prosthetics.”

Bob Watts

Sustained improvement for total knee replacement patients – study KNEE osteoarthritis patients who undergo total knee replacement surgery have sustained improvements in their condition for more than five years, a new study has claimed.

Total knee replacement surgery is offered as an option to patients whose day-to-day functioning is seriously affected by the condition, and is performed on more than 65,000 patients in the UK each year.

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Cooper of the MRC Epidemiology Resource Centre have now attempted to "assess long-term outcome and predictors of prognosis" for patients undergoing the surgery.

They studied the outcomes of total knee replacement procedures on more than 300 patients and compared their findings to a similar number who did not go through knee replacement surgery.

Data on age, sex, body mass index

and progression was also gathered from both groups and compared.

Cyrus said: “Results revealed that the patients who underwent total knee replacement had better physical function than patients who did not.

“The improvement in physical function tended to be greater in patients with more severe radiological disease of the knee, and was less in those who reported pain at other joint sites at the beginning of the study.

"Improvements in physical function following total knee arthoplasty for osteoarthritis are sustained beyond five years."

A spokesman for the Arthritis Research Campaign, which funds research into improving knee replacement surgical techniques and materials, added: "Knee replacement is not perfect but can improve the quality of life for many people with severe knee OA, particularly in reducing pain."

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Winter

Dolphin gel cushion helps protect human bones

By Dominic Musgrave A GEL cushion originally created for the first-ever prosthetic dolphin tail is being used to help protect human bones.

The tail was developed by Kevin Carroll at Hanger Prosthetics and Orthotics for Winter, an Atlantic bottlenose dolphin after she was stranded near Cape Canaveral in December 2005 after being caught in a crab trap when she was just three months old.

Winter’s tail fluke eventually came off and needed an extra-sensitive cushion beneath the prosthetic, and the gel liner he used to make the tail has been adapted for human amputees with severe skin sensitivities and irritations.

Kevin told Assistive Technologies that creating the tail was more difficult and took a lot longer than he had anticipated.

He added: “I first heard about Winter on the news and felt really sorry for her. I immediately rung the aquarium and told them I could

help and could make a prosthetic tail..

“At first I think the woman on the other end of the phone thought I was a prankster, but the following day I headed down to look at her and felt I could still do it.

“A lot of people said it was impossible and full of problems, but I still felt it was something I could do so took on the project.”

Casts are used to monitor Winter's growth and body shape. The casts are also able to provide the mould for Winter's new prosthetics.

Kevin added that the difference between dolphin and human skin is that a simple scratch that may last a couple of days on a human may take weeks to heal on a dolphin.

“We developed a gel to protect the dolphin and also provide suction to hold the tail in place when we attached. Since word has got out about it we have had numerous calls from humans asking where they could get it for their limbs to avoid irritation. The project to save

Kevin Carroll

Winter has given something back, and we have helped so many people. One little girl with meningitis got in touch to say that

her limbs were so painful when she put them on that she couldn't walk. Since using the gel she has started walking again."

Tissue scaffold can stimulate growth – engineers ENGINEERS in America and England have built a new tissue scaffold that can stimulate bone and cartilage growth when transplanted into the knees and other joints.

And the two-layer technology could offer a potential new treatment for sports injuries and other cartilage damage, such as arthritis, according to Lorna Gibson, from the Massachusetts Institute of Technology, who has worked on the project with professor William Bonfield from Cambridge University.

One layer mimics bone and one mimics cartilage. When implanted into a joint, the scaffold can stimulate stem cells in the bone marrow to produce new bone and cartilage. The technology is currently limited to small defects, using 16

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scaffolds roughly 8mm in diameter.

The researchers demonstrated the scaffold's effectiveness in a 16-week study involving goats. In that study, the scaffold successfully stimulated bone and cartilage growth after being implanted in the animals’ knees.

regenerate both bone and cartilage.

Their method produces two layers with a gradual transition between the bone and cartilage layers.

"We tried to design it so it's similar to the transition in the body. That's one of the unique things about it."

Lorna added: “There are currently a few different ways to treat cartilage injuries, including stimulating the bone marrow to release stem cells by drilling a hole through the cartilage into the bone; transplanting cartilage and the underlying bone from another, less highly loaded part of the joint; or removing cartilage cells from the body, stimulating them to grow in the lab and re-implanting them.

The project began when the team decided to build a scaffold for bone growth. The team decided to try to create a two-layer scaffold to

“The new scaffold could offer a more effective, less expensive, easier and less painful substitute for those therapies.”

Lorna said: "If someone had a damaged region in the cartilage, you could remove the cartilage and the bone below it and put our scaffold in the hole.

Lorna Gibson

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NEWS

‘Rollercoaster’ conference in Blackpool THE 10th annual NAEP conference takes place at the Norbreck Castle Hotel in Blackpool from June 16-18.

This year’s theme is The Equipment Rollercoaster are you Aboard? and is targeted at all individuals who work in the health, social care or voluntary sector and are involved in equipment commissioning, assessment, supply, loan and procurement within community equipment and wheelchair services.

The event launches with a champagne reception in the exhibition hall, which will include the innovative product showcase, a new addition for 2009.

Highlights of the conference include talks from professor Heinz Wolff talk on “The Equipment Rollercoaster”, a representative from Help for Heroes, the NAEP nominated charity for 2009, and Olivia Butterworth of the Third Sector Partnerships Team.

Five minutes with …

When did you become interested in the industry and why?

In 1992. I had been in sales and marketing management in medical devices for many years, and the company I had been working for was the subject of a management buyout.

I was genuinely relieved not be asked to join in, so, like so many before me, became a self-employed consultant.

How did your career in the industry begin?

After two anxious years I was looking to rejoin the corporate world, and saw an ad in the Daily Telegraph for contracts manager at Remploy Healthcare, Banbury.

How have you ended up where you are today?

When my immediate boss at Remploy, John Barklamb, rejoined Camp Orthopaedic he recruited me to their marketing department where I met Kay Purnell (general manager of Trulife) and John Meadows (now owner of G&M). John Meadows introduced me to Medistox owner Len Lloyd and I joined them in 2002. When Len set up Beagle in Blackburn last year I was delighted to become involved.

What's the biggest change you've seen in the industry?

I’m no longer involved, but I suspect

Graham Irons, business development manager of Beagle Orthopaedic Ltd it’s the change in the system of contracting for orthotic services.

There was a lot wrong with the old MHM50, and quite a lot of utilisation of schedules. There are good points with the present system, but in the extreme, service suppliers are screwed down on session costs without the opportunity to compensate by supply of product.

It can also lead to a loss of continuity of treatment. Also, as many orthotists of my age group are finding, jumping from one company pension scheme to another does not make for sybaritic retirement packages.

If you could make one recommendation to take the industry forward what would it be?

Get involved in the detail.

What would you like to see happen to the industry in the future?

I would like to see more innovation instead of all the ‘me-too’ products that are becoming readily available.

Innovation can be something so simple, yet completely brilliant.

Touch opens Company to invest £2m in site new centre TOUCH Bionics has opened its UK Centre of Excellence in Livingston, Scotland.

The centre offers full clinical services to upper limb amputees, and the service is tailored to each individual’s needs, managed by the “Touch Life Total Care Program”, taking the whole range of prosthetic solutions into account.

CEO Stuart Mead. “We are extremely pleased to have reached this stage and are looking forward to welcoming clinical customers and their families and friends to our UK Centre of Excellence”.

HOMECRAFT Rolyan will consolidate its newly enlarged rehabilitation and healthcare supplies business onto its purpose-built site at Huthwaite, Suttonin-Ashfield following the recent acquisition of Mobilis Healthcare.

It has also announced a £2million investment in a new 20,000 sq ft warehouse to house the increased product inventory, augmenting the existing 80,000 sq ft office and

distribution building, completed in May 2006 at a cost of £7 million.

The acquisition is expected to create up to 50 new jobs at Huthwaite, which are being offered initially to employees at the Mobilis site in Oldham, who choose to relocate to the East Midlands.

The amalgamated business is set to double in size from the present £45m combined turnover.

New research suite opens at university COVENTRY University's Health Design and Technology Institute (HDTI) has opened its new Usability Research Suite.

Designed to assess innovative community healthcare products and services, the new facility offers organisations the opportunity to test their ideas with expert panels of

patients and users of assistive technologies.

Led by healthcare professionals and academics, this unique resource allows clients to validate their innovations by subjecting them to an academically-led, rigorous, independent assessment by qualified experts – the intended users.

New website PROSTHETIC, orthotic, assistive technology and medical IT solutions provider RSL Steeper has launched its new website.

As well as regular news update, the new site features clear navigation to each of the company’s four operating divisions: Prosthetics, Orthotics, Assistive Technology and Meditech. It has also been designed to be informative for patients, health professionals and healthcare providers. The company’s CEO Dr Gary Sheard said: “The new website has been designed as a one-stop shop for all our customers. With clear navigation, it has never been easier to find out more about all of our professional clinical services and comprehensive product ranges.

“We have included plenty of material to support patients, with sections designed to help them understand the rehabilitation process and common terminology used within the industry, as well as a range of product and service brochures available for download.”

Additions to portfolio TRULIFE has introduced of Ongoing Care Solutions Inc’s (OCSI) range of orthopaedic products to its already extensive portfolio.

The range boasts an array of orthopaedic solutions using innovative materials, from ‘Bend to Fit’ WHFO’s for contracture management, air inflatable knee braces and static and dynamic splints.

Richard Nace, president of OCSI, said: “Trulife has an excellent reputation in the orthotic industry worldwide. We see the OCSI products complementing Trulife’s existing breadth of orthotics offering an even broader array of clinically effective solutions to Trulife customers.”

The range includes the new P.O.P knee brace designed to protect, support the knee, alleviate pain and rehabilitate the musculature of the leg, pre or post injury or surgery while the patient simply wears the device.

Bid to reduce trainee injuries RS SCAN Lab has taken part in a research project to try and reduce lower limb injuries in armed services trainees.

The aim of the study, believed to be the first of its kind, was to determine whether the company's D3D orthotic reduced injuries in 400 participants caused by running.

Technical director Ian Walker said: "The system works by measuring vertical force over a number of sensors, which allows the pressure to be calculated knowing the area that the force is being applied over. The system then measures the vertical force that is applied by the body 18

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through the foot to the ground during the stance phase."

By dividing the contact into different foot zones, the system looked at maximum pressures and forces applied in different areas, and the timing of the application of the force.

This allowed a detailed analysis of when and where force is applied during the stance phase. The D3D software could then highlight where an imbalance was, and what could be used to correct this.

Ian added: "The findings were that the system could predict injury and reduce it."

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Wheelchair ‘powered by thought’ A WHEELCHAIR controlled by the power of thought has been developed by academics in Spain.

A research team of the University of Zaragoza has developed a prototype of a brain-actuated wheelchair, designed for those with severe disabilities who are unable to use a conventional joystick.

During May 2008, five subjects – only using their thoughts – successfully carried navigation and manoeuvrability tasks with the wheelchair in the university.

A non-invasive method was used to record the human neural activity and the wheelchair was robotised and equipped with a laser sensor.

When in operation, the user faces a screen displaying a real-time virtual

reconstruction of the scenario and concentrates on the location of the space to reach.

A visual stimulation process elicits

Interest in launches PRIDE mobility’s newly-designed stand, complete with two private meeting rooms, received a warm welcome at this year’s Naidex.

There was also plenty of interest in the company’s new product launches, which included three new additions to the Colt family of scooters – XL8, Deluxe and Nine.

Also on show were a new lift chair (LC-101), three newly-developed Quantum powerchairs (Athena, Artemis and 600 Sport), the latest compact travel scooter, a new platform lift system for lifting equipment into vehicles (Backpacker MV) and the introduction of the exciting user-friendly UK website, which goes live soon.

the neurological phenomenon and the electroencephalogram (EEG) signal processing detects the target location.

This location is transferred to the autonomous navigation system that drives the wheelchair to the desired location while avoiding collisions with obstacles in the environment detected by the laser scanner.

The prototype was validated with five healthy participants and the overall result was that they were all able to successfully operate the device.

Dr. Javier Minguez, who led the team that developed the chair, is now working on a commercial version that is easier to use.

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Stuart comes up with a winning solar idea ...

A 15-year-old student from a school in Ipswich won a special prize in the national Ready Willing and Mobile competition that seeks bright ideas from young people to improve the lives of disabled people.

Stuart Tredree, who attends Northgate High School, won the prize for the best entry by a young person with a disability, the award sponsored by the Mouth and Foot Painting Artists (MFPA) with the aim to encourage young disabled artists.

His winning idea is the Solar

Charger, a sun charger for electric wheelchairs that utilises solar panels.

A full-time wheelchair user, Stuart conceived the idea after his battery “went down to two bars” on a sunny day. He received his prize from Tom Yendell, an internationally acclaimed mouth and foot painting artist at the Mobility Roadshow at Kemble airfield.

Stuart's school was given £1,000 worth of art and craft materials for his efforts, with him receiving £250

of art and craft materials for himself. He also met celebrity swimmer Sharron Davies, who announced the competition winners for the fifth Ready Willing and Mobile competition organised by the Mobility Roadshow.

It seeks concepts from young people – both disabled and nondisabled aged 7 to 16 years – that will help others with disabilities to be more independent and join in more at home, at school and at play. Around 400 entries were

received this year from schools and clubs across the United Kingdom.

The competition is organised and administered by the charity Mobility Choice. This year’s event was opened by Paralympian gold medallist Danny Crate, and was visited by the Duchess of Gloucester as well as wheelchair basketball player and television personality Ade Adepitan, former athlete Dame Tanni Grey-Thompson and tennis player Peter Norfolk.

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Wheelchair tennis bound for Nottingham INVACARE Europe, in association with the International Tennis Federation (ITF) and the Tennis Foundation, will host the 2009 World Team Cup, the largest team competition for wheelchair tennis.

The competition will be held at the Nottingham Tennis Centre from July 27 to August 2. This year the competition celebrates its silver anniversary, making it a unique occasion for all those involved.

Often referred to as the Davis and Fed Cups of wheelchair tennis, the Invacare World Team Cup tournament brings the elite wheelchair tennis players together to compete for national pride in one of the world’s premium disability sport team events.

£4,000 raised THE OSSUR Academy staged the latest in a series of sports medicine conferences at Cardiff University.

Several speakers presented papers aimed at advancing the modern understanding of sports medicine in a scientific and research orientated day. The day raised over £4,000 for the Welsh Virtual Institute of Sport, a charity which provides a learning resource to sporting practitioners working in the South Wales region.

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An orthotics company has come to the rescue of a young boxer as he fights for a chance to compete in the 2012 Olympics. Dominic Musgrave found out more.

Langer UK managing director Adrian Bishop, Olympic boxing hopeful Aziz Mahdi and university friend Dan Bishop.

Aziz gets a fighting chance AFTER injuring his back playing rugby, Belfast-born Aziz Mahdi thought his hopes of representing his country were dashed.

But help was on hand from a fellow student at Manchester University, Dan Bishop, whose father Adrian is managing director at Langer UK in Staffordshire.

The medical footwear company stepped in to help by offering the 18 year-old specially made orthotic devices for his boxing boots.

After two weeks of wearing the insoles, the cruiserweight is suffering less with lower back pain and has returned to training for the English Universities Boxing Championships in December, where he is tipped to be scouted for the British Olympic

boxing team.

Adrian said: “Dan told me about an Olympic hopeful in his halls of residence who was a great sportsman but had back problems which were hindering his training.

"As a company we supply many sportsmen and women with products which help enhance performance and promote healing after injury.

“We were glad to put this young boxer on the road to recovery, especially at this crucial time when so much is hanging on selection for the Olympics.”

Langer, based in Cheadle, specialises in footwear products which promote a proper walking structure. As few people have perfectly-matched legs

and feet, leading to unevenness in the way they move, a defective gait and posture is a common problem in all ages.

As well as treating tired legs and foot pain, Langer's custom-made orthotics help with ailments such as knee, hip and back pain.

The company is the main supplier of orthotics to the NHS. Demand for its products has allowed the firm to expand its workforce to more than 40 people employed in factory processes, sales and administrative tasks.

In March the company carried off a regional newspaper business award for Investing in People after ploughing major investment into staff training.

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True communication is both speaking and listening ...

By Ruth Everard IT is very easy to think that technology is a magic fix-it. Every advert will tell you that the product offered will make your life easier, quicker or happier.

An advert could be seen as communication in itself, but true communication is both speaking and listening. What an advert cannot do is to take on board what a particular consumer needs.

When it comes to assistive technology, the complexity of what is available means that no advert or sales literature can give you a fraction of the information you need for your own personal circumstances.

Unless it is a very simple gadget you probably cannot afford to buy it in the hope it works – you must know before you commit to it.

To take advantage of any product you see the next step is yours. But what action will you take? You

will need to take control for yourself, investigating the possibilities and exploring the options. Communication about a particular product will need to be initiated by you.

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You will need to bring information about your objectives and needs to the conversation, so that the company will know which of the product's features and benefits are relevant to you.

The best way to open a dialogue is by asking lots of questions; and the company should ask you plenty too. Don't be afraid to start a conversation.

Both consumer or company should be free to end it, but make sure that you do so in the same spirit of communication: if you think it is not right then explain why – that way if you have misunderstood something you won't miss out on what could have been great.

Finally, remember that a good

Communication: It really is always the key

company will be looking to find the very best thing for you – and the way to achieve that is communication.

The people you speak to should listen to your opinions and needs.

The way they relate to you is an indication of how the company relates to the users of its products, both in developing their product and looking after its existing customers.

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PRODUCTS

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G&M INTRODUCES THE HAWK LIGAMENT KNEE BRACE

CYBERTECH FLEX POWER PLUS NEW TO G&M

THE prefabricated Hawk ligament knee brace combines the benefits of rigid bracing protection with a new level of suspension, support and comfort.

NEW from G&M the Flex Power Plus is a lightweight, off-the-shelf LO spinal brace.

The Flex Power Plus features a patented ‘Flexible Pulley System’ that offers a 5:1 compression ratio and is so easy to use that it can be adjusted using only one finger, yet provide powerful, smooth and easilycontrolled compression.

The Flex Power Plus also features patented Flex Power Panels that in combination with the breathablematerial and single front fastening design comfortably contours and conforms to each patient’s body structure,

It features the patented Active Thigh Cuff (ATC) system, which accommodates soft tissue profile changes during activity, providing optimum suspension.

Strong and lightweight fibre reinforced composite shells and steel hinges provide the strength and protection needed by patients with deficient or repaired ligaments.

The Hawk ligament knee brace is just one of new range of knee braces available from G&M. A custom OA, custom ligament, combined instability and contact sports knee braces are also available.

Enquiries: Contact 0121 475 1101 for more information or a product demonstration or email marketing@gilbert-mellish.co.uk

WALK ON WITH FIT KIT THE new Otto Bock Fit Kit is an ideal tool to enable you to trial the Walk On orthoses before making a definitive purchase.

The kit comprises of two sizes (36 and 41), both left and right, to enable you to fit patients for trial purposes.

The Walk On is designed solely for use on active patients with peroneal palsies and weakness of dorsi-flexion of the foot or paralysis.

As a result of its anatomical design, and the use of carbon fibre compound material, the Walk On meets all requirements for higher walking speeds and load capacities. It supports dorsi-flexion of the foot and limits plantar-flexion in a passive, flexible manner.

Gait analysis studies have shown that, compared to other carbon orthoses with frontal contact in the standing phase, the Walk On offers increased stability for the user.

Enquiries: Contact 0121 475 1101 or email marketing@gilbertmellish.co.uk for more information or a product demonstration.

A DYNAMIC SOLUTION FOR A DYNAMIC PROBLEM THE SaeboStretch uses a revolutionary stretch technology which allows the fingers to move through flexion caused by associated reactions and tonal/spasticity changes.

It also utilises a low-load, long-duration stretch to return the fingers to the desired position. The SaeboStretch overcomes issues which can result from traditional splints, including deformity, joint damage, hypermobility, and contractures.

It includes three interchangeable hand pieces, each with a different grade of resistance. This feature further protects joints and allows the clinician the ability to customise to meet each individual’s specific needs. The liner is easily removable for routine cleaning.

The clinical target populations are stroke, head injury, incomplete spinal cord injury, cerebral palsy and multiple sclerosis.

Contact: Telephone 01707 33 69 69 or email ukinfo@saebo.com

Contact: Telephone 0845 430 1231 or visit www.ottobock.co.uk

BRACE USED FOR ‘KNOCK KNEE’ OR ‘BOW LEG’ INSTABILITY OF THE KNEE THE TVS brace from St Clare Engineering is an orthosis for moderate valgus (knock knee) or varus (bow leg) instability of the knee.

It is designed to hold a medially or laterally unstable knee from moving into a painful position of deformity while the knee is in extension and weight-bearing.

The brace is only effective when the wearer is walking or standing, the leather sling helps pulls the knee towards the telescopic tube and prevent the knee from sagging into the last few painful degrees of deformity.

The TVS Brace has been giving support and helping to relieve pain to patients with an arthritic condition of the knee for in excess of 20 years, with more than 20,000 people having benefited from its use in the UK alone.

The brace is ultra-lightweight (200 grams/8oz) and can be put on or removed in seconds.

The TVS Brace is manufactured to the ISO 9002 quality system, CE marked and registered with the Medical Devices Agency.

Contact: Telephone 023 805 10770 for further information.

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CASTING SAFETY STRIP Baby/Infant helmet (One size fits 7 months – 2+ years 40-50cm) Available in pink or blue Multi adjustable.

Constructed from soft foam and covered with Lycra/nylon Fastens with elastic Velcro strap - £39.00 Scrum type helmet (Sizes S M L) Available in black with rear lace adjustment.

Firm sponge covered with Lycra/nylon Fastens with Velcro chin strap - £44.85 Toppen 77 (Sizes 46cm-59cm ) Available in blue with red lining Constructed from soft sponge covered with Lycra/nylon Open sections on top of head for increased comfort Fastens with under chin strap - £51.70 These helmets are not suitable for high risk activities, e.g. skateboard/cycling Contact: For further information telephone 0161 747 8728 or email mggilligan@hotmail.com

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