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INNOVATION FOR INDEPENDENCE
ISSUE 78 April/May 11 £6.95
New device could help to stimulate paralysed cords By Dominic Musgrave AN American engineering researcher is seeking a new way to help those who are unable to speak to find their voice. Virginia Tech’s Alexander Leonessa wants to help bring back the voice of stroke patients and others who have suffered paralysis of the vocal folds, through electrical stimulation. The assistant professor of mechanical engineering is developing a small device no larger than an iPod, clipped to the belt, that could use functional electrical stimulation on the paralysed vocal folds of stroke patients or others who have lost the ability to talk, or even swallow and breathe properly. He said: “The device has the potential of improving the quality of life for patients with vocal paralysis, or neuromuscular disabilities, including traumatic brain injury, multiple sclerosis, cerebral palsy and Parkinson’s disease. Alexander won a $480,000 National Science Foundation Faculty Early Career Development (CAREER) award for his research. The grant is the National Science Foundation’s most prestigious award, given to creative junior faculty likely considered to become academic leaders of the future. The concept of electrical stimulation on
muscles is regularly used on legs and arms to prevent muscle atrophy. Doctors use an external electrical appendage placed on the exterior skin to provide a small electrical shock that can cause the muscle to contract. The practice exercises the muscles, and therefore can save the leg or arm. Alexander said that applying the same method to vocal folds can result in reinnervating the muscle, which also affects breathing and swallowing and other functions. She added: “The folds close and open – almost like eye lids – to create or release air pressure that vibrates the vocal chords, and makes sound. “If one of the flaps is unable to close, no pressure, hence no sound, can be created. In many cases, be it from a stroke or injury, one of the folds is affected by paralysis.” During the five-year study he and his graduate student research team will work with doctors at the Center for Voice and Swallowing Disorders, part of Wake Forrest University’s Baptist Medical Center in North Carolina. There, patients with paralysed vocal folds will undergo electrical stimulation tests to see if small shocks can reinvigorate their ability to talk through forced contraction.
Britain’s number one skier Chemmy Alcott has been using the latest technology to get her back on the slopes. The triple Olympian, who has won five British titles, suffered an open fracture to her right fibula and tibia when she crashed at around 80mph during her final training session before the start of the World Cup season in Canada. Working with DJO Global’s physio Cliff Eaton, she has used the DonJoy CMF (Combined Magnetic Field) bone healer, an Aircast Walker, a Compex mi Sport and a Game Ready to speed up her recovery.
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Research into robot that may help people walk By Dominic Musgrave COGNITIVE skills for a new robot which will help people with damaged limbs to walk again are being developed by researchers at the University of Hertfordshire. Dr Daniel Polani and a team at the University's School of Computer Science have received a European grant of 780,800 Euros for the fouryear research project Cognitive Control Framework for Robotic Systems (CORBYS) to build the cognitive features of these robots. He said: “There are already some robots which help people to walk, but the issue is that they need constant attention and monitoring by therapists and they cannot effectively monitor the human. “In CORBYS, the aim is to have robots that understand what humans need so that they can operate autonomously.” Daniel and his team will contribute in particular to the high-level cognitive control of these robots and their
synergy with human behaviour. This is based on biologically-inspired principles and methodologies that have been developed at the School of Computer Science over the last years. He added: “We believe all organisms optimise information and organise it efficiently in their niche and that this shapes their behaviour in a way, it tells them to some extent what to do. “We think it will help our system to take decisions similar to organisms and to better 'read' the intentions of the human it supports. Furthermore, we will use these techniques to balance the lead-taking between robot and human.” Over the four-year period, the project will produce two demonstrators, among them a novel mobile robotassisted gait rehabilitation system which will be a self-aware system capable of learning to enable it to optimally match the requirements of the user at different stages of rehabilitation.
Contacts Editorial Andrew Harrod Group Editor editorial@assistivetechnologies.co.uk Dominic Musgrave Healthcare Editor Email: dm@whpl.net Tel: 01226 734407 Louise Cordell Reporter Email: lcordell@whpl.net Tel: 01226 734694
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Oscar Pistorius has landed a lucrative contract with Thierry Mugler as the face of A*Men perfume. In the television commercial the South African Paralympic runner known as the ‘Blade Runner’ and ‘the fastest man on no legs’ is depicted as a modernday hero - part-man and part-god. Oscar, who won the 100m, 200m and 400 metre gold medals at the Beijing Paralympics, uses Ossur’s Cheetah blades.
Design/Production Judith Halkerston Group Deputy Editor Email: jhalkerston@whpl.net Stewart Holt Studio Manager Email: sth@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.
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Initiative aims to showcase good practice
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By Dominic Musgrave
Chris Holmes, director of Paralympic integration for LOCOG, Sir Philip Craven MBE, IPC president and Dr. Helmut Pfuhl, chief marketing officer at Otto Bock Healthcare, celebrate the Paralympics 2012 partnership.
London 2012 Paralympics objectives are outlined THE vision and expectations for the London 2012 Paralympics was the focal point of a press conference at the Otto Bock Science Center Medical Technology in Berlin.
Organising Committee of the Olympic and Paralympic Games (LOCOG), the International Paralympic Committee (IPC) and Otto Bock Healthcare, the official technical services provider.
British and German journalists learned about the joint objectives for the games pursued by the London
Otto Bock has been involved with summer and winter games since Seoul in 1988.
A PROJECT development initiative between the occupational therapists at the Oxford Centre for Enablement (OCE), Nuffield Orthopaedic Centre NHS Trust, and the occupational therapy programme of Oxford Brookes University has been launched. The programme will be spearheaded by Jenny Butler, professor of occupational therapy at Oxford Brookes and Alison Bragg, lead occupational therapist for both the neuro disability and the continuing disability management services at the OCE. Its aim is to showcase the specialist good practice in occupational therapy being carried out at the OCE by supporting and facilitating projects such as writing for publication, conference presentations, audit and evaluation, as well as research project development. Professor Derick Wade, director of OCE, said “As clinical director of a specialist neurological rehabilitation
service I think that it is important that all staff from all professions retain the excitement they first had on joining their profession and speciality. “Involvement of all staff in projects that research and develop clinical practice is one effective way of achieving this, helping all staff to retain a critical and curious attitude to work, always being prepared to consider a change in clinical practice.” The project development initiative builds upon a long-established research relationship between the occupational therapy teams in the clinical and academic arenas. Alison added “The plans will further enhance the quality and evidence base of the treatment we offer our patients. “We envisage it will also provide an opportunity to increase the skills and expertise of the occupational therapy team. We also intend that the developments will enable us to act as a specialist resource for occupational therapy colleagues working in neurological rehabilitation.”
Festival donations put patients a step closer to recovery WOUNDED military patients at Queen Elizabeth Hospital Birmingham are a step closer to recovery thanks to donations made by visitors to the Old Hill Festival. The QEHB Charity, the official charity of University Hospitals Birmingham NHS Foundation Trust, has used the money to buy a set of long parallel bars to help military personnel regain their strength, balance, range of motion and independence. Senior physiotherapist Victoria Johnson said: “Thanks to this generosity we are able to make a real difference to the care of our patients here, using these fantastic
long parallel bars. “As they’re longer than the standard bars we can see a patient’s gait pattern easily without having to ask them to keep turning round, which can be difficult for them. Plus, two patients can exercise using the bars at the same time and, as the bars are hydraulic, they’re easier and quicker for us to adjust to a patient’s height. Overall, the benefits of using these new bars are enormous.” The bars are used daily by rehabilitation therapists to improve mobility, balance and co-ordination. They help patients to be more independent with their mobility.
Pair team up for talk A FORMER football club physio has joined forces with an ex-professional footballer for a talk called Feel Great for Sport. Paul Gough, who worked at Darlington, and former Midddlesbrough and Barnsley footballer Craig Hignett hosted the session which offered advice to junior footballers, their parents and coaches on how to stay fit and healthy. The event was borne from Paul’s own experience of 4
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treating professional players and having amateurs and juniors come to his private practice with acute injuries that could have been avoided. Craig said: “Paul is a top, top physio who really helped me towards the end of my playing days at Darlington and his advice was fascinating to the young and amateur players. I offered insight into life in the dressing room, which was a bit different to the normal sportsman’s dinners.”
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The bones of people who died up to a hundred years ago are being used in the development of new treatments for chronic back pain. Dominic Musgrave found out more.
Old bones used for new treatments By Dominic Musgrave THE research is bringing together the unusual combination of latest computer modelling techniques developed at the University of Leeds, and archaeology and anthropology expertise at the University of Bristol. With Engineering and Physical Sciences Research Council (EPSRC) funding, spines from up to 40 skeletons housed in museums and university anatomy collections are being analysed in the research. The data generated, on different spine conditions and on how spines vary in size and shape, will play a key role in the development of innovative computer models. This will enable the potential impact of new treatments and implant materials (such as keyhole spinal surgery and artificial disc replacements) to be evaluated before they are used on patients. Dr Ruth Wilcox, from the University of Leeds, who is leading the project, said ultimately it will also
be possible to use the models to pinpoint the type of treatment best suited to an individual patient. She added: “The idea is that a company will be able to come in with a design for a new product and we will simulate how it would work on different spines. “The good thing about computer models is that we can use them over and over again, so we can test lots of different products on the same model. “If we were doing this in a laboratory we would need many new donated spines each time we wanted to test a treatment out.” This is the first software of its kind designed for the treatment of back conditions. The research will also speed up the process of clinical trials for new treatments, which currently can take up to ten years. The data provided by the old bones will also be used to supplement similar data collected from bodies donated to science, which are
limited in number and mainly come from older age groups.
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Dr Kate Robson Brown, from the University of Bristol’s archaeology and anthropology department, said the computer modelling breakthrough is possible thanks to recent advances in micro-CT scanning, which uses X-rays to build up three-dimensional images from multiple crosssectional pictures of body organs or tissues. She added:“The wider the pool of spinal data at our disposal, the more effective the computer models will be in terms of demonstrating the impact of treatments on different back conditions and back types. “The computer modelling software should be available for testing newly developed products and treatments in the next few years and along the way this cuttingedge research could even provide new insight into how our ancestors evolved.”
Dr Ruth Wilcox
Dr Kate Robson Brown
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Researchers look at chronic shoulder pain CLINICAL researchers are hoping to shed new light on the causes of chronic shoulder pain – one of the most common reasons for people taking time off work. Researchers at the Biomedical Research Unit based at the Nuffield Orthopaedic Centre are working jointly with clinicians at the hospital to unlock the mystery of painful shoulder conditions and how they can best be treated. They are presenting a public lecture on April 19 to highlight their research, which it is hoped will lead to more effective treatments. Principal investigator professor Andrew Carr, and director of the Biomedical Research Unit, said the majority of shoulder conditions are caused by tendon inflammation and degeneration. He added: "Chronic shoulder pain can be hugely debilitating, and yet we still have many unanswered questions about what actually causes it. We know that it is more common as people get older, and that both
genes and tendon wear and tear are factors. “We are seeking to find out more about the basic biological processes involved at the same time as testing through clinical trials new therapies.” Shoulder pain is a serious problem for the adult population in the UK, with around 30 per cent needing to consult their GP. It is the second most common orthopaedic problem after back pain and a key cause for impairment in quality of life. At the 'Joint Ventures' lecture Andrew and physiotherapy specialist Jane Moser will talk about the benefits of a range of treatments from physiotherapy to keyhole surgery and stem cell therapy. “We are getting closer to be able to use stem cells alongside engineered tissue patches in our surgery to repair tendons.” he added. “These exciting developments could ultimately help improve the surgical treatment of shoulder pain, which causes problems for so many people.”
Joanna Caton of Homecall with Alistair McDonald of Whickham Villa LLP
Innovative technology for rehabilitation facility INNOVATIVE technology designed to encourage independent living has been introduced at a NorthEast neuro rehabilitation facility. Chase Park Rehabilitation Centre – part of Whickham Villa LLP – has installed an array of ‘assistive technology’ at its Gatesheadbased site. The system uses stateof-the-art sensors to support clients recovering from serious injuries and assists them in the development of independent living skills around their conditions. Assisted by expert therapists, clients will initially learn how the technology works while at Chase Park. The reason for this is that the project also involves the introduction of the technology at clients’ own homes so by the time they move back into the community, they have a full understanding of how the system operates. HomeCall, the telecare division of Coast and Country Housing, has installed the communication and monitoring devices in two
apartments. Alistair McDonald, service development manager at Whickham Villa LLP, said: “The introduction of assistive technology supports our stepforward rehabilitation philosophy. “This involves providing clients with a period of specialist rehabilitation at Chase Park to aid recovery and then introducing this kind of focus on independent living to essentially prepare clients before their transition back into the community. “Our partnership with HomeCall has allowed us to install the innovative system and educate our clients on how the equipment works. “This transitional service gives our clients a much greater sense of what fully independent living is like while still maintaining access to our specialist team before moving home.” Chase Park primarily supports people with acquired brain and spinal injury as well as complex neurological conditions.
Study looks at bunions BUNIONS have a major impact on people's quality of life and are particularly common in women and older people, a new study has shown.
Analysis revealed that 36 per cent of participants had bunions, with women and older participants tending to be at greater risk than men and younger people.
The condition, known as 'hallux valgus', occurs when a bony swelling occurs in the joint at the base of the big toe.
Individuals with bunions tended to have greater pain and physical impairment and poorer quality of life than those without the condition.
Although the causes are not fully understood, people with certain conditions – including rheumatoid arthritis and gout – are known to be at increased risk.
Associate professor Hylton Menz, from La Trobe University in Melbourne, revealed: “Our findings indicate that hallux valgus is a significant and disabling musculoskeletal condition that affects overall quality of life.
Researchers at the Arthritis Research UK Primary Care Centre at Keele University, along with colleagues at La Trobe University in Australia, studied data on 2,831 people, all of whom were 56 years of age or older. 6
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“Interventions to correct or slow the progression of the deformity offer patients beneficial outcomes beyond merely localised pain relief.”
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Marine Mark wins Against All Odds award
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A FORMER Royal Marine has been recognised for his determination to overcome the severe injuries he received while serving in Afghanistan. Triple amputee Mark Ormrod, who lost an arm and both legs below the knee when he was injured serving with 40 Commando in Helmand Province on Christmas Eve in 2007, was presented with the Against All Odds award by BLESMA (the British Limbless Ex Service Men's Association). Mark, who works as the welfare officer for the Royal Marines
Association, said: “It's overwhelm-ing, it's a huge honour to be recognised for the things that I and all the other injured guys are going through. You see a lot on the TV and in the news but you don't see what goes on behind the scenes where it gets quite emotional, and real hard work, and you're pushing yourself and you want to give up.” The 27-year-old, who was originally told by doctors he would never walk again, recently took part in the 3,500mile Gumpathon race in the United States to raise money for injured servicemen and women.
New Electrode is launched
Mark Ormrod with the rest of the Gumpathon team
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TOUCH Bionics has launched its new Electrode which has been created exclusively for the control of upper limb prosthetic devices. The product is compatible with all of the company’s myoelectric devices, including the i-LIMB Hand, i-LIMB Pulse and ProDigits, and most upper
limb myoelectric prostheses from other manufacturers. The Electrode ships with components to enable the manufacture of both laminated and thermoplastic inner sockets. This provides facilities with a simple option for upper limb sockets, regardless of the type of socket being built.
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Injunction granted against mobility company owner By Dominic Musgrave
New world record for Jon-Allan ABOVE-the-elbow amputee Jon-Allan Butterworth set a new world record on his way to victory at the ParaCycling Track World Championships in Montichari (Italy). Utilising a prosthetic device developed and manufactured at PACE Rehabilitation in Cheadle, the 25-year-old, who only started cycling competitively 18 months ago, won gold in the 1km time-trial event in a time of 67.6 seconds, taking more than a second off the previous best.
PACE prosthetist Toby Carlsson said: “In close liaison with Jon-Allan, we have developed a device that provides him with strong and secure connection to the handle bar, as he pedals. “Judging by his fantastic result, it appears to be working.” He also achieved a new British record in the 4km race, and has firmly established himself as a potential medallist for next year’s London Paralympics.
AN INJUNCTION has been granted against the owner of a Derbyshire mobility company ordering him to trade fairly and legally. Derbyshire county council sought an injunction against Amarjit Gill, who ran ABM Mobility at Gainsborough Business Park, Long Eaton. At a previous hearing in December, Amarjit was found in contempt of court after breaching a previous injunction and was given a six-month suspended prison sentence. Judge Richard Inglis, sitting at Nottingham County Court, extended the injunction barring him from misleading customers and using aggressive sales tactics until 2015. Cabinet member for communities, councillor Carol Hart, said: “We’ve tried working with Mr Gill for a number of years but his business practices still caused concern. “We are pleased that the court has recognised that Mr Gill’s way of doing business is totally unacceptable. “The majority of people buying
mobility aids are elderly and vulnerable and we are determined to do all we can to protect Derbyshire consumers. We will continue to monitor Mr Gill and will not hesitate to take further action if he fails to comply with the court order.” The court was told Amarjit had deceived customers and failed to tell them they had a seven day “cooling off” period. It followed an investigation by trading standards which received more than 100 complaints from the public. The injunction orders Amarjit to tell customers about their right to cancel within seven days and to honour refund agreements. He must not mislead customers by claiming to act on behalf of a Government body or use aggressive sales tactics and he must supply goods that are fit for purpose. He is also banned from stating products are only available for a limited period and offering a prize when one is not available. If he breaches the injunction he could be sent to prison.
Rehabilitation research shows marked improvements SCIENTISTS at the University of Ulster are undertaking research into rehabilitation techniques to help sufferers of stroke. Researchers from the Health and Rehabilitation Sciences Research Institute (HRSRI) are examining the effects of an innovative treatment called constraint-induced movement therapy (CIMT) on attention, memory, self-awareness and arm movement recovery on stroke patients. With CIMT, the stroke survivor’s unaffected arm is constrained, forcing the patient to use his or her affected arm repetitively and intensively for two weeks. Dr Sheila Lennon, from Ulster’s HRSRI, said patients using these techniques have reported marked
improvements in the use of their stroke arm even many years after their stroke. She added: “Therapists are expected to remain up to date with new interventions and to implement research evidence into their practice. The work of the researchers within the institute is patient focused and aims to improve the lives of those who have suffered a stroke. “No one to date has studied whether CIMT can be used in people with mild to moderate cognitive impairment; this research team is also studying cognitive factors such as attention, memory and self awareness which may impact on patient performance in relation to CIMT.”
Opinions sought on sporting links ARTHRITIS Research UK is asking physiotherapists for their opinions on the link between sporting injuries and long-term disorders. The charity is carrying out a survey as part of a new campaign ‘Taking the pain out of sport’. This aims to find out more about the link between sporting injuries and osteoarthritis, and look at how the condition can be better prevented and managed. A spokesman said: “Elite 10
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sportsplayers’ risk of developing osteoarthritis is well-documented. But more needs to be known about risks to amateurs, who take part in sport for pleasure or general fitness.” BackCare is canvassing the views of the exercising public as well as of healthcare professionals who have worked with people suffering injuries from exercise or sport. Its survey can be found on the Pain out of Sport website.
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‘Extra’ limb proves realistic By Dominic Musgrave SCIENTISTS have created the illusion of having three arms – and made it so realistic volunteers came out in a sweat when their ‘extra’ limb was threatened with a knife.
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Brain scientists at the Karolinska Institute in Sweden set up an experiment in which participants sitting at a table had a rubber artificial arm placed next to their right arm. Both were covered with a cloth up to the shoulder, exposing only the real and false flesh-coloured hands. This created the appearance of having two right hands. To induce a feeling of ‘owning’ the false arm, researchers stroked the real hand and the rubber hand with two small brushes at the same time and in exactly the same spot. By synchronising the brush strokes the brain is fooled into experiencing the false arm as part of its body. Researcher Arvid Guterstam said the research may provide answers that benefit the development of prosthetic or robot limbs.
Arvid Guterstam
He added: “A conflict arises in the brain concerning which of the right hands belongs to the participant's body. “What one could expect is that only one of the hands is experienced as one’s own, presumably the real arm. But what we found, surprisingly, is that the brain solves this conflict by accepting both right hands as part of the body image, and the
The third arm illusion
subjects experience having an extra third arm.” To prove that the rubber arm was experienced as truly ‘real’, the scientists ‘threatened’ either the real or false hand with a kitchen knife while measuring levels of sweating from the palm. They found that the 154 volunteers showed the same stress response when the rubber hand was threatened as when the real
hand was. Dr Henrik Ehrsson, from the Karolinska Institute's Department of Neuroscience, said: “It may be possible in the future to offer a stroke patient, who has become paralysed on one side of the body, a prosthetic arm that can be used and experienced as his own, while the paralysed arm remains within the patient's body image.”
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Training shoe developed to improve mobility AN innovative training shoe that will help older people improve their mobility has been developed by a team of international researchers. The project named SMILING (Self Mobility Improvement in the Elderly by Counteracting Falls) focuses on the use of motorised shoes to improve walking and balance to reduce the risk of falling. A prototype has been trialled in four countries – Italy, Switzerland, Israel and Slovakia – and the results are currently being analysed. David Carus, an honorary research fellow in the University of Strathclyde’s Faculty of Engineering, and a member of the project, said: “As people get older, there are major functional changes in motor behaviour that can restrict people’s participation in every day activities. “The SMILING solution uses four motors in each shoe which react differently with every step taken by the person. This challenges the user to actively respond to the situation
as they can’t see what is coming next to allow time for an appropriate course of action. “People can re-learn the process of walking in later years and take that approach into real life situations. As the project moves into its latest phase, we are moving closer to a product that will significantly prolong independent living and in turn increase participation in society.” The university has handled th process of constructing the shoe’s mechanical structure and work will continue to streamline the model following feedback from those involved in the trial. Project coordinator Dr Fiorella Marcellini, of the Italian National Institute on Ageing, said providing elderly people with a platform to maintain a healthy lifestyle and an adequate level of physical activity is at the heart of the project.
and social participation through daily activities such as maintaining relationships with family and friends, participating in leisure time activities, accessing health care facilities and shopping. Mobility contributes to life satisfaction and subjective wellbeing.
She added: “Mobility is a key element to enhance independence
“Ability to walk safely is a significant predictor of satisfaction with life in
ageing. Therefore it is a fundamental precondition for people to participate in everyday life.” Israeli company Step of Mind Ltd initiated the SMILING project, which has received financial support from the European Commission under the European Union Seventh Framework Programme of Research and Development.
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‘Letting Lions do the legwork’ By Louise Cordell A CAMPAIGN has been launched for the return of NHS crutches, walking sticks and frames in a South West city. Royal Devon and Exeter Hospital estimates it costs them around £60,000 a year and, with the hospital trust looking at ways to save money in the face of a significant reduction in funding, the local Lions Club has stepped in to make it easier for former patients of the hospital to return equipment. Fellow Lion Angie Whawell came up with the idea of 'letting the Lions do the legwork' after breaking her ankle. She experienced first hand, as a former RD&E patient, the practical obstacles and disincentives in rural Devon which make it difficult to get the walking aids back to where they belong. She said: “When you have had a nasty break it knocks your confidence and although you are on the mend, part of you thinks you should hold on to the crutches just in case you have a setback. “For many people living in outlying towns and villages, making a trip back to the
RD&E to return the crutches is not always so easy. “I would imagine there are hundreds of crutches, sticks and frames out there and they belong back at the hospital, so we hope by making it easier for people to drop these items off at their local GP surgery or community hospital, the Lions can then collect and return them to the RD&E.” The hospital estimates that more than 2,500 crutches are issued along with more than 1,000 walking sticks and nearly 900 frames, but few are ever taken back. Senior physiotherapist Jane Roseveare said: “We are very grateful to the Exeter Lions for recognising the value of the walking aids we provide and the cost to the NHS when this equipment is not returned.
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New team members Petra Broden, Isabel Siewert, Victoria HodkinsonGibbs and Kevin Trehearn
Wheelchair specialist makes new appointments
“At the RD&E, each year we issue 2,692 pairs of crutches, more than 1,000 walking frames and almost 900 sticks. The total annual cost of this equipment is just under £60,000."
WHEELCHAIR passenger safety specialist Q’Straint has made four new appointments at its headquarters in Whitstable, Kent to increase its business capacity and enhance its technical, operations and marketing departments.
The charity volunteers will now be doing collections from local GP surgeries and community hospitals in east, mid and west Devon.
Victoria Hodkinson-Gibbs has joined as technical manager and will be responsible for ensuring utmost product
safety and reliability, compliance with legal requirements. Kevin Trehearn will be reporting to Victoria as operations engineer, while Isabel Siewert and Petra Broden, both originally from Germany, have been recruited as a sales/marketing assistant and marketing/admin assistant respectively.
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An army captain is set to become the first amputee to reach the North Pole unsupported on a charity expedition to the Arctic. Louise Cordell found out more.
Army captain Guy in Arctic challenge GUY Disney will be completing the Walking With The Wounded trek to raise money for charities supporting ex-service people. He lost his lower limb below the knee when his unit was ambushed while on patrol in Afghanistan in 2009. During the fire fight his leg was pierced by a rocket propelled grenade. Guy will be one of four wounded soldiers taking part in the challenge and facing risks including shifting ice, pressure ridges, hypothermia and frostbite. The group will be walking in temperature ranging from -15°C to -40°C and will also need to carry weapons because of the
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threat of polar bears. Guy said: “You get a lot of offers from various charities after you have been injured but this really struck me as a great cause and also an amazing opportunity.
The leg has been created using carbon fibre rather than metal to prevent it from being affected by the cold and has been designed to have as few working parts as possible, to cut down on the risk of breakage or malfunction.
“The money we raise will benefit charities including Help for Heroes, Skill Force, Blesma and The Warrior Programme and the expedition is being supported by people including Prince Harry and Bear Grylls.”
Guy added: “So far so good with the leg. The big concern is getting a rub. If it was a shorter trip I could work through it, but this is a 25 day expedition, so it really needs to be about prevention rather than cure.
Guy has been working with Pace Rehabilitation and a prosthetic team at Headley Court to develop a prosthetic especially for the expedition.
“It needs to fit really well and I also need to be able to alter it to adapt to my changing body during the trip. “Most people lose around a stone and half during the
journey, so I will need to be able to make sure that it still fits well when that happens. “On the flip side, amputees usually have problems with overheating rather than feeling the cold, so I won’t suffer quite as badly as some of the others on the trips. “I can’t see it catching on for other arctic explorers though!” The expedition is receiving a lot of support from the public and the team have currently raised over £415,500, with the aim of eventually reaching £2m. To contribute please visit: www.justgiving.com/walkingwitht hewounded.
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Funding for joint condition project By Christina Eccles A RESEARCHER from the University of the West of England has been awarded two grants to fund work that will encourage people with serious joint conditions to move and exercise more. Dr Nicola Walsh has won more than £500,000 that will fund projects looking to improve clinical delivery of treatments and therapies within the community and primary care. The research will look into the feasibility of offering self management advice and exercise for people with chronic musculoskeletal pain and osteoarthritis in a more joined up way. Dr Nicola Walsh has been awarded £250,000 from the Chartered Society of Physiotherapy Charitable Trust for a study into the clinical and cost effectiveness of exercise and self-
management for people with chronic musculoskeletal pain and osteoarthritis. The grant will complement a fiveyear fellowship grant from Arthritis Research UK for £346,000 to develop communitybased models of care for people with degenerative musculoskeletal pain. Nicola said current management strategies are expensive and frequently ineffective as they fail to encourage long-term exercise participation. She added: “The tendency is to treat people with site specific problems rather than taking joint pain and reduced function as broad entities. “The ongoing treatment for degenerative joint pain management is similar whatever the condition or location of the pain. “So there is an argument to work in a joined up way and merge
management rehabilitation classes to include people with the various manifestations of pain whether it be knees, backs or hips. “The key message to get across is the crucial part exercise has to play in helping people with joint problems. “Often as soon as people realise that they have degenerative joint problems the tendency is to rest joints when in fact proven benefits that help manage the pain better include a focus on building up the muscles that support the joints to make movement less painful. “As practitioners we recommend a combination of exercises to aid strength, mobility and functionality.” The work funded by CSPCT is in collaboration with the University of Bristol, St George’s University of London and Peninsula College of Medicine and Dentistry.
Deal signed for new product FLEXYFOOT, an innovative new concept in walking aids, has signed an exclusive distribution deal for the UK and Ireland with Trulife. The product, which was launched last summer, was invented by leading British product designer David Goodwin. It is designed to replace the old-fashioned ferrule (or rubber tip) on these aids and revolutionise walking for the injured or infirm. Trulife general manager Kay Purnell said the deal represents a substantial opportunity for both parties. She added: “As soon as we saw Flexyfoot we knew it was a game-changer: one of those unique products – simple yet effective and offering real benefits to users. “We can totally relate to the longer term issues of using crutches as we have been making them for many years – in fact user feedback was the motivation for the development of our softer handled crutches about seven years ago which have been well received by the market. In a separate deal, Flexyfoot has also signed a sales, marketing and distribution agreement with Scandinavian mobility aids distributor Swereco. Flexyfoot is being aimed at physiotherapists, occupational therapists and surgeons. The product is also being targeted at leading specialist and multiple retailers, many of whom are now moving into the mobility market.
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NEWS
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PODIATRY
sponsors podiatry Two artificial big toes – one found attached to the foot of an ancient Egyptian mummy – may have been the world’s earliest functional prosthetic body parts, says the scientist who tested replicas on volunteers. Dominic Musgrave reports.
Research shows that artificial toes did help people walk UNIVERSITY of Manchester researcher Dr Jacky Finch has shown that a three-part wood and leather artefact housed in the Egyptian Museum in Cairo, along with a second one, the Greville Chester artificial toe on display in the British Museum, not only looked the part but also helped their toeless owners walk like Egyptians.
them. “The stump must also be kept clean, so it must be easy to take on and off. But most importantly it must assist walking.
The toes date from before 600BC, predating what was thought to be the earliest known practical prosthesis – the Roman Capula Leg – by several hundred years.
“The big toe is thought to carry some 40 per cent of the bodyweight and is responsible for forward propulsion, although those without it can adapt well. To accurately determine any level of function requires the application of gait analysis techniques involving integrated cameras and pressure devices placed along a walkway.”
Jacky recruited two volunteers whose right big toe had been lost in order to test exact replicas of the artificial toes in the Gait Laboratory at Salford University’s Centre for Rehabilitation and Human Performance Research.
The volunteers were asked to wear the toes with replica Egyptian sandals and, while neither design was expected to perform exactly like a real big toe, one of the volunteers was able to walk well with both artificial toes.
She said: “To be classed as true prosthetic devices any replacement must satisfy several criteria. The material must withstand bodily forces so that it does not snap or crack with use.
No significant elevation in pressure under the foot was recorded for either toe, although both volunteers said they found the Cairo toe particularly comfortable.
“Proportion is important and the appearance must be sufficiently lifelike as to be acceptable to both the wearer and those around
The Greville Chester toe – made from cartonnage, a sort of papier maché made using linen, glue and plaster – shows considerable signs of wear, while the Cairo toe has
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Podiatry, Sports Rehab and Children To find out more ring Christine Daly-Sadler on 01226 734412 18
ASSISTIVE TECHNOLOGIES I APRIL/MAY 2011
Dr Jacky Finch with the prosthetic toes
certain features, such as a simple hinge, a chamfered front edge and a flattened underside.
laboratory conditions, it remained uncertain if they could indeed help their owners to walk.
“The wear on the Greville Chester toe and the important design features on the Cairo toe led me to speculate that these toes were perhaps worn by their owners in life and not simply attached to the foot during mummification for religious or ritualistic reasons,” Jacky added. “However, until we were able to test replicas of both toes using volunteers under
“My findings strongly suggest that both of these designs were capable of functioning as replacements for the lost toe and so could indeed be classed as prosthetic devices. If that is the case then it would appear that the first glimmers of this branch of medicine should be firmly laid at the feet of the ancient Egyptians.”
Wedge offers a ‘quick win’ A NORTH West physiotherapy clinic has teamed up with foot orthoses specialists at a nearby university to offer a ‘quick win’ for those suffering from medial osteoarthritis of the knee. Manchester Physio, which has sites in Sale and Macclesfield as well as in the city, has joined with University of Salford to offer the Lateral Wedge Technology insole. The development has been pioneered over the last five years by Dr Richard Jones in collaboration with colleagues in orthopaedics across the region. John Bowden, senior physiotherapist with the company, said: “It is obvious that alongside our physiotherapy treatment the insole provides pain relief and assists in improving function.
“It is clearly more convenient and economical for patients when compared to knee bracing and, therefore, compliance is high. “We find that most patients consider wearing a knee brace as a last resort or only on painful days. The advantage with the insoles is that the patient is happy to use them at all times from an early stage. This can allow us to concentrate on rehabilitation and improving quality of life.” Richard, who has recently delivered lectures about the insole to podiatrists, physiotherapists and orthopaedic surgeons in Dublin and Malmo, found that 27 of the 28 patients who used both the insole and a knee brace chose to use the insole longer term.
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sponsors sports rehab
Paul works with elite cricket academy A HARTLEPOOL physiotherapist has spent two months working with an elite cricket academy based in Melbourne, Australia. Paul Gough, owner of the Paul Gough Physio Rooms, whose company has practices in Darlington, Durham, Guisborough and Hartlepool, carried out the role of fitness and injury specialist to the Melbourne based SC Cricket Coaching academy. The former head physiotherapist at Darlington Football Club said: “I try to test my own skills as a physio as much as possible working with athletes from different sporting fields. “We travelled all over Australia with the lads playing games as well as spending long hard days practicing in the nets. “My role was to advise on fitness plans and be on hand to help out with acute injuries and work with the coaches to analyse players batting and bowling techniques and look at ways of preventing injury” “Cricketers these days are expected to play a huge number of games and, in particular, fast bowlers subject themselves to high levels of impact so modern players need to have the right technique to survive at the top level” The SC Cricket Coaching company is run by former Durham county cricketer Steve Chapman, and the academy was attended by some of the best young cricketers from both England and Australia.
Research looks at best ‘cool down’ methods
SPORTS REHABILITATION
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By Dominic Musgrave TOP sportsmen and women are set to get the lowdown on the best ways to wind down and manage their bodies between rigorous competitive action and training, thanks to groundbreaking new research. University of Plymouth academics and students have started looking at the best techniques to cool the body to prevent and manage injuries and ensure quick recovery to return to peak physical condition after undertaking strenuous sports activity. Particular emphasis is being placed on the use of cryotherapy techniques where low temperatures are used as a form of medical therapy to remove heat from the body to ease pain, spasms or inflammation. The research will involve assessing the effectiveness of the cryotherapy between training sessions for high-performance sportsmen and women by working with around 10 swimmers including double Commonwealth Games medallist and University student Antony James. Matt Barlow, an exercise physiologist at the University who is leading the research, said ‘cool down’ techniques are beneficial as they help remove waste products produced in the muscle during exercise. He added: “The findings could help Antony and other top
Antony James (front left) with the team at Plymouth university.
swimmers in their quest to win medals for Britain in top competitions like the Olympics. “They will be able to manage their bodies based on tried and tested scientific evidence backed up by hard facts, thereby ensuring that they are in peak physical fitness to compete at the highest level. “This could form part of Antony’s competition strategy – hopefully giving him the edge in competitions. He is very keen on this research, as he understands that even a small gain in performance could be the difference between first and second place.” This is the first time research of this kind has centred on swimmers and it will take around six months
to complete, with ice baths being compared to other forms of ‘cool down’ techniques, such as recovery swimming and stretching. The swimmers’ pain ratings and blood lactate levels will be measured to establish what is the most effective method to aid and speed up recovery – and that could have major benefits for people in other sports too. Antony added: “Although the research is particularly looking at competitions where swimmers may have more than one heat in a day and therefore need to recover quickly and efficiently between races, it could apply to any high intensity sprinting sport where multiple bouts are required so the results are likely to be useful in athletics too.”
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KIDS
Physio Rachael mentors teens on Arctic trek The Ready Willing and Mobile design competition for children returns to the Mobility Roadshow at Peterborough this year.
Interactive design zones launched at annual event DESIGN will feature strongly at the annual Mobility Roadshow which takes place again at the East of England Showground, Peterborough. In the new interactive Design Zone designers, innovators and visitors can meet in an open forum to exchange ideas about looks and functionality of current and future independent living products. The Design Surgery offers the opportunity to speak to a professional designer about the feasibility of an idea for a new product, and gain advice on how to take it forward, exploring practical issues such as design, production, marketing and cost implications. The Design Showcase will feature independent living products of the future, while visitors will be able to have their say about the products
they love, hate or would like to change in some way in the Design Video Booth. Jacqui Jones, executive director of Mobility Choice, organisers of the Mobility Roadshow, said: “Independent living and mobility products have evolved tremendously in recent years, some retaining popular classic origins, others pushing design and innovation boundaries. “However, many Roadshow visitors tell us they would like an opportunity to put forward their ideas at a much earlier stage; to tell the design teams what would really work for them. We’ve listened and now we are giving them the platform to speak.” The event takes place from June 30 until July 2.
Chris’ 1000-mile run benefits kids’ charity A DISABLED, ultra-distance athlete who lost his lower right leg and right arm while supervising mine clearance in Mozambique has completed a 1,000-mile charity run Chris Moon received a hero's welcome from Penny Lancaster Stewart as he arrived at one of the final stops of the ‘Post Office 1000 Challenge’ in aid of the Barnardo's Believe in Children appeal. He started his quest in Edinburgh on September 1 and since then he has crossed the country, visiting many Barnardo's projects to meet firsthand the children and staff his
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amazing feat will help in the coming months and years. He finished the event at the charity's headquarters in Barkingside, Essex. Chris said: “It’s been a very tough and arduous challenge at times but I am delighted to have been able to complete what I set out to do. “I have met some amazing people from Barnardo's who do fantastic work with children and young people, and I have been encouraged every step of the way by enthusiastic supporters and fundraisers working at post offices in towns and cities along the way.”
A NEUROLOGICAL physiotherapist mentored a group of teenagers as they attempted a 150km Arctic trek across one of the islands in the Svalbard archipelago, off Norway. Rachael Mackenzie, a sports ambassador for the Youth Sports Trust and former world number one Thai-boxer, was approached by the BBC to feature in a documentary about the expedition, due to be screened this summer. The one-week trek saw five children from Springfields residential school in Wiltshire, which specialises in pupils with behavioural and developmental disorders, brave harsh conditions as they pulled sledges loaded with equipment across the icy Arctic terrain. Joining Rachael on the trek were former Royal Marine Commando Alan Chambers, who led the first unsupported expedition to the North
Pole, and Dr Ed Coats who travelled with James Cracknell and Ben Fogle on their race to the South Pole. “Our role was really to inspire the young people to succeed,” she said. “We were there as role models and to let them know that all you need to succeed is hard work and determination.” “I was on hand to treat the aches, pains, strains and blisters caused by physical exertion, but my primary role was to provide psychological, rather than physical, support to the participants.” Rachael works at Physiofunction in Harrogate, and also with young people at the Leonard Cheshire Disability unit at Alne Hall, York. She took a break from Thai boxing when she had twins, but is now making a return with a British title fight in July.
Firms join to get AFOs to fit first time REED Medical and Beagle Orthopaedic are working together to resolve the problem of getting AFOs to fit functionally and cosmetically into paediatric footwear first time. Reed is one of the country's leading suppliers of specialist orthopaedic and diabetic footwear, produce stock, bespoke and semi bespoke footwear for adults who have a range of conditions, as well as an extensive range of specialist and orthopaedic children's footwear. Beagle Orthopaedic Custom Fabrication is a manufacturer of custom made orthotic products, and has extensive experience in the manufacturing of paediatric
AFOs. They hope this service should eliminate the fundamental problems of having to order two products from two different suppliers, who are in essence working blind, and hope that both will fit together. Beagle will manufacture the AFO from the cast; all information will then be passed onto Reed Medical who will produce the shoes from the designated prescription. This will ensure the AFO fits precisely into the boot, making the correct provisions for the circumference of the calf or any other requirements that should be taken into consideration in the manufacturing process.
Have you got a story for the kids’ section of Assistive Technologies? Let Dominic Musgrave know by ringing 01226 734407 or email dm@whpl.net
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Health secretary praises charity’s innovation HEALTH Secretary Andrew Lansley cited Whizz-Kidz’ pioneering NHS partnership working at a social enterprise conference in London. Speaking at the Voice11 event he described the charity’s pioneering NHS partnership working as “very clear evidence of how the business model, the social enterprise model, really does deliver.” He added: “We have to foster the enterprise and innovation which is the hallmark of all successful organisations. Frankly, I don’t think it’s about public sector versus private sector vs voluntary sector. It’s about the characteristics of successful organisations. “Take for example when I was in Tower Hamlets with Whizz-Kidz. They
designed what they did around the needs of young wheelchair users. And it wasn’t just that the wheelchair users got the service they need, when they needed it, but it cost 60 per cent less than it had done under the previous arrangements. “And for every pound spent on Whizz-kidz’ services you get up to £65 back in social value – because of the social, environmental and economic benefits of good wheelchair access for young people.” Andrew was quoting figures from a new report published by economic firm Frontier Economics which outlines the Social Return on Investment (SROI) of Whizz-Kidz’ work, and the impact of its equipment provision for disabled children and young people.
The report states that for every £1 invested in these services, benefits of between £10 and £65 are generated, and summarises four key benefits to families of better wheelchair provision:
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To the child: greater independence and the impact on future ability to work. To the family: freed up time from caring for full or part-time work. To the school: reduced need for support from a teaching assistant and classroom adaptation. To healthcare: reduced need for treatment (of child and carer) for health problems that can be caused by having the wrong type of equipment.
PACE’S free referrer’s day at its Chesham clinic provided professionals who refer patients to the company with the opportunity to have a behind the scenes visit to the facility and see how clients are supported by the multi-disciplinary team. The clinical team also discussed why particular components are chosen for patient provision, the latest prosthetic and orthotic solutions as well as demonstrating the casting of a patient for a prosthetic socket. Patients also attended to share their experiences. Pictured at the event are Jamie Gillespie, Toby Carlsson, Nicky Edwards and Scott Richardson.
Ride to benefit two charities WORKERS at a disability tricycle manufacturer and distributor hope to raise £1,000,000 for charity next April with a ride from John O’Groats to Lands End. Each of the three tandems being used for the challenge will be ridden by a Quest 88 employee, and they will be accompanied by representatives from the three armed forces that have been injured while serving their country. The trip will be spread across 12 days, with an average of 80 miles being covered per day. All money raised will be split between Help for Heroes and Caudwell Children. Various celebrities who work with both charities will also be joining the teams along the route. “We are incredibly excited about the
launch of Ride Side by Side,” said joint managing director David Vernon-Henshaw, who is one of the employees taking part. “To have the opportunity to ride the length of the UK with such brave people while also raising money for two such great charities will be a fantastic experience.” As part of the event, Quest 88 will also be holding All Ability Cycling days in Glasgow, Manchester, Shrewsbury, Taunton and Plymouth. At each event, anybody with a disability will have the opportunity to use a Quest 88 tricycle and hopefully realise that cycling is still a possibility for them. The other staff members taking part on the ride are technical services engineer Mark Leary and design engineer Tony Smart.
Prosthesis wearers day THE Murray Foundation is hosting a sport and activity fun day in conjunction with the National Centre for Prosthetics and Orthotics and Scottish Disability Sport (SDS) this summer. The June 4 event will be held at the Scotstoun Leisure Centre in Glasgow, with activities including swimming, sub aqua, athletics, badminton,; basketball, tennis, seated volleyball, cycling, table tennis and carpet bowls. SDS representatives will also be on the look-out for any participants who might be potential competitors for the Commonwealth Games due to be held in the city in 2014. ASSISTIVE TECHNOLOGIES I APRIL/MAY 2011
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PRODUCTS
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HEAD 2 TOE ORTHOTICS INTRODUCES THE NURNBERG SHOE
CUSTOM DOLLS’ COLLARS TO MEASURE
THE Nurnberg Shoe is one of the most popular in the Fior and Gentz range. It has a number of fields of application including: Diabetes prophylaxis. Wounds to forefoot area on the sole of foot caused by diabetes mellitus. Wounds to forefoot area in the sole of the foot caused by other indications. Wounds to foot area. The shoe is rigid and has an extra strong rocker bottom sole with a last pitch 30mm thick. Due to the rigid sole of the natural rolling off of the foot is changed. The flexion of the heads of the metatarsal bones is suppressed. Because of this the foot is immobilised, which results in relieving an existing wound that can heal up in a better way. The shoe comes in either left, right or as a pair and is available in a standard and a wide fit.
DOLLS’ collars are usually of a ‘bivalved’ design, and Beagle are able to fabricate these from a variety of materials to produce orthoses with diverse degrees of control. The sections can butt together, or can be manufactured as a clamshell design to provide the required rigidity for the head and neck. The anterior section contains and controls the chin, with the posterior shell extending to the occipital region distally, and to the superior angle of the scapula proximally. This provides excellent control of flexion and extension and minimises rotation, making them suitable for use in torticollis, MND, spondylolithesis, and for ununited and pathological fractures. Additionally, as these collars are custom produced, they are particularly effective with asymmetric patients. Total contact between the neck, chin and upper thorax and the device ensures a great degree of immobilisation, especially in the mid-cervical region, and the less conspicuous appearance means the collar may be more readily worn under clothing.
Enquiries: Telephone 0114 2584639, email sales@head2toeorthotics.co.uk or visit www.head2toeorthotics.co.uk
Enquiries: Contact 01254 268788 for an orthometry chart
EXTENDER ARM BRACE
REMEDY MAGNETIC ARM SLING
Indications: • Post-operative immobilisation or ROM control for the elbow. • Conservative treatment of elbow dislocation or luxation. • Stable or internally fixed fractures of the distal humerus or proximal radius or ulna. Functions: • Immobilisation of the elbow in 10-15° increments. • Limit ROM by adjustable simple setting hinges. Features: • Transcendent overall adjustibility. • Simply press and rotate settings. • “One push bottom” can be released for length adjustment. • Extension limitation at: 0°, 10°, 20°, 30°, 45°, 60°, 75°, 90° Flexion limitation at: 0°, 10°, 20°, 30°, 45°, 60°, 75°, 90°, 105°, 120°. Immobilisation limitation at: 0°, 10°, 20°, 30°, 45°, 60°, 75°, 90°. • Length adjustments from 13.5” to 17”. • Breathable laminated soft foam material offers air permeability and moisture vapor transport.
INTRODUCING “The Remedy” the first magnetic shoulder immobilisation sling with no over the shoulder straps. The Remedy uses powerful “rare earth” magnets at strategic places to hold the upper arm and forearm firmly and reliably in the chosen position. The most important advantage of this high tech approach to shoulder immobilisation is the complete absence of pressure on either the neck or the nerves of the brachial plexus. Suitable for post-operative uses such as Bankart or rotator cuff repairs, also suitable for post-injury use - anterior dislocation / subluxation or sprains/strains of the Glenohumeral joints for example. The brace is also very low profile and can easily be hidden under clothing. Compared to established “sling and swathe” devices, The Remedy is more comfortable and reliable, and represents a quantum leap in shoulder immobilisation techniques.
Enquiries: For further information telephone BeneCareMedical on 0161 273 6789 or email info@benecaremedical.com
Enquiries: Telephone 0121 475 1101, email marketing@gilbert-mellish.co.uk or visit www.gilbert-mellish.co.uk
DYNAMIC CORRECTION ORTHOSES WITH ADJUSTABLE SPRING JOINT A CONTINUOUSLY adjustable spring mechanism creates a corrective force in the direction of the physiological normal position. The permanent tension stimulates the stretching of the shortened tissue, whilw detrimental painful over extension is avoided. The brace has been designed to correct the mal-positioning of the big toe by virtue of the force applied and to counteract the immobilisation of the abnormal soft tissue situation. Enquiries: Contact Peacocks Medical Group on 0191 276 9620 or sales@peacocks.net
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If you would like to gain exposure for your product please contact: Christine Daly-Sadler on 01226 734412
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