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INNOVATION FOR INDEPENDENCE
ISSUE 70 December 09/January 10 £6.95
Dora opens doors for chair users By Dominic Musgrave SCIENTISTS in America have developed a robotic arm to help wheelchair users open doors. The permanently mounted door-opening robotic arm (Dora) was brainchild of Erin Rapacki, and has the potential to increase a power wheelchair user’s accessibility to indoor spaces. In tests the gripper opened doors with 14 different handles in 85 per cent of tests involving pushing the door, and 65 per cent of pulling. Erin told Assistive Technologies that while creating the arm, which cost 2000 dollars, she kept in mind that wheelchair users are often unable to reach and turn handles. She added: “Wheelchair-mounted robot arms are typically designed with many degrees of freedom to provide users with a general-purpose device for manipulating many of the objects necessary for activities of daily living. I considered a variety of designs of door knobs and handles that a door-opening robot must be able to grasp, and calculated how much force is needed to open the door, the twisting angles to unlatch the door, and how much force is needed to unlatch it.
“Commercially available systems are quite expensive and are usually not covered by insurance. What we have designed is an arm specifically to unlatch door knobs and door handles while being permanently mounted to a power wheelchair.” The idea for the arm began as a project while she was studying at the University of Massachusetts, and she has continued to develop it while working at Anybots. The system works by using a single motor, with a slip clutch allowing the arm to twist and push (or pull) at the same time. Erin said the key to its success was finding the right material for the fingers, something hard enough to grasp the handle, but supple enough to fit a range of shapes. She added: “I first tried flexible neoprene fingers, thinking that they could bend to grasp the knob, but these proved too thick and soft. Stiff plastic fingers with plates to constrain their sideways motion proved much more effective.” Although Dora is able to unlatch a number of door knobs and handles with similar characteristics, Erin said there are several limitations to the design that need to be addressed prior to using the robot in a rehabilitation environment.
Former Paralympic basketball player Ade Adepitan was the special guest at the annual British Healthcare Trades Association (BHTA) awards held at Hotel Russell in London. The television presenter was on hand to help present numerous awards on the evening, including the excellence awards sponsored by Assistive Technologies magazine.
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Top award for robotic hand By Dominic Musgrave THE team behind a robotic hand that can automatically change its grasping force using compressed air has won a top award. The undergraduate students from Virginia Tech College of Engineering’s robotics and mechanisms laboratory (RoMeLa) won first place in the American Society of Mechanical Engineers’ Student Mechanism and Robot Design competition at the International Design Engineering Technical Conference. Their winning entry was RAPHaEL 2 (Robotic Air Powered Hand with Elastic Ligaments), a secondgeneration version of the hand that
previously won an award from the Compressed Air and Gas Institute.
material that was prone to breakage.
Dennis Hong, director of RoMeLa, told Assistive Technologies that because the hand's grasping force and compliance is adjusted by changing the air pressure, it does not require the use of motors.
"This gives us a lot more control over the kinds of things we can do with the hand and eventually we hope to be able to tell how soft an object you're grabbing is just by touching it."
He added: “The most significant change for RAPHaEL 2 is the closed loop control mechanism and sensors for automatic position and force feedback of the fingers using LabVIEW and data acquisition hardware.
Additional tweaks planned include the ability to grasp small moving objects as well as the use of silicone, carbon fibre and other materials to make the hand lighter, simpler in structure, and also appear more human.
“The material that comprises the hand were also changed to a durable polycarbonate material, replacing a fragile acrylic-based
RAPHaEL 2 is part of a larger RoMeLa project called the humanoid robot CHARLI (Cognitive Humanoid Robot with Learning
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Intelligence). Once the hand is connected to the body, it will be able to pick up – not just grasp and hold – objects as would a person. It is hoped that CHARLI will one day be able to walk around campus, giving tours of Virginia Tech to visitors and potential students.
Research claims people would rather rely on gadgets than family
Olympic athlete Jade Johnson and new boxing world champion David Haye are using healing technology usually reserved for people recovering from plastic surgery to help with their recovery. Long jumper Jade is using the Hilotherapy system, which reduces post-trauma swelling and pain by circulating cool water through adaptable cuffs, on the knee she injured in training for BBC’s Strictly Come Dancing. And David also used the system to help both prepare and recuperate from his encounter with the seven-foot Russian Nikolai Valuev. Picture: BBC images from Strictly Come Dancing
PEOPLE would rather rely on gadgets than family in old age, new research has claimed. Almost half the people asked by Which? magazine said that ideally they would rely on equipment to help them with day-to-day practicalities at home, while only a third said help from relatives and friends was their first choice. Around eight in 10 of the 1,105 people aged 45 or over questioned thought assistive technology had the potential to improve quality of life in later years, and said they would use products that help prevent accidents if they enabled them to stay independent. Claire Lilley, senior policy adviser at Which? said: “People are clearly open to the idea of using assistive technology. “They want to remain
independent for as long as possible into old age, and feel these products have the potential to help them. “What we need to look at now is how we can break down the barriers stopping people from using and buying assistive technology, and whether the market is ready to handle increased demand.” However, affordability emerged as the biggest potential barrier for people buying products in future, with more than a third of people are more inclined to consider buying assistive technology if they thought the products represented value for money, or they could access financial help to pay for them. Other barriers included a lack of information about the technology available and how to access it.
Contacts Editorial Andrew Harrod Group Editor editorial@assistivetechnologies.co.uk Dominic Musgrave Healthcare Editor Email: dm@whpl.net Tel: 01226 734407 Sales Ellen Sharp Email: es@whpl.net Tel: 01226 734412
Sales representative Fax: 01226 734478
Sales and Marketing Director Tony Barry Email: tb@whpl.net Circulation circulation@wharncliffepublishing.co.uk 24 hour hotline: 01226 734695 Design/Production Judith Halkerston Group Deputy Editor Email: jhalkerston@whpl.net Stewart Holt Email: sth@whpl.net
Studio Manager 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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Record number of entries for AT-sponsored awards ASSISTIVE Technologies magazine was again the sponsor of the excellence accolades at the annual British Healthcare Trades Association (BHTA) awards. The awards were again presented by Angela Rippon for the fifth year, while special guests included television presenter and former Paralympic basketball player Ade Adepitan who, after being diagnosed with polio as a child, won a bronze medal in Athens in 2004 and gold at the World Cup in Manchester the following year. The evening’s speaker was Baroness Sue Campbell of Loughborough, who is one of the most influential people in British sport as the chair of UK Sport and of the Youth Sport Trust. Instrumental in preparing the successful British Olympic and Paralympic teams in Beijing, she is now heavily involved in ensuring they build on this for London 2012. The excellence awards recognise those companies that have gone the extra mile in providing excellent service and innovation over the last year. There are four categories: Mobility, Rehabilitation, Prosthetics and Orthotics, with the first three places in each receiving an award. Wharncliffe Publishing managing director Michael Hewitt said: “Assistive Technologies magazine was delighted to sponsor these awards that recognise those organisations that have made an exception contribution to the industry. “It was very encouraging to see that we had a record number of companies nominated and more than double the number of votes we received last year. “Our congratulations go to all those companies put forward, but in particular the category winners.” The BHTA excellence awards sponsored by Assistive Technologies magazine: Mobility
Winner – Albion Mobility Runner-up – Remploy Healthcare Highly commended – Invacare Prosthetics
Winner – RSL Steeper Runner-up – Touch Bionics Highly commended – Otto Bock Rehabilitation
Winner – CareFlex Runner-up – Nottingham Rehab Supplies Highly commended – Minivator Orthotics
Winner – Trulife Runner-up – Remploy Healthcare Highly commended – RSscan Lab Ltd 4
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Ade Adepitan with the winners above: Albion Mobility, RSL Steeper, Careflex and Trulife
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Awards ‘continue to reflect excellence and high standards’ CHAS A Blatchford and Sons won the Independent Living Design award at the annual British Healthcare Trades Association (BHTA) ceremony. Salts Healthcare was second and Equip-able third in the awards which were sponsored by the association’s insurance services. They are judged from the point of view primarily of innovation, but also examine aesthetics; usability and practicality; enhancement of quality of life; and finally clarity of user instructions and literature. BHTA director general Ray Hodgkinson said: “This year’s awards have continued to reflect excellence and high standards being achieved in the assistive technology sector. “With people living longer and the Government’s aim to encourage
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them to stay in their own homes, such products are more important than ever.” Other awards presented on the evening saw Malcolm Lattimer from Brookwood Mobility in Chesterfield named employee of the year and The Lifecare Centre in Dartford, Kent team of the year. Both were sponsored by Naidex. Bromakin Ltd took the Donald Blatchford retailer of the year sponsored by Thiis magazine prize, while Mike Sawers (Hollister) won the lifetime service award. The ceremony was again held at the Hotel Russell in London, and this year’s charity was When You Wish Upon a Star, which makes dreams come true for children with life threatening illnesses.
The Chas A Blatchford and Sons team which won the independent living design award
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Personal companion robot aiming to combat loneliness in elderly
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TRIALS of a personal companion robot have begun in homes in the US. GeckoSystems say their CareBot aims to combat the feeling of loneliness and loss of independence that many elderly people living in their own homes feel. It is made up of an aluminum frame, plastic shroud, two independently driven wheels, multiple sensor systems, microprocessors and several onboard computers connected in a local area network. The microprocessors directly interact with the sensor systems and transmit data to the onboard computers. GeckoSystems president and CEO Martin Spencer said: “Practical, cost effective mobile robot solutions are our primary goal, and we now aim to prove our long held belief that personal companion mobile robots, like the CareBot, can help tens of thousands of families take better care of their loved ones while saving a significant amount of money. With these trials we expect to learn a great deal as to the reality of social interaction between human and robot in-home settings. In the near future we will be reporting on the social interaction responses of the care receiver – and the care giver – to this new type of in-home medical monitoring system.” The onboard computers each run independent artificial intelligence software programs. GeckoSavants completes tasks, while GeckoNav is responsible for manoeuvering, avoiding dynamic and/or static obstacles, seeking points and patrolling. GeckoChat is responsible for interaction with the care receiver such as answering questions, assisting with daily routines and reminders, and responding to other verbal commands.
Quicker and closer physio for Sheffield By Dominic Musgrave ADULTS requiring physiotherapy will soon be able to receive treatment quicker and closer to their homes thanks to NHS Sheffield’s planned changes to the city’s musculoskeletal community physiotherapy services. A number of Sheffield’s family doctors, who are part of practicebased commissioning consortia, identified to NHS Sheffield that they felt the service was not giving patients timely enough access to physiotherapy. Patients then confirmed they felt the speed and flexibility of appointments needs to improve, and that they would benefit from being treated closer to home. Lead for improving physiotherapy services at NHS Sheffield, Alastair Mew, said: “It is estimated that up to 30 per cent of all GP consultations are about musculoskeletal conditions and that up to 60 per cent of people who are on long term sick leave cite musculoskeletal problems as the reason. “This change will offer the improvements to the service requested by patients and GPs alike,
including making them closer to where people work and live, and speeding up access to treatment. “We’re confident that we’ll receive bids from a number of organisations, expressing a wish to deliver this community based service, enabling us to pick the providers that will offer the best possible community physiotherapy for people in the city.” NHS and private providers can bid to deliver the re-designed service, on condition that they prove that they can meet the requirements of the people of the city. The successful applicants will have to meet a number of criteria, including offering pain management programmes, acupuncture, ultrasound, exercise treatment, manipulation, and access to a gym and swimming pool if appropriate to a patient’s treatment needs. Members of the public also identified that the new services should offer convenient and easy access, with adequate parking facilities and public transport stops within a five minute walk. It is anticipated that the redesigned services will be offered from 1st of April 2010.
Academy to host annual teaching seminar at Loughborough THE Össur Academy will host its fourth annual teaching seminar next Spring at Loughborough University.
The CareBot is undergoing trials in the US.
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More than 150 delegates are expected to attend the meeting, which will be held at the Imago conference facility in the town. The programme will focus on lower
limb joints and common injuries, with speakers presenting papers on topics such as hip replacement, knee ligament injuries and tendon complaints. The course has been approved by the Royal College of Physicians and awarded eight CPD hours.
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PRODUCT NEWS
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Beagle acting as sole UK distributor BEAGLE Orthopaedic are acting for Saebo UK as sole distributors of the SaeboStretch® to the NHS. Saebo Inc. is a leading global provider of innovative rehabilitation products for stroke survivors and other neurologically impaired individuals. The leading cause of long-term disability in the UK, stroke affects over 150,000 people every year, leaving many with degenerating side effects including the loss of hand function. The company’s treatment protocols are based on new research documenting the brain’s ability to ‘reprogramme’ itself following injury. The SaeboStretch® uses a revolutionary stretch technology, which allows the fingers to move through flexion caused by associated reactions and tone. In addition, it 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 also includes three interchangeable hand pieces, each with a different grade of resistance.
Five minutes with Gordon McQuilton, MD of Specialised Orthotic Services Ltd
‘Growth in industry the biggest change’ When did you become interested in the industry and why?
Back in 1975 I spotted an advertisement for a qualified engineer at the Orthotic and Disability Research Centre that was opening at Derby Royal Infirmary. Shortly after applying for the post I went to look around the centre and was instantly attracted to the work that was to be done there. How did your career in the industry begin?
One of the projects I was involved with was researching the application of supportive seating for disabled wheelchair users. This resulted in the development of the Derby moulded seat. How have you ended up where you are today?
I set up Specialised Orthotic Services as a business to provide a service for the assessment
manufacture and supply of special seating. At first this was a one man show working from home and Gordon McQuilton manufacturing equipment from a workshop. What’s the biggest change you have seen in the industry?
Without doubt the biggest change has been the growth in the industry and the increased range of services now offered by the healthcare commercial sector. If you could make one recommendation to take the industry forward what would it be?
I would like to see the industry really capitalise on its wealth of expertise.
National award for ‘P pod’ product A CUSTOM made lightweight device which provides postural support for disabled children has scooped a national award. Specialised Orthotic Services’ ‘P pod’ product won the best bedroom/sitting product category at the enABLE09 Innovation Awards. The awards aim to demonstrate and
promote the products and services available to disabled consumers and their carers to meet their independent living needs. The ‘P’ pod is a simple, effective support for use by disabled clients, and its unique design combines a custom moulded support within the simplicity of a conventional bean bag base.
New range of products launched by Promedics PROMEDICS launched a new range of products when they exhibited at their first Medica conference in Dusseldorf. The trade fair attracts more than 138,000 visitors from more than 100 countries, and more than 4,300 exhibitors from 60 nations. Managing director David Baxendale said the company was keen to promote the benefits of having products manufactured in Europe at the event. He added: “We pride ourselves on the
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high quality of our products manufactured in our purpose-built site in Port Glasgow. “We also recognise the need for excellent service and meeting specific customer needs which we feel can only be met being based in the UK. “We were inundated with visitors from the first minute to the last. The response to our manufacturing capability was incredible, particularly from the European companies, and we obtained many sizeable orders and requests to visit our facility.”
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The Promedics stand at Medica
Firm changes product focus A CHANGING consumer profile and recent improvements in material and modeling technologies have eased the task of standardising specifications of orthotic devices. Within this climate Talar Made Ltd has elected to focus its future efforts on the pre-fabricated aspect of its business having sold its custom manufacturing division to the Langer UK Group earlier this year. However, clinical research and technical innovations will remain at the centre of its new operations. CEO Bernie Crewdson said: “Strong professional support and education has always been the hallmark of Talar Made’s reputation. Our appreciation of the resource issues that confront our customers has allowed us to position our company carefully to greatest effect. “A greater understanding of what orthoses do is triggering a higher use of support devices.” The company has added a website for the general public to their marketing profile. It can be viewed by visiting www.paincontrol.co.uk
Product reduces falls markedly FLEXYFOOT is a new ferrule that uses the same shock absorbency devices as leading 4x4 vehicles. It hugely improves the grip of aids, leaving users feeling significantly more stable, reducing falls markedly. Users on an independent trial praised the grip, comfort, safety and reduction in arm and shoulder pain. Flexyfoot uses a patented sealed plastic bellows: the air inside is pressurised during each step. Shock is progressively absorbed as the bellows is squeezed. The bellows simultaneously flexes so that the tread is always in full contact with the ground to maximise. In tests, Flexyfoot had 50 per cent more grip than a standard ferrule and lasted 50 per cent longer.
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Technology questions for patients
Insole solution for falls by elderly investigated
CARERS and patients with disabilities or mental impairments are being asked if newly-introduced technology is benefiting them.
By Dominic Musgrave
NHS Somerset is aiming to expand its use of a range of devices and services helping people live more independent lives.
Injuries caused by falls can lead to serious health problems, especially in older people.
The Assistive Technology products being tested include a simple alert system and a blood pressure monitor.
METHODS to help older people who are prone to suffering falls are being investigated by researchers at a North East university.
Now a team of researchers at Teesside are looking at possible methods of intervention which could help to prevent falls in those who may be most susceptible.
Deputy director of strategic development for NHS Somerset, Ann Anderson, said: “We have identified five priority areas where we think we should start to expand the use of assistive technology.
Anna Hatton, a qualified physiotherapist and research assistant in the university’s health and social care institute, told Assistive Technologies that one area they are investigating is whether wearing special textured insoles could help improve balance.
“For vulnerable people assistive technology could be used to increase independence and confidence and we are considering introducing a range of equipment to help them live safely and independently in the community.”
She added: “Falls can lead to other major health issues. We’re looking at whether balance could be improved though textured insoles. It’s something which could be used alongside current interventions to help prevent falls.” The team, which includes academics
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from New Zealand and a consultant from Newcastle’s Royal Victoria Infirmary, has worked with around 20 volunteers, and aims to see around another 30 volunteers in the coming months. The research is focused on people aged over 65 who are otherwise in good health but have fallen at least twice in the past year. Volunteers are invited to a special laboratory at The James Cook University Hospital, where they undergo a few simple tests involving their eyesight, balance, muscle activation and sense of feeling on the bottom of their feet. Anna added: “Each volunteer visits the laboratory just once for a few hours, although we may ask a few people to come back again as the research continues. It’s simple and non-invasive. “Those who have taken part have said it has been an enjoyable experience in that although it may not make a difference to them, they are pleased to think that their involvement in the research could help older people in the future with balance problems.”
Anna Hatton
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BAPO keynote speaker is announced
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SENIOR lecturer and consultant in paediatric neurology at Newcastle university Dr Rob Forsyth will deliver the OETT keynote speech at next year’s BAPO conference. He will speak about paediatric neurorehabilitation after acquired brain injury at the annual event, which will once again be held at the Reebok Stadium, Bolton on March 5 and 6. Peter Harsch, director of prosthetics at the Naval Medical Center in Sand Diego, will deliver the Ossur keynote speech on challenges and solutions for blast wound injuries. Lined up as part of the orthotic programme are paediatric consultant Rachael Hutchinson, who will speak on prescribing insoles/heel cups for children with asymptomatic flat feet, and Mike Grice, who will be hosting a practical session on biomechanical screening. Bilateral amputee film and TV extra and action performer Darren Swift will also talk about his current project to develop a snowboard bindings system that will enable double lower limb amputations to participate efficiently and effectively in snowboarding as part of the prosthetics programme.
Men sought for crutch study By Dominic Musgrave
be much more complicated.”
SCIENTISTS at a North West university are looking for male volunteers to help them with a new study they are conducting.
“Our research aims to develop methods to both stop muscle wastage happening before people go into hospital and to speed up their recovery.”
Those who take part in the Manchester Metropolitan University study will be asked to use crutches for three weeks while having one of their legs suspended in a sling and wearing an adapted trainer with a 10cm sole on the other foot. It is part of a £650,000 EU-funded project into disease and ageing secured by professors Marco Narici and David Jones, which forms part of a £12m integrated project taking place at universities across Europe. Research fellow Dr Olivier Seynnes, who is overseeing the study, told Assistive Technologies that the information gathered will be used in a variety of further research into ageing. He added: “Our muscle mass and strength naturally begin to decrease from the age of 30 but muscle wastage can be a real problem after 65. “It is especially bad during times of bed-rest or hospitalisation when muscles aren’t being used and recovery from surgery and illness can
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After three weeks on crutches volunteers will have their leg muscles examined using ultrasound and magnetic resonance imaging (MRI) techniques, which are both free from ionizing radiation and not harmful to health, and their strength will be tested by performing leg extensions on a dynamometer. Three weeks of recovery using resistance training with weights will follow, and all effects from leg suspension are completely reversible. Student Emma-Louise Campbell, who is exploring the role of exercise and diet in preventing muscle wasting in old age for her PhD, added: "Half of our volunteers will also drink an amino acid solution to assess the impact of a protein supplement on muscle wasting." Volunteers must be male, aged between 18-35 years and in good health. During the three-week leg suspension period , which is due to start in January, volunteers will not be allowed to drive.
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Drug and training combination boost for spinal injury patients By Dominic Musgrave COMBINING a common antidepressant medication with intensive walking training could help people recovering from a spinal cord injury, a study has claimed.
“We are working to apply the promise of this new approach to current patients, and will soon begin clinical trials to determine if intervention earlier in the recovery process may also provide benefits and help patients regain walking ability.”
Researchers at the Rehabilitation Institute of Chicago found that patients with partial recovery of voluntary strength after a spinal cord injury who received common antidepressant medication while undergoing intensive walking training showed greater recovery of their walking ability.
The research included 50 patients with some residual motor function one year removed from their initial spinal cord injury.
Dr. T. George Hornby, director of the Neurolocomotion Lab at the institute, said: “These results show a stark contrast to the typical school of thought regarding the use of a prescription medication for improving motor function.
Patients also received up to 40 per cent body weight support and therapist or robotic-assistance as needed to facilitate continuous walking.
“They suggest that people with spinal cord injury and some residual motor function may benefit from administration of SSRIs when performing intensive walking training.
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Patients received up to 24 sessions of intensive walking on a motorised treadmill over the course of eight weeks, in addition to 10 mg of common antidepressant medication.
Results were measured by the fastest possible walking velocity performed, with secondary measures including balance, strength, spastic reflexes, measures of depression and lower limb coordination and muscle activation patterns during treadmill walking.
A patient being treated as part of the trial
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Walking aid brings success for Ilsa NEWS
By Louise Cordell
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AN innovative walking aid has helped a product designer win a television competition. Ilsa Parry beat off 11 rivals with her Flo design to win BBC2’s Design for Life programme, winning a six-month placement with award-winning designer Philippe Starck’s agency in Paris. The Liverpool-based 27-year-old developed her walking aid after exploring lifecycles and the concept of perpetual motion during assignments, and became fascinated by improving the efficiency of lifecycles. Applying the concepts to humans, she created the Flo, with the intention of helping the less mobile retain a sense of dignity and self worth. Ilsa added: “I like to look at all my products as companions to their owners, to be used in conjunction with their daily lives, being used wherever they may go and enabling them. “The idea behind Flo was to let those who are less physically able continue their lives in a way that reflects the inner person and overcomes the outward physicality barriers.” Made from a carbon fibre
composite, the twisted aid is designed to lock the lower leg in place, while the longer retained upper body strength is used intuitively to pull the body up. It has been granted design rights in the UK, and currently has patents pending in both the UK and USA. Ilsa is currently also seeking investment and commercial manufacturing partnerships to extend production. She added: “I was so thrilled when I won Design for Life. It was a great learning experience for me, especially as I was given the chance to work with Philippe. “As a designer my focus has always been on innovation and experimentation, getting people to question things and recognise products for what they are and assisting people to build relationships with more valuable products in order to encourage a more discerning consumer society.” The product has also been endorsed by Age Concern and Help the Aged, and head of policy Andrew Harrop added: “The challenge older people face in staying as active and independent as possible is an often overlooked
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Ilsa Parry and, inset, the walking aid
issue, which is why it’s been great to watch Ilsa address this with such passion and creativity and see it take her so far within the show. “Lack of appropriate support can have a devastating impact on an
Picture: BBC/TWO FOUR
older person’s long-term mobility, leaving them at risk of becoming housebound, isolated and depressed. Hopefully Ilsa’s ambitious design will go some way to rectifying this.”
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Sensation test under trial on trauma patients By Dominic Musgrave A SENSATION test to help clinicians decide whether to reconstruct or amputate the lower limbs of patients with severe injuries is being trialled at Charing Cross Hospital. The Semmes Weinstein monofilament test (SWMT) is commonly used to assess sensation in hands, but this is the first time it is being used on the feet of trauma patients. Participants in the study are patients who have suffered from legthreatening injuries – many of which have been caused by motorcycle or pushbike accidents. Donna Kennedy, clinical specialist in hand therapy, who is leading the study, told Assistive Technologies that sensation in patients’ feet is currently tested by touch or pinprick. She added: “We see many patients who have had horrific lower limb injuries. If we can prove that the SWMT is a reliable and responsive test for sensation in the foot, it could really assist with the clinical decisionmaking process.
“The new test works by pressing strands of fibre with different thickness against the patient’s foot in seven different areas. “Clinicians test the finest or softest fibre first, progressing to the thickest until the patient says they can feel it. The test is repeated twice at fourhour intervals and the patient's uninjured foot is used as the study’s control.” The study, which is painless and takes half-an-hour to complete, is taking place at the bedsides of 30 patients who have suffered injury to one leg in the acute trauma and orthopaedic wards at Charing Cross Hospital. Donna added: “The test has previously been used globally to test the protective sensation thresholds of patients with diabetes and leprosy “Participants involved in our study will typically have suffered a severe lower limb trauma like acute foot and ankle injuries, knee dislocations, tibia fractures and major soft-tissue issue.” Joining Donna on the team are Katharine Carlisle, clinical lead for
trauma at orthopaedics for occupational therapy and Jagdeep Nanchahal, professor of hand surgery. It is being funded by the Hammersmith Hospitals Charity Trustees and is organised by Imperial College Healthcare NHS Trust.
Naidex opts for children’s charity in 2010 WHEN You Wish upon a Star is the chosen charity for next year’s Naidex exhibition. The charity grants the wishes of children suffering from lifethreatening illnesses from the ages of two to 16. The event returns to the Birmingham NEC from April 2022 and, as well as the seminars, will also feature thousands of products being exhibited by more than 360 companies. Visitors will be able to see the latest innovations in assistive technology and communication aids in the new Communication Village, while another launch for 2010 is the sensory garden – an interactive area which allows visitors to stroll through, sit and enjoy a functioning garden that appeals to all the senses. Event director Liz Virgo said: “We are very excited about the plans for 2010. Following on from this year’s event, which was the largest Naidex ever, next year’s show will be the first to cover three halls. With the new zones announced we truly believe there will be something for everyone.”
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Future robots could have touch sensors as sensitive as fingertips ROBOTS of the future could have fingertips as sensitive as those of people, thanks to research into the way our brains interpret our senses. Researchers at the universities of Edinburgh and Sheffield connected artificial mouse whiskers to a robotic brain to better understand how the brain processes information relayed by our sense of touch. The study could help develop robots with touch sensors as sensitive as fingertips – which could be useful for prosthetic limbs or for carrying out intricate work in dangerous environments, such as bomb disposal. The scientists found that when objects were brushed against the whiskers, the robot brain learned how to interpret the whisker movement according to its direction, mimicking the function of how a real brain understands the sensations of touch. Dr James Bednar, of the University of Edinburgh’s School of Informatics, who took part in the research, said: “Our findings increase our
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understanding of how the brain learns how to process tactile information. We hope these results will help the design of robots with senses even more finely tuned than our own. “The next generation of robots will learn from experience just as we do. This study is helping us to understand how the brain learns, without a teacher, to extract useful information from sensory signals.” Researchers were able to build profiles of whisker movements and their corresponding brain functions to build a clearer picture of how the brain learns about touch, which will be helpful for robot design. The study, funded by the European Union, adds evidence to support the theory that the brain learns to understand signals from the senses through experience, and suggests that interpreting touch is not simply instinctive. Scientists hope to expand on the findings by investigating how the brain interprets the shapes of objects with which it comes into contact.
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Tissue engineering could ‘restore sense of touch’ placed over the severed nerve endings like a sleeve. The muscle cells on the scaffold and in the body bonded and the body’s native nerve sprouts fed electrical impulses into the tissue, creating a stable nervemuscle connection.
By Dominic Musgrave MODERN tissue engineering could improve the function of prosthetic hands and restore the sense of touch for injured patients, a study in America has claimed. Researchers from the University of Michigan unveiled their findings at the 95th annual Clinical Congress of the American College of Surgeons.
Paul added: “In laboratory rats, the interface relayed both motor and sensory electrical impulses and created a target for the nerve endings to grow properly.
Paul Cederna, a plastic and reconstructive surgeon at the university’s health system, told Assistive Technologies that the project arose from a need for better prosthetic devices for troops wounded in Afghanistan and Iraq. He added: “Most of these individuals are typically using a prosthesis design that was developed decades ago. “This effort is to make a prosthesis that moves like a normal hand. There is a huge need for a better nerve interface to control the upper extremity prostheses.” The researchers hope to overcome some of the shortcomings of existing robotic prostheses, which they say have limited motor control, provide
“The polymer has the ability to pick up signals coming out of the nerve, and the nerve does not grow an abnormal mass of nerve fibres.
Paul Cederna
no sensory feedback and can be uncomfortable and cumbersome to wear. They have created an “artificial neuromuscular junction” composed of muscle cells and a nano-sized polymer placed on a biological scaffold. The bioengineered scaffold was
“The animal studies indicated the interface may not only improve fine motor control of prostheses, but can also relay sensory perceptions such as touch and temperature back to the brain.” The Department of Defence and the Army have provided $4.5million in grants to support the study, while the research team has submitted a proposal to the Defense Advance Research Project Agency to begin testing the bioengineered interface in humans in three years.
Wiltshire first for clinic couple A CHIROPODIST and podiatrist clinic in Salisbury has become the first in Wiltshire to be accredited by the profession’s governing body. The Society of Chiropodists and Podiatrists has awarded the accreditation to Total Foot Health of Brown Street after a review of its standards.
NEWS
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A review ensures a clinic complies with national standards set by the Health Professions Council and professional standards outlined by the Society of Chiropodists and Podiatrists. Accreditation means patients are assured of receiving advanced, evidence-based treatment within a safe and lawful environment and an accredited practice is subject to unannounced inspection by independent inspectors. Total Foot Health was founded in 1998 by husband and wife team Lyndon Jones, a consultant podiatric surgeon, and Elizabeth Green, a registered chiropodist and podiatrist.
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PODIATRY
Why record keeping must embrace technology By Jennifer Grundy PODIATRISTS are fast becoming essential members of the healthcare team, yet the structure used for managing and communicating patient records is still predominantly paper-based. We all recognise that the management of foot care is essential to the well being of the patient, and we know we can attain better treatment results by using the technology available to us. However, the challenge we have to consider is; how do we as a profession create transparent, auditable patient records that minimise the risk of successful litigation. Primarily, we all have the founding principles in our subjective, objective, assessment and plan techniques (SOAP) that provide a baseline for us to ensure we have considered all
facets of a patient’s symptoms and conditions. The evaluation we complete needs to be evidence-based, offering measurements where appropriate. Our patients must be informed, aware and subsequently give consent (our principle concerns), and this must be duly reflected in their records. These allow us to form a considered assessment and subsequent diagnosis, the keystone of a successful treatment.
Maintaining records in this way will create the opportunity for informed improvements within the profession.
Using a standard format for capturing and reporting this will allow us to ensure we are compliant with all published standards.
It is our duty to maintain and store all records in a secure environment for extensive periods of time.
New digital concepts are allowing the profession to strive for better accuracy encompassing the use of different technologies, such as those available for gait analysis. These bring with them new challenges and enhanced pressure on podiatrists in maintaining consistent, detailed records.
This in itself exposes paper records to degradation, loss or even theft, not accounting for time spent searching for relevant patient detail. Moving with technology, these issues can be embraced and not feared.
Within engineering environments it is essential for process driven activities to create “repeatability” through the establishment of standardised approaches that drive “best practice”.
By storing and backing up computerised records of the patient that reflect the assessments, diagnoses and treatments using a standardised format, allows us to access and review records with ease and reliability.
Similarly, utilising this approach and learning from it within our profession, we can establish our own format using our SOAP.
We also have the obligation to ensure our CPD is contemporary and relevant for re-registering with the Health Professions Council.
A standardised approach to record keeping which utilises technology, is imperative in ensuring we have the confidence in our principles to engage with other health care professions and we as podiatrists can minimise the risk of a successful litigation against us. Jennifer Grundy is the creator of Podi, a complete practice management system.
New podiatry reward scheme is launched for customers ALGEOS has launched a new podiatry reward scheme for private podiatrist customers. The company has developed this new to the UK in-house loyalty scheme – Arthurs Club – as a way to reward
loyalty.
vouchers.
Customers will be rewarded each time they spend over £100 exclusive of VAT by accruing Arthurs Club points that they can redeem for recognised high street and online
The scheme coincides with the launch of the new complete and comprehensive Algeos podiatry catalogue, features new additions to range such as premium consumables,
diagnostic devices and clinic equipment. Products are listed and categorised into colour coded sections, with each listed against its price to provide cost clarity for customers.
More than 1,300 delegates attended the annual Society of Chiropodists and Podiatrists’ annual conference in Harrogate. The focus of the event was on development, both personal and professional, with skill based sessions that looked at basic, general skills and clinical updates, as well as new medicaments and prescription only medicines. Keynote speeches were made by some of the profession’s foremost experts including professor William Jeffcoate, Dr Howard Dananberg, professor Benjamin Lipsky, professor Keith Rome and Trevor Prior. The conference also attracted more than 80 exhibitors, showing a wide range of podiatry products and services.
Pupils introduced to health career opportunities A NEW scheme is being started in Bradford to show school pupils the range of career opportunities in the health sector other than training to be a doctor or nurse. Tomorrow’s Health Professionals Today has been developed by Aimhigher Bradford, the scheme that encourages young people to take what they love doing and build it into a great future through higher 18
education. Director Richard Wilkinson said: “Students tend to have a very narrow view of health-related careers with many aiming for medicine, with pharmacy as an alternative. “We want them to look at the full range of degree courses that can lead to great careers in, for
ASSISTIVE TECHNOLOGIES I DECEMBER 2009/JANUARY 2010
example, podiatry and occupational therapy and specialist nursing areas.” Tomorrow’s Health Professionals Today is funded by Aimhigher, who will be working closely with West Yorkshire NHS Trusts and colleges and universities across the region. Richard added: “The NHS is the biggest employer in Europe and
there are many new opportunities in para-medical services, such as theatre technicians, assistant physiotherapists and radiography technicians. “Tomorrow’s Health Professionals Today will encourage young people to think about what kind of careers they could have and understand what they need to do to get there.”
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‘Mind-blowing’ win for brothers A NEWLY-launched company which aims to change the way people think of wheelchairs and mobility has become the first in the UK to win a prestigious award. Nomad Wheelchairs, which was set up six months ago in Wales by brothers Mark and Jon Owen, won the excellence in a first-time design project award at the Design Management Europe awards in Eindhoven, Holland. The pair set up the company because Mark, a wheelchair user for more than a decade, was growing increasingly frustrated by the choice of wheelchairs available on the market. Jon told Assistive Technologies that the awards attracted entries from companies across Europe from a wide range of industries including architecture and soft drinks. He added: “To win the award was just mind-blowing, and it is proof that it is possible to make the best of any situation, no matter how bad it seems at first. “To be judged against such strong mainstream and lifestyle companies is a huge compliment to Nomad. “It is exactly the goal we had
Nomad directors Mark and Jon Owen receive their award from Kathryn Best, a leading figure in the design management field.
when we started – to move wheelchairs towards a more aspirational lifestyle sector.” The awards recognise and reward companies for management of the complete design process, from product design to branding, marketing and literature. It covers how a company pulls all these elements together in order to lead through design and includes planning, communication, delivery and results. The company’s Mrk1 frame was
designed by Studio SDA, while Angela Gidden MBE from Attic 2 developed the upholstery. The award-winning poster plotted the company’s journey through the design process, and was produced by Nomad and Elfen, who were responsible for all the branding and marketing materials. The Nomad journey started when Mark had a road traffic accident in 1996, which left him paralysed from the chest down.
Revamp for prosthetics degree THE University of Salford has revamped its prosthetics and orthotics degree in time for next year's intake of students, introducing an intensive three-year course with work placements throughout the programme. Current students spend a fourth year on work placement, but the new programme will give new ones hands-on experience throughout their three years, and studying for one year less will reduce debt. The degree trains prosthetists who provide artificial replacements for people without a limb, and orthotists are trained to provide a range of braces, splints and special footwear to assist people's movement and relieve discomfort. Senior lecturer Dr Martin Twiste said: “The Salford prosthetics and orthotics degree is unique in England, and one of only two programmes of its type in the UK. It will help to address the world-wide shortage of prosthetists and orthotists while ensuring we maintain our leading edge.” The programme changes were approved by the Health Professions Council.
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MOBILITY
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SPORTS REHABILITATION
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David Leinweber is passionate about sports wheelchairs, helping disabled people by distributing chairs from showrooms throughout the UK. Mary Ferguson met him.
Why David, 71, still gets a buzz out of helping disabled people enjoy sport RDK MOBILITY has been operating for 30 years as a family business, with David at the helm and his son Nigel taking the role of sales director. The company started off providing disability kitchens then got into mobility products and seven years ago, began supplying sports wheelchairs. Their range includes sports-specific chairs for archery, badminton, tennis, fencing, rugby, dancing, shooting and table tennis. David said the basketball chairs are most popular as they can be used for other sports too, due to the guard that sits around the bottom, protecting the wheels. “People play internationally and in club competitions in our chairs – they are substantial and because of that they stand up to use. We have had really good feedback and we
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are prepared to trial our chairs against any others on the market, particularly for club use.” David admitted that his products may be a few ounces heavier than some of the more expensive chairs, but claims his are half the price. “People should be spending their money more wisely and I think clubs that have been given a grant or have a budget for some new chairs, should be putting it out to tender. It’s something I feel really strongly about.” David said the quality of sports wheelchairs has improved greatly in recent years, becoming more streamlined with greater protection. The seat designs have evolved too, enhancing people’s sports performance. “There is an increase in people wanting to play wheelchair sports, especially because of the number
ASSISTIVE TECHNOLOGIES I DECEMBER 2009/JANUARY 2010
of casualties from Iraq and the buzz around 2012. The most important aspect of the chair is that it can stand up to usage. Some sports are more demanding on the chair than others but in tag rugby, they are colliding all the time. The chairs also have to be very manoeuvrable and wellbalanced.” David predicted that the next few years will see the production of more specialist chairs, suitable for a wider variety of sports that require their own needs. Products for bowling and golf, for example, require bigger tyres. David added: “I get a real buzz out of helping disabled people enjoy sports – I’m 71 now and I could have retired years ago but I love what I do. And that’s why it niggles me so much that people waste money by paying too much for sports wheelchairs.”
David Leinweber
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A high-tech robotic arm that can be used at home by children with dyspraxia to improve hand coordination is being developed. Dominic Musgrave found out more.
Pioneering robotic arm system can be used at home THE pioneering robotic system has been developed and tested by a team from the Institute of Psychological Sciences at the University of Leeds, working in collaboration with colleagues at the universities of Aberdeen and Indiana. It allows children with coordination problems to practice therapistprescribed exercises at home using an interactive desk-top system, which can also monitor how they move, measuring things like smoothness and speed of movement. Early tests suggest that children's writing skills improve after they have used the robot arm. Professor Mark Mon-Williams, who is leading the research team, told Assistive Technologies that at least
five per cent of children – roughly one child in every classroom – is affected by dyspraxia He added: “We know that children with dyspraxia can overcome many of their difficulties if they are given intensive therapy. The harsh reality is that there are not enough qualified therapists available to give every child the regular one-to-one help they require. “This project offers the first objective evidence that following therapist prescribed home-exercises using assistive technology has the potential to help improve children’s movement and writing skills. This opens a window of hope for the many children who experience the profound problems associated with dyspraxia. “The children we’ve worked with
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Professor Mark Mon-Williams demonstrates the system to Matthew Alton have really driven a lot of the development, so we now have a system we know they like and will want to use.” The fun exercises involve children using a pen, guided by the robotic arm, to push objects along a 3D track shown on a computer screen. The system applies guiding forces to the child’s arm and hand to help them to control their movements and discourage inappropriate ones. The strength of the forces can be altered to shape appropriate movements and vary the difficulty of the exercises. The work has been funded by children’s health charity Action Medical Research, and deputy director of research Yolande Harley
added: “We are very proud to have supported such a cutting-edge piece of work, which could make a big difference to supporting children with dyspraxia and widen access to intensive therapy. “Providing therapy for children’s coordination problems will bring allround benefits, helping them to do better at school, make friends and enjoy physical activities and hobbies.” Further tests are now planned to investigate how long the robot should be used to get the best outcome and which children could benefit the most. The research team anticipates that the basic system, or a form of it, could be widely available by 2012.
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PRODUCTS
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REED EXTEND GAITOR INSOLE RANGE
DENOVO HEALTHCARE INTRODUCES NEW CATALOGUE
REED Medical has extended its range of Gaitors to include the full length Roadrunner version, due to popular demand. Both insoles are ideal for the relief of heel spurs, plantar fasciitis and moderate arch support. The combination of modern materials allows these insoles to provide a lightweight, yet highly effective shock absorber. Revolutionary technology offers an ultra thin carbon fibre arch support which will provide long lasting relief and comfort. This advanced carbon material may be adjusted when necessary, offering a degree of customisation. Both insoles will provide immediate and maximum relief. Enquiries: Telephone 01254 503333 or visit www.reedmedical.co.uk
DENOVO Healthcare Ltd has introduced its new Nimco catalogue to take its range of footwear to the next level. Since the introduction of Nimco’s innovative approach to footwear manufacture, the company has been able to supply thousands of shoes reliably and with the highest level of customisation The 2010 catalogue has been created to simplify all aspects of the ordering process, so creating the perfect pair has never been so easy. All 18 boot styles are now available in all sizes (18-45), with a choice of lace or velcro fastening, different colours, four different stiffener types and various soles. In addition to the new and exciting range, the company has also introduced a new selection of children’s shoes. For use when a boot may not be suitable or necessary, the new styles combine the same build quality with a design that complements the range. Enquiries: Telephone 01934 808416 or email sales@denovohealthcare.com
KIDDIEGAIT™ THE SMALLEST TOEOFF® EVER
OTTO BOCK UNVEIL E-MAG CONTROL
KIDDIEGAIT™ offers innovative options that have never been available for AFO management of paediatric gait by creating functional environments, supplementing gait instead of immobilising or inhibiting function. It is suitable for patients with mild to severe footdrop, gait deviations secondary to proprioceptive deficit, idiopathic toe walkers, low tone crouch gait, spina bifida, spastic diplegia, muscular dystrophy, cerebral palsy and myelomeningocele. Available in left and right models in three sizes, small, medium and large, accessories include the popular ComfortKIT and SoftKIT padding sets. All sizes are in stock and available from Gilbert and Mellish. Enquiries: For more information or a product demonstration telephone 0121 475 1101.
OTTO Bock’s E-Mag is an innovative electromagnetic orthotic knee joint designed with safety, reliability and ease of handling in mind.
GLASSES REVOLUTIONISE MIRROR THERAPY FOR PHANTOM LIMB PAIN TREATMENT PRISM Glasses are a new innovation to revolutionise mirror therapy for treatment of phantom limb pain and rehabilitation of patients suffering from limb paralysis following a stroke. The patient looks at the healthy limb through the glasses and sees a reflection of the healthy limb. The patient is ‘tricked’ into believing they are seeing an intact amputated limb.
With a conventional knee orthosis the two occasions when the user is most at risk of falling are when the joint is manually released or when the lock in the knee does not engage during standing. Since the E-Mag gives clear acoustic or vibration feedback, the user is informed of its status at all times and allows a balanced position when the joint is operated, assisting in overcoming all sense of insecurity during the stance and engage phases. A remote control is used to lock and unlock the E-Mag and can be used either as a hand held device or can be integrated into an Otto Bock forearm crutch, allowing the user to fully support him or herself with both arms at all times. The E-Mag recently won the Limbless Association’s orthotic product innovation award. Enquiries: Telephone 0845 430 1231.
NEW WRAP-AROUND FUNCTIONAL HINGED KNEE BRACE LAUNCHED ACTIMOVE® GenuFlex is the new wrap-around functional hinged knee brace from BSN medical and the latest addition to the Actimove® range of orthopaedic supports and braces. It is constructed from advanced breathable, neoprene-free fabric which provides effective compression and pain relief. Stabilisation Neoprene-free AirFlow™ material provides good compression
For example, a right leg amputee would see a reflection of their left leg at the position of the right leg, thus creating the illusion of the presence of the right leg even though that leg has been amputated.
Advanced polycentric hinges guide knee movements anatomically, allowing full flexion while preventing hyperextension
Similarly, stroke patients suffering limb paralysis place a functional limb in front of a mirror, tricking the brain in to seeing the paralysed limb as a functional one.
Comfort
The mirror image is thought to provide visual feedback that influences sensory and kinaesthetic stimulation, aiding recovery of movement in the patient’s paretic arm. Enquiries: Telephone 0141 248 7334 or visit www.prismglasses.co.uk
Advanced counter-strap system reduces brace migration and rotation Breathable, moisture transmitting AirFlow™ fabric Snug, non-slip fit for enduring comfort and strong support Open popliteal area prevents wrinkling and skin maceration Molded hinges prevent pressure points Latex free Enquiries: Telephone 0845 1223 600 or email orders.uk@bsnmedical.com
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