By Dominic Musgrave

THE first human testing of a mind-controlledartificial limb is ready to begin in Americaafter the university behind it received a$34.5million contract. A joint project between the Pentagon andJohns Hopkins Applied Physics Laboratory(APL), the Modular Prosthetic Limb will befully controlled by sensors implanted in thebrain, and will restore the sense of touch bysending electrical impulses from the limbback to the sensory cortex. The Defense Advanced Research ProjectsAgency (DARPA) has provided the funds forthe device, which researchers claim wouldby far eclipse the hook-and-cable deviceused by most amputees. The final design offers 22 degrees ofmotion, including independent movementof each finger, in a package that weighs thesame as a natural limb. Programme manager Michael McLoughlintold Assistive Technologies it is designed torespond to a user’s thoughts.He added: “We’ve developed the enablingtechnologies to create upper-extremityprosthetics that are more natural inappearance and use, a truly revolutionaryadvancement in prosthetics.“Now, in phase three, we are ready to test

it with humans to demonstrate that thesystem can be operated with a patient’sthoughts and that it can provide thatpatient with sensory feedback, restoring thesensation of touch.”The team will develop implantable micro-arrays used to record brain signals andstimulate the brain. They will also conductexperiments and clinical trials todemonstrate the ability to use implantableneural interfaces safely and effectively tocontrol a prosthesis, and optimise armcontrol and sensory feedback algorithmsthat enable dexterous manipulation throughthe use of a neuro-prosthetic limb.Michael added: “Initially, we have targetedthe quadriplegic patient population becausethey have the most to gain.“Unlike most amputee patients who haveother options in terms of care andindependence, these patients are totallydependent on others for most things. Thereis no alternative. Their lives will be trulytransformed by this advancement.“The goal is to enable the user to moreeffectively control movements to performeveryday tasks, such as picking up andholding a cup of coffee.” Over the next two years, the team hopes totest the systems and neural interfacetechnology in five patients.

Human tests onmind-controlledartificial limbs

British motor racing legend Sir Stirling Moss officially opened theannual Mobility Roadshow exhibition at the East of EnglandShowground, Peterborough. Other guests over the three daysincluded former England rugby union international, county cricketerand broadcaster Alastair Hignell, wheelchair basketball player andTV presenter Ade Adepitan and disabled actor David Proud, who hasappeared in Desperados and EastEnders. Full story, Page 20

INNOVATION FOR INDEPENDENCE ISSUE 74 August/September 10 £6.95

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ContactsEditorialAndrew Harrod Group Editoreditorial@assistivetechnologies.co.uk

Dominic Musgrave Healthcare EditorEmail: dm@whpl.net Tel: 01226 734407

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Whilst every effort ismade to ensure the accuracy of all contents,the publishers do notaccept liability for anyerror, printed or otherwise, that may occur.

www.assistivetechnologies.co.uk

Britain’s Missing Top Model winner Kelly Knox hosted a fashion show at an event whichhad service users as the stars modelling some eye catching creations.The Enfield council event was a Beacon celebration to acknowledge and thank all thepartners, service users and carers, that have supported and contributed towards theachieving the status and working during the year.Kelly hosted the show, which proved that disability is no bar to beauty.

Stem celllifeline forsufferersBy Dominic Musgrave

CULTURED stem cells are to be usedfor the first time in the UK to treatthe common joint condition ofosteoarthritis, throwing a potentiallifeline to millions of sufferers in thefuture.

A new clinical trial funded by medicalresearch charity Arthritis Research UKaims to test the effectiveness of stemcells derived from bone marrow atrepairing worn cartilage inosteoarthritis of the knee.

The stem cells will be tested againstcultured cartilage cells which arecurrently used to repair small areas ofcartilage damage, but notosteoarthritis. These cells areextracted from patients, grown in thelab and re-implanted back into thepatient.

A combination of both types of cellswill also be trialled with the aim ofrepairing damage to the joint,stopping osteoarthritis getting worseand delaying or even avoiding theneed for knee replacement surgery.

Professor of orthopaedic surgery atKeele University, James Richardson,who is jointly leading the study withSally Roberts, professor oforthopaedic research, said the studyoffered a real chance to helposteoarthritis patients, for whomthere is currently little effective

treatment, apart from jointreplacement. He added: “It’s greatthat Arthritis Research UK is fundingthis work in Oswestry to take thingsfurther. We are the first laboratory inthe UK producing mesenchymal stemcells and chondrocytes for treatingpatients, so we are unique in beingable to test the effectiveness of bothtypes of cell therapy.

“The important thing is to run arandomised trial. If successful, weneed to find out if it is cost-effective.If a few years can be saved, thebenefit to the patient may be not toprevent the need for a jointreplacement, but to prevent need fora revision of a joint replacement.”

Up to 70 people with establishedknee osteoarthritis will take part inthe year-long trial, scheduled to startby the end of 2010, to be run at theRobert Jones and Agnes HuntOrthopaedic Hospital in Oswestry,Shropshire, as part of a five-year£500,000 research programme.

The hospital has been at theforefront of using a surgicaltechnique originally pioneered inSweden called autologouschondrocyte implantation (ACI) usingengineered cartilage cells taken frompatients with cartilage problems –usually caused by sports injuries – formany years.

Study reveals dangers of high heelsA STUDY by an American kinesiologymaster's student has foundprolonged wearing of and walking inhigh heels can contribute to jointdegeneration and kneeosteoarthritis.Danielle Barkema recently completedher thesis research at Iowa StateUniversity studying the effects ofhigh-heeled walking on forces actingon lower extremity joints. She was assisted by professor anddepartment chair Phil Martin.Danielle said: “Obviously withresearch like this, you can't say withany certainty that if you wear highheels regularly you will developosteoarthritis. We don't know that.“There are probably high heelwearers who do and those who donot. However, based on thisinformation, wearing high heels putsindividuals at greater risk for

developing osteoarthritis. And itseems to be that the higher the heelheight, the greater the risk.”She elected three different heelheights – flat, two inches, and 3.5inches – and had each of the 15women in her study completewalking trials. Danielle then measured the forcesacting about the knee joint and theheelstrike-induced shock wave thattravels up the body when walking inheels. Using sensors, accelerometersand lab equipment such as a forceplatform and markers/cameras, shewas able to capture motion andforce data and translate them intoresults that could change the waymillions of women select theirfootwear.While previous studies haveexamined the effect of high heels onjoints, the researchers found that

heel height changes walkingcharacteristics such as slower speedsand shorter stride lengths. And asthe heels got higher, they also sawan increase in the compression onthe inside or medial side of the knee.Danielle added: “This meansprolonged wearing and walking inheels could, over time, contribute tojoint degeneration and kneeosteoarthritis. Visually, it's quiteapparent that somebody's posture isaltered when wearing high heels. “We noted those changes in posturein the study, as well as various jointangles, such as the knee and ankleangle. The most dramatic changeoccurs at the ankle.”The idea for the research thesis topicactually came from Barkema's twinsister, Ashley, who saw the physicaltoll regular high heel wear washaving on her co-workers.

If you’ve got a story forus please ring ourhealthcare editorDominic Musgrave on 01226 734407

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By Dominic Musgrave

A STATE-of-the-art robotic arm fororthopaedic surgery that couldpotentially transform the way inwhich knee joint replacements areconducted is to be employed inclinical studies.

It is the first time the robotic armtechnology pioneered by the MAKOSurgical Corp will be used outsidethe US. The American firm hasjoined forces with orthopaedicsurgeons from NHS Scotland andengineers from Strathclyde Universityto establish the multidisciplinaryMAKO Centre for Surgical Robotics.

Over the course of the next threeyears, the Centre at the University’sDepartment of Bioengineering,together with the participatingsurgeons at the NHS, will take partin randomised clinical trials of

MAKO’s Robotic Arm InteractiveOrthopaedic System, which allowssurgeons to perform a precise kneeresurfacing procedure calledMAKOplasty®.

Professor Jim McDonald, principal ofthe University, said the technologycould reduce the cost to the NHS.

He added: “The creation of theCentre for Surgical Robotics reflectsStrathclyde's strategic mission toapply high quality research andenhance our successful links withindustry and the NHS to bringbenefits to wider society

“If successful, the Centre willcontribute to improving thefunctional outcome of knee surgerypatients in Glasgow, reducing painand helping patients recover morequickly.

“The potential for further

developments through this newpartnership could transform manyother aspects of orthopaedicsurgery."

MAKOplasty®, which is commonlyperformed on patients with early tomid-stage osteoarthritis of the knee,has been employed by orthopaedicsurgeons in the US since 2006 toenhance the accuracy of the surgicalprocedure and significantly improvepatient recovery time.

MAKO, the University and NHSScotland will support the first fulland independent randomised clinicaltrial of the MAKO RIO®, and willdraw on NHS Greater Glasgow andClyde’s experience in orthopaedicinnovation and joint replacementsurgery, as well as the University’sinternationally recognised expertisein biomechanical and functionalassessment of orthopaedic devices.

Dr Maurice Ferre from MAKO and professor Phil Rowe from the University of Strathclyde

Robotic arm to beused in clinical trials

A PHYSIOTHERAPIST has been struckoff the HPC Register for failing toprovide a private area for a patientto undress, failing to provide a gownfor a patient, failing to leave theroom whilst patients were undressingand inappropriately massagingpatients when there was no clinicalreason to do so.A panel of the HPC Conduct andCompetence Committee heard howthe allegations against Ashok ChitteSreenivas involved his conducttowards three female patients, all ofwhom had been referred to Physio-matters for treatment followinginjuries that each had received inseparate road traffic accidents.A complaint was also made after hehad telephoned one of the patientstrying to pressurise her into havinganother session with him, explainingthat the female physiotherapistswere often fully booked.Ashok later telephoned the patientagain asking her to withdraw hercomplaint and write a letterregarding this. She told the Panelthat the registrant had explained toher he had been suspended fromwork and if the complaint was notwithdrawn he could lose his job.Chair Mr John Williams said: “ThePanel having found the majority ofthe facts to be proved that theactions of the registrant amountedto misconduct. There was no clinicaljustification for performing frontalmassage on the patients. The Panelis satisfied that there was a sexualmotivation in the actions andcomments of the registrant towardsall three complainants.“A patient is entitled to place trust ina treating physiotherapist, and theregistrant’s actions breached thistrust. The Panel considered theregistrant’s behaviour to be soegregious that a finding ofimpairment was inescapable.”Ashok was present at the hearingand represented by Counsel.

Physio ‘hada sexualmotivation’

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By Dominic Musgrave

A GROUND-BREAKING painmanagement device featuringtechnology similar to that foundin the iPhone and Wii remoteshas been implanted into a patientfor the first time in the UK.

The neurostimulator at Guy’s andSt Thomas’ Hospitals will treatchronic back pain using SpinalCord Stimulation, with mildelectrical pulses delivered to thespinal cord to mask the body’spain signals and replace themwith a tingling sensation.

The neurostimulator is the first inthe world to use motion-sensingtechnology similar to the spiritlevel function in an iPhone or Wiiremotes. It can sense a change inthe patient’s body position oractivity level and automaticallyadjust how much pain relievingstimulation to deliver.

Until now, patients have onlybeen able to use devices thatdeliver pre-set levels of constantstimulation which meant they hadto frequently change their pain-relief settings manually wheneverthey changed position or activity.

The RestoreSensor was designedin the US and features technologythat uses the force and directionof the Earth’s gravity to sense the

patient’s position. It also housesits own ‘black box’ which recordsand stores the frequency of theposture and activity changes.

Dr Adnan Al-Kaisy, who carriedout the first procedure using thedevice, said: “This is a verysignificant improvement ontraditional Spinal Cord Stimulationimplants because for the first timeit will automatically increase orreduce the pain relief the patientreceives – particularly during thenight.

“I’ve been working in this fieldfor 15 years and this istechnology we have alwaysdreamed of.

“We expect it to be used withsome patients who suffer fromsevere leg or back pain, or post-surgery problems, who have notresponded to traditional therapyor medication. When successful, itreduces pain by around 80 percent, and patient satisfaction andquality of life will be very high.”

Spinal cord stimulation wasapproved for use in adults withcertain forms of chronicneuropathic pain in October 2008by the National Institute forHealth and Clinical Excellence.RestoreSensor will be rolled outnationally with 25 hospitalsexpected to offer the service.

Robert Mason, a former agricultural engineer who suffered from chronic pain inhis back and legs following a freak accident removing a gearbox from a largebaler, was one of the first people in the UK to have the treatment.

UK first forimplantedpain device

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WHEN Hayden Allen injured hisspinal cord five years ago he becamea full-time wheelchair user anddoctors told him he would neverwalk again.

But he is one of the first people inthe world to test Auckland-basedcompany Rex Bionics’ RoboticExoskeleton, and is now able tostand, walk and go up and downsteps and slopes.

Being out of his chair and on hisfeet again allows Hayden manymore options on a day-to-day basis,increasing opportunities foremployment and recreationalactivities by providing access for himindependently to go placespreviously inaccessible to him.

Dr Richard Roxburgh, medicaladviser to the Muscular DystrophyAssociation, said: “For many of mypatients Rex represents the first timethey’ve been able to stand up andwalk for years.

“There are obvious immediatebenefits in terms of mobility,improved social interaction and self-image. There are also likely to bemajor long term health and qualityof life benefits through reducing thecomplications of being in awheelchair all the time.

“I think this will also enablepeople to stay well longer; thismeans that those who haveconditions where diseasemodifying treatments are comingover the next five to 10 years, will be in better shape when thosetreatments finally arrive.”

Users self-transfer from theirwheelchair into Rex, strapthemselves in and control theirmovements using a joystick andcontrol pad.

It is powered by a lightweight,long life rechargeable battery,and is the brainchild ofchildhood friends, Richard Littleand Robert Irving.

Both of their mothers arein wheelchairs, and Robert’s MultipleSclerosis diagnosis seven years agowas the catalyst for them to puttheir engineering skills to use todevelop a practical, standing andwalking alternative.

Rex is not a replacement for awheelchair, but a complement thatoffers a range of options notcurrently available anywhere else inthe world. It is potentially suitablefor manual wheelchair users whocan self-transfer and operate handcontrols.

Potential customers must complete amedical appraisal including checkswith their own physician to ensuretheir general health and suitabilitybefore they can begin the process offitting and training.

Rex has undergone thorough testingduring its seven-year developmentincluding engineering validation andclinical trials, with the approval ofthe New Zealand Ethics Committee,in conjunction with disability andrehabilitation advisors.

Researchers in New Zealand have developed a pair of robotic legs to support andassist a person who usually uses a wheelchair. Dominic Musgrave found out more.

Rex founder Richard Little

Rex helps Haydento walk again ...

Hayden Allen with Rex

TOUCH Bionics has won the Most InnovativeCompany of the Year prize in Europe at theannual International Business Awards.

Nicknamed the Stevie from the Greek word‘crowned’, the awards will be presented at agala dinner at the Ritz-Carlton Hotel in Istanbulin September.

In the application process for the award, TouchBionics was assessed on its progress ininnovation over the past year, which includedthe launches of both its ProDigits partial handsolution and its new prosthetic hand device,the i-LIMB Pulse.

Honourees were selected through two roundsof judging by business professionals worldwide.More than 1,700 entries were received fromorganisations and individuals in more than 40nations.

CEO Stuart Mead said: “Winning anInternational Business Award is ademonstration of Touch Bionics’ outstanding

innovation and business success over the pastyear, and to win ahead of some of the biggestnames in global business is a tremendousachievement.

“Innovation is at the core of this company and,from the launch of our first product, the i-LIMBhand, we have never stopped innovating toensure we continue to lead the world in thefield of commercial bionic technology.”

International business awardssuccess for Touch Bionics

Stuart Mead

Sports presenter JohnInverdale has beenappointed president ofAspire. The BBC radio andtelevision personality hasbeen involved with thespinal injury charity for thepast 10 years. He said:“During my involvementwith Aspire, regrettably Ihave seen how far too manypeople’s lives can bedevastated by spinal cordinjuries. It is the essential

and practical support fromcharities like Aspire thatreally helps people regaintheir independence, which iswhy I am extremely proud totake on the role aspresident.”John commenced his role aspresident by officiallyopening Aspire’s newlyrefurbished gym.Picture: John Inverdalechats with a user of Aspire’snewly refurbished gym.

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A patient tries the Wii Fit machine

Andy touchesdown with Wiiboost for patientsPATIENTS at the Nuffield Orthopaedic Centre arebenefiting from the use of Wii Fit machines, oneof which has been bought by former Englandrugby player Andy Gomersall.

Andy has donated the console to the hospital,with one of the machines being used in theOxford Centre for Enablement (OCE) based atthe Centre.

The OCE, which was also given a flat screen TVby a former patient, provides specialistrehabilitation services for patients with limbamputation or complex neurological andneuromuscular conditions.

Senior prosthetics physiotherapist Lucy Holt said:"We have seen a vast improvement in some ofour patients who also have a Wii Fit machine athome.

“Using this machine as part of physiotherapysessions really helps to improve the mobility andstrength in our patients and is a bit of fun too.

“We are extremely grateful to Andy Gomersalland the two former patients of OCE fordonating the machines as they are proving to bea useful addition to our rehabilitationphysiotherapy programme, which helps a rangeof patients who suffer from conditions such asstroke or loss of limb."

Andy is president of the hospital’s League ofFriends, and in 2008 officially opened thechildren's outpatient play area.

One of the first people to benefit from themachine is Jon Martin, whose leg wasamputated below the knee following a car crashthree years ago.

He tried out one of the programmes whichfocuses on balance and required him to shift hisweight across the Wii Fit board to slot balls intoholes on the screen.

John added: “It’s been interesting trying out theWii Fit and I can see how useful patients will findit as part of their rehabilitation programme.”

£1m boost forchip researchersBy Dominic Musgrave

A TEAM of researchers has been awarded agrant of more than £1m to develop a chipwhich can be implanted in the brain.

The chip being designed by academics fromLeicester and Newcastle universities and ImperialCollege London will be wirelessly connected toprosthetic limbs.

It will collect data from neuron activity in thebrain, and send the information wirelessly tomove prosthetic arms or legs.

Professor Rodrigo Quian Quiroga, a bioengineerwho is heading up this research at Leicester, saidthe technology has the potential to enablepatients with spinal cord injuries to moveparalysed parts of their bodies by using roboticdevices which are controlled by the wirelesschip.

He added: “This research is the first of its kind.We are addressing the problem of how totransmit a signal of hundreds of neurons frominside the brain to outside the brain.

“The answer is by using wireless technology andadvanced processing in a chip. This research willdevelop new technology to transmit messagesfrom the brain to elsewhere in the body.

“The use of wireless technology provides analternative to cables, which can be obtrusiveand have risk of infections.”

Rodrigo said the battery-powered chip would,essentially, decode a person’s thoughts, whichare represented in the brain as a pattern ofneuron activity.

He added: “A patient with a spinal cord injury

may lose the ability to move his or her arm, butthere is nothing wrong with the person’s brain.

“The guy can see the object he wants to reach,the guy can have the intention to reach to theobject, the brain can send a command to thearm – “Reach for this cup of tea” – but thesignal gets broken at the level of the spinal cord.

“If we can get the signals from these neuronsand interpret them with what is called decodingalgorithms, then we can move a robot deviceplaced on the paralysed arm.”

The £1.2m grant is being funded by theEngineering and Physical Sciences ResearchCouncil.

Rodrigo Quian Quiroga Picture: University of Leicester

Fit for Work campaign is launchedBRITISH workers are sufferingphysical pain as well as stressfrom working long hours, nottaking lunch breaks and going towork when they are sick, newresearch has revealed.

A survey commissioned by theChartered Society ofPhysiotherapists found a quarterof people regularly work all daywithout taking a break, andmore than half said they oftengo to work when they arestressed or physically unwell.

Other results from the surveyshowed that 46 per cent ofworkers had physical painscaused by working in the sameposition for long hours, and 41per cent of employees said theywere too busy with work toexercise regularly.

Chief executive Phil Gray saidoverwork was harming workers’health, and also costingemployers. He added:“Withadvice and support fromphysiotherapists and other

occupational health experts,employers can create healthierwork environments and benefitnot only society but also theirprofit margin.”

To combat these problems, thesociety launched its Fit for Workcampaign, which providesinformation for physios andleaflets for staff in offices andfactories, suggesting ways toimprove their health at work andfit exercise into their dailyroutine.

Chiropodist struck off after convictionA CHIROPODIST/podiatrist hasbeen struck off the HPC Registerfollowing a conviction for breachof the peace and assault to injuryat Perth district court.A panel of the HPC conduct andcompetence committee wassatisfied from the statement ofPC Barry McIntosh and thenotification of conviction byInspector Kinghorn that theallegations against Nicholas M

Grant have been proven.Panel chair Colin Allies said: “ThePanel is satisfied that theregistrant’s fitness to practice isimpaired by the convictionscontained in both allegations.“In reaching this decision thePanel has taken into account thenature of the convictions and thecritically important public policyissues including the need tomaintain confidence in the

professions, upholding properstandards of conduct andmaintain public confidence in theprofession and regulatoryprocess.”The panel decided the mostappropriate action was to strikeNicholas from the Register withan interim suspension ordergranted to cover the appealperiod. He was neither presentnor represented at the hearing.

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Two amputees are part of a team walking to the North Pole next year. Dominic Musgrave spoke toprosthetist Jamie Gillespie about creating a limb for the challenge.

GUY Disney is part of the seven-manWalking with the Woundedexpedition that will encounterextreme temperatures of up to minus40 during the 30 days.

If successful, both he and fellowformer soldier Jaco van Gass, willbecome the first amputees to reachthe Pole, raising money to enable theblind, amputees, the burn victims,the mentally disabled and all theother wounded to rebuild their livesand to return to a work place.

Jamie, who works for PaceRehabilitation, said: “As an amputeemyself, when I saw theadvertisement for the trip, I wantedto be involved in some way.

“The next best thing to being theremyself will be creating a prostheticlimb to get Guy there, and I will beable to sleep well at night knowinghe has got there.

“I went with the team for a trainingsession to the Arctic in May to see ifhis limb was going to be suitablebecause they are going to be cross-country skiing 12 hours a day towinga sled.”

Guy lost a leg in Afghanistan lastyear when his armoured vehicle

came under fire in an ambush and arocket propelled grenade wentthrough it, killing his colleague.

South African born Jaco, a memberof the Parachute Regiment, lost hisleft arm in Afghanistan last summerfollowing a similar attack. Both wereselected from more than 100 injuredsoldiers who applied to go on theexpedition.

Jamie said he has consulted withother prosthetists around the globewho have designed legs foramputees to climb Everest.

“One of the main issues we pickedup from training was the sweatingbecause they are going to beworking very hard. Guy was able tostop, take his leg off, dry it andattach it back again then because wewere only working in temperaturesof between zero and minus 10.

“But on the expedition he is notgoing to be able to stop for half-an-hour because he will hold up the restof them and there will be anincreased risk of frostbite.

“Another problem we face is theamount of weight he will lose, whichtypically can be between one andone-and-a-half stone. The limbs we

design tend to fit if the individualloses or gains a couple of pounds,but not this much.”

To combat this he says he hopes tocreate an adjustable socket over thenext few months that Guy cantighten or loosen when required.

He added: “The key is to get thelimb in place so Guy can do lots oftraining with it.

“The worst thing I can do is give himsomething a few weeks before hesets off that he is not totallycomfortable with.”

How Jamie’s helping Guy rise to challenge

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RESEARCHERS at TeessideUniversity have been awarded a£30,000 grant to help transformthe lives of disabled learners andtheir teachers.

Widgets for Inclusive DistributedEnvironments (WIDE) aims toproduce up to 50 high qualitywidgets, similar to iPhoneapplications, which will supportdisabled students through theirlearning journey.

The innovative project will be ledby the Accessibility ResearchCentre within the School ofComputing.

Elaine Pearson, principal lecturerin the Digital Futures Institute,said: “We are really excited about this project because itmeans we can take a communityapproach to make a realdifference to disabled studentsacross higher and furthereducation.”

Funding was secured through theJISC Distributed LearningEnvironments scheme, and WIDEwas one of only three projectsthat was successful in the fundingapplication process.

The £30,000 grant will providebursaries for two researchers whowill spend six months defining,designing, developing andevaluating digital resources.

WIDE will bring together groupsof staff who are involved in theteaching and support of disabledstudents in further and highereducation. In a series ofbrainstorming sessions andworkshops those teachers will putforward their own ideas for howthe small WIDE applications canhelp and support disabledstudents.

Researchers will then design anddevelop a series of widgets whichwill be created for specificlearning needs, with the aim ofproducing up to 50 digitalapplications which can bedistributed to the educationsector.

Each widget will includedescriptions of the user scenarioon which it was based, togetherwith a summary of its use inpractice.

The six-month WIDE project willrun until December 31.

£30k grant to help disabledstudents through widgets

Depression ishamperingstroke recoveryDEPRESSION is preventing aroundone in seven stroke patients frommaking a good physical recovery, anew study suggests.

The impact of depression on recoveryfrom stroke has been largelyunderestimated and patients'psychological wellbeing should bemonitored much more closely,according to the researchers fromthe University of Leeds.

A study of more than 400 strokesurvivors revealed that in around 15per cent of patients, a downturn inmood can be severe and last forseveral months.

One year after the stroke, patientswith prolonged depression weremore likely to have problems withspeech and movement. Those withpersistently poor mood were stillstruggling with simple tasks such aswalking upstairs or holding aconversation.

Dr Kate Hill, who led the study, toldAssistive Technologies thepsychological wellbeing of strokesurvivors is seldom monitored.

She added: “There are all sorts ofreasons why stroke survivors whosuccumb to depression do worse.

“They may not be engaging in theirrehab, they may not be taking theirmedication, and they may becomemore socially isolated.

“The label of post-stroke depression

is extremely common, especially inelderly care wards. Our resultssuggest that a policy of 'watch andwait' would be better rather thanautomatically giving out anti-depressants.”

After monitoring stroke survivors, theresearchers discovered that patientsfell into one of four different groups.Some had depression that improvedrelatively quickly, but at the otherend of the scale, some were stillsuffering considerable psychologicaldistress after six months.

Kate added: “Some patients’ moodwill improve after a short time butothers will remain depressed forseveral months. We need a longerterm view of looking at psychologicaleffects after stroke.

“If we can understand how peopleare likely to react after a stroke, forinstance by looking at how theyresponded to previous psychologicalhealth problems, we can perhapsfind better ways of managing theassociated depression.

”The researchers also found thatpatients with persistent depressionafter a stroke were most likely tohave had psychological healthproblems in the past.

The research was funded by TheStroke Association and the NHSService Delivery and OrganisationResearch and Developmentprogramme.

New role for RossROSS Andrews has joined seatingfor disabled children and adultsspecialists Specialised OrthoticServices as product demonstratorand sales executive.The new position in the marketingteam has been created inresponse to increased interest inand demand for products such asthe popular ‘P’ Pod – a supportiveseat bean bag for children.Ross said: “My remit is to take ourproducts direct to occupationaltherapists and explain to them therange of equipment we offer, howand why they were developed as

well as the health benefits to theirclients and service users. “We recognise that OTs’ time isprecious and they aren’t alwaysable to attend exhibitions andshows. This way we go direct tothem. There’s an added benefit toseeing something demonstratedfirst hand, being able to try it andsee it in action.”Ross previously worked for asupplier of rehabilitation aids andequipment in Nottingham as salesmanager looking after trade andNHS accounts.

Olivia recognised for charity workAMPUTEE Olivia Giles has received anOBE for services to charity afterbringing relief and support tothousands of others who have lost alimb.A former partner in an Edinburghlegal firm, she was struck down by

meningitis aged 36. Both her armsand legs were amputated in a bid tostop the spread of the disease.Olivia now concentrates on hercharity 500 Miles, started in 2008,which supports amputees in Malawiand Zambia.

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LATERAL Wedge Technology is theresult of more than five years ofresearch by the team at Universityspin-off company Salford Insole,and will offer pain relief to arthritissufferers.

And Richard Jones, who haspioneered the product through hisdoctoral work and collaborationswith colleagues in orthopaedicsacross the North West, toldAssistive Technologies it could be amuch cheaper alternative to kneebraces, which cost more than£200.

He added: “All too often use ofanalgesics is the first option forpatients, often suggested by GPs.However, this only exacerbates themechanical problem at the kneebecause without pain suffererswalk faster and further, increasingthe damaging loads on their knees.So, providing pain relief does notaddress the mechanical cause ofthe knee pain.

“There is some evidence of theeffectiveness of physiotherapy andknee braces in cases of knee OA,but these are costly to the NHS andcan be time consuming forpatients.

“Knee braces often have poorlevels of compliance and, whilephysiotherapy can help kneemuscle development, it is commonfor more than eight physio sessionsto be required.”

As an alternative approach, Richardand colleagues wanted to build onemerging orthopaedic evidenceindicating that a lateral wedgeunder the foot can help reduce thevarus forces at the knee.

Previous research has shown this isdirectly linked to the loading onthe medial compartment of theknee (the forces that cause thearthritis) and that reducing thisforce reduces pain.

Richard added: “Lateral wedges are

most often manufactured as acustom foot orthosis prescriptionwhich can be expensive in terms ofclinician time, and can necessitatea return visit by patients for fitting.

“The simplest solution is use of apiece of EVA wedge material underthe foot, but the fit into differentfootwear can be problematic.

“Another issue is that by pronatingthe foot with a lateral wedge manyclinicians are concerned aboutcausing foot problems associatedwith foot pronation.”

During Richard’s PhD he workedwith podiatry lecturer Phil Laxtonto build the lateral wedge onto aprefabricated anti-pronation insole.The concept was to have a lateralwedge to correct the forces at theknee, but to build the wedge ontoan anti pronation orthosis tosupport the arches of the foot.

The research involved 28 peoplewith mild to moderate OA of the

medial knee and compared thelateral. Patients wore the insole fortwo hours more than the braceeach day and, at the end of thesix-week trial 26 of the 28 subjectschose the insole over the kneebrace, with two choosing to useboth.

“To make sure the proven orthosisdesign gets into the hands ofclinicians and into the footwear ofpatients, the lateral wedge insolehas now been converted into asingle piece orthosis,” addedRichard.

“This requires no additions and canbe fitted directly into footwear atthe first visit. It offers a massivecost saving to the NHS against thecost of a knee brace or multiplesessions of physiotherapy.”

Richard is continuing the researchthrough a major researchprogramme sponsored by ArthritisResearch UK.

A lateral wedge developed at Salford University could save the NHS thousands of pounds, it hasbeen claimed. Dominic Musgrave found out more.

Lateral wedge proves thepreferred choice in patient trials

Representatives from the Mexican Disabled Children’s Trust and InsitutoNuevo Amanecer visit the Specialised Orthotic Services stand at Kidz South.

Mexican visitors attend Kidz SouthSPECIALISED Orthotic Services welcomedsome special visitors to its stand at KidzSouth. Members of the company’snominated charity Mexican DisabledChildren’s Trust (MeDiCT) and guests fromInsituto Nuevo Amanecer (INA), a charitableinstitute in Mexico that MeDiCT supports,where disabled children are treated andeducated, attended the annual exhibition.The team from Mexico were in the UK fortraining, and attended Kidz South to meetthe team to thank them for their supportand to see the latest innovations availablefor disabled children.Managing director Gordon McQuilton andother SOS employees have visited Mexicoover the last three years to work with theUK-based charity MeDiCT, which helps

Mexican children with cerebral palsy. SOS appeals for wheelchairs and seatingequipment which is no longer used andhelps fund the shipment of a container toMexico. In addition, Gordon and his teamalso donate their time and expertise on anannual visit to help assess the children’scomplex seating needs, and ensure thedonated equipment benefits them.SOS also showcased its popular ‘P’ Pod and‘T’ Max on its stand. The ‘P’ Pod is abeanbag with a special seat attached whichhelps support a child or young adult in abeneficial seating position.‘The T’ Max is a moulded seat which helpschildren that cannot use conventional toiletequipment as well as being a showeringaid.

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A FORMER Paralympian who had hisartificial legs stolen has been able towalk his sister down the aisle thanksto a hospital team and prostheticscompany. Anthony Booth, who lost his legswhen he was nine, had beenpractising for four months to walkwithout sticks to give away his sisterAngela at her wedding. But a fortnight before her big day hiswheelchair and prosthetic legs werestolen, along with his car, and theday before the wedding he made anational television appeal for theirreturn.The former wheelchair ice-hockeyathlete had already been in contact

with his local prosthetics provider totry and get some replacement limbsafter the robbery, but was told thatthey could do the preliminary castingfor the new legs, but they would nothave been ready in time for thewedding.Rehabilitation services managerNancy Rhodes, who manages theSeacroft Rehabilitation Centre, sawthe appeal and requested RSLSteeperbranch manager Steven Carter tooffer help. Anthony was invited to the Leedsteaching hospital site at SeacroftHospital, where RSLSteeper providedthe clinical input. Steven said: “We are probably the

only company in the UK who wereable to provide a replacement pair oflimbs for Anthony in such a shorttime frame. “This would not be possible withconventional manufacturingtechniques, but thanks to theleading edge CADCAM system thatRSLSteeper has invested in and agreat effort from everyone involved,we made it happen.”Anthony arrived at the centre at 3pmand, at 4pm, RSLSteeper used itsBiosculptor CADCAM scanner tocollect digital data from the patient’slimbs.Half-an-hour later the data waspassed through to the BioMill for

manufacture, with each limb takingjust 25 minutes to be carved. By5.45pm the fitting process beganand, shortly afterwards, he wastaking his first steps on the newlimbs. The whole process wasfinished by 8pm.Anthony said the team “went abovetheir call of duty”. He added: “Theystayed for an extra five hours onFriday night to make sure I was fittedwith a new pair of legs. I had givenup hope before I got the phone callon Friday morning. I had assumed Iwould have to use a wheelchair Ihave borrowed instead of walkingmy sister down the aisle on herspecial day.”

Right:Anthony withthe team atLeedsTeachingHospital and,left: thescanner usedto create thenew limbs

Team saves the day for Anthony

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Workshop gives disabledchildren chance to talkwith leading designersBy Dominic Musgrave

CHILDREN with disabilities andtheir carers have been given theopportunity to take part in aDragons’ Den-style workshop withleading designers.

Hosted by Devices for Dignity(D4D), Healthcare TechnologyCooperative and industrial designconsultancy Frazer-NashConsultancy, the workshop’s aimwas to give children and carers thechance to talk about the problemsthat affect their daily lives andhighlighting how these are notcurrently addressed by existingtechnologies.

Held in conjunction with children’scharity Whizz-Kidz, four designswere presented to the group, withthe aim of the choosing one overallconcept that caters for all theirneeds and provides care, quality oflife and independence forthousands of children across theUK, including children with severe

disabilities and wider groups.

The overall aim of the project is todesign a chair that allows childrento confidently leave hospitalenvironments and be able to getout and about safely and moreindependently.

While the designs incorporate themost complex equipment needssuch as catering for ventilators andoxygen cylinders, they also have awider generic appeal as well.

Another feature of the designs wasits ability to adapt with thechanging size of a child;encompassing a range of framesand seat options thataccommodate growing children.

Wheelchair user Leanna Hornesaid: “People don’t usually ask uswhat we want and need but byworking together we can ensurechildren in the future get betterwheelchairs than the ones I hadwhen I was growing up.

“There isn’t a clinical need for

wheelchairs to be fashionable, butas you get older you want to makesure you fit into society and thatyour disability isn’t any moreobvious than it needs to be. If youhave a slim-line chair withcharacter, it’s easier to get aroundand makes you feel moreintegrated into society.”

Over the last year the team haveworked closely with paediatricconsultants from Great OrmondStreet Hospital and SheffieldChildren’s Hospital, occupationaltherapists, engineers and clinicalscientists to design a new transportsystem that caters for the children’severyday needs.

D4D, which is hosted by SheffieldTeaching Hospitals NHS FoundationTrust, and Frazer Nashcommissioned a series of on-linesurveys, user and carer focusgroups to find out exactly what it isneeded and how this can be inincorporated into the new designs– these were hosted by Whizz Kidz.

Roadshowready to rollinto EdinburghMOBILITY Roadshow Scotland returnsto Edinburgh for two days inSeptember.The fourth Mobility Roadshow to beheld in Scotland, it brings together onone site the widest choice of mobility,healthcare and rehabilitation products,services and information for disabledand older people throughout Scotlandand the north of England.Already there is a good line up ofexhibitors from all mobility sectorsshowcasing their latest innovations andmodels – motor manufacturers;conversion and adaptation specialists;motoring accessories suppliers;wheelchair, scooter, bike and trikecompanies; independent living productsfor the home; as well as organisationsoffering information and advice on allaspects of mobility.Visitors can try and assess hundreds ofwheelchairs, scooters and mobilitycycles for comfort and safety – fromhigh-end power chairs to lightweightportable models.Always a popular attraction at thisevent, the Sports Arena will again bebuzzing with activity. Mobility Roadshow Scotland takesplace at the Royal Highland Centre onSeptember 17 and 18.

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By Dominic Musgrave

A PRODUCT design student hasmade a talking gadget forsupermarket trolleys to help themillions of elderly and visuallyimpaired people who find shoppingdifficult.

Ben Charles, who graduated with a First, designed the wirelessdevice for his final project on hisUniversity of Portsmouth BSc inComputer Aided Product Designcourse.

The device is attached to thetrolley's handle and when ashopper scans a product, it displaysproduct information and price inlarge type and says the price aloud.

According to his research, threequarters of the UK's 13 millionpensioners find it difficult to readprices and product information insupermarkets.

Ben said: “I wanted to design adevice that makes it easier for theelderly and visually impaired toshop in supermarkets.

“Many of them face huge hurdlesin trying to read productinformation, such as if a productcontains nuts or if it is high in fat,and many can't read the pricelabels.

“I carried out lots of marketresearch and it was clear thatmillions of people find it reallyhard, or impossible, to know whatthey are buying and at what price.These people are not disabled, butthey are socially handicapped.”

The rechargeable device has anadjustable, tilting screen and threelarge buttons embossed with braillefor displaying price and productinformation, triggering a quietalarm at customer service desks ifhelp is required and a third for

keeping a running total of the costof the shopping. It also gives clearvisual and audible warnings if aproduct contains any commonallergens, such as gluten and nuts.

The design was developed to bemanufactured through the injectionmoulding process, and a scaledprototype was made for theproduct launch. Ben now hopes asupermarket will buy the device.

His project tutor John Bishop said:“Ben identified a problem, did

market research, designed thefinished article and made aprototype all to an exceptionallyhigh standard.

“The result is not just an excellentacademic grade, but also an ideathat could be used in the nearfuture in our supermarkets.”

Ben was awarded the University'sproject prize sponsored by theDefence Science and TechnologyLaboratory and ImechE BestStudent prize.

Ben Charles

Ben’s shoppingtrolley gadgetspeaks for itself

A NEPALESE woman who lost herhand to leprosy has had a new limbfitted with help from a StrathclydeUniversity student.

Roger Hamlet, who is in his secondyear at the University's NationalCentre for Prosthetics and Orthotics,flew to Nepal to work at theAnandaban Leprosy Hospital duringhis summer break.

When the staff there heard he wascoming, they asked for help to findan artificial hand for 22-year-oldleprosy patient, Belly Thapa, who has lost her left hand at thewrist.

Roger said: “It’s not uncommon forleprosy patients to lose their handsor feet. The disease affects thenerve-endings, leading to loss ofsensation.

“When you feel no pain, it is veryeasy to seriously injure yourself,without even knowing it. Womenoften burn themselves whilecooking, and even a tiny piece of gritin a shoe can lead to terrible footulcers."

Linda Todd, director of the LeprosyMission Scotland, which supportsAnandaban Hospital and sponsoredRoger's trip, added: “In Nepal, thestigma associated with leprosy and

with disability can be just asdamaging as the disease itself.

“Belly may be ostracised by herfamily, she may never be able tomarry, and she may not be able tosupport herself financially.

“But The Leprosy Mission Scotlandworks to rehabilitate people like Belly– to help them find work, andrecover their sense of their ownworth.”

Student Roger helpsNepalese leprosy victim

Roger Hamlet

Kat named a Live-WIRE winnerA DE Montfort University graduatehas been named one of Shell Live-WIRE’s Grand Ideas Award-winnersfor a revolutionary innovation whichcould change the lives of peoplewith mental and physical disabilities.Kat Pattison started the companySonodrome with her partner JimFrize after they both graduated fromthe Leicester university in 2009 withdegrees in Music, Technology andInnovation.The new technology is a bio-signalInterface which works through asmall circuit board that is connectedto a PC through a USB cable. It useselectrical signals from the body (the‘bio’ part of the product) to control acomputer programme, and means ithas a number of uses from thehealthcare industry to immersivegaming. The breakthrough nettedthe pair £1,000 to help develop thebusiness, which is based inTynemouth, Tyne and Wear.Kat said: “The innovation is a piece

of hardware which works alongsideopen source software, meaninganyone can write any programmewhich can then be shared withothers through an online community.“Because the freedom ofprogramming is given to thecommunity, the applicationsdeveloped will only be restricted bythe user's imagination. “Anything that requires the use ofbio-signals, such as those of thebrain, heart and muscles forexample, can be implemented –think music creation and immersivegaming, to a brain operatednavigation system for the disabled.“This is why we anticipate the newtechnology will have a huge impacton a lot of people’s lives and, as weare now seeking investment, theaward funding will help with thedevelopment of our brand andwebsite and will allow us to makesome significant steps towardsbusiness growth.”

ARTHRITIS Research UK and theInstitute of Sport and ExerciseMedicine (ISEM) are holding aconference to investigate theprevention and management ofosteoarthritis following sport orexercise.International speakers presenting atTackling Osteoarthritis in Sport onOctober 21 and 22 include Dr JRichard Steadman, renowned for his

knee surgery and rehabilitation workwith elite sportspeople andSwitzerland based Jiri Dvorak, chiefmedical officer to FIFA. It will behosted by professor Alan Silman ofArthritis Research UK and professorDavid Patterson of ISEM. Theconference has been awarded 10CPD credits by the Faculty of Sportand Exercise Medicine (UK).

Tackling Osteoarthritis in Sport

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RAY Edwards is part of a team offriends and fellow amputees whoplan to tackle Mount Kilimanjaro toraise money for his recently formedLimbcare charity.The 56-year-old from Sandhurst,who had to have his arms and legsamputated after developing bloodpoisoning following radiotherapyand chemotherapy treatment forHodgkin’s Disease in 1987, alsohopes the challenge will help raiseawareness of amputees.The former chief executive of theLimbless Association told AssistiveTechnologies the idea camefollowing a boozy night with hisfriend Stan Hetherington, whoreached the summit six years agoand is also part of the team.He added: “After a few bottles ofwine Stan suggested going for awalk ... up a mountain calledKilimanjaro and, because my brainwasn’t fully engaged, I agreed.“The following day I thought tomyself what have I done, but I’mnow really looking forward to it. I’mfully aware that it is going to bequite hard for someone without anylimbs – but I’m not one to shy away

from a challenge and all I can thinkabout is getting to the top.“There are four other amputees,most of whom have lost a leg, andanother person who is going to bewalking on crutches because shehas a bad foot. It is really going totest our strength of character.”With the aid of three prosthetic andone hi-tech I-limb, Ray haspreviously completed theWokingham Bikeathon and piloted aplane. He has had some legsspecially designed for theexpedition, and says he is takingspare limbs with him.“It’s a bit of a logistical nightmarebecause I cannot really look aftermyself, and there are certain tasksthat I cannot do. But we will all behelping each other and workingtogether as a team to make sure weall get to the top.“I am going to be a bit of a walkingMeccano set with all of my sparebits and pieces, but it is going to beso rewarding seeing other peopledoing this, and it is without doubtthe hardest challenge of my life.“We have been busy walking theBrecon Beacons and Surrey Hills in

preparation, and I am planning tospend some time in Lanzarotetraining in warmer weather,although nothing can prepare youfor how you will feel at altitude.”Physiotherapists and doctors arealso part of the team for the trip,which has been organised byCharity Challenge. It will takebetween seven and nine days tocomplete, and hopes to raiseapproximately £100,000 for charity.Ahead of the trip they hope to visitan amputee centre in Tanzania.To donate visitwww.justgiving.com/rayskilimanjarochallenge

A quadruple amputee is aiming to become the first to scale the world’s highest free-standingmountain. Dominic Musgrave found out more.

Ray Edwards

Quadruple amputee to tackle Kilimanjaro

The team which plans to tackle Mount Kilimanjaro

Extension work underwayWORK has begun on an orthoticscompany’s new two-storeyextension at its Staffordshire base tohelp fulfil its four-week ‘fromcommission to delivery’commitment.The ground floor of SpecialisedOrthotic Services’ new build will behome to a series of demonstrationrooms showing its range ofproducts to commissioners andusers. There will also be a schoolroom, bedroom, living room andbathroom to allow the products tobe seen in action.Managing director GordonMcQuilton said: “Due to the success

of new innovations and ourcontinuous product developmentwe need both more space and morestaff. This added extension to theexisting building will allow us tohost open days for teams ofoccupational therapists andwheelchair services to reallyshowcase our products. They’ll beable to see the products in actionand the benefits they can bring.”Other departments such asupholstery, sales and marketing,customer services, and technical andplanning teams will also be movedinto the new extension when it iscompleted in October. Gordon McQuilton and operations director Andy Elson oversee the new build taking shape

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By Dominic Musgrave

OXFORD researchers are workingon a new study that hopes toshed light on how the brainadapts following handamputation.

Representatives from the OxfordCentre for Enablement (OCE)based at the NuffieldOrthopaedic Centre, are workingwith colleagues from OxfordUniversity to look at whathappens to this part of the brainwhen a hand or arm is missing.

The study will involve using thelatest technology in MRI scanningto examine changes in the brainfollowing amputation of a handor arm.

Dr David Henderson Slater,rehabilitation consultant at theOCE, is the leading clinicalinvestigator on the study.

He said: “We are particularlyinterested in the relationshipbetween brain re-organisationand phantom limb sensation orpain following amputation.

“Phantom limb pain is painperceived to be arising from theamputated limb; it can bedifficult to control or predictwhen it will strike and can bevery debilitating.”

Amputees taking part in thestudy will have scans taken oftheir brains while responding todifferent types of stimulation,such as being pinched.

Scans will be undertaken at theUniversity’s Centre for FunctionalMRI of the Brain where highperformance scanners are able toprovide high quality images atmuch higher resolution andspeed to capture greater detail ofbrain activity.

It is hoped the study will lead tobetter rehabilitation techniquesand better treatment of phantomlimb pain.

The three-year study is being ledby Dr Tamar Makin of theUniversity’s Oxford Centre forFunctional MRI of the Brain.

She added: “Specific parts of thebrain control different parts ofthe body. Our research will testwhat happens to parts of thebrain controlling the arm andhand when the limb is missing.

“We are also interested to learnhow the representation of thehand in the brain of intactparticipants is shaped by sensoryand motor skills and learning.”

Groups of non-amputees andthose with congenital limbdeficiency will also be invited totake part in the study in order tocompare the organisation of theirbrains with those of amputees.

The aim is to increaseunderstanding of the brain’sability to re-organise itself byforming new neural connectionsin response to situations such aslimb amputation or nervoussystem injury.

Dr David Henderson Slater

Amputationstudy looks atbrain changes

Simon Hawkins receives his award from Bruce Forsyth and Barry Cryer

A BROMSGROVE firefighter whodefied the odds to return to workdespite having his lower-left legamputated after a motorcycleaccident in 2004 has won an award.

Simon Hawkins was namedFirefighter of the Year after beingshort-listed as one of just fivefirefighters from across the countryto be considered for the honour atthe 2010 Spirit of Fire Awards.

Simon, who was presented with hisaward by TV legends Bruce Forsythand Barry Cryer, said: “I can’t quite

believe it – I’m astounded and Ithought everyone was great.”

After his leg was amputated hethought he would never walk again,but five months after his accidentreturned to work in a nonoperational role involving communityfire safety and administrative duties.

A year after the accident, Simonbegan his attempt to return to workfully, and in February 2006 heachieved his dream of becoming thefirst fully-fledged serving firefighterwith a prosthetic limb in Europe.

Simon wins awardin a blaze of glory

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By Dominic Musgrave

RESEARCHERS have moved a stepcloser to producing a new device forGPs to detect osteoarthritis andmonitor its progression by listeningto the noises emitted by their knees.

A team at Lancaster University andUniversity of Central Lancashire, ledby professor John Goodacre andprofessor Lik-Kwan Shark, havefound that a technique calledacoustic emission – routinely used inthe engineering industry to detectunsafe buildings and bridges – canalso be used to pinpoint jointdegeneration.

A two-year study involving 50 peopleshowed that the soundwaves madeby the knees of healthy people weredifferent to those with osteoarthritisof the knee.

John, head of postgraduate medicineat Lancaster’s new School of Healthand Medicine, and an honoraryconsultant rheumatologist atBlackpool, Fylde and Wyre NHSFoundation Trust, said: “We foundthat by measuring and analysinghigh frequency sounds releasedwithin knee joints during movementwe could tell whether or not theperson had osteoarthritis of theknee, and also their age group.”

He added that the research, fundedby Arthritis Research UK, provided anexcellent basis for the development

of a small, portable piece ofequipment which could be usedeasily by GPs, hospital doctors and nurses to assess patients with knee osteoarthritis regularly to see whether the knee is changingor responding to treatment.

However, there were still questionsaround the power of the testingmethod and whether it could detectmore subtle changes.

In the study, microphones wereattached to the knees of patientsand healthy controls, and the noisesemanating from their knees weremeasured as they stood up from asitting position five times.

John said he is now keen to developthe work further by testing andvalidating the equipment on largernumbers of people, and is currentlydesigning the next phase of thework which he hopes will involve GPsurgeries and orthopaedic andrheumatology departments aroundthe country.

He added: “At the moment it’slooking very optimistic, and I canenvisage that this device could beused as both an early diagnostic toolfor GPs, and potentially as a quick,simple means of detecting theprogression of osteoarthritis,reducing the need for MRI or otherexpensive, and less accessibletechniques.”

Professor John Goodacre, Dr James Selfe and professor Lik-Kwan Shark

Soundwavesused to detectosteoarthritis

A PHYSIOTHERAPIST who recentlygraduated plans to volunteer at arural hospital in Uganda for twomonths.

Laura Steed, who studied at theUniversity of East Anglia, will jointwo other full-timephysiotherapists at Kiwokohospital, which serves 500,000residents. The physiotherapydepartment helps increase themobility of patients suffering fromthe after-effect of illnesses suchas AIDS/HIV, TB or meningitis.

Laura raised the majority of themoney needed for the Ugandanplacement through part-timework as a carer, but was alsoawarded a small grant from TheChartered Society ofPhysiotherapy.

She said: “When I heard aboutthe possibility of doing voluntarywork in Uganda, I jumped at thechance and I am really lookingforward to joining the team atKiwoko.

“It will be a fantastic experienceto work with such a variety ofpatients including in generalmedical and surgical wards aswell as paediatrics and intensivecare in conditions which will bevery different from what I amused to.

“But our course has encouragedus to think and work flexibly andcreatively – so hopefully I’ll beputting as much into the team’swork as I hope to gain from theexperience.”

Laura Steed

Newly-trained physioheads for Uganda

Masseur Sylvan swaps Simply Red for the RedsLIVERPOOL Football Club have given themselves the best possiblechance of hitting the right notes onthe field this season by employingthe original lead guitarist fromSimply Red.

Part-time masseur Sylvan Richardson,who was in the band for two years and recorded two albums,has joined up with the club's new-look medical team at Melwood.

Sylvan said: “To work for Liverpool is a great honour and when I got the call I was really excited.

“My role is to prepare the playersand deal with their recovery after

training.

“I am used to working with top athletes and so am verymuch looking forward to thisopportunity.”

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Bone growth studygoes hi-tech usingyoung footballersYOUNG footballers in Tayside and Fife willhave their movements captured using thesame kind of hi-tech motion analysis that isused to represent the likes of Wayne Rooneyand Tiger Woods in computer games.

Researchers at the University of Dundee arelooking for the footballers to contribute to aproject investigating the effects of intensivefootball training on bone growth.

As part of the project, volunteers will beasked to visit the Institute of MotionAnalysis and Research (IMAR) at theUniversity, where hi-tech motion analysiscameras will be used to capture theirmovements in 3D.

Professor Rami Abboud, director of IMAR,said: “Although football is a major globalsport, there is a significant weakness in thescientific literature as to whether targetedexercise training and many hours of practiceare actually beneficial to growingindividuals.

“The limited knowledge is extremelyworrying with respect to the short and long-term welfare of young footballers, as well associety as a whole due to the ever

increasing focus on promoting a healthylifestyle in order to tackle childhood obesity.

“Understanding the long-term growth anddevelopment of individuals couldsignificantly influence school curricularactivities and professional training regimepolicies, therefore this research has thepotential to improve the overall health ofour future society.”

The new research project is a joint onebetween IMAR and another of theUniversity's internationally renownedcentres, the Centre for Anatomy andHuman Identification (CAHID), whichrecently featured in the major BBC2 series'History Cold Case'.

The combination of IMAR’s expertise inmotion analysis and biomechanical andmusculoskeletal medicine, and CAHID’sexcellence in osteological and anatomicalresearch will generate an invaluable sourceof evidential research, helping to bridge thegap in scientific knowledge.

Researchers are looking for 12 to 14-year-old footballers to help with the project, andneed around 20 volunteers.

ONE of Britain’s greatestParalympic athletes and thefounder of a portable text-to-speech communication aidhave been awarded honorarydegrees by the University ofBath.Dame Tanni Grey-ThompsonDBE, pictured above, whowon 11 gold medals, threesilver and one bronze over 16years and five ParalympicGames, received her Doctor ofLaws at a ceremony recently.She is patron of the BritishParalympic Association and iscurrently promoting a newinitiative to boost the greencredentials of Paralympics GB,the UK Paralympics Team for2012, which has its trainingbase at the University.And Toby Churchill, who was

a student at Bath in 1965,received an honorary Doctorof Engineering degree at aprivate ceremony.During a two-month workplacement in Paris andClermond Ferrand in 1968 hecontracted viral encephalitisafter swimming in a river,which resulted in himbecoming paraplegic with aspeech disability. He completed his degree fromhome and graduated in 1971.As communication aids at thetime were few and farbetween Toby designed hisown, the Lightwriters, whichchanged the lives of peoplewith speech loss. Hisinventions later earned himmany awards.

Honorary degree for Dame Tanni

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By Dominic Musgrave

AMONG the innovative products foryoung people on show at the annualMobility Roadshow were wheelchairsthat adapt to fit as a child grows.

And among the new features onoffer this year was Sensory Corner, atherapeutic room and soft play areathat was fun, stimulating and safefor children with special needs.

Also launched this year wasCyclefest, which focused on specialneeds cycling options from tiny trikesto companion, passenger, tandemand wheelchair cycling, withspecialist advice and assessmentavailable to assist visitor choice. Newproducts included a new mountainbike for wheelchair users.

Jacqui Jones, executive director ofMobility Choice, the charity thatorganises the event, said: “The newvenue, ideal weather and a wealth ofmobility innovation, as well as classicmobility solutions for visitors to testdrive, try out and compare – from160 exhibitors – delivered one of themost successful events in our 27 yearhistory.”

National Young Disabled Persons’Day was celebrated with theannouncement of the winners of the sixth national Ready Willingand Mobile competition that calls for bright ideas from school children to help young disabledpeople.

Holly Moggridge, a student at SacredHeart of Mary Girls’ School inUpminster, was named the overallwinner, having won the 12 to 16year age category.

Her winning entry was an iPodhearing aid device designed toeliminate the embarrassment felt bymany deaf or partially deaf childrenwho have to wear a traditionalhearing aid.

The runner-up was Morgan Coy, apupil at Perry Hall Primary School inBromley and winner of the seven to11 age category. Her CrawlingCaterpillars’ adventure trail entry was designed to help youngdisabled wheelchair users to enjoy all the activities of a trail,together with their non-disabledfriends.

The wider selection of sports to trythis year offered the opportunity tojoin in, gain fitness advice andcontacts for getting involved whenvisitors returned home.

The action included wheelchair rugbyand rugby league, basketball, sledge

hockey and wheelchair dancing, withthe Red Wheelies scooter formationteam also doing a demonstration.

The Mobility Roadshow moves toThe Royal Highland Centre nearEdinburgh Airport on September 17and 18.

Ready Willing and Mobile competition winner Holly Moggridge receives her award fromactor David Proud

Roadshow ‘one of the mostsuccessful in event’s history’

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Research shouldlead to boost forreplacementsAN international research centre hasbeen set up by UK and Germanscientists to lead the development ofa machine which pumps out powerpulses with the same intensity as alightning bolt.

Sheffield Hallam University hasestablished a HIPIMS Research Centrewith German research instituteFraunhofer IST to lead the globaldevelopment of the physical vapourdeposition (PVD) process – which isrevolutionising high tech industry byimproving the quality of a widerange of applications includingbiomedical implants.

Sheffield Hallam, which pioneeredHIPIMS – High Power ImpulseMagnetron Sputtering – in 2001,launched the new research centre ata recent conference.

Dr Arutiun Ehiasarian, director of theHIPIMS Research Centre at SheffieldHallam, said: “Sheffield Hallam andFraunhofer are the pioneers inHIPIMS and this new centre will helpto implement this process in industryacross the world.

“By establishing a commonphilosophy and working processes,we can explore the full potential ofHIPIMS in developing coatingsapplications for the aerospace andautomotive industries, as well asfunctional coatings andmicroelectronics research.”

The HIPIMS process can help in themanufacture of a range of productsincluding knee joints by pumping outan eight mega watt of electricalimpulses that create a plasma toimprove coatings.

Professor Günter Bräuer, director ofFraunhofer IST said: “Joining upresources from Sheffield Hallam andFraunhofer IST creates a worldwideunique Competence Centre forinnovative sputter processes.”

Professor Mike Smith, pro vicechancellor for research andknowledge transfer at SheffieldHallam, added: “This leap forwardwill help lead to replacement kneeand hip joints becoming longer-lasting, and to jet enginesperforming at a higher temperatureand with greater efficiency.”

Study giveship hope toathletesBy Dominic Musgrave

A STUDY led by Americanorthopedic experts has found thatminimally invasive arthroscopicsurgery to treat hip disorders may give athletes the opportunity to resume their sport back at their pre-injury level of competition.

The researchers at Rush MedicalCenter found that 78 per cent ofathletes suffering from hip labral tearcaused by internal ball and socketjoint damage to the hip were able toreturn to their sport within anaverage of a little more than nine months following a hiparthroscopy.

And 90 per cent were capable ofcompeting at the same level as theyhad prior to their initial hipimpairment.

All 47 patients involved in the studywere diagnosed withfemoroacetabular impingement (FAI),a condition that occurs when thefemoral head of the thigh bone rubs abnormally against theacetabulum, or cup-like socket of thehip joint.

This rubbing results in damage to therim of the hip socket as well as thecartilage that covers the hip bones.

Study lead investigator Dr Shane J.Nho, a sports medicine and hiparthroscopy expert at the university,said: “Arthroscopic hip surgery is an outpatient procedure that can decrease soft tissue trauma and decrease blood loss, leading to a faster recovery period compared to a more invasive opensurgery.

“Some people may be geneticallyinclined to develop FAI, but manyathletes experience early on-set ofsymptoms of FAI because of theirathletic activities require a highdegree of motion and force throughthe joint.

“Symptoms of FAI symptoms includepain, limited range of motion, andfor athletes, loss of the ability tocompete at their top level.”

Hip arthroscopy is a less invasiveoutpatient procedure compared totraditional open hip surgery.

It is performed by an orthopedicsurgeon who makes small incisionsabout one centimetre each thatpermits the insertion of a tinycamera in order to visualise theinside of a joint.

Small surgical instruments are thenused through the incisions to makethe repairs.

SENIOR staff from prosthetic limbmanufacturer Chas A Blatchford and Sons attended an eveningreception hosted by The Queen and Prince Philip for businesses thathave won Queen’s Awards forEnterprise.

The company was being honouredfor its outstanding commercialachievements in International Trade,Innovation or SustainableDevelopment.

It is the fourth time that Blatchford’shas won a Queen’s Award, on thisoccasion for innovation.

Chief executive officer StephenBlatchford said: “We are especiallyhonoured to have been awarded ourfourth Queen’s Award in thisparticular year, since it is also the

120th anniversary of the founding ofthe company by my greatgrandfather.

“The ceremony, kindly hosted by The Queen and Prince Philip at Buckingham Palace, was a proud moment in which to join in a celebration of Britishenterprise.”

Blatchford’s won the Queen’s Awardfor Innovation for its continuousdevelopment of artificial feet. Havingpioneered the use of carbon-fibrecomposite materials for prosthetics,the company incorporated it into itsrange of artificial feet, making itpossible to manufacture a foot andlower leg which are suitable for bothextended walking and for sportingactivities.

Company’s achievementsmarked in Queen’s Awards

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ASSISTIVE TECHNOLOGIES I AUGUST/SEPTEMBER 201022

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by Dominic Musgrave

RESEARCHERS at the universitiesof Manchester and Salford are tocarry out a series of clinical trialsin 300 patients with osteoarthritisof the knee.

The £1.8m study, funded bymedical research charity ArthritisResearch UK, will take five yearsand aims to reduce the painexperienced by patients andimprove their disability.

Osteoarthritis is a painfulcondition that causes progressivebreakdown of articular cartilageand bone, leading to joint failure.Treatment options are limited topainkillers and ultimately joint-replacement surgery.

The Manchester and Salfordteams, led by world-renownedosteoarthritis expert David Felson,an honorary professor atManchester, plan to take a newapproach to treating thecondition.

He said: “Unlike many researcherswho believe that repairingcartilage is the most importantaspect of treating osteoarthritissuccessfully, we believe treatmentstargeting the underlying causes, such as correctingpatients’ gait and posture, may be more effective in relievingpain.

“We believe this new approach

will have a significant impact onthe way this common jointcondition is treated and will resultin practical, effective treatment forthe six million people affected bythis debilitating condition in theUK.”

To test this theory, the multi-disciplinary research team willstudy the effectiveness of threetypes of treatment on groups oflocal people: special shoes andinsoles, knee braces and steroidinjections. They will use the latestimaging techniques andsophisticated computer tools tomeasure outcomes.

Fellow researcher Dr Michael

Callaghan added: “We hopethese trials will make a realdifference to the vast number ofpeople suffering from painfulknee osteoarthritis.

“We think these treatments willbe attractive options to GPs, whooften have little practical advice tooffer osteoarthritis patients, otherthan weight loss, analgesia andexercise.”

People will be recruited fromManchester and Salford and willattend sessions at either theWellcome Trust Clinical ResearchFacility in Manchester, SalfordUniversity Gait Laboratory orSalford Royal Hospital.

£1.8m trials aim to cutosteoarthritis pain

David Felson

Seminarsannouncedfor NaidexA COMPREHENSIVE CPD seminarprogramme is being launched forhealthcare professionals at NaidexSouth in September.

The programme, designed to appealto all who need to demonstrate thatthey are keeping abreast of newknowledge, techniques anddevelopments relating to theirprofessions, has been developed byoccupational therapist Kate Sheehan.

Topics include ‘CPD audits’, ‘MakingHouses Comfortable’,‘Understanding the Disabled FacilitiesGrant’ and Age UK’s seminar on“Prevention in later life – is it worthit?”.

Event director Liz Virgo said: “Overthe years, Naidex has built up anunrivalled reputation for offeringhealthcare professionals theopportunity to enhance their CPDportfolio with informative and wellstructured seminar programmes.

“In addition to the programme,those attending Naidex South will beable to network with fellow industryprofessionals in a professionalenvironment, while also enjoying theopportunity to see and compare thelatest products from many of theUK's leading disability and healthcaremanufacturers.”

Its co-location with Primary Care Livewill also provide additionalopportunities for career andknowledge progression.

Naidex South will also feature aLifestyle Seminar Theatre, wherevisitors can view practical productdemonstrations and hearinspirational speakers; the KideQuiparea, which is dedicated to children’sequipment and services; aCommunication Village, featuringthe latest in assistive technology, aswell as hundreds of products to aidindependent living.

Entry for the event at ExCel, Londonon September 29 and 30 is free,with further CPD-accredited seminarsavailable on topics including woundcare, care for older people, mentalhealth and palliative and end-of-lifecare.

New CAD system is launchedPRECISION 3D has launched the firstCAD system to fully utilise the fullcolour 3D data created by itsFotoScan scanners.

FootMILL allows its operators toimport a 3D foot scan in full colourand quickly adapt any standard lastto fit the foot.

And, unlike any similar systems, formore extreme orthopaedic lasts you

can also transform the 3D footdirectly into a shoe last by adding atoe shape and heel pitch to the scan.

Steve Robinson said: “For insoledesign, you can use 3D colour scansfrom any of our scanners andinstantly map the plantar surfaceonto a standard insole.

“Then you can use a range of toolsto modify the shape to meet any

corrective requirements. In all cases,the finished orthotics can beexported to standard 3D file formatsfor use with pattern engineeringsystems and a wide range of CNCmilling machines.

“It's simplicity of operation makes itpossible for users of all levels ofability to rapidly create accurate lastsand insoles based on 3D scans.”

A SURGEON at the University ofNottingham has become the UK’sfirst female professor oforthopaedics. Brigitte Scammell, head of thedivision of orthopaedic andaccident surgery in the School ofClinical Sciences at the Queen’sMedical Centre is among 20 newprofessors in the research andteaching promotions for 2010.She said: “It is a great honour tohave been promoted and an

absolutely amazing feeling to bethe first ‘lady’ professor oforthopaedics in the UK. “I couldn’t have done it withoutthe support of my colleagues andthe enthusiasm of my studentswhen they have learned a new skill. “I am very excited about the newchallenges that being a professorwill bring and I hope that I willinspire other women to followacademic and surgical careers andenjoy their work as much as I do.”

Professor Scammell now specialisesin elective orthopaedics – themajority of her patients suffer fromdegenerative diseases of the knee,feet and ankles. Their problems canstem from pain and deformitiescaused by arthritis and problemsassociated with diabetes.With funding from the MedicalResearch Council and ArthritisResearch UK, her main researchinterests focus on the biology ofbone healing and osteoarthritis.Brigitte Scammell

UK’s first female professor of orthopaedics

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