assistive technologies october/november 2015

INNOVATION FOR INDEPENDENCE ISSUE 105 OCTOBER/NOVEMBER 2015 £6.95

By Dominic MusgraveAN Austrian team of researchers hassuccessfully fitted a human being with a legprosthesis that sends feelings to its wearerfor the first time

The study results indicate that it greatlyincreases safety when in motion. The newprosthesis is perceived to be much moresimilar to the original limb and helps to lettorturous phantom pains subside.

Prosthetics expert Dr. Hubert Egger, aprofessor at the FH Upper Austria(University of Applied Sciences), has, for thefirst time, fitted a human being with asensory-enhanced prosthesis.

Due to the neural interface, the patient hasfeeling on the sole of the prosthetic foot,and therefore manages much better torecognise the nature of the ground he/sheis walking on.

There is also more awareness of obstacles,which reduces the risk of falling.

The re-established transfer of informationalso contributes to a more naturalintegration of the prosthesis into the bodyconcept of the patient and, in this case, hasled to the complete disappearance ofprevious long lasting pains.

The patient also underwent “Targeted

Sensory Reinnervation”, a selective transferof nerves, by OÄ Dr. Eva-Maria Baur andOA Dr. Thomas Bauer at the UniversityClinic for Reconstructive Plastic andAesthetic Surgery in Innsbruck, which is acooperation partner of the FH UpperAustria.

During this procedure the sensorial nerveendings of the sole of the original footwere reactivated to serve as an indicator forpressure on the sole of the prosthetic.

Another goal of the operation was todecrease pain from neural scarring(neuroma) by redirecting the nerves. Thestudy results show that amputees and theirlives can greatly benefit from all this.

The method of “Targeted SensoryReinnervation” will also be used on futurepatients at the University Clinic in Innsbruckto potentially bring an end to theirphantom pains by allowing the artificiallimb to resemble the original one moreclosely and naturally.

The initiator of the research project, HubertEgger, also headed the development of aprototype of a mind-controlled andsensory-enhanced arm prosthesis.

The mind-controlled prosthetic arm wasapproved by the Food and DrugAdministration in 2014.

Team successfullyfits prosthesis thatsends feelings

An ex-soldier who lost a leg in Afghanistan has recently completed agruelling Tough Mudder assault course. James Cairns, 26, fromYorkshire completed the challenge in four hours and 42 minutes,despite suffering pain caused by the moisture rubbing on his leg. Hesaid: “Tough Mudder is a big challenge for able bodied people let alonedisabled people, it was even harder than I imagined it would be, but Ididn't train at all, I got off a lads holiday a few weeks before.” James,who was shot in Afghanistan in October 2011, hasn’t stopped there.Next year he hopes to compete in the Orlando Invictus Games – asporting event for wounded and ill service men and women. He alsohopes to compete in the 1,500 metres at next year’s Paralympics.

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ContactsEditorialJudith Halkerston Group EditorEmail: [email protected]

Dominic Musgrave Group Production EditorEmail: [email protected]

Tel: 01226 734407Olivia Taylor ReporterEmail: [email protected]

Sales Carole Rice Product ManagerEmail: [email protected]: 01226 734412 Fax: 01226 734478

Tony Barry Sales and Marketing DirectorEmail: [email protected]

[email protected] hour hotline: 01226 734695

Design/Production Stewart Holt Studio ManagerEmail: [email protected] Firth Graphic DesignerEmail: [email protected]

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

Robotics researchers star atMediaCityUK industry eventROBOTICS engineers from theUniversity of Salford were prominentplayers at a major industry day atMediaCityUK.

Led by professor Samia Nefti-Meziani, Dr Steve Davis and DrAdham Atyabi the team showcasedcutting edge research in ‘softrobotics’ industrial automatedsystems and robotics for healthcareand assisted living.

Their work featured on the BBC, SkyNews and Granada and ProfessorMeziani – a key player in regionalresearch and development – wasinterviewed by the broadcasters.

Salford University is part of theNorthern Robotics Network – whichlaunched at the event at Salford’sMediaCityUk campus at thebeginning of September.

The Network brings togetherresearch institute and universities andhigh tech businesses in the regionand grew out of the GAMMA projectto revolutionise manufacturing

processes in the aerospace industry.

Professor Nefti-Meziani said: “PrimeMinister David Cameron describedrobotics as one of the eight greattechnologies of the future and one,we believe, will emerge as apowerhouse for the North.

“To fulfil this potential, we need aforum in which to work togetherand that is what we hope to achievewith the Northern RoboticsNetwork.”

The University has been at theforefront of Robotics since 1987when it was chosen as the site of theUnited Kingdom's National AdvancedRobotics Research Centre and hasled projects for DEFRA and theEngineering and Physical SciencesResearch Council.

The event, opened by DVC (forResearch Professor Nigel Mellors andentitled Powering Productivityincluded speakers and exhibitorsfrom Siemens, Rolls Royce, ABB,Festo, the National Nuclear

Laboratory and more than 30 SMEs.

Alan Norbury, central technologyofficer at Siemens UK, who waspaying his second visit to Salforduniversity said: “We hope to workclosely with Samia and the Salfordengineering team.”

At Script Media, we try to get things right but occasionally, we make mistakes. If you have a complaint about a story featured in ourmagazine or on our website, please, in the first instance, contact us by email: [email protected] We abide by the Editors’ Codeof Practice as demanded by the Independent Press Standards Organisation. For details on the code and what to do should you beunsatisfied with the way we handle your complaint, please visit www.ipso.co.uk

Dr Steve Davis and professor Samia Nefti-Meziani.

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Directory of Evidence Based OrthoticPractice (DEBOP) is releasedBy Simon Dickinson

ON October 4, 2014 a group of pro-active orthotists met in BuchananOrthotics boardroom in Glasgow toform a working group to answer thequestion; “What is the evidence fororthotic treatment for MSKconditions?”

The driving force to put this grouptogether initially came from the MSKlead for Orthotics in NHS Scotland,Chris Rowley.

As discussed in the last edition, NHSScotland is undergoing a review andtransformational change of its MSKpathways in order to reduce thestrain on orthopaedic services.

Other AHP professions alreadyclaimed to have an evidence baseand orthotics was sadly lacking.

Chris managed to secure somefunding from Scottish Governmentand successfully coerced someprofessional colleagues to join aworking group.

At our first meeting Chris challengedthe group to attempt to documentthe evidence for successful orthotictreatment for MSK conditions.

Foot and ankle was identified as theinitial priority with knee, hip andupper limb to follow. We were givena deadline of nine weeks to producea draft document on the evidence fororthotic intervention for foot andankle.

As a group we used Sign 50’smethodology (seewww.sign.ac.uk/methodology formore info) in order to ensure wefollowed the correct procedures aswe attempted this mammoth task.

As a group we created a MutuallyExclusive Collectively Exhaustive list inorder to identify every possible MSKfoot and ankle condition.

We then merged these conditionsinto groups representing regions ofthe foot and ankle.

Our methodology then led us toformulate our literature searches foreach group using a PICO chart. Inone day we achieved a great startand five of us were identified to carrythe project forward. The five peoplewere Nicola Munro, FionaMonaghan, Chris Cox, Lynne Rowleyand myself.

With some support from the librarywe then performed level two andthree literature searches to gather theevidence. All too often I have heardpeople say “there is no evidence fororthotics!” The level two forefootliterature search returned over 1,700abstracts of studies and articles!

As a group, continuing to follow Sign50 methodology, we proceeded tofilter the literature search andultimately critically appraise therelevant papers producing asystematic review of the literaturewith all of the studies classified and

appraised.

This was an exhausting and timeconsuming process which took manyhours.

The group then discussed how topresent the information we hadcollated. We wanted to ensure it wasclear and accessible but also did notdetract from clinical skills or provide“the idiots guide to orthotics”.

Nicola Munro was instrumental indiscovering and creating the wedbased platform we intended to use,clinical knowledge publisher, and wasably supported by Fiona Monaghanin setting up what we referred to atthe time as the “algorithms”. Not

only could we have the“algorithmns” live on the web, wecould also link them directly to theEvidence.

By mid-December we had the draftversion complete for foot and ankle.Hip, knee and upper limb thenfollowed also using Sign 50guidelines.

The one final question related towhat exactly had we created. Was ita protocol, a pathway or somethingelse?

After much discussion we agreedthat we had created a “directory forevidence based orthotic practice”and DEBOP was born! DEBOP is nowlive and can be accessed by anyonewith the link below:

http://www.clinicalknowledgepublisher.scot.nhs.uk/Published/PathwayViewer.aspx?fileId=1422

DEBOP is the first of its kind. It willneed regularly updating and refiningas the evidence base increases.BAPO have agreed to assist with itsmaintenance in the future.

There is a great deal of evidence forsuccessful orthotic treatment of MSKconditions. Our collective ongoingchallenge is to maintain DEBOP anddo the studies to add to theevidence.

� Simon Dickinson is a clinicaldirector at TalarMade.

Simon Dickinson

Physiotherapists save departmentthousands with recycling missionWEST Cumbria physiotherapyservices have been on a recent‘recycling’ mission in order to savecosts within their department.

Their campaign has saved the NHSthousands of pounds. The team,based in the West CumberlandHospital, noticed that a significantamount of the walking aids such aszimmer frames, elbow crutches andthe like were not always returnedwhen patients no longer neededthem.

Kathryn Mitchell, clinical leadphysiotherapist at CumbriaPartnership NHS Foundation Trust,said: “A significant amount of non-pay budget is spent on walking aidequipment in the Trust largely downto a decline in the number of aidsreturned.

“In order to both reduce budgetspend and improve appropriate‘recycling’ of walking aids, all care

homes within Copeland andAllerdale were contacted and askedto return any unused or unwantedequipment.

“We were able to retrieve and re-use many unwanted walking aids.These homes now have contactdetails of their local physiotherapydepartment should they have anymore unused equipment to return inthe future.”

The campaign even took to socialmedia to raise awareness within thecommunity as well.

Fiona Temple, specialistphysiotherapist at CPFT, added “Idecided to launch an appeal usingsocial media to create moreawareness on returning walking aidequipment.

“We received a very positiveresponse and a large amount ofequipment has been returned dueto this, which is fantastic to see.”

Both of the above actions, as well aschanging equipment suppliers, haveled to a significant budget saving ofmore than £4,000 and also anincreased awareness of recycling ofwalking aids.

Kathryn added: “As a team we arethrilled with the response we havehad from people returningequipment and hope, due to moreindividuals being aware of this, wecan continue to save our budgetcosts and recycle more equipment.”

West Cumbria physiotherapy services staff with some of the recycled walking aidsthat have been returned.

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Northumbria Health Trust pavesway for first OT service in GhanaA NORTH East health trust is helpingto set up a much-needed servicewhich will improve the quality of lifefor thousands of people in WestAfrica.

Due to its clinical expertise and trackrecord for developing internationalpartnerships, Northumbria HealthcareNHS Foundation Trust is working withThe Ministry of Health in Ghana tointroduce the first occupationaltherapy service in the country.

Three years ago, a team from thetrust visited Ghana to witness first-hand the health challenges peopleface. Now six students, who will beamong Ghana’s first occupationaltherapists when they graduate nextyear, have worked with the Universityof Ghana to design and implementthe first OT course.

They are experiencing for themselveshow an OT service can help patientsovercome or adapt to an illness, suchas a stroke, and regain theirindependence with advice and theassistance of specialist equipmentand adaptations for the home.

For six weeks, the students areworking alongside experienced OTs at

North Tyneside and Wansbeckgeneral hospitals and in thecommunity, gaining valuable skillsthat they can use to benefit patientsback home.

While in Northumberland and NorthTyneside, the students are focussingon areas of OT that will help toaddress major health challenges inGhana, such as stroke, which is asignificant cause of mortality andmorbidity, and an area in whichNorthumbria Healthcare excels.

In Ghana, like many other Africancountries, patients who have had astroke, or other debilitating illness,have to stay in hospital for longperiods because there is little or nosupport to help them when they gohome.

Barbara Kemp, head of occupationaltherapy at Northumbria Healthcare,said: “Welcoming the students to ourtrust has been another step towardsour goal of helping to set up the firstOT service in Ghana.

“It’s been an absolute pleasure tohave the students here and to showthem how a well-run and establishedOT service can help patients get back

on their feet and often regain theirindependence.

“The students have been surprised tosee how by working as a team, andjoining up care delivered in hospitaland the community, patient canquickly leave hospital following majortrauma, such as a stroke, with theright support in place.

“The differences between the NHShere and the health service in Ghanaare stark, however, the students willbe able to take valuable learning

home with them to help set up aneffective service and improve thequality of life for thousands ofpatients.

“We look forward to following theirprogress and returning to Ghana toattend their graduation next year, forwhat will be a real celebration ofwhat has been achieved.”

Northumbria Healthcare’s OT teamplan to keep in touch with thestudents via Skype and follow theirprogress with interest.

The OT students with representatives of Northumbria Healthcare NHS Foundation Trust.

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Woman is first in UK to be fitted withcomputer-controlled prosthetic legAN East Sussex woman has become the first UKpatient to be fitted with the new and improved C-Leg 4.

It was fitted on Lorraine Pooley by MatthewHughes, clinic manager at Dorset Orthopaedic.

The C-Leg 4 is the fourth generation of the firstever computer controlled prosthetic leg, and boastsadditional features compared with its threepredecessors.

Lorraine lost her right leg above the knee shortlyafter her 21st birthday when she was struck by amotorbike in 1991. Shortly after her accident,Lorraine was given her first prosthetic leg butfound it to be heavy and cumbersome.

Throughout all the challenges she has had to face,Lorraine has remained focused on reclaiming herdetermination and getting back to the activelifestyle she enjoys.

Since being fitted with C-Leg 4, Lorraine is noweager to get back to her active lifestyle, whichincludes trekking through the Nicaraguan junglefor the BBC2 programme Beyond Boundaries andcompeting in half marathons.

“Ever since the accident I have always kept up todate with the latest technology”, said Lorraine. “Iwant to make sure I have technology that cansupport what I want to do; I thought that way, Ican do more and be more active. Without thetechnology I’ve used, I would not have achievedwhat I have done in my life so far. I was thrilledwhen Matt told me about the C-Leg 4.”

The new C-Leg 4 is available in two colours andenters a new era with its additional features,including real time swing phase control fuelled by3D motion analysis and strengthened stumblerecovery support. Another highly beneficial featurefor amputees is the new standing function.

This recognises when the wearer has stopped anddampens the knee in a slightly flexed position toprovide maximum stability and comfort. Walkingbackwards has also never been easier than with C-Leg 4.

“Lorraine is a great candidate for the new C-Leg4,” added Matthew. “She is an active amputeeand will really benefit from the additional featuressuch as intuitive locking.

“We’ve also created a new bespoke silicone socketcomplete with a pre-preg carbon fibre frame. Thiswill greatly increase comfort and reduce bulk andweight".

The new and improved weatherproof prosthesishelps people master everyday life more confidentlywith two additional modes. The knee can beadjusted to meet an individual’s specificrequirements for unique activities such as cycling,dancing or playing sports.

For the first time, users can quickly switch betweenmodes and monitor battery life using the new‘Cockpit’ app for Android smartphones.

The optional remote control also supports thisfunctionality and both options integrate Bluetoothtechnology. Lorraine Pooley shows off her new C-Leg 4.

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The London Prosthetic Centre led by consultant prosthetist Abdo Haidar is promising change forpeople with prosthetic limbs...

IN RECENT years technicalinnovations have combined to makeprosthetic limbs much morefunctional and lifelike than earlierversions.

SocketMaster is a completerethinking of the most crucialprosthetic component: The socket.The aim is to bring moderntechnology and innovative design tobear on a long-ignored pain point.

Less glamorous, but the mostfundamental element in theprosthetic industry are prostheticsockets. The main interface thatconnects those sophisticatedprosthetics to peoples’ residual limbs.

The prosthetic limb may be fittedwith the highest advancements ofelectronic or bionic knees or feet, butthe socket remains the real point ofcontact. It’s the interface where thehardware meets the human.

Different measuring techniques areused in the prosthetic industry atpresent to capture the size and shapeof residual limbs.

These techniques remain limited andare unable to identify theinfrastructure of residual limbs andpressure tolerance of individual

amputees and offer the adjustabilityto improve the fit.

As a result, the design of a prostheticsocket is still basically an art, which ishighly dependent on the experiencesand skills of the prosthetist.

This is a time-consuming process,involving the production of multiplecheck sockets before a well-fittedsocket can be achieved, during whicheach check socket is modifiedaccording to the feedback of thepatient.

Abdo Haidar, lead prosthetist at TheLondon Prosthetic Centre, togetherwith six leading Europeanorganisations: TWI, Innora ProigmenaTechnologika, Fondazione BrunoKessler, Polkom Badania SP Zoo,Sensing Future Technologies, VenetoNanotech SCPA and the University ofSurrey are working on a three-yearproject called The “SocketMaster”.

Their aim is to develop a new medicaltool and a procedure to achieve fastand optimised design of a prostheticsocket for an above knee amputee.

The SocketMaster medical tool willbe developed by integratingmechanical and micro electronicsensors such that the parameters

relevant to the comfort of anamputee such as pressure, frictionbetween the socket and the residuallimb can be measured during awalking cycle.

This data will then be used to designan optimised socket by theSocketMaster software.

With a rapid prototyping machine itis envisaged that the design andfabrication of a well-fitted prostheticsocket can be completed within afew hours in the same day.

“Achieving comfort for amputeesand improved quality of life will bepossible with the SocketMaster.

“This is one of the most innovativescientific project ever attempted toimprove amputee comfort,” saidAbdo.

He also says the final stage will bethe clinical trials of 50 lower limbamputees. These trials will be carriedout at LPC to validate theSocketMaster

Abdo added: “The project is in itsfirst stage and we expect to becompleted within 36 months.

“I envision a remarkable outcome forSocketMaster.”

The SocketMaster project has beenawarded funding worth €4m fromthe European Commission’s newlylaunched Horizon 2020 Research andInnovation programme, under thetheme of ICT-2: Smart SystemsIntegration.

The project officially started onFebruary 1 and will last for threeyears.

For more details, please visit projectwebsite www.socketmaster.eu orwww.thelondonprosthetics.com

Group to develop new medical tool

Abdo Haidar

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DM Orthotics remove need formedication for cartoonist ...DM Orthotics has given a new leaseof life to cartoonist Hannah Ensor.

Hannah, who has Hypermobility TypeEDS and POTS, has been using acombination of the company’sproducts to alleviate the symptoms ofher conditions helping her to becomemore independent and less reliant ona wheelchair.

She was also able to stop takingprescribed medication for her POTSonly a few weeks after using herDMO’s, something she was reallypleased to do.

Speaking of the changes that she hasundergone, Hannah said: “Idiscovered DM Orthotics three yearsago and I can honestly say beingintroduced to their productscompletely changed my life.

“The enhanced proprioception meansI have awareness of the whole of mybody – it’s awesome! Theimprovement in sensation wasinstantaneous – it was really quiteunbelievable.

“With my full DMO outfit I can walka few metres and talk at the sametime – trust me, this is totally

awesome!”

Hannah uses a DMO Vest, DMOLeggings and DMO Socks as analternative to a full DMO Suit forgreater flexibility of use.

DM Orthotics clinician Liz Bettsexplains her choice of prescription.

“Ehlers Danlos Syndrome meanswithout aid Hannah is very unstableand is prone to a number ofsymptoms,” she said.

“This adds to her POTS, increasing itspre-potency. The use of multipleDMO’s would not only improve herstability and proprioception but alsoimprove her blood circulation,alleviating some of the blood poolingand low blood pressure symptoms.

“We opted for single items asopposed to a full suit as it would giveher greater versatility and flexibility ofmovement.”

Before using DMO’s Hannah was tiedto a rigid management programmefor her conditions involving;injections every three weeks, aspecific diet, wearing conventionalcompression stockings and a coolingvest, specific exercises and lying

down frequently to try and managethe blood pooling issues. Hannahexplains the difficult effects this hadon her everyday life,

Hannah added: “Although this [theprogramme] helped it was not ideal.The injections were painful and themedication could take a week tobecome fully effective, peaking forabout a week and then wearing offagain.

“My symptoms varied hugely and Istruggled to ‘pace’ my activities – itwas like the goalposts wereconstantly moving, and I often

couldn’t do the exercises essential tomanaging my EDS. I often missed outon things because they happened atthe wrong point in my medicationcycle.”

Within three weeks of using herDMO’s she was able to come off themedication she was taking for herPOTS. This also led to cost benefitsfor the NHS where the prescription ofDMO’s led to a 75 per cent savingversus the cost of medication.

Now, Hannah is able to plan her timeso she can get the most out of herDMO’s and consequently, the mostout of life and running her illustrationbusiness, Stickman Communications.

She added“The use of the DMO’s hasgiven me so many more possibilitiesin life. I am stronger and fitter, andcan cope better with being out of myhouse for several hours at a time.

“I’m still reliant on my wheelchair,and have to manage a complex set ofsymptoms, but my DMOs are a tool Iwouldn’t be without – I no longerhave to plan my life around amedication cycle, I can socialise andwork to my own schedule; my DMOshave given me back control.”

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By Olivia Taylor

LEEDS based Physio Med has beenrecognised at a prestigious awardsceremony for the third year in a row– this time alongside its client JohnLewis Partnership.

JLP was awarded the Employer’sRehabilitation Initiative of the Year atthe Rehabilitation First Awards havingworked with Physio Med to increaseproductivity and reduce sicknessabsence rates amongst its staff.

The company employs more than90,000 staff across its UK sites,including John Lewis and Waitrosestores, distribution centres and groupsites.

Many of the job roles at JLP – fromretail sales to warehouse operatives,office workers to security workers –can be physically demanding and JLPfound that employees sufferingmusculoskeletal disorders were oftenabsent for extended periods or lessproductive at work while waiting toaccess NHS physiotherapy, which cantake up to 14 weeks.

JLP Partnership Health Servicesworked with Physio Med toimplement its innovative and awardwinning Physiotherapy Advice Lineservice, providing fast access to ablended approach of fast-tracktelephone triage, remote multimediaself-management and on-site face-to-

face treatment/advice.

Over a 12-month period 2,324appropriate referrals were made toPhysio Med.

89 per cent of those off sick at thepoint of referral returned to workfollowing treatment and overall 96

per cent of all who used the servicewere safely maintained at or returnedto work.

Physio Med’s treatment resulted in a24 per cent improvement inproductivity and function – equatingto 1.2 days per person working a five

day week.

This is estimated to have saved JLP41,010 working days in total,delivering excellent ROI of 5:1.

Physio Med’s managing director PhilClayton said: “We’re absolutelythrilled that Physio Med’s service hasbeen able to achieve such fantasticresults for the John Lewis Partnership.

“Being recognised in therehabilitation industry for three yearsin a row for providing an excellentservice is a strong achievement andwe’re proud of our great team thathelped make it happen.”

Physio Med has previously beenrecognised at the Rehabilitation FirstAwards for its work with publicsector organisations St Helens andKnowsley Teaching Hospitals NHSTrust and North East AmbulanceService.

Recognising the achievements of JLPand Physio Med, Stephanie Denton,editor of Post magazine and headjudge at the Rehabilitation FirstAwards, said: “This entry stood outas it showed a good solidcommitment from a progressiveemployer using a simple practicalsolution to aid musculoskeletaldisorders.”

The awards ceremony took place atthe Royal Garden Hotel in London.

Firm wins award for third consecutive year

Nick Davison, head of partnership health services at JLP, with Phil Clayton, managingdirector at Physio Med.

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A professional singer was devastated by severe back pain before specialist intervention at the RoyalOrthopaedic Hospital changed his life for the better. Assistive Technologies found out more.

Getting rid of back pain without surgeryGAVIN Newman was diagnosed witha prolapsed disc which stopped himsinging, working or even doing basictasks like shopping.

At one stage he was taking 30painkillers a day and was told he’dneed spinal surgery if he was torecover.

That was when he met Dr GrahameBrown and extended scopephysiotherapist Dave Rogers at theRoyal Orthopaedic Hospital inNorthfield.

They introduced Gavin to thefunctional restoration service theyrun, which provides support topeople living with back pain, andhelps them recover without the needfor major surgery.

Gavin said: “I owe everything to theteam at the Royal OrthopaedicHospital. Everything has changed. Ihold them responsible for myrecovery. Without them I dread tothink what I’d be doing now.”

The service was set up with the aimof improving patients’ confidence,

reducing disability and pain, makingthem less reliant on medication andbetter able to cope when back painflares up.

Extended scope physiotherapist DaveRogers added: “This is all aboutputting the patient back in control.

We used the latest research to designthe programme, and patients findthat after the four-week programmethey are much less disabled, in lesspain and much more confident.

“They are getting back into work andenjoying their leisure time more.

“Until 10 years ago people withsevere long term back pain wouldfind themselves having a spinal fusionoperation, which is major surgery.”

The programme involves education,relaxation techniques and gradedexercise and encourages patients touse a toolkit of techniques to helpimprove function.

There is support fromphysiotherapists, a doctor and a paincounsellor.

For Gavin, it was life changing. Hespent six months going back andforth to his GP who providedpainkillers which gave him manyunpleasant side effects.

Gavin said: “Everything I touchedgave me pain. I couldn’t even do theshopping. I came into the

programme really dismissive of it. Ididn’t think it was for me. I was theworst possible patient.

“Then something just clicked. Ilistened to the functional restorationteam and together we set a goal thatI would come off one of the mostpowerful painkillers. In a couple ofweeks, the pain I was taking thetablets for had almost gone away.

“As soon as the pain began toreduce and the exercise took effect Igot into it more. I startedvolunteering to do extra, took onboard everything they were saying.

“I used the breathing techniques tohelp me and I still use them. In fourweeks I was pain free. It wasabsolutely amazing.”

Having been out of work due to hisdebilitating back pain, Gavin wasfinally able to get a new job.

And now he is IT Service Desk teamleader at the Royal OrthopaedicHospital. He married his fiancée inAugust and is looking forward totaking up singing once again.

Gavin Newman

Opening ceremoniesmark completion ofwalking gardensAN OPENING ceremony has takenplace at Colchester General Hospitalto mark the completion of a £59,000scheme to create two walkinggardens.

The gardens, which are located incourtyards next to the hospital'sGainsborough Wing, will be used tohelp patients who have been fittedwith prosthetic legs learn to walk andalso in the rehabilitation of manymore types of patients, includingpatients who are recovering fromstroke.

Tracey Williams-Macklin, head ofoccupational therapy at ColchesterHospital University NHS FoundationTrust, said: “They are the vision ofthe Colchester Prosthetic User Group,which has worked in partnershipwith us on the design and funding.

“The gardens will encourage manyindividuals to gain confidencewalking on everyday surfaces, forexample, individuals with a prostheticlimb or those who have had a stroke.

‘Patients can try the varied surfaces ina safe and controlled environment,which will lead to them being able tohave an independent lifestyle withintheir local community.

"It's a great place for the prosthetist,

physiotherapist and occupationaltherapist to assess an individual’soutdoor mobility.”

The work has involved new planting,laying down artificial turf, improvingthe drainage, replacing all handrails,putting down new surfaces (includingsome special non-slip surfaces), andinstalling a bespoke parasol.

A plaque was unveiled in one of thegardens by Frances Collins, ofColchester, who was a foundermember of the Colchester ProstheticUser Group (PUG) in 2009 and whostill serves on its committee.

Among the guests at the openingwas Kiera Roche from LimbPower;Gordon McFadden, chairman of theUnited Amputee Community Charity;PUG committee members;representatives of various user groupsaround the UK, includingRoehampton, Luton and Dunstable,Wrexham and Stanmore; and AlanRose, chairman of ColchesterHospital Trust.

The project cost £59,162 tocomplete. Colchester Hospital Trust,which runs Colchester GeneralHospital, secured almost two-thirdsof that amount – £38,462 – byapplying to a government fund setup to improve prosthetic services.

Samantha fitted with newcarbon fibre wheelchairSAMANTHA Kinghorn, one of theUK’s most successful wheelchairracers, has become the first personin the UK to be supplied with anew ‘every day’ carbon fibrewheelchair from mobility specialistsOttobock.

Provided by Bromakin Wheelchairs,the Voyager Evo wheelchair ismade to the highest quality,designed for active wheelchairusers and is nearly indestructible.

Perfect for her busy, active lifestyle,the Voyager Evo is made entirely tosuit Samantha’s size, weight andindividual style. Built in Germanyon a modular system, her VoyagerEvo has been designed to suit herlifestyle and is enabling her totravel with ease around the worldas she trains for the upcomingDoha World Championships laterthis year.

Samantha Kinghorn broke her backwhen she was 14 years old in atragic farming accident at herhome in the Scottish Borders.

Airlifted to hospital in Glasgow, sheunderwent six months ofrehabilitation before returning tothe farm with the knowledge thatshe would never walk again.

“As part of my rehabilitation I gotthe chance to attend the StokeMandeville Spinal Injury Games andcaught the bug,” she said. “Threeweeks after I got my first racing

chair I competed in the LondonMini-Marathon and came second –I didn’t realise you weren’tsupposed to stop and spent therace thanking everyone whostopped to wish me well.”

“I’ve always been active, and spentmy childhood outdoors on thefarm. I used to horse ride, andenjoyed gymnastics at school. Assoon as I tried wheelchair racing Iknew it was what I wanted to do. Inow compete in the T53 racingcategory”.

“Off the track, I have used anumber of different wheelchairs – Ihave a farm chair for the mud andpuddles and have now opted for anew carbon fibre active wheelchairfrom Ottobock. It’s lightweight,easily manoeuvrable and is reallycomfortable due to its customdesign.”

Samantha Kinghorn

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The WalkAide® SystemTHE WalkAide® system wasintroduced to the UK functionalelectrical stimulation (FES) market byTrulife in 2008, after many years ofdevelopment at the University ofAlberta, Canada.

WalkAide® provides movement andfunction to those with drop foot ofcentral neurological origin. It is asignificant technological advance inneuro-orthotics.

A device that can be used by adults andchildren

WalkAide® stimulates the commonperoneal nerve to send signals to themuscles that lift the foot. TheWalkAide® system is suitable forthose with drop foot due to centralneurological origin, including patientswith:

� Stroke

� Multiple Sclerosis

� Cerebral Palsy

� Acquired head injury

� Hereditary spastic paraparesis

� Incomplete spinal cord injury

Advanced Unique FES Technology

WalkAide® uses tilt sensortechnology to analyse the movementof the leg during walking and

stepping. The system is programmedby a clinician to stimulate muscles atthe correct time during the walkingcycle for each individual.

This provides a smoother, morenatural and safer stepping motion.

Advanced tilt sensor technologymakes the WalkAide® system a one-piece design without requiring anyother parts to be placed in footwearor pockets.

This results in simplicity of use andallows the patient complete freedomof footwear choice. They can evengo barefoot!

Easy to use

Although highly-advanced,WalkAide® is small and easy to use.Itis powered by one alkaline AAbattery.

The two electrodes are housed withinthe Bi-flex cuff with Velcro. The Bi-

flex cuff is designed to make donningof the system easy for the user, and itis also designed for one-handedapplication.

The WalkAide® unit is applieddirectly to the leg below the knee –not implanted underneath the skin –which means no surgery is involved.It can be worn discreetly under mostclothing.

Accessories

There are a range of standard,hypoallergenic and cloth electrodesthat can be used, depending on theindividual needs of the patient.

A WalkAide® clinician will be able toassess which is most suitable.

A silicone cover is also available toadd further protection to theWalkAide® unit.

Patterned material can be added tothe ribbon of the WalkAide® systemto customise the Bi-flex cuff.

WalkAide® clinicians

Trulife train and support cliniciansthroughout the UK and Ireland.

For more information please [email protected] or to speak to our

customer services team, call

0800 581 596.

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Family’s high-tech help for stroke patientsSTROKE patients at MorristonHospital in Swansea have been givensome high-tech help with theirrecovery thanks to the grateful familyof one patient.

After Keith Lewis suffered a stroke inDecember he was able to use hisown iPad during his therapy andrecuperation. It not only providedaccess to information and useful appsbut also helped him recover hisdexterity and coordination.

Now other patients who areexperiencing difficulties withcommunication will be able to enjoysimilar benefits after Keith’s familyhanded over a new iPad to thespeech and language therapy team.

The money for the device was raisedby Keith’s step-daughter HannahJones who took part in a sponsored10k run in Bristol in March. She alsomanaged to collect £600 for theStroke Association to spend on itswork with patients in Swansea.

Speech and language therapist NiaJenkins said: “We are so grateful forthe kind gift Keith and his familyhave donated to the speech andlanguage therapy team.

“It was a pleasure working with Keithand his wife Anne, they were somotivated and engaged in therapyeach week and worked tirelessly inbetween sessions working on histargets and goals. He has maderemarkable progress.”

Hannah, along with her mum Anneand Keith, returned to the hospital tohand over the iPad to speech andlanguage therapist Nia who hadworked with him during his recovery.

Hannah, who is a junior doctor inBristol, said: “I’m not a runner andalthough a short distance, I enjoyedthe challenge especially to supportsomething close to my family’s heart.Mum and Dad were both there

cheering me on, it was an emotionalfinish to say the least.”

Keith has made such a good recoverythat he has now been able to returnto work as a partner in a landscapegardening firm three days a week.

“He is so much better now, it is greatto see how much progress he hasmade and is now back at workwhere things like negotiation and

calculation are very necessary skills,”added Hannah. “We were so happywith the care that dad received wewanted to thank the team for alltheir hard work and positiveencouragement.”

Nia added: “The iPad is already upand running and we have utilised itfor both assessment and therapypurposes on the ward.”

Hannah Jones with her mum Anne Hodge-Lewis, speech therapist Nia Jenkins and step-dad Keith Lewis.

A LEADING scientist fromMassachusetts in the USA who haspioneered the stroke robottechnology recently visited staff andpatients at North Tyneside GeneralHospital.

Dr Hermano Igo Krebs, principalresearch scientist and lecturer atMassachusetts Institute ofTechnology, has led the developmentof stroke rehabilitation robots overmany years and is widely recognisedby peers around the world for hisleading edge research intorehabilitative robotics.

Just over a year ago, North TynesideGeneral Hospital became the first inEngland to house two of his‘rehabilitation robots’ which are nowbeing used as part of clinical trialsusing robot assisted training to helpNHS stroke patients regain movementin their affected arm.

Now, the hospital is leading clinicaltrials in the North East withNewcastle University, working withstroke patients from across Tyne andWear.

During his visit to North TynesideGeneral Hospital, Dr Krebs met public

governors of the trust, staff from thehospital’s dedicated stroke unit, aswell as patients who have been caredfor by the expert stroke team inNorth Tyneside.

He was also joined by Dr HelenRodgers, professor of stroke care atthe Institute of Neuroscience atNewcastle University and consultantstroke physician at NorthumbriaHealthcare NHS Foundation Trust,who is leading the UK research.

Commenting on his visit, Dr Krebssaid: “It is fantastic to visit the UKand the North East of England inparticular, where great things arehappening with stroke research usingrobotic rehabilitation.

“The technology we have developedat MIT is already helping many strokepatients and people with otherneurological conditions in the US ontheir road to recovery and we hopeto see similar results here in the UKover the next five years thanks to theNHS research now taking place.

Dr Krebs was in the North East aspart of a week-long visit to theregion being hosted by NewcastleUniversity and was a keynote speaker

at The Society for Research inRehabilitation’s annual conference –‘Rehabilitation in the 21st Century:Using Robots & Computers toPromote Recovery’.Helen added:“Since launching our UK clinical trialsjust over a year ago we haverecruited almost 200 patients to takepart in the robot research and arewell on track to meet our target ofworking with 700 patients over thecourse of the research programme.

“We have been working closely withcolleagues in Massachusetts overmany years and if the UK research isshown to be effective, it has thepotential to revolutionise how weprovide rehabilitation in the NHS forpeople who have suffered a stroke.”

A clinical trial of robot assistedtraining in the USA has shown thatthis approach to rehabilitation mayimprove upper limb recovery forsome stroke patients.

Now, the NHS is conducting a muchlarger study to see if robot assistedtraining using Dr Kreb’s technologyleads to improved clinical outcomesfor patients and more efficient use ofvaluable NHS resources.

US stroke robot pioneer visitspatients and staff at hospital CAMBRIDGESHIRE Community

Services NHS Trust has won firstplace in the CommunityTrustcategory of the prestigious BestPlaces to Work awards 2015.

The results were revealed at theICC in Birmingham, where thehealthcare industry elite cametogether for an afternoon ofrecognition and celebration.

The Top 100 list of NHS providersincludes 42 acute trusts, 31mental health trusts, 16 specialisttrusts, 11 community trusts, plus20 clinical commissioning groups.

The winner and runner-up in eachof the five categories werecommended as the top 10organisations across the countryfor their outstandingperformance.

Matthew Winn, chief executive,said: “I am incredibly proud thatthe Trust has been recognised asthe best Community Trust in thecountry to work for.

“Research demonstrates a provenlink between engaged staff andpositive patient outcomes and thisaward recognises the passion andcommitment of every member ofstaff within the Trust.”

NHS Trust winstop accolade

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sponsors podiatry

By Nikki Joule

FOOT ulcers and amputations have acatastrophic impact on quality of lifefor people with diabetes and lead toearly mortality.

Latest figures show that each week inEngland there are around 135diabetes related amputations. Thefigures continue to rise – but this isnot inevitable.

The recently published NHS Atlas ofVariation in Healthcare finds that the3.9-fold variation in amputation ratesmay be due to differences in theorganisation of care for people withdiabetes.

An estimated 80 per cent ofamputations are potentiallypreventable, through improvedawareness among people withdiabetes about their risk status andthe actions to take, as well as accessto good quality care.

When people with a foot attack(active foot disease) get rapid accessto treatment by a specialist multi-disciplinary footcare team, there hasbeen faster healing and feweramputations, saving money and lives.

Integrated foot care services

The risk of amputation can bereduced through provision of an

integrated foot care pathway thatensures access to the right care at theright time.

Everyone with diabetes should havean annual foot check and be referredto trained staff in community footprotection services if they are atincreased risk.

However, the most recent NationalDiabetes Audit (2012/2013) showedthat 28 per cent of people with Type1 diabetes and 13 per cent of peoplewith Type 2 diabetes are still notreceiving their annual foot check.

Access to foot checks and the qualityof the check varies widely across thecountry.

In a recent foot care surveyconducted by Diabetes UK nearly halfof respondents said they had notbeen advised (32 per cent) or did notremember (nine per cent) if they hadbeen made aware of their risk of footproblems. This is unacceptable.

Ensuring that patients get a qualityannual foot review and have a goodunderstanding of how to look aftertheir feet is essential.

Our free leaflets, ‘10 steps to healthyfeet’, ‘What to expect at your annualfoot check’ and ‘How to spot a footattack’ offer clear and useful advice

to patients.

Healthcare professionals can orderthem from our online shop to helpthem empower people with diabetesto understand more about how tolook after their feet, to understandmore about the care they should bereceiving and what to look out forand who they should contact if theynotice any changes with their feet.

The integrated pathway should alsoensure quick access tomultidisciplinary specialist teams forthose who need it.

However although the percentage of

hospitals with multidisciplinary footcare teams has been increasing –from 61 per cent in 2010 to 72 percent in 2013, more than a quarter ofhospitals still have no MDT at all.

What needs to happen?

Clinical Commissioning Groups needto ensure an integrated foot carepathway is being delivered acrossprimary, community, and specialistcare services as set out in recent NICEguidance.

This includes having a MDT and afoot protection service in every area.In addition, people with diabeteswho go into hospital, for whateverreason, should have their feetchecked on admission and regularlythroughout their stay. If they are atincreased risk their feet should beprotected when in hospital.

All healthcare professionals should beaware of the local diabetes foot carepathway and how to referappropriately to ensure that peoplewith diabetes access the right care atthe right time and avoid thedevastating impact of foot ulcers andamputations.

� Nikki Joule is policy manager atDiabetes UK.

Putting an integrated serviceat the heart of foot care ...

Nikki Joule

A PODIATRIST at SouthWarwickshire NHS FoundationTrust has taken inspiration fromher family and patients to ‘bravethe shave’, a national campaignwhich involves shaving all of herhair off.

Sue Pike has worked at the Trustfor 16 years, and faced the

shavers to raise money forMacmillan.

She said: “My inspiration fortaking part in brave the shave is,first and foremost, my auntiewho lost her long battle withcancer in 2013.

“She always faced her hair loss

with such strength and dignity,and always looked fantasticdespite the drawn out cancertreatments that she endured.”

So far, Sue has raised around£200 for Macmillan. You cansupport Sue by sponsoring her athttps://bravetheshave.org.uk/shavers/sue-pike/

Sue braves the shave in aid of national cancer campaign

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TheraBand® CLX™ –Consecutive Loops� All-in-one product deliversversatility and value.

� Does the work of four products -band, loops, tubing, handles, anddoor anchor.

� Integrated App engages users(patients and practitioners).

TheraBand is breaking new groundwith its latex free, patented CLX –Consecutive Loops. Never before hasresistance training been so versatile,so simple and so inspiring (effective).

The TheraBand CLX with Easy GripLoops™ provides multiple uniquegrip options that enable exercises likeopen and closed hand grips, holdingobjects with resistance, no-grip-required exercises and never beforepossible exercises such assimultaneous upper and lower bodywork.

The TheraBand CLX deliversunparalleled versatility and ease ofuse that may increase exercisecompliance to improve patientoutcomes.

A FREE integrated CLX App providesa CLX exclusive exercise library withunique support tools to enhance anyrehab or training programme.

Enquiries: For more information or to ordercall Patterson Medical today on 08448 730

035 or visit www.pattersonmedical.co.uk

TalarMade are pleased to announcethe launch of their new AmbulatoryPressure Relief Boot.

The APRB is a welcome addition toTalarMade’s pressure care portfolioand can be used for the preventionand treatment of heel ulcers.

It is designed to allow patients totransfer and ambulate short distanceswhilst offloading the posterior heeland can also be used to offload theheel and prevent contractures at theankle whilst the patient is in bed.

This highly cost-effective product hasthe following key features:

� Easily removable sole plate toprevent contamination of bed sheetsfollowing ambulation without theneed for tools.

� Soft, breathable, washable liner.

� Adjustable length toe support.

� Anti-rotation bar.

� Available in two sizes.

For more information and pricing call01246 268456, email [email protected]

or visit www.talarmade.com

APRB added to portfolio

BEAGLE Orthopaedic houses a largespinal database of spinal models tosuit a variety of patients.

From this extensive library we canmanufacture your CTLSO usingmeasures provided from a simplemeasurement chart, we then adaptthe relevant model to meet thespecification.

Each orthosis is fabricated to thepatient’s unique model and yourspecifications, ensuring the optimumfit, support and comfort.

CTLSO’s are available as; bi-valvedesign finished to completion (nointermediate fitting) with a variety ofliners such as cool foam, north foam33, evazote and lambs wool.

We can also provide a customisedcombination of products for highthoracic fractures / instabilities. Thechosen TLSO is then coupled withcomponents from the Aspen CTO, toprovide the stability required for yourpatient in the upper thoracic andcervical region.

This design offers a step-downreduction for on-going rehabilitationtherapy. Available in paediatric andadult sizes.

Models to suit a variety of patients

BOLTON Bros are delighted to workwith Klaveness shoes to offer a widerange of styles for men and women.

Klaveness Skofabrikk areScandinavia's best known shoecompany with a wide range offashionable, comfortable shoes.

In collaboration with Bolton Bros,prescription shoes are available formany individuals with a requirementfor footwear modifications due to a

medical condition.

Have a look at this short slideshow tosee some of the styles we currentlyhave on offer with Klaveness shoes.

You can also download the newcatalogue to see the huge range ofoptions available.

Enquiries: Contact us for moreinformation on 0191 2732012

or email [email protected]

Bolton Bros work with Klavenessto offer wide range of styles

THE Talarmade Elite Foot Orthoticincorporates superior biomechanicaldesign to maximise foot function.

‘Designed by clinicians for clinicians’,utilising the latest biomechanicaltheories, Elite allows improved clinicaloutcomes when treating pronatedfeet.

Its full length design is focused onimproving first ray function whileproviding enhanced biomechanicalcontrol to the hind and mid foot.

Features and benefits:

� EVA construction.

� Three densities – soft, medium andfirm.

� Intrinsic four-degree medial heelpost.

� Mild metatarsal support.

� Robust heel cup.

� Antimicrobial top cover.

� Replaceable heel and first methead cushioning.

� Plantar surface can be easilycustomised using TM ‘Microgrip’surface additions.

� Multiple extrinsic wedge optionsfor further customisation.

Enquiries: For more information andpricing call 01246 268456, email

[email protected] or visitwww.talarmade.com

Elite orthotic designed tomaximise foot function

The BAPO Education Committeework hard to create the short courseprogramme each year.

The Committee are keen to considerthe needs and views of theprofession as whole and would liketo encourage individuals to contactthe BAPO Secretariat with topicsuggestions for short courses, specificlocations you would like a shortcourse to be run, or perhaps tovolunteer to present a course.

We hope that together we can

address the educational needs of theprofession.

This year we launched a series ofMSK (Assessment Diagnosis andTreatment of Musculoskeletal Footand Ankle Problems for Orthotists)courses in Scotland which have beena great success.

Send your ideas/suggestions ofcourses to [email protected] andlook out for more information on theupcoming 2016 programme atwww.bapo.com

Short course suggestions wanted

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assistive technologies october/november 2015

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