Download - Assistive Technologies February/March 2015

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By Olivia TaylorA COLORADO man recently became thefirst bilateral shoulder-level amputee towear and simultaneously control two ofJohns Hopkins University Applied PhysicsLaboratories’ modular prosthetic limbs.

Les Baugh, who lost both arms in anelectrical accident 40 years ago, was ableto operate the system by simply thinkingabout moving his limbs, performing avariety of tasks during a short trainingperiod. Before putting the limb systemthrough the paces, Les had to undergo asurgery at Johns Hopkins Hospital known astargeted muscle reinnervation.

Johns Hopkins Trauma Surgeon Albert Chi,M.D explained: “It’s a relatively newsurgical procedure that reassigns nervesthat once controlled the arm and the hand.

“By reassigning existing nerves, we canmake it possible for people who have hadupper-arm amputations to control theirprosthetic devices by merely thinking aboutthe action they want to perform.”

After recovery, Les visited the Laboratory fortraining on the use of the ModularProsthetic Limbs.

First, he worked with researchers on thepattern recognition system, and by the time

the socket was finished, Les said he wasmore than ready to get started.

When he was fitted with the socket, andthe prosthetic limbs were attached, he said:“I just went into a whole different world.”

He moved several objects, including anempty cup from a counter-shelf height to ahigher shelf, a task that required him tocoordinate the control of eight separatemotions to complete.

APL’s Courtney Moran, a prosthetistworking with Les, added: “This tasksimulated activities that may commonly befaced in a day-to-day environment athome.

“This was significant because this is notpossible with currently available prostheses.He was able to do this with only 10 days oftraining, which demonstrates the intuitivenature of the control.”

The next step is to send Les home with apair of limb systems so that he can see howthey integrate with his everyday life, andhe’s looking forward to that day. “Maybefor once I’ll be able to put change in thepop machine and get pop out of it,” hesaid. He’s looking forward to doing “simplethings that most people don’t think of. Andit’s re-available to me.”

Amputee makeshistory with twoprosthetic limbs

British disabled skier Heather Mills is attempting to break the GuineessWorld Record for speed skating – wearing a prosthetic leg that hasbeen a year in development. Heather – who lost her leg in a collisionwith a motorbike in 1993 – only started her professional sportingcareer in 2011 when she was approached by the head of the SlovenianMasters while on a skiing holiday in Austria. She has a host of medalsunder her belt and now has a permanent position with the Britishdisability skiing team – but she’s now in training to become the fastestdisabled female speed skier in the world.

Full story, Page 8

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www.assistivetechnologies.co.uk

Microprocessor-controlled legputs Jim’s life back on trackBy Nicola Hyde

A MAN who lost his leg after it wascrushed in a forklift has spokenabout the challenges of getting theright prosthetic that worked for him.

Jim Bruce, from Glasgow, was a keengym-goer, football supporter andgardener, but a freak acccident in1995 saw him injure his knee andshin so badly that he had to beamputated above the knee – despitethe fact that his foot was uninjured.

He said: “When they told me theywere going to amputate my leg, itfelt strange but didn’t really hit meuntil afterwards. It was only after theamputation that it dawned upon methat this would change my lifeforever. I was in hospital for threemonths which gave me time toreflect and then it was another sevenweeks until I got my first NHS leg.

“The amputation had a huge impacton my day-to-day life. It left meunable to do the small things I didn’teven realise that I would miss, likeusing a step ladder and doing DIY.”

Jim’s first NHS leg used a hydraulicsystem which he found very tiringand often stumbled and fell. Later on

in life, Jim found out about the C-Leg microprocessor knee fromOttobock from his active involvementin the amputee patient communityand was given the opportunity to tryit at the University of Strathclyde in

Glasgow.

He said: “I was lucky to be able totry it out and I was immediatelyimpressed and knew it wouldimprove my lifestyle significantly andlet me get back to some of theactivities I enjoyed prior to myamputation.

“I can be active again; I’m back atthe gym and have a bluetoothremote control that lets me changethe settings to use the treadmill orthe rowing machine. I’m also havinggait training which is helping mebuild up speed and pace andimprove my walking pattern.”

Jim now volunteers on theprosthetics course at the Universityof Strathclyde. He regularlyparticipates to help aspiringprosthetists learn.

Jim added: “I really hope that in thefuture the NHS will be able toprovide microprocessor knees. It hashelped me to continue the activelifestyle I led before my injury, and Ibelieve that if a patient had a C-Legas their first leg it would help greatlywith healing and lead to fasterrecovery times.”

Jim Bruce with his C-Leg microprocessorknee from Ottobock

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Is your orthotics service meetingyour customers’ requirements?By Simon Dickinson,clinical director, TalarMade

I HAVE always found it interesting toask any clinician working in the NHSwho their customers are?

The immediate answers are alwayspatients, but are patients really thecustomers of the NHS?

The Oxford English dictionary’sdefinition of a customer is “a personwho buys goods or services from ashop or business”.

The obvious question therefore is, dopatients buy goods and services fromthe NHS? Although the NHS isfunded by taxation, the transfer ofcash to the providers of NHS servicesis not paid directly by patients(although a contribution may bemade by prescription charge in somecircumstances). So if patients arepotentially consumers of NHS serviceswho are the customers?

Ultimately any customer has the rightto decide whether to buy yourservices or not. Therefore thecustomers of NHS orthotic servicesmust ultimately be commissionersand finance/procurementmanagers/directors in the NHS.

These people essentially hire servicesand people (NHS or contracted) to

deliver the care required for theirconsumers (i.e. patients).

Over the last year I have been askedto do some work for theParliamentary and Health ServiceOmbudsman. This organisation is thefinal step in the NHS complaintssystem and is independent of theNHS. One of the questions posed tome by the Ombudsman was specificto timescales relating to orthoticservice delivery.

As a result I investigated nationalguidelines relating to orthoticprovision timescales. I was morethan surprised by the result.

The only timescale target that existsnationally that is applicable toorthotic services relates to the 18-week RTT (Referral to Treatment)target that 95 per cent of all patientsin England should receive their firstdefinitive treatment within 18 weeksof being referred by their GP.

This treatment could be delivered byany professional on the patient’sjourney through NHS consultant ledservices.

“Stopping the clock” for orthoticservices is achieved at the first fittingof the orthosis or by a decision “notto treat”.

In my previous role I was more thanaware of this target but I wasincredibly saddened to discover thatthere is no national servicespecification for orthotic services inEngland.

Further investigation led me to

discover that local orthotic servicespecification documents existed.Dialogue with the BAPO chairmanconfirmed this was the case andBAPO are trying to influence this.

Therefore orthotic services are in therather bizarre position that itscustomers, i.e. commissioners, haveno national framework forcommissioning orthotic services todeliver and monitor consistency intimely access and treatment.

Could this possibly mean thereforethat commissioners are uncertain ofexactly what they are commissioningregarding orthotic services? What iscertain is there are currently noquality standards for orthotic servicesnationally except the 18-week RTTtarget.

Fortunately patient groups like theOrthotics Campaign are nowengaging with the NHS andcommissioners to inform them ofwhat patients want.

Neil Churchill, director of patientexperience for the NHS, has graspedthe nettle and his listening event inSalford on March 2 will hopefullybecome the start of a brighter andmore consistent future for orthoticsservices, its customers and itsconsumers.

Simon Dickinson

A SPORTS medicine consultant hasbeen chosen to be the official doctorfor the England Rugby Union Team.

Nigel Jones, who works at SpireLiverpool Hospital, will be workingwith the English senior team, asofficial sports medicine consultantand doctor as they take part in thisyear’s Autumn Internationals andnext year’s Six Nations and WorldCup.

Nigel said: “It's an immense honour.I have acted as official doctor for the

under 19s and under 21s before butthis is a different level of workloadand intensity. I intend to enjoy everymoment.”

Nigel's role will involve handling allmedical issues for the team but inparticular issues related to sportsinjury, diagnosing problems, anddeveloping rehabilitation plans andtreatments.

He has extensive experience in thisarea from his work at Spire HospitalLiverpool and also from previous

posts with Liverpool Football Cluband British Gymnastics.

Dr Jones will balance hiscommitments with England Rugbywith his patient work at SpireHospital Liverpool.

Alison Peake, Hospital Director atSpire Liverpool Hospital said: "It'sgreat news for Nigel and reallyshows Spire's leadership in sportsmedicine with our consultants beingappointed to some of the topmedical roles in UK sport."

Nigel chosen to be doctor for England rugby union team

Nigel Jones

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AN 18-year-old from Plymouth who lost his leg in asailing accident has had his ability to get back onthe water restored with the help of the world’smost advanced bionic leg developed by mobilityexperts Ottobock.

The Genium X3, originally designed for militarypersonnel, is the only completely waterproofmicroprocessor prosthetic knee and has aBluetooth remote control to switch betweensailing, walking, jogging and cycling modes.

Laurence Greenough was just 10 years old whenhe lost his leg in a tragic accident in the sea.Sailing in Plymouth harbour, a routine capsize drilland subsequent incident with a safety boat wentterribly wrong.

The injuries Laurence sustained resulted in anabove the knee amputation of his left leg. Onlytwo months after the accident, Laurence was backon the water, choosing to use crutches to getaround as there were no suitable waterproofprosthetic legs on the market; using a normalprosthesis in the sea would cause it to corrode.

Carrying on with his sailing dream, he washonoured with the prestigious Raymarine YoungSailor of the Year award in 2007, following in thefootsteps of past winners including Olympic Goldmedallist Ben Ainslie OBE and world classyachtswoman Dame Ellen MacArthur.

As time went on, Laurence stopped sailing as thedifficulties of sailing and doing other activitieswithout a prosthetic leg became apparent.

After three years on crutches he was referred toand fitted by Richard Nieveen of ProActiveProsthetics with a computer controlled prosthetic‘C-Leg’ which provided him with improved mobility

but could not be worn on deck due to the risk ofwater damage.

When Ottobock’s Genium X3 was releasedLaurence was keen to find out more about thebionic leg which was designed for people who leadan adventurous lifestyle. He was recently fitted atthe ProActive Prosthetics clinic in Surrey.

Lawrence said: “The first thing I planned to do wasto take it sailing! It also has a ‘walk to run’ featureand bespoke running mode; I had not run since2006 and it was the most exciting thing to be ableto do it again.

“It makes walking feel so natural – I trust it anddon’t have to use so much energy. I feel safe andcan just relax and let the leg do all the work.”

The Genium X3 is the world’s most technologicallyadvanced prosthetic leg and features activitymodes that will allow Laurence to take part ineverything his friends do: sailing, grass boarding,running and football in the park.

The bionic technology can be programmed from alaptop and can be switched manually betweendifferent modes using bluetooth.

Sensors, a gyroscope and in-built computer meanthe Genium X3 can be programmed to perfectlymatch Laurence’s lifestyle.

Richard Nieveen, Laurence’s prosthetist at ProActiveProsthetics, added: “The set up and fitting ofLaurence’s new leg is tailored to get him backdoing all of the things he enjoyed before hisaccident. We’ve also programmed a special sailingmode in the knee to allow him to move aroundthe boat with ease – and of course he’ll be safe inthe knowledge that he can get it wet without anyproblem”

Bionic leg gets Laurence back on the water

Laurence Greenough with his Genium X3 leg.

PHYSIOS say they could ease pressureon accident an emergencydepartments if more was done tohelp patients with musculoskeletalconditions.

The Chartered Society ofPhysiotherapists said that up to afifth of A&E patients have conditions,which can be treated by physios.

Chief Executive Karen Middletonsaid: “Today’s new statistics highlightthe urgent need to look harder athow NHS A&E departments arestaffed and to properly utilise theskills of health professionals trainedin reducing the number of patientsgoing to casualty in the first place.

“Proper consideration must be givento straightforward solutions thatcould make a real difference towaiting times and the quality ofservice patients receive, includingmaking physiotherapists available inevery A&E department.

“Physiotherapists are experts indiagnosing and treating MSKproblems and other long-termconditions. They are also highlyskilled in managing patients who

have fallen and can support them toself-manage and return home safely,often without needing to beadmitted to hospital.

“Too few A&E departments routinelymake physios available on the frontline. Those which do are seeingimprovements in waiting times andhelping vulnerable older people tofeel more secure about their healthwhen they leave.

“An established workforce ofphysiotherapists is already availableto the health service and must begiven greater opportunity to assistthe work done by medics to helpease the pressure on the system as awhole.”

Using physios couldreduce A&E waitingtimes, says Society

Karen MiddletonA TECH-savvy care and housingprovider enjoyed a bionic boost atthe launch of its new headquarters.

Staff at Blackwood took part in aribbon cutting ceremony with adifference, thanks to experts fromTouch Bionics.

Representatives from the hi-techScottish prosthetic limb pioneersjoined Margaret Burgess, Minister forHousing and Welfare, to officiallyopen the new Blackwood HQ inEdinburgh.

Colleen Robertson, Communicationsand Marketing Manager forBlackwood, said: “Having bothMargaret Burgess and the team fromTouch Bionics at our official launchwas a fitting testament that we arestill innovating and challenging the

status quo every bit as creatively asour founder, Dr Margaret Blackwood,did in the 1960s and 70s.”

Dr Blackwood was a renowneddisability rights campaigner andfounded the organisation which stillbears her name in 1972.

Touch Bionics demonstrated some oftheir latest designs and innovations,showing how prosthetic technologycan enhance the lives of those withimpairments.

Sally Bowie, International MarketingManager at Touch Bionics, said: “Wewere thrilled to help Blackwoodcelebrate the launch of their newheadquarters as we are very like-minded companies who believe inthe advantages of technology for thissector.”

Firm gives tech-savvy providera bionic boost at HQ opening

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Heather has been working with Abdo Haidar of The London Prosthetic Centre on her prosthetic leg for the past year.

Heather hopes to break GuinnessWorld Record for speed skating By Nicola Hyde

BRITISH disabled skier Heather Mills isattempting to break the GuinnessWorld Record for speed skating –wearing a prosthetic leg that hasbeen a year in development.

Heather – who lost her leg in acollision with a motorbike in 1993 –only started her professional sportingcareer in 2011 when she wasapproached by the head of theSlovenian Masters whilst on a skiingholiday in Austria.

She has a host of medals under herbelt and now has a permanentposition with the British disabilityskiing team – but she’s now intraining to become the fastestdisabled female speed skier in theworld.

She will need to reach speeds of

more than 200km/h – a feat that willinvolve a vertical of drop of between300 and 340 metres.

Heather said: “Skiing is a high-octanesport and I knew the risks when I firstset about training. For me though,the most frustrating thing was thatmy initial prosthesis only offered verylimited movement which was neithernatural nor comfortable and tendedto hinder my performancesomewhat.”

She is using a specialist prostheticskiing leg designed and built by AbdoHaidar of The London ProstheticCentre. A painstaking, year-longproject which involved over 15appointments, the prosthesis hasbeen designed to withstand theharshest of racing conditions.

Abdo said: “I have been a prosthetist

for many years and made limbs forcycling, horse riding and Paralympicrunning challenges, but nothingcompares to skiing – it is withoutdoubt the most difficult sport for anamputee.

“A below the knee amputation, suchas Heather’s, causes reduced kneecontrol due to the loss of the anklejoint, so the limb must compensatefor this. In this instance, the key liesin the design and fit of the socket –it’s responsible for reducingmovement, which consequentlyenhances control and precision.”

Heather is also confirmed to appearin the next series of Channel 4’sreality TV show, The Jump, where shewill train alongside 15 othercelebrities to master various wintersports.

Key diary dates for 2015March 19: Kidz in the Middle, Coventry.March 20-22: BAPO, Manchester.April 28-30: Naidex National, Birmingham NEC.May 29-30: IOCP, Southport.June 4: Kidz South, Reading.June 9-10: Foothealth, Kettering.June 22-25: IPSO World Congress, Lyon, France.June 25: Mobility Roadshow, Donington Park,Derbyshire.July 12-16: ISB, SECC, Glasgow.September 17: Kidz Scotland, Edinburgh.November 20:Kidz Up North, EventCity, Manchester.

OTs and wardplay key roleOCCUPATIONAL therapists and theuse of activity as a treatment modehas played a key role in the openingof a temporary ward designed tospeed up patients’ recovery and freeup beds at the Royal Free Hospital.

The reablement ward will give up to25 patients at any one time thechance to socialise and start lookingafter themselves in preparation fordischarge to their home or acommunity-based rehabilitationcentre.

Since the ward opened in November,OTs have been working alongsidenurses and other members of themultidisciplinary team to encouragepatients to do more for themselves.

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Dave Buchanan, Ottobock Orthotics Academy Clinician, explains the science behind stance control andhow the imminent launch of a new intelligent leg brace is about to change the future of orthotics.

C-Brace: The future of orthotic technologyORTHOTIC bracing is changing. Asnew technology, extensive researchand new light-weight materialsemerge we can expand the way wepractice.

For people with problems rangingfrom isolated quadricep weakness, topolio, post-polio, multiple sclerosis,unilateral paralysis, incomplete spinalcord injury and some traumas,walking can be a challenge.Technology is helping us overcomethis challenge and a new wave oforthotic bracing is pushing theboundaries of orthotic care.

In recent years, Stance ControlOrthoses, and now Stance and SwingControl (SSCO®) have changed theway we approach bracing – fromstatic, always-locked or always-unlocked approach to new dynamicsystems that unlock only whenneeded.

Compared to walking with a lockedleg brace, a stance-control orthosis isa brace that helps create a morenatural stride. Stance control meansthat instead of stability coming froma locked knee joint, the brace is ableto lock and unlock at just the righttime while walking.

So what does this new technologymean for the user? You may haveseen or experienced a hip hike orother unnatural motions that comefrom walking with a locked kneebrace. A Stance control brace helpsavoid the physical strain and damagethese abnormal movements cancause over time. Stance controlbraces closely mimic natural gait (orwalking), and help the wearer coverthe variable terrain they face everyday, from carpet and grass touneven, rocky ground. This all meansmore energy can be spent movingforward with a great deal less wearand tear on the body.

New Technology

This year, the world’s first intelligent,electronic orthosis is being launched,allowing people who were previouslywheelchair-bound, to walk again. TheC-Brace, the world’s first Stance andSwing Phase Control Orthosis (SSCO),is a custom orthosis controlled by acomputer and sensors.

The C-Brace® mobility system ismade by manufacturer Ottobock andis the culmination of their advancedprosthetic technology and orthoticexpertise. The C-Brace mobilitysystem can be considered for allneurological indications of the lower

limbs and contains a computer andsensors so that it moves and adaptsintuitively to any circumstances.People living with partial paralysis,spinal injury, post-stroke and post-polio syndrome will be able to walkwithout having to concentrate onevery step.

Unlike conventional orthoses, the C-Brace (SSCO) reacts intelligently to itsenvironment. The uniquecombination of sensor technologyand an integrated microprocessormake it possible to control hydraulicstance and swing phase in real time.This means the patient is supportedin every position throughout theirgait pattern. The microprocessor inthe brace allows it to be completelycustomised for the individual andadditional settings can be tailored toactivities such as bike riding.

Custom built, light-weight, strongand stable, the future of orthotics ismost certainly in stance controlorthotic braces and it will be excitingto see how the technology continuesto evolve to benefit those withlimited mobility.

For more information on Ottobock’s rangevisit www.ottobock.co.uk

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A UK company is launching a newproduct that has been developed inpartnership with SouthamptonUniversity.

DM Orthotics have worked with RodLane, from the university, for theDMO E-step – a pioneering newproduct which combines DynamicMovement Orthoses (DMO) andFunctional Electrical Stimulation (FES)technology to aid the managementof adult and child Dropfoot.

The DMO E-step is a hybrid neuro-stimulation unit, which improvesusers walking gait, whilst providinggreater ankle stability.

Managing director Martin Matthewssaid: “I have wanted to incorporateFES technology into our products forquite some time – but it was the case

of being able to develop aninnovative solution that wouldaddress the specific problemsexperienced by other products on themarket.

“Research suggested that althoughmany stimulators were able toprovide an improvement to the gaitof people with Dropfoot, theyrequired to set the foot in an un-natural position in order to improvestability in their foot.

“Our orthosis allows a muchimproved walking pattern whichreduces the un-natural loading onthe knee.”

The DMO E-step combines DMOrthotics’ highly successful DMODorsiflex Sock, which provides activedorsiflexion to people with low

muscle tone, with a neuromuscularstimulator.

The stimulator offers a number ofbenefits including a wirelessfootswitch and motion sensor

utilising Bluetooth technology, whichmonitors the movement of the user’sleg swing, to determine when itshould activate itself in order toproduce a more natural walkingpattern.

DM Orthotics have also developed aspecialist conductive silicone polymerelectrode through which the electricalcurrent can pass to the user’s skin.

The DMO E-step has undergone itsown clinical and field testing showingpositive results.

One patient involved in the clinicaltrials, Sam Jones has already seen thebenefits of the E-step.

The DMO E-step will showcase at thisyear’s BAPO Conference held at ThePoint, Lancashire Cricket Ground onMarch 20 to 22.

Company works with university on new product

Sam Jones has already seen the benefitsof the E-step.

Sam Jones puts the DMO E-Step hybrid neuro-stimulation unit through it paces during a game of squash as part of the clinical trials.

Algeos to partner withPodiatry Hive in the UKA LEADING medical productsdistributor is to partner with abusiness mentoring service to helppodiatrists in the UK grow theirpractices.

Algeos will be working with PodiatryHive to market its services topodiatrists across the UK.

Podiatry Hive is already provingpopular with podiatrists in Australiawhere the organisation isheadquartered and where Algeos hasan office.

The first major Podiatry Hive event inthe UK will be held at the ibisLondon Earls Court hotel in Londonon March 6-7.

The Business Reset event will showpodiatrists how they can:

� Become more profitable withoutsacrificing work-life balance.

� Automate their marketing.

� Learn about leadership anddelegation.

� Move from being a podiatrist to apodiatry business owner.

Podiatry Hive is led by leadingAustralian podiatrist Troy Parsons andexperienced business mentorsJonathon Heath and Greg Gunther.

Through its workshops andconferences, Podiatry Hive alsoprovides members with access tonumerous other business leaders.

Hugh Sheridan, CEO of ALGInternational Holdings, whichincludes Algeos, said: “ALG is proudof its reputation for not onlyproviding medical professionals withindustry-leading products, but also asan innovator and provider ofeducation to improve the lives ofmillions of patients.

“Our partnership with Podiatry Hivefits neatly with our desire to educateby providing podiatrists in the UKwith business support to help themdevelop their practices, enhance theservices they offer and become moreprofitable.”

Fast growing ALG now distributes itsproducts to more than 70 countriesthrough its offices in the UK,Australia, United States and UnitedArab Emirates.

Among the leading podiatry brands itdistributes are Diaped, Podotech,Nova and Slimflex.

To book your place on the PodiatryHive “Reset Your Business” event goto www.podiatryhive.com/expo

A company that provides rehabiliitation services to amputees has opened the doors to itsthird UK clinic. Pace Rehabilitation has a new clinical facility in West Moor (NewcastleUpon Tyne) and resident physiotherapist Tracy Millar was joined by herprosthetist/orthotist colleagues Toby Carlsson and Paul Richardson for the officialopening. One patient who is already benefitting from the new facility is local inspirationalabove the knee amputee Glenn Johnstone, 46, from nearby Stanley. Using his bespokecycling prosthesis, Glenn (pictured above) demonstrated his riding prowess and sharedhis personal patient experiences since becoming an amputee, including recently takingpart in his first ever triathlon.

STATISTICS on work-related injuryand illness show the need for a'renewed focus' on employee health,according to the Chartered Society ofPhysiotherapy.

Natalie Beswetherick, director ofpractice and development at the CSP,said: “The increase in the number ofpeople with a work-relatedmusculoskeletal disorder bucks thelong-term trend and demands arenewed focus on employee health.

“Supporting staff health andwellbeing to cut sickness absence isgood for individuals, employers andthe economy.

“We need employers to recognisethis and take immediate action to getsedentary staff more active andprovide fast access to rehabilitationservices for those who need it.

“We must do more to stop so manypeople from suffering what is oftenentirely avoidable ill-health.”

‘Renewed focus’ on health needed

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DeNovo Healthcare is a dynamic andprogressive patient centred companyfocused on providing some of themost innovative products fromaround the world to the UKhealthcare market.

As distributors for some of the bestknown and reputable suppliers in theworld we have a lot to offer.

New for 2015

Our new and highly competitivelypriced range of DeNovo DailyOrthotic inlays offer unique solutionsfor your inlay requirements. Initialreaction to these has been excellent.

The slimline profile and wide range ofoptions make these a good choicewhere space is an issue in footwear.

A handheld 3D scanning system forunder £1,000 was a dream up untilthe introduction of our new scanningsolution.

Using our easy digital system, whichis designed to offer a fast and reliableway of collecting data for themanufacture of all types of orthoticdevices and footwear, give thepractitioners the ability to captureaccurate and detailed images which

can be used to collect accuratemeasurements, create foam modelsand store digital data which can beused to monitor clinical changeseasily.

Arriving soon is a new solution formanaging ankles and feet. This newdevelopment will bring an excitingoption to the clinic and more will berevealed soon so keep an eye on ourwebsite!

Our successful Nimco Made4Youfootwear with children and adultranges has now been enhanced withmany exciting additions including

children’s shoes with a new lightweight flexible sole option from size16 and new stylish adult footwearoptions.

We are also introducing additionallasts which make this collection themost comprehensive to date.

The Centri Dynamic Walk orthoses ismanufactured with ultra-light weightthermo formable carbon fibre to givethe clinician the option to makeadjustments for better fit and relief ofpressure that has not been an optionwith other carbon fibre materials.

These orthoses are also available inmix and match, custom versions andmade to cast.

Atlantic Rim Spinal Brace Corp.manufacture bespoke high qualityspinal orthoses produced anddelivered into clinic within a weekfrom measurements, cast or scanoffering an unbeatable option formeeting your clinic deadlines.

Basko Healthcare’s SPL 2 articulatingKAFO is a light weight reliableorthoses aimed at users who havequadriceps insufficiency and need toretain articulation while walking.

This unique system can be used invarious design configurationsdepending on the users’ needs, singleor double sided with or withoutankle joints making this the mostversatile option in the market.

A wide range of prosthetic andorthotic products manufactured andsupplied by the Fillauer groupincluding the RGO and TRS terminaldevices. thousands of products tochoose from to meet any prostheticand orthotic need.

A full list of products available can beviewed at www.denovohealthcare.com


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DeNovo provides many innovativeproducts from around the world

Amputee’s Marathonworld record goalAN ISRAELI runner has used a UKcompany to create him a runningblade to help him smash the legamputee Marathon world record.

Below-the-knee amputee distancerunner Eitan Hermon was firstreferred to Pace Rehabilitation in2013 by the Tikbot charity whofunded his first dedicated runningprosthesis.

He has already achieved a personalbest time of just over three hours, forthe gruelling 26-mile race but – afterhearing of a new world record of2:57:06 set by fellow amputee KimDe Roy – Eitan decided to try to claimthe world record for himself.

Accompanied by Tikvot chairman andfounder Rocky Muravitz, within hoursof landing in the UK Eitan was castfor a new prosthesis by prosthetistJamie Gillespie.

Jamie said: “Eitan has alreadyachieved a very impressive Marathontime, but like any athlete, he wantsto improve upon his personal best.”

A series of diagnostic sockets wereproduced, incorporating an OssurCheetah blade, to fine tune the fitand comfort, with Eitan embarkingon test runs around the

Buckinghamshire countryside.

Having optimised the socket, thePace technicians produced thedefinitive prosthesis, enabling Eitanto take it back to Israel to train onjust ten days after his arrival.

Eitan plans to return to Europe thisyear to compete in the Berlin andLondon Marathons, where he hopesto achieve the fastest ever time by abelow-the-knee amputee.

Eitan Hermon

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TVS Brace – the ‘kneesupport you can rely on’The TVS Knee Brace is designed tohold a medially or laterally unstableknee from moving into a painfulposition of deformity while the kneeis in extension and weight bearing.

While the patient is wearing the TVSBrace the knee will be re-aligned toits original gait and long term usewill stop the knee from sagging to amore extreme position preventing theneed for a surgical solution.

The TVS has helping relieve arthriticknee pain to over 25,000 patients inthe UK alone for over 40 years.

� Varus (bow-legged) and Valgus(knock-kneed) deformation support.

� Helps relieve arthritic knee pain.

� NHS approved and clinically provenfor over 35 years.

� Easily attached and removed inseconds.

� Ultra lightweight (200grams/8oz).

� Greatly increase stability andsecurity for the wearer.

� Comfortable to wear andunobtrusive (can be worn underclothes).

� Suitable for both legs.

� Children’s size available.

For more information call 02380 643402,email [email protected] or

visit www.tvskneebrace.co.uk

By Nicola Hyde

A MECHANICAL engineering lab inTexas is moving forward withexperimental research in bipedalrobotics that could change the faceof the prosthetics industry.

AMBER Lab, established in 2008 inthe Mechanical EngineeringDepartment at Texas A&M Universityand led by Prof. Aaron Ames, isdevoted to both theoretical andexperimental research in prostheticdesign.

Prof Ames has been trying todescribe the complex challenge ofwalking into a mathmatical solutionthat can be written into software that

would be understood by roboticlimbs.

By developing robots that mimichuman movements, Ames and thestudents who work with him aim togain a deeper understanding ofhuman walking to developexoskeleton and smart prosthesis thatwill assist individuals afflicted withamputations and other human bodylimitations.

The AMBER lab has constructed anumber of robots, including theAMPRO, DURUS and AMBER seriesrobots.

“We’ve beefed up the AMBER robotseries and are focused in trying to get

human-like walking,” Ames said. “Alot of the structural elements aresimilar from AMBER II, so it too hasarticulated feet and had chain drivebut you can tell the scope is a littlebit different.

“AMBER II did some great things butthe maximum torque was about 10newton meters and AMBER III willhave over 100.”

AMBER II was the second robot inthe series and the first to use a heel-toe movement in order to walk.

This differed from AMBER I, whichdid not have articulated feet andinstead possessed long stubs. Thatsmall difference made AMBER II more

human-like, but because of it,AMBER II was unable to conquerobstacles like binders or foldersplaced in front of its path.

Ames has also developed a smartprosthesis known as AMPRO –sensory feedback is taken from anindividual’s healthy leg andinformation is fed to a controller,which then tells the algorithms whatto do.

Prof Ames said: “I think down theline we shouldn’t need wheelchairs atall,” Ames added. “Instead of gettinga wheelchair you would get a framethat you step into and it takes youwhere you have to go.”

Texas lab moves forward with bipedal robotics research The AMBER lab in the Mechanical Engineering Department at Texas A&M University has constructed a number of robots, including the AMPRO, DURUS and AMBER series robots.

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Promedics expands its bracing portfolioPROMEDICS has been appointed as the official UK distributor forBledsoe bracing products followingits recent merger with BREG in theUSA.

Adding the Bledsoe bracing range tothe existing range from BREG allowsPromedics to offer an unparalleledportfolio of bracing solutions in theUK.

CEO David Baxendale said he wasdelighted Promedics had secured thedistribution rights for the Bledsoerange.

He added: “Adding the Bledsoeproducts to those of BREG will allowus to offer our customers anunparalleled choice that will continueto meet the needs of their patients inall areas of bracing ”

Understanding the demands on busyclinics and hospital departments issomething Promedics takes veryseriously, and all bracing products areshipped on a same day basis.

Customer service manager Anne Fordsaid: “My team fully appreciate thedemands placed on today’s clinicians,and we ensure we always meet andexceed the expectations of ourcustomers.

“We do everything possible to makesure the goods are delivered on time,every time.”

Totally Dynamic

The Bledsoe range brings a novelconcept to the field of knee bracingand products such as the Axiom D &Z-12 D ligament support braces applydynamic forces against tibialtranslation like no other brace.

National bracing manager ChrisEverett added: “ACL deficient andreconstructed knees share commonproblems that may not berecognised.

“Static bracing, musclestrengthening, and other forms of

training cannot completely eliminatethe symptoms of ACL deficiency. Thedynamic nature of the Bledsoe bracesworks with the patient to helpmanage these symptoms.”

Dynamic Braces use quadricepspower to push the tibia posteriorwith increasing force as the kneeextends to help stop anterior tibialtranslation before foot strike.

Dynamic braces have several benefits:

� Eliminate ACLD symptoms.

� Limit further damage.

� Protect ACL reconstructions.

The benefits can be quickly proven byactual brace use on symptomaticknees.

OA Bracing

In the treatment of osteoarthritis theBledsoe DUO and Legacy Thrusterare welcome additions.

The DUO (Dynamic UnloadingOsteoarthritis) is the only dual-upright DYNAMIC OA brace on themarket.

In extension, the brace provides aload across the knee to open thejoint surface and as the knee goesinto flexion, the load turns off. Thereduction of pressure when sittingeliminates the skin irritation

associated with a constant pressureexerted by many other bracesavailable.

This makes the DUO ideal forpatients that wear the brace all dayfor activities of daily living and is idealfor a patient with an active lifestylewho may need additional supportfrom a dual upright brace due toligamentous instability.

The Legacy Thruster hinge is on theaffected side of the knee creatingrelief by pulling on the strap systemto open the joint space vs. pushingagainst the opposite side of the knee.

Chris added: “These are only a fewof the extensive range of productsavailable from Bledsoe and they willcomplement the already successfuland market leading BREG productsalready available from Promedics.

“To support our customers we willcontinue our commitment to bracingawareness and education byextending our already successfulaccredited regional study daysthroughout the UK.”

For information on the Bledsoe and BREGrange of products, or to arrange a product

demonstration, contact Promedicscustomer services on 01475 746400,

national bracing manager Chris Everett on07768 833416, visit www.promedics.co.uk

or email [email protected]

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PIEDRO Ltd has acquired Gilbert &Mellish Ltd.

The merger has resulted in thecompanies being renamed to formPiedro & Gilbert & Mellish Ltd, whoare now the only suppliers for allPiedro adult and children’sorthopaedic footwear in the UK andIreland.

Piedro & G&M Ltd is a subsidiarycompany of PiedroVerkooporganisatie B.V. (based in TheNetherlands).

Piedro Verkooporginsatie B.V. are thedesigners and manufacturers ofPiedro high quality fashion andorthopaedic footwear for both adultsand children, and have beenoperational since 1957.

Piedro is a well-known brand bothhere in the UK and internationally forits design of high quality and highperformance orthopaedic footwear.

Design, style and functionality hasalways been at the forefront ofPiedro’s drive to provide products thathelp people increase their quality of

life daily, and will remain to be at theforefront and driving force behindthem moving forwards.

Until December 2014 Gilbert &Mellish Ltd were the sole UKdistributor for Piedro footwear, andfor over 50 years they workedtogether developing a close andstrong working relationship.

Moving forwards Piedro & G&M Ltdwill continue to build on their strongpartnership, with the companyretaining the sole distributorship forthe UK and Ireland of Piedro adultand children’s orthopaedic footwearcollections.

Ideally located in Castle Donington,Piedro & G&M Ltd will continue toprovide a first-class customer service,processing all orders and dealing withany enquiries and accountingpractices at theUK office.

All orders will be processed here andshipped directly from our head officeand extensive warehouse in TheNetherlands. This new, streamlinedorganisation will significantly improvethe high level of customer service

already received by our customers,with faster order processing anddelivery times.

This really is an exciting time for bothcompanies and for the UK market,with customers already seeing theimprovements and benefits from themerger.

Emil Van Swaal is the owner anddirector of Piedro VerkooporganisatieB.V and was heavily involved in thesmooth establishment and merger ofboth companies.

John Meadows (previously ManagingDirector for G&M Ltd) has joined Emilin this new venture and is themanaging director for Piedro & G&MLtd.

The pair have extensive experience inthe orthopaedic footwear andmedical bracing market, both here inthe UK and internationally.

They look forward to building astronger, more efficient andstreamlined organisation, withcontinual development and serviceimprovements along with developing

new and innovative products for ourmarket.

Work has already started on neworthopaedic footwear collections for2015, and we are also looking toextend our orthotic softgoods/bracing range. 2015 brings usa wealth of new opportunities andways to enhance and build upon thegood relationships we have with ourcustomers and we look forward tocontinuing to provide you with aexcellent, high quality product rangeand service.

2015 is a year of change for Piedro &G&M Ltd with many challenges andexciting things to come, we alreadyhave a few new products lined upready to launch.

Some of which will be unveiled atthis year’s BAPO exhibition in March.We look forward to seeing a lot ofour customers at the show andmaking some new ones.

For any further information on the changesat Piedro & Gilbert & Mellish Ltd call our

new office number on 0845 617 1976for further information.

Piedro LTD acquires Gilbert and Mellish Ltd

Innovative product easesAnna’s mobility problemsAN INNOVATIVE piece of equipmentis helping a woman with drop footcaused by Multiple Sclerosis ease hermobility problems.

Anna O’Conner, 56, was diagnosedwith MS in 2000 – it has caused dropfoot in her right foot, meaning shescuffs the ground when she walks.

She has become the first person inIreland to be fitted with MyGait, anadvanced Functional ElectricalStimulation (FES) device by mobilityexperts Ottobock, which has allowedher to regain some of her activitylevels and restored her confidence.

Anna is a decorative painter, creatingmurals that required her to useladders and scaffolding.

She said: “I love spending timeoutdoors, going for walks and beingin the garden, and had recentlylearnt to ski when I got the news.

“I became very conscious of myphysical self and gradually my foot-drop became more and moresignificant. It made everyday tasksmore difficult and I felt I did notwant to go out as much. I began touse hill-walking sticks to help mybalance.”

Anna found out about FunctionalElectrical Stimulation from the MSSociety of Ireland, and was intriguedas to how it could help her. Shevisited Cappagh NationalOrthopaedic Hospital in Dublin whereshe undertook a FES trial.

The pioneering device works byapplying small electrical impulses tothe nerves in the affected muscles,

with the nerve then stimulating themuscle into movement, lifting thefoot from the ground at each step.

Lynn Vale, clinical specialist atOttobock, said: “MS disrupts theneural communication to themuscles, causing weakness. Walkingalso uses more energy and peoplemay alter their gait to compensate,commonly lifting their leg higher andswinging it to the side.”

Anna O’Connor is using a MyGaitFunctional Electrical Stimulation device tohelp her get her life back on track.

A GYMNAST whose career was cutshort by injury is helping patientsback on their feet as aphysiotherapist at HillingdonHospital.

Candice Carter, 30, took gymnasticsup as a five-year-old and competedfor Great Britain before having toretire from the sport at 16.

The physical demands of trainingmore than 20 hours a week took itstoll but Candice later put an initiallyheart-breaking experience to practicaluse.

Candice said: “It was tough at thetime because gymnastics was my lifebut I went on to gain a sports sciencedegree and then chose to focus onphysiotherapy.

“It’s a hands on profession but you

can see the positive results of whatyou are doing which is rewarding andenjoy the interaction with patients.

“It does involve some detective workgetting to the root of the problembut that’s what makes it interestingand patients are often surprisedabout how the body compensates foran injury by making another partwork harder.”

Candice sees around 20 patients aday in the hospital’s rehabilitationgym for everything from whiplashand fractures to back pain and footinjuries.

She is part of an 18-strongoutpatient team whose widerdepartment includes inpatientphysiotherapy, occupational therapyand outpatient physiotherapy.

Ex-gymnast turned physiogets patients on their feet

Candice Carter has put an initially heart-breaking experience to practical use.

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S AN amputee who lost her leg in a caraccident says years of poorly fittingprosthetics made her depressed andin pain.

Lisa Eagleton, 40, from Wigan, had abelow-the-knee leg amputation in2007 and for seven years struggledwith the physical and emotionalchallenges in accepting her new life.

She said: “Even months after myamputation I was in pain every day,living on morphine. The socket onmy prosthetic leg rubbed, causingblisters that resulted in me beingbarely able to walk. I had lost my lifeas it was.

“I thought I had to accept mylimitations. I was told that I wouldnever be as I was before my accident.Everyone was telling me what Icouldn't do, what I no longer was. Iwas depressed and in pain.”

Lisa was eventually referred to anindependent rehabilitation providerto try and address her prosthetic limbissues.

Howard Woolley at PaceRehabilitation in Cheadle (Cheshire)picked up the case. He said: “Thediscomfort Lisa was experiencingwith her existing prosthesis and lackof mobility was understandablynegatively impacting on many otheraspects of her life.”

She underwent several months of

bespoke prosthetic and physiotherapysupport, and began to makeprogress.

She began to walk again and thendecided to focus on body imageissues. She was invited to take part ina photo shoot by David Draken -becoming an alternative model calledLady Lush Lisa. She’s appeared inmagazines and has even been on theNation Geographic Channel talkingabout her modelling work and herprosthesis.

She said: “I felt unattractive, had lowconfidence and was uncertain ofwhat the world thought of a limbless woman. However I felt that itwas time to accept that this is meand rebuild myself.”

It was at this point she decided toreturn to dance – a sport she hadloved but never thought she couldreturn to.

She added: “I missed it so much, butdecided a route to return to it waspole dancing, as that is low impact

on my leg and offered me support.

“My teachers helped me to learnmoves, some of which took a longtime to master, but I was determinedto dance again. After lots of practice,I eventually managed to compete insome competitions and becameBritain’s only below knee amputeepole dancer.

“There is always a way to dosomething that makes you happy.The hardest thing to do is take thefirst step to try.”

Lisa dances again after seven years of pain

2015 sees exciting changes for V-MOrthotics Ltd, who have recentlymoved to new premises.

A beautiful modern workspace andwarehouse has been created within aconverted barn with wonderful viewsof the surrounding countryside.

Situated in the heart of beautifulSuffolk, V-M Orthotics Ltd started outas, and remains, a family runbusiness.

They have been operating since 1985and have accrued a wealth ofexpertise within the Orthoticsindustry over the years.

V-M Orthotics manufacture andsupply their own series of Multifitproducts and source a variety ofinnovative products to complementtheir existing catalogues.

Their customers are drawn fromacross the healthcare spectrum,ranging from community andhospital based NHS establishments,trade companies, care homes as wellas members of the public.

The company prides itself on itsexcellent customer service with well-trained staff, responsive to customerneeds. They carry comprehensivestock levels enabling them to offer aprompt and efficient delivery servicewith competitive prices that areavailable to all.

As well as their own range oforthopaedic goods, V-M is a longestablished distributor of both theDARCO and HEELIFT range ofproducts and enjoy a very closeworking relationship with bothcompanies which continues todevelop.

The company continues to grow fromstrength to strength, finding newproducts and ways to enhance theirservice. They regularly attend nationalconferences and organise workshopsand training events with valuedcustomers. Please just get in touch ifyou have any questions about wherethey are exhibiting or if you have aquery about possible study/trainingdays.

Family-run firmmoves to newsite in Suffolk

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A new area manager has been appointedfor the South and West by RadcliffeRehab. Matthew Sanders, from Somersethas a background in assessment in allaspects of postural and pressure carewith vulnerable patients,recommendations of accurate seating toOccupational Therapists andPhysiotherapists, the training ofOccupational Therapists, Physiotherapistsand Care Teams in postural care andpressure management. Matthew has hadstrategic involvement in productdevelopment and the design process ofproduct portfolios both current and future.

Matthew has previously worked for KirtonGroup, Ottobock and Ottobock Prosthetics.

RESEARCHERS in Glasgow have beenawarded grant funding to design andmanufacture innovative foot orthoticsusing 3D-printing technologies.

Glasgow Caledonian University (GCU)researchers, in partnership with theUniversity of Newcastle andNewcastle-based Peacocks MedicalGroup have been granted a £77,000Small Business Research Initiative(SBRI) Healthcare developmentcontract.

The funding was awarded followinga call to address challenges inimproving diagnosis, self-management and prevention ofmusculoskeletal disorders.

The GCU team, led by Dr GordonHendry and Professor Jim Woodburn,will work with Peacocks MedicalGroup and researchers fromNewcastle University on the‘FootFEMan’ project, which will utilisea computational engineering toolcalled finite element analysis toimprove the functional design oforthotic devices for individualpatients.

The improved personalised designwill then be printed layer by layerusing 3D-printing techniques

developed previously in the team’saward-winning EU-funded project, A-FOOTPRINT.

Dr Hendry said: “We are confidentthat we can successfully 3D printnew orthotic insole devices. Thisproject will now enable us to improveeach orthotic tailored to theindividual patient according towhatever foot problem they have.

“We will test the new products incontrolled clinical studies here atGCU to see if we can improve footfunction during walking and furtherlessen disabling foot symptoms.”

Peacocks have already produced theworld’s first 3d printed one piece footorthoses (podfo) and have spokenabout their work at globalconferences.

A team of five full-time engineersand one technician from Peacocksare working on this latest projectwhich builds on their previousachievements.

Peacocks’ operations director SteveCook said: “This latest collaborationlooks to further optimise the designof orthoses by combining detailedengineering processes with thebenefits of 3d printing.”

Disabling foot and ankle conditionsaffect approximately 200 millionEuropean citizens.

Over 300 million Euros per annum isspent treating many of these peoplewith orthoses and splints, oftenrelying on hand-craftedmanufacturing techniques which areslow, costly and difficult toreproduce.

With an increasingly ageingpopulation and a growing healthburden in long-term conditions, theglobal market for custom footorthoses continues to grow.

Researchers awarded funding todevelop 3D printed foot orthotics

Professor Jim Woodburn

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Advertiser’s announcement

DAVIES Odell has beenmanufacturing and supplyingprecision footwear components forover 150 years and is proud to be theexclusive distributor of Vibram to thefootwear manufacturing industry inthe UK.

Vibram has been making the mostadvanced heels, soles and finishingmaterials for more than 75 years andits instantly recognisable yellowoctagon logo has become the sign ofgold standard quality and

performance in the footwear market.

Based in Rushden Northamptonshire,Davies Odell manufactures and stocksa large range of products that aresuitable for the orthopaedicsfootwear industry with a variety oftop quality EVA, cork & rubbersheeting available in numerousdensities, thicknesses and colourswith many materials and productsavailable from stock while others formore specific applications can bemade to order onsite.

Also available exclusively is the classic ITSHIDE range of rubber soles and heels which are known for their hard wearing depend-ability.

ITSHIDE soles and heels are longlasting, proven, trusted and favouredby a large number of prestigious and world class welted shoemanufacturers and are now availablewith a brand new for 2015 pattern,the BRITGRIP, which incorporates thedesign of the Union Jack flag into the

pattern on the heel and sole for atruly unique look.

Available in a number of differentcolours the BRITGRIP has proven sopopular that a lightweight optionmade from EVA has been added tothe range.

To find out more about Davies Odell and itsrange of products either visit stand 50 at

the BAPO Conference or contact salesmanager Tim Soloman directly on 07894423891 [email protected]

Davies Odell exclusively distributes Vibram in the UK

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Brains of people with one hand adaptwell to disability, new research findsBy Nicola Hyde

A RESEARCH project is breaking newground on how the brain controlshand and arm movements when alimb is missing in a move that couldhelp amputees with prosthetics.

The project sheds new light on whathappens to the large parts of thebrain that control hand and armmovements when a hand is missingand how the brain adjusts to findnew ways to complete everyday taskslike tying shoelaces.

The study was led by the Universityof Oxford in collaboration withOxford University Hospitals NHS Trust,supported by the Wellcome Trust andthe artificial limb provider Opcare.

The researchers used functional MRIbrain scans to measure the brain’sresponse in people missing a handwho attend the Oxford Centre forEnablement, a specialist rehabilitationunit at the Nuffield OrthopaedicCentre.

Study co-author Dr David HendersonSlater, Consultant in NeurologicalDisability and RehabilitationMedicine, based at the NuffieldOrthopaedic Centre, Oxford, said:“We have always known that some

people adapt to the loss of a limbvery soon, and start to make changesin the way they use other parts oftheir body to compensate for nothaving a hand.

“This study helps us to understandthe neuronal basis for this, andshows us that the brain adapts andlearns how to supplement for thehand loss.

“It is encouraging to see that there ishope for improvement even afterdevastating injuries, and tounderstand better what is going oninside the brain to make thesebehavioural adaptations. We may beable to incorporate this knowledgeinto the therapy we offer to newamputees.”

Study leader Dr Tamar Makin, ofOxford University's Centre forFunctional MRI of the Brain (FMRIB),which is based at the John RadcliffeHospital, Oxford, added: “This studytells us a lot about the science ofhow the brain works and how itadapts really flexibly to compensatefor a disability.

“Whichever body part is being usedto compensate for a hand loss takesover the brain territory of the missing

hand – and this happens in adifferent way depending on whetherthe individual is an amputee or hascongenital limb loss.

"One of the key findings was thatthe brain doesn't care if you are bornwith only one hand. The brain is notfussy about whether there is a handat the end of the arm, a prosthetic ora ‘stump’ – so long as it is used in asimilar way."

“There has been quite a lot of

investigation into phantom limb painin people who have had amputationsbut much less into people bornwithout a hand who face a differentset of challenges.

“We now understand this a littlemore and are excited about theimplications for rehabilitation andfurther research, particularly into howit might be possible to takeadvantage of the brain’sadaptability.”

Researchers used functional MRI brain scans to measure the brain’s response in peoplemissing a hand

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AMPUTEES’ lives are beingtransformed by the latest generationof prosthetics with Itap (intraosseoustranscutaneous amputationprosthesis) and multi-mode laptopprogrammable devices amongrevolutionary new technologies.

The former is being trialled at twospecialist orthopaedic units andaccording to one recipient is a life-changer.

Mark O’Leary enthused to TheGuardian: "It's like they've given memy leg back. I know that sounds a bittrite. With this thing I just click thestump on in the morning and I canwalk as far as I like, do anything Iwant within reason. There's nolimit.”

Former soldier Gregg Stevenson isequally enthusiastic about hisOttobock Genium X3 knee, whichoffers pre-programmed modes suchas walking, jogging and running.

“It feels fantastic, well balanced andcomfortable. I can now walk up anddown stairs, backwards and it'swaterproof which is reallyimportant.”

Whilst such technological advances

are great news, the devices don’tcome cheap: Gregg’s costs £70,000.In addition, with many amputeesfunding prosthetics throughinsurance settlements they frequentlyopt not for one, but several devicesto match their lifestyles.

“The price ceiling for an above-the-knee prosthesis a few years ago wasaround £25,000. The cost now isnearing treble that figure,” addedScott Richardson of leadingindependent rehabilitation providers,Pace Rehabilitation. “At PACE wealso find a typical provision would bethree prostheses, one for everydayuse, a cosmetically covered device,perhaps for ‘Sunday best’ and awater activity limb.”

One patient, he reports, has no fewer

than 12 devices.

The move away from reliance simplyon NHS provided (and owned)prosthetics does however raise animportant question: what happens ifyour expensive, life-enhancingprosthetic is lost, damaged or stolen?

It was a question disability insurancespecialist Fish Insurance addressedlast year when it responded todemand by introducing the UK’s firstdedicated prosthetic insurance policy.

“There was this huge gap inprotection because insurers had failedto recognise and respond to thechanging needs of amputees,” saidFish’s managing directo, JohnGarrard. “The rapidly increasing costof devices and growing trend for

amputees to own a number ofprostheses meant they were indanger of being left woefullyexposed. Not many people can easilyafford to replace a device costingtens of thousands of pounds – andthat means they’ll lose theirindependence.”

His response was to develop andlaunch a policy which protects, asstandard, devices worth up to£55,000 and offers bespoke cover forprosthetics that breach that figure.

Annual premiums kick in at £99 withthe policy able to protect multipleprostheses as well as orthotic devicessuch as braces for the spine, upperand lower limbs, feet, knees andankles.

Scott added: “To be honest, it wasincredible that there wasn’t insurancefor prosthetic cover available beforethe Fish policy. We feel a lot morereassured that our clients now haveaccess to a policy to specific covertheir considerable investment in theirprosthetic devices.”

For more details visitwww.fishinsurance.co.uk

or call 0500 432 141

Growing need for protection asprosthetics make great leaps

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JOBSKIN are delighted to announcethe re-launch of the Orthowraprange of garments.

The range includes bracing tosupport hands, wrists, legs, anklesback and abdomen.

We also have a range of garmentssuitable for support duringpregnancy.

Garments are available in traditionalbeige with the addition of most itemsnow being available in black with arange of trims as desired to jazz upthese traditional garments forsportswear and other activities.

The materials used are of the highestquality breathable fabric for wearercomfort with easy to secure Velcrostrapping for patients with poormanual dexterity.

Garments are available in a range ofsizes and many include removablesteels for added comfort andsupport.

Please contact our customer service teamshould you have any questions or request

a new catalogue Tel: 0115 973 4300 oremail [email protected]

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Jobskin re-launchOrthowrap range

A rehabilitation company has joined together with a former footballer to raise cash anddonate items to Birmingham Children’s Hospital. Radcliffe Rehab have donatedequipment and former Wolves defender Jody Craddock handed over a cheque for£20,000 as it is the hospital where his youngest son Toby has been treated for leukaemiafor the last two-and-a-half years. Equipment worth over £3,000 was donated by RadcliffeRehabilitation Solutions (RRS). This includes two paediatric wheelchairs – one a ‘Tilt inSpace’ comfort wheelchair accommodating children with special needs and the other aneasy clean ‘Sanichair’ for paediatric toileting and bathing. They have also donated somelight weight paediatric walking aids.

A COMPANY has developed a set ofwearable fabric sensors that willmeasure patients’ physicality –including bend, rotation, angle andtorque.

The BeBop Sensors are developed bymusical instrument inventor KeithMcMillen and KMI, who claim theBeBop Wearable Smart Fabric Sensor

could become a major benefit in thedevelopment of prosthetic limbs.

Unlike other wearable sensors on the market today that onlymeasure physiology (EKG, EMG), electrical conductivity orbreathing, BeBop measures actualphysicality to sense and display 3Dmaps of data.

Sensors measure patients’ physicality

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A WORLD first. Jack Eyers, rolemodel, walks on the Linx prostheticleg, the first ever prosthetic limb withintegrated computer control of kneeand foot, a system in which the partstalk to each other like a human leg.

Jack’s story is about someone whosedream is something the fashionauthorities often dismiss as irrelevantbut which each of us can applaudand delight in seeing in action. Jack isa model.

He was born with a disorder calledproximal femoral focal deficiency(PFFD) that meant sections of hisright leg didn’t form properly andeventually at 16 he needed anamputation to enable him to walkeffectively.

Prosthetic technology helped himachieve the level of fitness he strivesfor on a daily basis.

A year after his amputation Jack gotinvolved in the ParalympicAssociation and did some trials andwon a scholarship that resulted in hisbecoming a member of the GBJuniors Basketball Team.

The training schedule and seeminglyaggressive nature of Wheelchair

Basketball required a fitness regimethat turned his body from that of anormal fit teenager into that of ahoned athlete with a physique thatenabled him to spin a wheelchairround the maelstrom of court actionwith speed, agility and a certain levelof fearlessness.

Jack grabbed a number ofopportunities to work in the filmindustry with agencies that promotethe use of people with disabilities.

This led to a number of gory roles asan injured battle casualty in films likeGladiator and in real life on militarytraining exercises.

One highlighted role was being partof the trapeze team in the 2012Paralympic opening ceremonies. Thisyear he is booked to appear on thecat walk in fashion shows in Milanwhich start in February, success willmean that Jack is breaking newground in introducing people withdisabilities into an area of life thathas always had stringent views onperfection. The fashion industry isn’tparticularly forgiving of differences tothe ‘body beautiful’ as defined withinits own ranks so it is quite someachievement.

The nature of Jack’s limb loss, PFFD,means that his right hip joint hasn’tformed properly and this has animpact on his balance and the wayhe walks.

The prosthetic limb he has beenusing is designed for athletic activitiesand allows him to train and trainothers in his job as a personal trainerbut it doesn’t give him the type ofsubtle control required to showfashion off on the catwalk.

The new Linx Limb system monitorshis movement and activity constantlyand adjusts to every nuance of hisgait. When he stands still it locks sothat he can relax and conserveenergy, even when the knee is bentat a relaxed angle.

The Linx is different to all previoussystems because it has a newsoftware called MiÇ (Motionintegrated intelligence) whichmonitors software from the sensorsthroughout the system, this meansthat the foot and knee are effectivelysharing information about theenvironment Jack is walking in andtogether they make subtle controladjustments so that he canconfidently move around knowing

that the limb will be at the rightspeed and support level at all times.

Previous systems shared the powersupply between the knee and footbut didn’t actually talk to each other.The Linx, therefore, is a whole newlevel in lower limb prosthetictechnology.


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Amputee Jack fitted with Linx prostheticlimb with motion integrated intelligence

Jack Eyers walks on his Linx prostheticlimb.

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DELCAM will demonstrate the2015 version of its OrthoMODELsoftware for the design of customorthotic insoles at the BAPOconference to be held at the Point,Manchester, from March 20-22.

The new release includes theability to design three-quarter-length rigid orthotics and anextended range of corrections forrigid orthotics, plus otherenhancements.

Those not attending theconference can see further detailsat lz.orthotics-cadcam.com

OrthoMODEL offers ‘real-timedesign’ of both accommodativeorthotics, ideal for patients withdiabetes and for those requiringcomfort insoles, and correctiveorthotics, to address problemswith the patient’s foot orientationand gait cycle.

The software has a direct interfaceto Delcam’s iQube range ofscanners, all of which are able toscan the patient’s foot, foamboxes or casts.

As an open system, OrthoMODELcan also import scan data frommost other systems as well ascreate NC code for orthoticsgenerated in other CAD systems.

The main addition to the 2015release is the new option to createthree-quarter-length rigidorthotics.

The new style can be selectedfrom the existing menu of orthotictypes, with the same options tospecify the size and width requiredfor the patient.

The range of corrections that canbe made to rigid devices has beenextended in OrthoMODEL.

Options available to be added now include extrinsic and intrinsic forefoot and rearfootposts, as well as heel lifts andraises.

In addition, all rigid orthotics cannow be designed with constantthickness across their width, evenin areas with steep walls, therebymaintaining rigidity.

Other enhancements in

OrthoMODEL 2015 includesupport for orthotics with flat heels, dynamic reporting ofthe pad height as a pad isadjusted, and an easier methodto set up a new library of orthotics with improved errorreporting if details are enteredincorrectly.

As with all of Delcam’s productsfor the orthotics industry, the newsoftware has been developed inassociation with Delcam customers

from laboratories, podiatrists and orthotists around the world, coupled with Delcam’sknowledge of footwear design and manufacture gained from its relationships with leadingbrands.

For further information on Delcam’ssolutions for orthotics design andmanufacture, please contact Peter

Dickin, Marketing Manager, on

0121 683 1081 or [email protected]

Delcam to showcase updated versionof its OrthoMODEL software at BAPO

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Active Hand grippingaid helps Rebecca toreturn to the waterBy Nicola Hyde

A WOMAN who was partiallyparalysed after suffering a braintumour has been able to return tothe sport she loves – waterskiing.

Rebecca Hopkins has always lovedsports and outdoor activities – shewas a keen soccer player, ran her firstroad race aged 12 and came first inher age group just three weeks afterbrain surgery to remove a tumour.

But her greatest love is water skiing -a sport she had to give up when herbrain tumour returned.

In 2012, she began experiencingsevere headaches – she had brainsurgery and radiation therapy. Theseleft her partially blind in her right eyeand partially paralysed in her right legand arm.

But – although Rebecca joined theYMCA “Live Strong” programmethat helps to rehabilitate people

recovering from cancer - she did nothave enough gripping strength tohold her hand onto the differentexercise equipment.

Now, after finding Active Hands,Rebecca water-skis with a speciallyadapted system. She is attached tothe training pole by her Active Handgripping aid, a mountain climbingharness attached via a heavy dutykarabiner and a cord: providing herwith a three-point connection. Thisprotects her from an uncontrolled fallyet still gives her the responsibility forcontrolling the ski.

Mark, Rebecca’s father, said: “I can'ttell you how much Rebecca looksforward to skiing, it makes her feelnormal and the joy it brings her ispriceless, without the Active Handshe would just be another kid sittingon the side-lines with only memoriesabout what life was like beforecancer.”

NEW College Durham is one of thefirst colleges in the UK to launch abrand new podiatry apprenticeship.

The Advanced Apprenticeship inClinical Health Care Support hasbeen specifically tailored to the roleof a Podiatry Assistant and started inJanuary.

Apprentices will spend half a daystudying at New College Durham andwill spend the rest of the week basedwith an employer.

Claire Kelly, curriculum manager atNew College Durham, said: “Thisexciting new apprenticeship, whichwe think is a first for the UK, will

offer a fantastic opportunity to those employed in a clinical setting,to gain the qualifications andexperience to be a qualified PodiatryAssistant.

“This programme has beendeveloped in conjunction with NHSmanagers to meet the demands ofthe industry.”

The apprenticeship is free and willlast for approximately 18 months.

Apprentices will learn to support aPodiatrist in all aspects of patientcare including the preparation of theclinical environment, both in the NHSand private practice.

College launches apprenticeship

OCCUPATIONAL therapists have beentold to expect extra responsibilitieswhen changes to Blue Badgeassessments come into force.

Assessments will move from GPs to‘independent mobility assessors’following government reforms of theBlue Badge scheme.

The College of OccupationalTherapists say the change representsan ideal opportunity for OTs to takeon additional responsibilityparticularly those working in localauthorities as budgets begin totransfer from the NHS to social care.The scheme which allows peoplewith long term mobility problems topark for free or on yellow lines isundergoing a staged programme ofreform.

Changes seek to provide a consistentand uniform approach toadministration and delivery of thescheme, preventing abuse andgreater sustainability for those who

rely on it most.

Peggy Frost, head of professionalpractice at the College ofOccupational Therapists, said: “OTsare the best and most appropriatechoice to assess eligibility for BlueBadges and it’s important we seizethis opportunity.

“Occupational Therapists are expertsat assessing the impact of disabilityand illness on all areas of a person’slife – mental, physical and social –and the skills to understand thecomplex needs of those withdisabilities as a result of a long termcondition, illness or accident.”

The College of OccupationalTherapists has been closely involvedin Blue Badge Reform Consultationsince it was launched in February2010.

An expert panel of OTs was alsoformed to discuss issues andconcerns around the assessment andtake part in the pilot programme.

OTs warned to expectextra responsibilities

Foot drop stimulatorbeneficial for strokerehabilitation, claimRESEARCHERS have discovered that afoot drop stimulator is beneficialwhen it comes to strokerehabilitation.

The Kessler Foundation say theapplication of it during task-specificmovement for four weeks can retrainneuromuscular system and that itsuse as a rehabilitation interventionmay facilitate recovery.

“EMG of the tibialis anteriordemonstrates a training effect afterutilization of a foot drop stimulator"was published online byNeuroRehabilitation – the authors areRakesh Pilkar, PhD, Mathew Yarossi,MS, and Karen J. Nolan, PhD, ofHuman Performance & EngineeringResearch at Kessler Foundation.

Dr Nolan said: “Compensatorystrategies have a negative effect ongait pattern.

“While use of an ankle-foot orthosiscan improve speed and function, it isnot designed to restore musclefunction. We looked at whetherstimulation of the peroneal nerveduring walking would retrain thetemporal activation of the tibialisanterior muscle.”

Four participants more than threemonths post right-sided strokecompleted ten walking trials (fivewith and five without stimulator) atbaseline and after four weeks ofusing a commercial device.

She added: “We found a potentialtraining effect in all participants.These results indicate that use of thestimulator may facilitate recovery ofmuscle function.”

This study was funded by KesslerFoundation, a major nonprofitorganisation that is considered aglobal leader in rehabilitationresearch that seeks to improvemobility issues.

Dr. Nolan is a research scientist in HumanPerformance & Engineering Research atKessler Foundation. She conducts clinicalstudies of new technologies in therehabilitation of people disabled by strokeand brain injury.

Credit: Kessler Foundation

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sponsors podiatry

Following the foot care pathwayto avoid diabetic amputationsBy Margaret Stubbs,clinical advisor at Diabetes UK

EACH week in England there arearound 100 amputations in peoplewith diabetes. People with diabetesare up to 30 times more likely tohave an amputation compared to thegeneral population.

The fact is that an estimated 80 percent of amputations are potentiallypreventable, through improvedawareness among people withdiabetes about their risk status andaccess to good quality structuredcare.

The risk of amputation can bereduced through provision of anintegrated foot care pathway, withtrained staff in community footprotection services and quick accessto multidisciplinary specialist teams.

The percentage of hospitals withmultidisciplinary foot care teams hasbeen increasing – from 61 per cent in2010 to 72 per cent in 2013.However, more than a quarter ofhospitals have no multidisciplinaryfoot care team.

Amputations have been reduced by

over 50 per cent where hospitalshave introduced multidisciplinaryfootcare teams and promoted rapidaccess to them. In addition, throughthe reduction of costly amputations,such teams can save over four timestheir cost.

There is currently considerablevariation in amputation rates acrossEngland. All Clinical CommissioningGroups (CCGs) should be looking athow they can improve foot care forpeople with diabetes, and thoseCCGs with a higher than averageamputation rate compared to theEngland average should take urgentaction to reduce it. Footcare forpeople with diabetes should not be apostcode lottery.

All people with diabetes need toreceive a high-quality foot check eachyear. They should be told their risk offoot problems and be offered adviceon how to care for their feet.

In addition, poor-performing CCGsneed to take action to increase theavailability and uptake of foot checks– particularly in people with Type 1diabetes, younger people, and any

hard-to-reach groups.

CCGs also need to ensure anintegrated foot care pathway is beingdelivered across primary, community,and specialist care services.

This includes having amultidisciplinary foot care team (MFT)and a foot protection service in everyarea. The MDT also plays a crucialrole in being able to assessoutpatients with active foot diseasewithin one working day of

presentation.

The integrated footcare pathwayhighlights the importance of rapidreferral to, and management by, amember of the MDT if someone hasactive ulceration or infection in theirfoot.

It is also important to ensure thatthose at high risk of foot problemscan be identified through goodquality annual foot checks andregular review by a specialistpodiatrist or a member of the FootProtection Team. In addition, peoplewith diabetes who are at high risk offoot problems, and their carers, needto know what to look out for andwhere to go in the event of aproblem.

In order to reduce the number ofamputations, everyone with diabetesshould have an annual foot check,understand their risk score and knowhow to look after their own feet.People in all areas should have quickaccess to Foot Protection or Multi-disciplinary Foot Care Teams, whichhave been shown to significantlyreduce levels of risk.

Margaret Stubbs

A STUDY has revealed that around125 lower limb amputations arecarried out every week in Englandalone on people with diabetes due tocomplications caused by theircondition.

Amputations currently cost the NHSbetween £600-700million every year– but 80 per cent of theseamputations are avoidable throughimproved integrated foot carepathways.

The report by the National

Confidential Enquiry into PatientOutcome and Death (NCEPOD) hasshown that fewer than half ofpatients that needed lower limbamputation received good care.

More than half of the patientsincluded in the study had diabetesbut the report highlighted that therehad been little involvement in theircare by diabetes specialists and carewas often poorly co-ordinated with alack of multidisciplinary teamworking.

In a statement on its website,Lawrence Ambrose, lead policyofficer for The College of Podiatry,said: “Podiatrists have a vital role toplay in the prevention and treatmentof lower limb amputation associatedwith diabetes. Ensuring rapid accessfrom podiatrists to vascular teams forall people recognised to be at risk ofor in need of amputation, needs tobe made key in all amputation carepathways.

“However more funding and betterpathways need to be in place. Many

diabetes patients are not beingprovided access to podiatrists andwhile cases of diabetes are increasingby approximately five per cent perannum, podiatry staff are planned toreduce by one per cent. This reportdemonstrates that the care pathwayis not being rolled out effectively andwe’d like to work more closely withthe government and NHS to ensurethis happens and that adequatepodiatry services are in place.”

The report can be read on theNCEPOD website.

Podiatry services can prevent diabetes related limb amputations

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Össur to exhibit new and interesting productsand have clinical specialists on hand at BAPOÖSSUR are pleased to be supportingBAPO again in 2015, returning toThe Point, Lancashire CountyCricket Club on March 20-22.

As last year, Össur will be exhibitingsome new and interesting productsas well as having clinical specialistson hand to take questions and joinin discussions about amputeerehabilitation and orthotic practice.Innovation has always been a keypart of the Össur Values.

Not afraid to bring new concepts tothe sector, there have been manynew products that are nowembedded in modern clinicalpractice.

The original Iceross (Icelandic RollOn Silicone Socket) liner, developedby Össur Kristinsson himself back inthe early 1990’s, has changed thelandscape of prosthetic socketfitting globally, bringing new levelsof comfort and function to users aswell as ease of fitting for clinicians.

Since then, many new iterations ofthe iconic silicone interface have ledthe way for solutions offeringgreater comfort and personalisation.

The new Iceross Seal-In X TF offers

the benefits of previoustransfemoral suspension methods,but now allows the user to adjustwhere he or she places the Seal-In®membrane.

This not only adds greater comfortopportunities, but also helps usersmanage small daily and longer termvolume fluctuations, minimising therisk of losing socket suspensionduring normal use.

The new liner is also significantlylonger.

A recent addition to the socketsolutions portfolio is Össur’s newUnity® Vacuum Suspension System.

A small pump, hidden within thearchitecture of the Flex-Foot range,uses normal deflection of the footmodule to draw a class leadingvacuum from within the socket via anew tri-functional valve.

Used in conjunction with either thetransfemoral or transtibial Seal-In®liner range, the system offersenhanced socket fitting along withthe convenience of sleeveless andself-suspending socket solutions.

Adding vacuum to the socketsystem can help manage residual

limb volume fluctuations, and bydoing so ensuring an alreadyexcellent socket fit remains so forlonger periods.

Össur have also worked closely withinnovators in other fields ofexpertise, culminating in projectslike RHEO KNEE® for example.

Now in its 3rd generation, thisMicroprocessor Knee is rapidly beingacknowledged as a genuinealternative among experiencedclinicians and amputees alike. Withits unique feel, ease of use forpatients and simple set-up for theclinician, the RHEO KNEE 3® issuitable for new and experiencedusers alike.

RHEO KNEE 3® is now stableenough for less experienced andlower activity users, and yet allowsmore dynamic and active amputeesto walk their own way!

At BAPO this March, Össur will bedemonstrating these and other newproducts, including the newUnloader Fit and Rebound PCL,making a meaningful contributionto what everyone hopes will be agreat conference.

A UK company iscelebrating afterlaunching over 20new orthopaedicproducts in the lasttwo years.

medi UK said theproducts include aselection of specificknee, lumbar andchildren’s fractureproducts developedthrough closepartnership workingwith clients.

A spokesman said:“Products such asM4s Comfort andGenumedi PT havebeen well acceptedby clinicians andpatients alike, whileKIDZ epico ROM forthe elbow, claviclesupport and mediROM for the kneehave helpedchildren throughtheir recovery andrehabilitation.

“Innovative designs as seen in ourmedi Humeral Fracture Brace, ProtectROM telescopic have helped patientsrecover through fracture or post-opconditions while Manumed activeand Lumbamed Thermopad have

provided support and relief forpatients with chronic conditions.”

The company now aims to add afurther ten product launches this yearand add to the lumbar and kneeportfolio and Genumedi family ofproducts.

medi UK celebrates launching20 products in last two years

WITH so many shapes, sizes of feettogether with numerous muscles,bones, joints and ligaments affectingthe way we move, can a standardoff-the-shelf or modular device reallybe the optimum treatment plan foryour patient and may even lead tofalse economy.

A custom-made foot orthoses fromBeagle Orthopaedic is fabricated byskilled technicians completely byhand to individual prescriptions, castsand foot impressions.

Correctly prescribed these handmadedevices can give optimum correction

and/or pressure relief for effectiveoutcomes.

To keep ordering simple we havedesigned a small range of productswhich can be tailored to suit a varietyof indications.

Named after Lancashire towns;Lytham, Blackburn, Bolton,Accrington, Lancaster and Whalleyany one of the “Urban Collection”will provide a unique three-dimensional orthoses to suit yourpatient pathologies.

For further information please contact01254 268788

Beagle unveils UrbanCollection of orthoses

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Download - Assistive Technologies February/March 2015

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