Centre for Clinical Biomechanics and Footwear Research March 2014

Staffordshire University Faculty of Health Sciences Clinical Biomechanics and Footwear Research The biomechanics team within the Faculty of Health Sciences has a substantial track record of collaborating with industry and health services sectors through knowledge transfer partnership projects. We were one of the major research partners in the project titled HEELLESS, (which was funded by the European Union) while simultaneously being involved in a number of other clinical and industrial projects. Currently we are leading a FP7 funded IndustryAcademia Partnerships and Pathways programme under Marie Curie Actions . This project titled Diabsmart has a focus on developing biomechanically suitable smart material for the use in diabetic insoles that can alleviate the symptoms of the diabetic foot.

The facilities within Staffordshire University include a fully equipped biomechanics lab in the recently developed ÂŁ30M Science and Technology centre. In addition to a state of the art 3D movement analysis system and associated software, this lab has the ability to measure muscle activation (using surface electromyography) and performance (dynamometers), balance and posture (pressure mat based systems and force plates), 2D ultrasound, thermal imaging (useful to study interfaces between patients and devices or footwear), in-shoe pressure measurement systems and a Universal Testing Machine. We also have 3D printing facilities to print prototypes for testing. As well as the substantial lab space and measurement equipment we have a consultation room equipped for clinical use.

Customised protocols for product development and evaluation have been developed by our team. Additionally, the laboratory is also equipped with safety hoist systems and a virtual reality test treadmill to conduct experiments with elderly and people with physical disabilities.

Our team is currently working with regional (West Midlands based) SME’s in the areas of design and development of products related to human movement and performance. The subject areas that we cover range from medical and sports technology to ergonomics.

Furthermore kinematic and kinetic analysis for assessing clinical conditions and to develop treatment protocols and assistive devices are being offered along with musculoskeletal clinics (clinical biomechanics involving all musculoskeletal clinical professionals) for the local clinical practitioners and patients. Our clinic has a role within the local health trusts and provides specialist services to diabetic and rheumatology clinics. Typically the staff at the lab will assess the gait pattern and the pressure distribution under the feet to inform the clinical management of various musculo skeletal conditions. The highlight of our clinic is the footwear provision which is not provided anywhere else in the country. We also offer a wide range of Gait and Movement Analysis testing for the prescription and assessment of prostheses and physical therapy intervention both in clinical and sporting situations.

Apart from the strong post graduate programs in the area of Clinical Biomechanics and Musculoskeletal Diagnosis, Staffordshire University, offers several continuing professional development (CPD) workshop and training days in the areas of clinical biomechanics and disciplines related to musculoskeletal sciences. We have a substantial track record of scientific publications and we collaborate with researchers across various countries. We continue to expand

these partnerships across the EU and beyond, the research within our team focuses on (1) evidence based clinical practice (2) innovative design and technology for both athletic and prescription footwear (3) effective lower limb orthotic intervention and (4) aetiopathology of scoliosis.

Current activities within the Biomechanics Facility include:         

Protocol development for human movement research. These protocols are intended to be used to underpin product development and evaluation, e.g. footwear research and Clinical Gait Analysis.

Falls assessment and identifying predictors for falls.

Methods to reliably map the user needs in elderly and disabled population. These protocols are essential for product development, product enhancement, market research, etc..

Foot/ footwear research (lower limb biomechanics, Patient specific finite element modelling of the human foot): Therapeutic and Diabetic Footwear (footwear modifications/ orthotic intervention) Sports Footwear (Cycling boots, Skating boots – design and development aspects) Sports Biomechanics - related research (Rehabilitation – Sports equipment, Various) Medical and Assistive Technology Biomechanical Assessment of the Diabetic foot and footwear (Material testing, Product design and Development)

Focus on a few of our current projects: Development of a new generation of DIABetic footwear using an integrated approach and SMART materials (DiaBSmart) This project led by Staffordshire University is funded by the European Commission through Grant Agreement Number 285985 under Industry Academia partnerships and Pathways (FP7-PEOPLE-2011-IAPP). DiaBSmart aims to generate, transfer and exchange the clinical, academic and manufacturing knowledge between the partners to create a new generation of diabetic footwear through a newly developed patient assessment system. The transfer of knowledge between various sectors ensures that the need of patients is considered and transferred effectively to product development using a scientific approach. The objectives include: (1) the design and development of an integrated system of DIABetic foot assessment (2) to validate the developed system using experimental methods (3) to develop a suitable material to meet the mechanical and clinical requirements (4) to evaluate the mechanical and clinical effectiveness of material choice in reducing the potential risk of foot complications. The Numerical, Experimental and Mathematical Analyses system will integrate all aspects of diabetic footwear including; clinical and biomechanical assessment, material choice and aesthetic design. Proposed interdisciplinary, intersectorial approach is unique and brings together the expertise from research institutions, industry and clinics. This project while enhancing the knowledge base in diabetic assessment; will have a clear impact on new product development leading to both clinical and economic benefits. The products include a new generation of integrated SMART /multi material midsoles and/or orthoses for diabetic footwear. Properties of the materials will be optimised with a view to minimise/ redistribute the pressure and hence the stress on the soft tissue in the critical plantar areas of the foot. Whilst significantly affecting the course of the disease, the products will aim to reduce the risk of limb loss in patients with diabetes, the most frequent cause of non-traumatic lower-limb amputations. (We are currently conducting an RCT as a part of this project - ClinicalTrials.gov Identifier: NCT01816906)

Development of an integrated system for monitoring balance training in Elderly (El-BET) This project is a collaboration between Stoke on Trent Clinical Commissioning Group (CCG) and Staffordshire University. EL-BET will aid in remote intervention and monitoring of exercise and physical activity for the frail elderly within the community setting.

Falls or the fear of falls can lead to an individual making major changes to their lifestyle and social participation. The reasons for falls is multifactorial and varies with individuals, their past history of activities, and can often been considered to be task dependent.

Deteriorations in muscle strength and postural balance are considered to be of major importance in preventing a fall and as a result much of the current research has focussed on developing exercise based therapy programmes, in particular those aimed at improving strength and balance. Whilst it is not the aim of this project to develop exercise intervention, this initiative focuses on remote monitoring, assessment and recording of balance and posture whilst performing various exercises. This will benefit the NHS both in terms of money and time.

CL-7 Ltd Redbacks Unique Shoe Technology (RUST) This collaborative project between CL-7 limited, Staffordshire University and Coventry University is funded by Technology Strategy Board.

Whilst we can’t provide specific details of this project due to the commercial confidentiality, the overall aim of this project is to introduce a new technology into the footwear industry that successfully minimises peak pressures that impact on the diabetic foot and has the potential to reduce likelihood of injuries to Diabetic foot. Overall, this new technology will assist in the reduction of foot ulcers in people with diabetes.

Some of the other projects include (1) AFO tuning for Children with Cerebral Palsy (2) Back Surface Topography in patients with Scolisosis (3) 3D reconstruction of biplanar xrays to assist in estimating the volume of thorax in patients with spinal deformities (4) Characterisation of posterior tibial tendon dysfunction and its clinical assessment (5) Assessment of biomechanical efficacy of sandals and slip-on footwear.

For Further Information, please contact: Professor Nachiappan Chockalingam Faculty of Health Sciences Staffordshire University Leek Road, Stoke on Trent ST4 2DF United Kingdom Phone: + 44 1782 295853 email: n.chockalingam@staffs.ac.uk