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INNOVATION FOR INDEPENDENCE

ISSUE 100 DECEMBER 2014/JANUARY 2015 £6.95

Studies to repair damaged spinal cord set to start

By Nicola Hyde CLINICAL studies will start next year in a pioneering project that uses cells from the nose to repair damaged nerves in the spinal cord and potentially ‘cure’ paralysis.

A state-of-the-art clean room to culture cells is currently being completed at the UCL Institute of Neurology which will lead the research into use of Olfactory Ensheathing Cells (OECs) to repair brachial plexus avulsion, an injury common in motorcycle accidents when the nerve roots are pulled out of the spinal cord and the arm is left paralysed.

The pioneering research from Professor Geoff Raisman was plunged into the spotlight last month when it appeared on BBC One's Panorama programme.

The patient, Darek Fidyka, was paralysed after suffering stab wounds to the back in 2010, leaving an 8mm gap in his spinal cord. Scientists used the OECs that regenerate damaged cells in our nose to make repairs to his spinal cord.

Professor Raisman first discovered OECs in 1985 and in 1997 successfully showed that they could be used to treat spinal injuries in rats.

He has spent the past decade developing spinal repair techniques for patients.

He said: “It is immensely gratifying to see that years of research have now led to the development of a safe technique for transplanting cells into the spinal cord.

“I believe we stand on the threshold of a historic advance and that the continuation of our work will be of major benefit to mankind.

“I believe we have now opened the door to a treatment of spinal cord injury that will get patients out of wheel chairs.

“Our goal now is to develop this first procedure to a point where it can be rolled out as a worldwide general approach.”

For the experimental treatment, Darek first underwent brain surgery to remove one of his olfactory bulbs, it was placed in a cell culture for two weeks to produce OECs. These were then injected into the spinal cord above and below the injury, and four strips of nerve tissue were taken from the ankle and patched across the 8mm gap.

These formed ‘bridges’ for the spinal nerve fibres to grow across.

Three months after the surgery, Darek’s left thigh muscle began to grow and after six months he was starting to walk within the rehabilitation centre with the help of a physiotherapist and leg braces.

A woman has modelled in a Marilyn Monroe inspired photo shoot – wearing a running blade encrusted with crystals. Belinda Gatland wanted the shimmering prosthesis for a charity photo shoot.

Prosthetist Bob Watts worked closely with GlamSticks to create the glamorous end result. Belinda modelled the crystal leg to re-enact one of the most iconic images of the 20th Century; the infamous moment when Marilyn’s white dress blows up as she stands over a subway grate.

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Bid to fund simple device A CROWDFUNDING campaign has been launched to help produce a simple device that will create a wheelchair push-rim cover that will make it more comfortable for users to propel themselves.

Contacts Editorial Judith Halkerston Email: jh@scriptmedia.co.uk

Dominic Musgrave Group Production Editor Email: dm@scriptmedia.co.uk Tel: 01226 734407 Nicola Hyde Reporter Email: news@scriptmedia.co.uk Tel: 01226 734715 Sales

The invention – called Grippoz – is the brainchild of Paul Lawson from Alyth, Perthshire, whose partner Diana has been wheelchair-bound for six years.

Paul made a prototype of his invention after seeing how pain and lack of grip frustrated Diana in completing everyday tasks.

Carole Rice

Product Manager

Email: cr@scriptmedia.co.uk Tel: 01226 734412 Fax: 01226 734478 Tony Barry Sales and Marketing Director Email: tb@scriptmedia.co.uk

The plan is for the invention to go into full production, with the pushrim covers made from colourful, durable silicone with antimicrobial element.

Circulation circulation@wharncliffepublishing.co.uk 24 hour hotline: 01226 734695

The social enterprise that has been set up to market the product will sell Grippoz online, with profits being used to help other small businesses and new products in the area.

When I first went out with my Grippoz on, I realised I didn’t have to wait for him and went off myself into the hospital for my appointment.”

enterprise managed by GrowBiz.

The initial funding needed for the injection moulds is being raised through the established crowdfunding platform, Kickstarter.

The campaign will run online until 8th December and aims to raise at least £22,500.

Grippoz are made from injected silicone which offers users additional protection from germs and infection, and their robust design helps to protect furniture from bumps and scrapes.

It is estimated that nearly 70 per cent of manual wheelchair users will experience upper extremity pain or overuse injury at some point in their lifetime.

Diana said: “I always had to wait for Paul to come and push me along.

Group Editor

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Paul and Diana want the benefits of Grippoz to help others and are licensing the product to a social

Self-propulsion is a highly repetitive task for wheelchair users, frequently resulting in musculoskeletal disorders.

If the campaign achieves its target of £22,500, it will then aim to raise additional funding to produce Grippoz for children’s wheelchairs.

Design/Production Stewart Holt Studio Manager Email: sth@scriptmedia.co.uk Laura Blackburn Graphic Designer Email: lb@scriptmedia.co.uk

Whilst every effort is made to ensure the accuracy of all contents, the publishers do not accept liability for any error, printed or otherwise, that may occur.

www.assistivetechnologies.co.uk

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Is a national tariff the solution to funding Orthotic services in the NHS? NEWS

by Simon Dickinson, Clinical Director, TalarMade DUE TO the financial constraints placed on the NHS and the need to do “more for less”, the strain on rehabilitation services has never been greater.

Orthotics and Prosthetics, as clinical services have a very different financial composition than many other AHP services. In most physiotherapy services in England the ratio of staff pay to consumables (non-pay) is heavily in favour of staff costs with staff pay making up around 80-90% of service delivery costs.

In Orthotics the non-pay costs (costs of orthoses & consumables) far exceeds the pay costs (staff costs) with 60-70% of service delivery costs estimated to be non-pay costs.

An ageing population and increasing rates of people with diabetes does add extra strain onto orthotic services, but there is another hidden reason why I believe Orthotic services are under increasing pressure. Our ability as orthotists to help patients has increased. As the practical application of biomechanical theory

has become better understood in the healthcare system, our skills and input is increasingly being demanded by colleagues and patients.

As our clinical abilities have expanded, we have been asked to see increasing numbers of patients with very few occurrences of the funding for our services being increased. This has been highlighted by the Orthotics Campaign, a patient group desperate for improvements in clinical services, reduced waiting times and improvements in the way orthotic services are funded (visit www.orthoticscampaign.org.uk for more information). This patient group are currently working with Neil Churchill, director of patient engagement at NHS England. Neil has agreed to carry out an initial project to collect Orthotics data from providers across England. The NHS Quality Observatory is in the process of pulling together this data on his behalf. In February 2015 Neil will present the data he has extracted from the Orthotics Providers at a round table event. The output of this event will hopefully formulate a plan to address the Orthotic needs in a population and how to monitor and address these needs.

The way orthotic services are funded across the UK varies significantly. The vast majority of services are funded on a block contract (fixed sum per year). These services have not seen any inflationary increases in funding for many years. A small number of services however are funded on a patient by patient basis either by direct reimbursement (all bills paid), single or combined tariff.

The inconsistency of how services are funded and delivered is, I believe, the biggest challenge currently to our profession and Orthotic services.

Commissioners of orthotic services are often unaware of the complexities of the orthotic services they are commissioning and the epidemiological variance in types of orthotic treatment given from one provider in a particular setting to another.

BHTA, BAPO and NOMaG have been working together to try to formulate a national tariff structure for commissioning orthotic services in an attempt to have some consistency in the way services are funded. This work has been difficult and protracted but has highlighted huge variance in the way services have

Simon Dickinson

been provided and funded. There has also been inconsistent input from all orthotic service providers (both commercial and NHS).

With the NHS currently demanding “more for less” I am uncertain that a national tariff for orthotics will or should be accepted. Having a commissioning framework based on a tariff structure would be a significant improvement but is not the final solution. It is however a step in the right direction.

‘Bionic leg improves balance, mobility and quality of life’

By Nicola Hyde AN innovative bionic leg is set to help patients of a leading physiotherapy and healthcare practice recover from neurologic and orthopaedic conditions.

BWT, which operates physiotherapy and healthcare centres across Dorset, secured £13,000 from asset finance specialist Academy Leasing to purchase the state-of-the-art rehabilitation equipment.

“The leg is a wearable device that can dramatically improve balance, mobility and quality of life,” said BWT Partner Linda Whike.

“Thanks to lease funding from Academy Leasing we can now offer the very latest treatment innovation for patients – and provide a therapy that is currently unavailable from the NHS.” The bionic leg can also help patients re-learn functional movements and is currently being used

by BWT to support the recovery of stroke victims.

BWT, which employs a team of 25 physiotherapists, is now planning to invest in more of the bionic leg units from US company AlterG – famed for its Anti-Gravity Treadmills.

“BWT boasts an impressive track record for pushing the boundaries of healthcare and rehabilitation,” added Academy Leasing Managing Director Michael Nolan.

“This latest investment will help the company lay the foundations for even greater success and patient care.”

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New report suggests lack of AHP data A NEW report suggests there is a lack of data on the contribution allied health professionals are making to the quality of patient care.

More than 64,000 AHPs work in the NHS in England outnumbering GPs and representing one of the largest providers of outpatient appointments.

Focus on: Allied Health Professionals, a QualityWatch report published by the Nuffield Trust and the Health Foundation, states that there should be more focus on the contribution of AHPs. It explores how best the quality of care can be measured, with key recommendations such as having access to technologies for shared care records, recording a broader range of activity, more specific studies on short term outcomes and further training in recording and using comparable data.

Chris Austin, Research and Development officer at the College of Occupational Therapists said: “There is a paucity of data that demonstrates what we already know – occupational therapists and other allied health professionals are delivering excellent care. There are some exemplary research studies in the report, illustrating that occupational therapy is improving patient outcomes in key areas such as stroke. However, we need more studies like these to be commissioned, we must start measuring quality of care.

“We know that just 57 per cent of occupational therapists are using digital care records and only 70 per cent have access to word processing and other office software at work.

“I encourage occupational therapists to bring this report to the attention of their managers and discuss their needs for collecting quality data to improve patient care.”

Stanford Chemical Engineering Professor Zhenan Bao points to a diagram of a rubber molecule, indicating the springy feature exploited by her team’s wireless pressure sensor.

Credit: Stanford Engineering

Touch-sensitive technology developed by scientists SCIENTISTS are developing a pressure-sensing technology that could lead to touch-sensitive skin for prosthetic devices.

A team at Stanford have invented a sensor that uses radio waves to detect subtle changes in pressure which has already been tested in lab mice with brain injuries.

But the underlying technology has such broad potential that it could one day be used to create skin-like materials that can sense pressure, leading to prosthetic devices with the electronic equivalent of a sense of touch.

A nine-member research team led

by Chemical Engineering Professor Zhenan Bao detailed two medical applications of this technology in Nature Communications.

In one simple demonstration they used this wireless pressure sensor to read a team member's pulse without touching him.

In a more complex application, they used this wireless device to

monitor the pressure inside the skull of a lab mouse, an achievement that could one day lead to better ways to treat human brain injuries.

effect was measurable, giving them a way to gauge the pressure exerted on the device by tracking the frequency of radio waves interacting with the device.

Bao's wireless sensor is made by placing a thin layer of specially designed rubber between two strips of copper. The copper strips act like radio antennas. The rubber serves as an insulator.

Former Stanford graduate students Lisa Chen and Benjamin C-K Tee designed and modelled the physics behind the device, and calibrated the pressure sensor in simple laboratory tests.

The technology involves beaming radio waves at this simple antenna-and-rubber sandwich.

When the device comes under pressure, the copper antennas squeeze the rubber insulator and move infinitesimally closer together.

Alex Chortos, graduate student in the department of materials science and engineering, made the wireless device more robust and re-usable.

That tiny change in proximity alters the electrical characteristics of the device. Radio waves reflected by these antennas slow down in terms of frequency. When pressure is relaxed, the copper antennas move apart and the radio waves accelerate in frequency.

The engineers proved that this

Bao said: “The device we invented here is extremely easy to manufacture and consumes no energy until readings are being made.

"In the short term we hope to use devices like this to track packages and monitor health conditions. In the longer run we dream of using this technology to create touchsensitive lining for prosthetic devices."

Rogue trader is jailed over mobility goods con A MAN who conned disabled and elderly customers out of their much needed mobility goods has been jailed and fined.

Rogue trader Scott Keeley, 26, of Sincil Mobility, was investigated by Lincolnshire Trading Standards following a complaint by one of his customers.

He had sold the man a mobility scooter as an ex-demonstration when it was actually over seven years old.

Registration documents from the DVLA had been faked and he had taken payment for insurance, despite not arranging any.

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scooters to other customers and if anyone complained, he failed to offer repairs or a replacement. On one occasion a victim received a cheque for a full refund of approximately £2,500, but it bounced.

Mr Keeley also cheated residents by offering to sell their mobility goods in his shop on Sincil Street for an agreed price. These victims received no payment and never saw their items again.

Then, when he realised his business was in trouble he contacted customers who were happy with their purchases and claimed their vehicle needed a service. It is

ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2014/15

believed these vehicles were sold to other customers, leaving his victims without the mobility scooters they depended on and out of pocket.

Rebecca Money, Senior Trading Standards Officer, said: “This was clearly a very serious case as the trader was intentionally targeting and exploiting elderly and vulnerable residents.

“Having worked closely with Mr Keeley’s victims and seen the upset and detriment they have endured, this is a welcome result. I hope this will be a warning to other mobility aids businesses who may be tempted to take advantage of vulnerable consumers.”

The British Healthcare Trades Association (BHTA) has condemned fraudulent practice and said the firm were not members.

Ray Hodgkinson MBE, Director General of the BHTA, said: “We need to stop rogue traders preying on vulnerable consumers.

“Our members are alert for bad practice in their area and have often also been able to assist consumers who are victims, for example by helping them replace equipment fraudulently removed, such as a scooter.”

Mr Keeley was also ordered to pay compensation to ten of his victims totalling £5,734.99.

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Diamonds are a girl’s best friend A WOMAN has modelled in a Marilyn Monroe inspired photo shoot – wearing a running blade encrusted with crystals.

Belinda Gatland wanted the shimmering prosthesis for a charity photo shoot. Prosthetist Bob Watts worked closely with GlamSticks to create the glamorous end result.

Belinda modelled the crystal leg to re-enact one of the most iconic images of the 20th Century; the infamous moment when Marilyn’s white dress blows up as she stands over a subway grate.

She said: “I feel a bit like Cinderella as I am the only person in the world whom it fits. It is quite surreal as people come and take photographs of it, it is truly beautiful.”

Belinda had her left leg amputated after years of operations to try and correct damage that resulted from a horse-riding injury.

Now, with a standard running blade from Dorset Orthopaedic she lives an active life in Dubai and continues to work with horses as an Equine Sports Massage Therapist, keeping horses in good physical health.

She added: “You go on a journey when you have your leg amputated and at first you want to hide it, but then after a while it becomes part of you and to me my blade is a thing of beauty.”

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Belinda wears her day-to-day prosthesis for work but wears a running blade Belinda Gatland when she is wearing a heel and likes to show it off, even adding touches of bling and glam to her socket with ribbon and gems so it looks the part when she is wearing an evening gown.

“A prosthesis is an amazing piece of innovation, a work of art, and it almost becomes an accessory that you want to show off – and why not? Why not have some fun with it?”

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Student team creates one of first 3D-printed prosthetic hands A STUDENT-led research group has developed a 3D-printed prosthetic hand that can learn functional algorithms.

audio mixing board, it will eventually shrink to a size that can fit into the socket of a residual limb.

The team from the University of Illinois have created one of the first 3D-printed prosthetic hands with pattern recognition capability.

Akhtar's team has created a mathematical model of five actions – a hand at-rest, open-faced, closed (tool grip), a three-finger grasp, and a fine pinch. The initial training takes about one to two minutes and involves a patient going through each one of the gestures.

A machine-learning algorithm allows it to do more than just open and close. It learns other positions of the hand for more functionality – and it costs $270 compared to the average myoelectric prosthetic, which retails for between $30,000$40,000.

Team leader Aadeel Akhtar, an MD/PhD candidate in neuroscience from the College of Medicine at Illinois, said: “Using the machinelearning algorithm based off the signals it picks up from the muscles, it can figure out which of these grips he is actually doing.

“The microcontroller with the machine-learning algorithm will then replicate the grip he's trying to make. Based on those signals, it sends commands to motor drivers, which churn the motor and make the hand move.”

Although the EMG board that is being used for the current prototype is the size of a standard

In August 2014, Akhtar and Mary Nguyen, a master's student in aerospace engineering, travelled to South America to put an opensource dexterous artificial hand to the test on an Ecuadorian man.

“The goal of the trip was to get it to work with a patient," Akhtar said. “Although it took some debugging, we were successful."

The hand itself takes about 30 hours to print, then another two hours to assemble. All the electronics that are necessary to convert the neural signals into movements are located within the hand.

The team is working on the third iteration of their design in which the palm will be thinner and the fingers stronger.

The 3-D-printed prosthetic hand can be programmed to recognize a hand at-rest, open-faced, closed (tool grip), a three-finger grip, and fine pinch.

They plan to return to Ecuador in early January to leave it for a patient, and the group has even bigger plans for future iterations of the device.

nerves. By stimulating your sensory nerves in different ways with different amounts of current, we can make it feel like vibration, tingling, pain, or pressure.

He added: “No commercial prosthetic device has any sort of feedback. We're going to put sensors in the fingers. Based on the amount of force that the fingertips are detecting, we are going to send a proportional amount of electrical current across your skin to stimulate your sensory

"We did some initial experiments in the lab and found that with only six minutes of training, users could distinguish between six different grips with 88 percent accuracy without looking. With that kind of result, image how well someone could operate it in even a week's time."

Charity to get Online lottery share app to A CHARITY that was set up to support amputees has been told it will get a share of a £2.1m lottery pot to help increase the numbers of disabled people playing sport.

Sport England announced the boost to disability sports funding with an award from the National Lottery – and LimbPower will get a share of the cash to fund a three-year scheme to help them engage with, and increase accessibility to sport for amputees and ambulant disabled.

The cash – over £210,000 – will be spent on rebuilding the LimbPower website, running four new Introduction to Sport workshops in or around limb centres each year, creating toolkits to support access to sport, and creating a Guide to Sport. The charity will also be employing a full-time Sports Officer.

Kiera Roche, LimbPower founder, said: “This a really exciting time for us and the charity’s development. We have achieved a great deal in just four years, and with this funding we are now able to really build upon the strong foundations we have laid and put into action some of the plans we have been working on for some time.”

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help with knee choice AN APP has been developed that will help prosthetists decide which knee is best suited to individual patients based on both mobility and activities.

grade of the amputee, the user’s weight class and what activities they participate in regularly in everyday life.

Ottobock has launched the Knee Selection online application which analyses amputees’ needs, daily life and activities to find the best Ottobock knee joint for their individual requirements.

It then quickly determines which prostheses would be most suitable and provides in-depth product details, including how effective each is for achieving selected activities and a 360 degree video of each knee.

The online app asks multiple choice questions based on the mobility

Ken Hurst, Academy prosthetist, said: “We aim to provide advice and

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support to our customers whenever possible, and as such have developed this new online tool to guide clinical team members as to the best knee joints for their clients.

It will enable quick and easily obtainable intelligence to aid the decision-making process of a fitting.

“Ottobock have a range of knee joints to suit a wide selection of amputees from indoor walkers to those who partake in an active lifestyle. This tool will quickly select which are most appropriate.”

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Ottobock celebrates 15 years of computer-controlled lower limb

By Nicola Hyde

getting on with life.

A PROSTHETIC leg is celebrating its 15th anniversary with the news that it has helped over 40,000 amputees worldwide thanks to its popular microprocessor knee.

“To get the most out of it you need to practice and it takes time and repetition but eventually you will be walking without constantly thinking about each step and when that happens, it's a marvellous feeling.

Ottobock’s C-Leg was introduced in 1999 and was the world’s first computer-controlled lower limb prosthesis and since its launch has been developed with more technology to make it the leg it is today.

Louise Tait was the UK’s first ever C-Leg patient.

She became an above knee amputee in 1987 and had problems finding a socket that fit due to the shape of her stump. She is still using a C-Leg over a decade later.

Louise said: “Finding a knee that you trust builds confidence so everyday activities become more natural.

“You use less time and energy thinking about where you are stepping and more time just

“Even after 15 years I remember how brilliant the C-Leg felt the first time I tried it, how fluid the motion was and once I learned to trust it.

“I can walk down slopes with confidence and the knee doesn’t give way or collapse.

When I learned to walk stepover-step down stairs, it gave me a feeling of real achievement.”

The C-Leg has on-board sensors and microprocessors to anticipate and adapt to a person's movement, it immediately adjusts 50 times per second to changes in walking speed and direction, providing knee stability the moment it is needed.

This optimised stumble recovery feature means users are able to walk down ramps and stairs step-over-step and manoeuvre on rough terrain with a greatly reduced fear of falling.

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Programmed via Bluetooth technology to match the unique gait of their sound leg, a user also has several different activity modes available to them that allow stances for biking, golfing, and are activated using a remote control.

Phil Yates, Managing Director of Ottobock UK, said: “The C-Leg has been paramount to changing the way that amputees have been fit with prosthetic knees in the past 15 years and has changed many people’s lives by providing more stability, more flexibility, and a knee that responds differently in a range of circumstances.

“Ottobock is also very grateful to the talented Prosthetists and dedicated patients who have helped the development of the technology across the years.”

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BBC’s Panorama programme showed us the first ever repair of the spinal cord in a human being and it has prompted a global debate. The experts at Cyclone Mobility share their thoughts.

Fact or fiction?

IN THE aftermath of the BBC Panorama programme there is some turmoil as to whether this is the beginning of a new era or just another publicity stunt to get the millions of 'normal' able bodied people to realise that in a split second spinal cord injury (SCI) could get them.

So the jury's out and judgment is yet to be clinically delivered and printed media together with social media is wild with statements like ‘it was under his nose all the time’ and this is the moment when we begin to reverse paralysis.

What is without question now is that we are truly getting closer than ever to the actual possibility of one day SCI meaning exactly that Spinal Cord Injury. It will one day no longer be taken for granted that SCI whether complete or incomplete will ultimately lead to paralysis.

But and this is a big BUT! how long will it be before we see that day and what does this mean for those who today are paralysed through SCI. Statements like this summarise a lot of people's thoughts: “If the current study is not furthering development of a therapy, it's just gee-whiz, wowie-zowie. We have to

“If the current study is not furthering development of a therapy, it's just gee-whiz, wowie-zowie.We have to fight for studies that further development of therapies – that move the damn dial toward the end goal."

vital work.

fight for studies that further development of therapies -- that move the damn dial toward the end goal."

Reality is sometimes a harsh reflection which is left to amazing charities like BackUp, SIA and Aspire to deal with, and deal with it remarkably they do with mentoring, daily living skills training, family support, counselling, housing, peer development, political campaigning and welfare support to name just a few of their combined support.

What is absolutely true is that presently we cannot reverse paralysis for the masses, but we can because of years of clinical trials make the operational muscles in the body actually work. In 2005 Restorative Therapies of Baltimore USA were the first people to clear FDA with an FES cycle that could be used in home or rehabilitation clinic.

The RT300 is cleared for use by all SCI victims to maintain muscle mass and have their limbs move as if their central nervous system was processing the information.

No media attention in the masses covered this however, even though this is actually more important than just one person being miraculously cured or robots taking control of our ambulatory movement and 'walking' us. This is more important because it

is actually triggering the bodies own system to function and when the scientists make their miraculous breakthrough it will be vitally important that the body is ready to take opportunity.

If we breakdown the factors of paralysis we can easily see that the end goal is not necessarily the most important, first on the list bladder, then bowels followed closely by sexual function then for tetraplegics the ability to use hands, arms and fingers. But imagine the storyline 'man able to pee' or 'first time he could feed himself'.

What we need to remember is that research is going on ALL the time but to make serious in roads into WHEN because we no longer talk about IF, real scientists need our support.

I personally have accepted life sat down however I would be lying if I told that I had given up on ever seeing the ‘cure’ in my lifetime. I now believe I will see it but not benefit from it, and if I can be part of that process that cures paralysis whether it is partial cure to get people breathing independently, toileting freely or the whole package big dream then I'll be happy.

Programmes such as the Royal Holloway breaking down of scar tissue are behind the veils of mass media attention and getting on with

Today we are part of that whole process with Exoskeletons, FES therapy and psychological support, tomorrow who knows.

Exciting times for rehabilitation ...

By Derek Jones PhD MBA Director, Anatomical Concepts (UK) Ltd CARE today is shaped by guidelines for clinical effectiveness which are indexed to a large statistical population rather than an individual - and this constitutes a problem. Rehabilitation has always been a demanding speciality because of the very individual challenges each person presents.

It’s hard for the NHS to provide an efficient system that can deliver intensive and highly personalised rehabilitation services.

Sadly, restoring an individual’s quality of life following a catastrophic injury or after they experience a neurological condition such as a stroke is more often limited by the resources, attitudes, beliefs, structures and processes of our health and social services than it is by any fundamental lack of knowledge of how to implement healthcare.

We often might know what to do but lack of financial resource in the system acts as a barrier. Other

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barriers exist too – the question is – how can these barriers be surmounted?

Some feel that technology is the answer. Certainly with some of the technology now available for rehabilitation, we can rejoice that this has attracted greater awareness and interest to an area that has not been a well-resourced area of medicine in the past.

Technology alone will not provide the answer though. It provides the leverage to bring about positive improvement but to exploit this potential is not easy.

In a long academic career I learned to look outside of our field for the technology that would be capable of changing the status quo. We can now see evidence, for example, of technology developed for military or car manufacturing use appearing in rehabilitation.

The Ekso Bionics system, for example, is a leading edge product that emerged from an original

ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2014/15

What we do understand from years of research is that fundamentally if we don't give the muscles in our body a job to do they will forget to do that job and maybe just maybe they will find something else to do.

investment for military purposes.

The result is an exciting product but at a cost that would challenge the pockets of most people right now. The Tek RMD (Pictured) also taps into military robotics technology but aims to be a more “down to Earth” practical product that is affordable right now.

Now technology brings energy and hope. We now need some “big thinking” if we are to tackle some of the problems we face in bringing effective rehabilitation to many more people. Google X believes in going for the huge problems of life with a mantra of “10 times rather than 10%”. The logic of this is that when you try to do something just 10% better, you inevitably create a structure that maintains the status quo. If the premise is to create something 10 times better, it requires a different mindset and some counter-intuitive thinking. Exciting times if we have the courage.

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Contact us today for further information at orthotics@rslsteeper.com Please visit www.rslsteeper.com/products/orthotics

TVS Brace ‘the knee support you can rely on’ THE TVS Knee Brace is designed to hold a medially or laterally unstable knee from moving into a painful position of deformity while the knee is in extension and weight bearing.

While the patient is wearing the TVS Brace, the knee will be re-aligned to its original gait and long term use will stop the knee from sagging to a more extreme position preventing the need for a surgical solution.

The TVS has helping relieve arthritic knee pain to over 25,000 patients in the UK alone for over 40 years.

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

Helps relieve arthritic knee pain.

NHS approved and clinically proven for over 35 years.

Easily attached and removed in seconds.

Ultra lightweight (200grams/8oz).

Greatly increase stability and security for the wearer.

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Comfortable to wear and unobtrusive (can be worn under clothes).

Suitable for both legs.

Children’s size available.

For more information call 02380 643402, email sales@stclare-engineering.co.uk or visit www.tvskneebrace.co.uk

ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2014/15

Chief Executive Ruth Owen OBE, has been celebrated in the Health Service Journal’s (HSJ) 2014 ‘most innovative people in healthcare’ list, run in partnership with Bird & Bird.

The charity has influenced government policy through constant innovation – the ‘Child in a Chair in a Day’ initiative is credited by the NHS as a beacon of good practice and means that in 80 per cent of routine cases, a child goes home in their wheelchair on the day of their assessment.

The charity also launched an innovative smartphone app last year, designed to offer a faster and more efficient service for disabled children and families seeking mobility equipment and access to other services.

Ruth said: “I’m very honoured to be among such inspirational innovators and leaders – all of whom are on this list for their tenacity and determination to get things done,

Ruth Owen OBE

and make a real difference to the lives of the people they serve.

“All credit should really go to the Whizz-Kidz team of staff, volunteers and partners who work so hard to provide equipment and services, raise funds, and campaign so effectively to help disabled kids get the good start they deserve and go on to fulfil their potential in life.”

Award-winning paediatric products from Specialised Orthotic Services LOOKING for specialist seating options for children with complex postures?

Specialised Orthotic Services has the answer.

Better known as SOS, Specialised Orthotic Services are one of the UK’s leading providers of special seating, mobility and positioning products. SOS works closely with NHS Wheelchair Services, OTs and physiotherapists to offer clinical services, advice and assessments nationwide.

The company offers a comprehensive range of special seating, the successful Mojo wheelbase range of mobility products and the Poziform range of harnessing and positioning equipment, SOS has a wealth of experience in dealing with complex postural problems. This includes the award winning P Pod Bean Seat, Equipoise Straddle Seat and Nessie Positioning Aid. The P Pod gives clients an alternative seating option for the home without

compromising on levels of support.

The standard or custom moulded top combined with a unique beanbag base offers unrivalled comfort without the wheelchair.

Nessie and Equipoise help aid posture development, a comfortable alternative to 90/90 corrective seating systems.

Contact SOS today or visit their website for more information. Specialised Orthotic Services Ltd Unit 127-128 Fauld Industrial Park, Fauld Lane, Tutbury, Staffordshire, DE13 9HS Call: 01283 812860 Email: enquiries@specialorthotic.com

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sponsors kids

Fundraising begins for young meningitis victim Harmonie FUNDRAISING is underway for a baby from Bath who has had to have her arms and legs amputated after suffering meningitis.

Harmonie-Rose Allen, from Bath, was diagnosed with what doctor’s labelled one of the worst cases of meningitis they had seen and was given just a ten per cent chance of survival.

But the 11-month-old battled through – but doctors need to amputate both her arms above the elbow and both her legs above the knee to save her.

She’s undergoing her third operation this month and now the community is rallying round to help raise money to pay for prothetic limbs for her.

Company Goldgenie Global has also stepped in to run an ebay auction for a gold Iphone 6 to boost the fundraising.

Laban Roomes, CEO, said: “We were very moved when we read about Harmonie’s situation in The Metro.

“Meningitis is such a cruel disease

and it is an awful thing for such a young child to lose her limbs to it. To ensure a suitable living environment and the best prostheses possible, Harmonie has an expensive road ahead and we wanted to do something to help straight away. We hope that donating a 24ct. Gold iPhone 6 to an online auction will not only raise funds towards this worthy cause but also raise awareness about the Hope for Harmonie campaign.”

Anyone wanting to make a donation here for Harmonie-Rose can do so here: http://www.justgiving.com/hope4har monie where amost £30,000 of the £250,000 target has been raised.

The cash for charity Tree of Hope is for Harmonie-Rose’s future rehabilitation and will include hydro therapy, physiotherapy and good quality prosthetic limbs.

Any surplus will go to the general funds of Tree of Hope to assist other sick children.

Dorset Orthopaedic treat clients of all ages and are highly experienced in the prosthetic care of children from all over the UK with a variety of congenital or acquired limb loss. A fifth of their clients are under 21 and require an on-going, changing level of care as they grow up. Managing Director David Hills reports.

Specialist prosthetic care for children CHILDREN can often present with a number of complex challenges, sometimes with all four limbs missing.

Changes can take place in the space of less than a year and we ensure we are always available to change or adapt limbs to suit size and height changes, activities and requirements at various periods in a child's life.

We also undertake research and development to produce ‘child specific’ products such as the EasyfitTM Junior, which is essential if we are to meet their needs.

In addition to exceptional care management, Dorset Orthopaedic has invested into the research and development of ultra-lightweight composite materials and soft shore silicones to further support children’s requirements.

Their clinics throughout the UK, from Glasgow to the South coast, have provided numerous children with specialised sports blades and P.E. prostheses, water activity limbs and every-day prosthetics.

KIDS

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Their team of upper limb specialists also fit and supply custom designed electronic, body operated and cosmetic arms, including special adaptations to assist with playing sports and other activities.

The EasyfitTM Junior is a cost effective and durable cosmetic cover designed specifically for children.

Developed around the awardwinning adult version, the EasyfitTM Junior can be ordered and fitted through any NHS or private clinic, helping kids to live ‘life without limits’.

ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2014/15

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21/11/14

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NEWS

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The bubble actuator pictured is what the UT Arlington research team is designing and building.

Robotic speech allows Irving to walk at daughter’s wedding A PARALYSED man has manage to walk and deliver the speech at his daughter’s wedding standing up thanks to a robotic suit being developed in the UK.

messages a second to each other.

Irving Caplan was paralysed in a biking accident in 2012 and was worried he would have to give his father of-the-bride speech sitting down.

They are currently estimated at costing £97,000 but the company is aiming to get the price down to £40,000.

But thanks to a £100,000 device from Rex Bionics – he was able to walk across the venue to address the guests.

The exoskeleton suit has legs that contain 29 computer processors which communicate 3,000

The motors can carry a person weighing up to 15 stone have been used by 50 people, clocking up 4,000 hours of walking.

The exo skeletons are currently being tested by the US military in rehabilitation centres for wounded servicemen.

Developers are also researching using brain control to help users mobilise in the device making it truly the only hands free exoskeleton.

Research-led products RESEARCHERS investigating clinical implications of ill-fitting orthoses have shown that dermal contact with an ill-fitted cervical brace can cause skin lesions and affect patient compliance. Thus leading to the additional increased cost of then having to nurse pressure sores.

For those patients who are at risk of occipital breakdown, due to extended periods lying supine Aspen have specifically developed the Vista® ICU Back Panel Inspired by the needs of ICU nurses, the Vista ICU Back Panel is constructed of dual density foam that eliminates bed sheer during patient movement and repositioning.

The first level of foam cradles the patient’s head for maximum pressure 14

distribution, while the second firmer layer provides an added support and structure.

Like all Aspen collar pads, the Vista ICU Back Panel is cotton-lined to wick moisture away from patient’s skin whilst providing same superior motion restriction as the standard Vista Back Panel.

For further information please contact Customer Services 01254 268788

ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2014/15

Researchers win grant funding for adaptive interface development RESEARCHERS have been awarded grant funding to develop an adaptive interface which fits between a prosthetic and the limb to improve fit and comfort.

UT Arlington scientists are working on a wearable interface to make prosthetics more comfortable after being awarded a $744,300 grant from the Department of Defense Peer Reviewed Orthapaedic Research Programme.

Haiying Huang, professor in the Mechanical and Aerospace Engineering Department, and Muthu Wijesundara, principal research scientist at UT Arlington's Research Institute, are collaborating on the project. The interface will resemble an inflatable bubble wrap that will be embedded with sensors.

Huang is an expert in sensor technology. She said four types of sensors will be used with the interface to monitor the fitting of the prosthetic device. The sensors will measure vertical movement of the limb relative to the socket wall, the pressure on the limb, the changes in the circumference of the residual limb during the day, and the water content in the tissue.

She said: “Eventually, we want to build the socket that can adjust automatically to the patient. In order to do that, we need the sensors to tell us when and how to adjust the socket. We plan to design a warning system first, then the sensor data will teach us how to adjust the interface automatically.”

Prosthetic users frequently experience discomfort, blistering and ulcers between their

Haiying Huang, professor of Mechanical & Aerospace Engineering.

prosthetics and their residual limbs. The limb's volume changes throughout the day - an unavoidable fluctuation which changes how the limb and prosthetic socket fit together.

At the moment, many prosthetic users manually adjust the fitting between the prosthetics and their limbs by adding or removing socks.

Wijesundara – who specializes in medical devices for applications in tissue regeneration, wound healing, and prosthetic devices/interfaces – said they want an adaptable interface that can improve comfort and the fit regardless of the residual limb conditions and improve the quality of the life for the user.

He said: “We want everything to adjust depending on whether the person is walking, running or simply sitting down.

“This interface technology can be applied to various prosthetic devices and exoskeleton applications.”

The researchers believe it could take three to five years to start clinical applications of the device.

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sponsors podiatry

Views sought on proposed new standards

By Nicola Hyde A CONSULTATION is underway about the proposed new standards for podiatric surgery.

The Health and Care Professions Council is seeking the views of stakeholders on proposed standards for podiatric surgery which outlines the knowledge, skills and understanding necessary for safe and effective podiatric surgery practice.

Once agreed, the HCPC will use the standards to approve and monitor post-registration education and training programmes.

The HCPC will in the future annotate (mark) the register to indicate podiatrists who have successfully completed an approved programme.

By providing information to the public about who is qualified in podiatric surgery, this annotation will help support informed choices.

Podiatrists complete additional training lasting a number of years in order to practise podiatric surgery and must already be registered with the HCPC. Therefore, podiatrists practicing podiatric surgery will also still need

“We believe that annotation will improve public protection as we will be able to set separate standards and create an independent, robust framework for safe and effective practise of podiatric surgery. to meet the standards of proficiency for podiatrists, the standards of conduct, performance and ethics, and standards for continuing professional development.

Director of Policy and Standards for the College of Podiatry Michael Guthrie said: “We have carefully considered feedback from our stakeholders about our approach to annotating the register for podiatrists practising podiatric surgery.

“We believe that annotation will improve public protection as we will be able to set separate standards and create an independent, robust framework for safe and effective practise of podiatric surgery.

“When we drafted these standards, we drew on our existing standards of education and training as well as

documents and frameworks developed by different organisations.

“We also held a consultation event with key stakeholders in the field of podiatric surgery and are grateful to all those who have contributed to the process so far.”

The consultation will run until 16 January 2015 and will be of particular interest to podiatrists who practise podiatric surgery, education providers, employers, professional bodies and service users.

The HCPC will analyse the responses once the consultation closes, publish the comments received and explain the decisions made as a result.

The HCPC plans to publish the approved standards in June 2015.

Younger diabetics at more risk of amputation

By Nicola Hyde SHOCK statistics have revealed that younger diabetes patients are more likely to face amputations as they get fewer vital checks.

The latest National Diabetes Audit reveals that diabetes patients under the age of 40 are receiving fewer vital checks and hitting treatment targets less often than older age groups.

Diabetes UK says the figure should be a wake up call to the NHS as if younger people are missing their checks and failing to reach their treatment targets, this is putting them at increased risk of amputation.

PODIATRY

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A spokesman said: “Put simply, younger people who develop diabetes end up living longer with the condition.

“Surely they should be receiving just as good careº as those who are older.

“After all, if they get the help and support they need throughout their lives then they are far less likely to develop the serious complications which make up 80 per cent of the NHS’s current budget spend on diabetes. We hear from many people with diabetes in their 30s and 40s who tell us that patchy care and lack of structured education when they were younger has already resulted in life-changing complications.

“Things need to change for the next generation but the figures tell us that this just is not happening.

Alarmingly, it appears things are not getting better for young people; they are actually getting worse.”

ASSISTIVE TECHNOLOGIES I DECEMBER/JANUARY 2014/15

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20/11/14

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