Thursday 27 September 2012

Find and follow us on our Social Media

BAPO can now also be found on Twitter, LinkedIn and Facebook. Please see the links below and find and follow us on your preferred Social Media.

Wednesday 26 September 2012

Final Reminder: Consultation of revised Standards

Final Reminder to have your say on the revised Professional Standards for Prosthetics and Orthotics before the consultation period ends on 30th September 2012.

We are committed to engaging with our members, taking account of their views and input in the way that we carry out our work.

It is the intention of BAPO that these standards will form the baseline of practice for Prosthetists, Orthotists and Assistant Practitioners in the UK by providing more detailed information and guidance for both day to day practice and service planning. As such they sit alongside all other regulatory documents by which the profession is guided.
 
We expect the revised standards to be useful not only for Prosthetists and Orthotists, but for all healthcare commissioners and providers, Service Heads and managers, other healthcare professionals and interested members of the public.
 
When fully approved, the Standards will be freely available to all stakeholders.
 
Please review the draft standards which can be found on the member only section of the BAPO website under Downloads & Documents/Guidelines.

Tuesday 25 September 2012

Hospital Directions show: November 21-22, 2012

If you are unable to view this email please click here to view online.

NHS Clinical Leaders Network

Hospital Directions show: November 21-22

Hospital Directions Show

21-22 November

Olympia, London

http://www.hospitaldirections.co.uk/

The NHS is going through significant change with high expectations for improved efficiency and savings.

NHS Chief Executive David Nicholson set the organisation a massive challenge to deliver savings of £20bn by 2015, at the same time as the government launched the biggest reform of healthcare services since the inception of the NHS.

It has left hospitals desperately trying to manage rising demand against the backdrop of a real-terms cut to funding.

The new structures in primary care mean that hospitals are forging fresh relationships with commissioners, who are in turn under pressure to deliver more health services in the community and nearer to people's homes.

In the past, when such funding challenges have arisen, services have been slashed, waiting lists increased and training and quality compromised. But with an ageing population, increasing levels of obesity, and rising expectations, the NHS can't afford such short sighted solutions.

Secondary care will not survive this squeeze and reform unchanged. However, investment in prevention, improvement, information and infrastructure during these tough times could make frontline hospital services more productive in the future.

Now the need for strong leadership and efficiency improvement is greater than ever.

Offering comprehensive speaker streams on Innovation, Efficiency and Leadership, Hospital Directions will bring senior hospital managers together from the fields of patient services, human resources, information technology, estates management and procurement to listen to – and share – best practice.

Experts will speak on service redesign, integration and innovation; improved use of information, evidence and technology; new approaches to leadership, recruitment and performance management; flexible and efficient estates and facilities management; and progressive procurement and use of the private sector.

Six speaker streams run over two days, jam-packed with seminars, and supported by an exhibition, and will bring managers together from across the different disciplines and from all around the country.

Tickets for Hospital Directions are being offered free up to 10 individuals for their hospitals.

Register now at www.hospitaldirections.co.uk/register



Monday 24 September 2012

BAPO Practical orthotic assessment course

BAPO Practical orthotic assessment and is due to run on 20th October 2012 and is aimed at developing upon the

required skills for graduate orthotists and is to be held at Peacocks in Newcastle upon Tyne.

Sunday 23 September 2012

SPINAL IMAGING IN PATIENTS WITH INFANTILE AND JUVENILE IDIOPATHIC SCOLIOSIS: IS ROUTINE MAGNETIC RESONANCE IMAGING INDICATED?

K. O'Shea, H. Mullett, C. Goldberg, D. Moore, E. Fogarty and F. Dowling.

Author Affiliations

Abstract

Surgical correction of spinal deformity in patients with neural axis abnormalities has established risks of causing further neurological injury. It is necessary to identify individuals with a predisposition for such abnormalities before treatment is instituted.

Objective: Examination of the association between idiopathic scoliosis and underlying neural axis abnormalities in the infantile and juvenile age groups.

Design: Retrospective chart and radiographic review.

Subjects: Ninety-four (36 infantile, 58 juvenile) consecutive patients with non-congenital scoliosis under the age of eleven years.

Outcome measures: These consisted of the MRI findings, neurological examination, associated curve morphology and necessity for neurosurgical intervention or surgical curve correction.

Results: Approximately 25% of patients presenting as idiopathic juvenile scoliosis had underlying neural axis abnormalities. No patient with apparent infantile idiopathic scoliosis had an abnormal spinal MRI scan. Using the Z score for independent proportions, there was a statistically significant difference between infantile and juvenile scoliosis and the presence of an underlying neural axis abnormality (Z score of 2.089, equivalent to p<0.02).

Conclusions: We advocate routine MR spinal imaging in all patients with juvenile idiopathic scoliosis. In infantile idiopathic scoliosis, to avoid unnecessary general anaesthetics, one should image the spinal canal only when clinically indicated.

http://www.bjjprocs.boneandjoint.org.uk/content/84-B/SUPP_III/336.5.abstract

Friday 21 September 2012

An advanced virtual model of the human foot has been created by researches to drive forward improvements in treating serious injuries and illness.

The 3D model depicts bones, joints, ligaments, muscles and tendons in an unprecedented level of detail.

Virtual foot

"Start Quote

Prof Jim Woodburn

The Glasgow/Maastricht foot is a game-changer"

Prof Jim WoodburnGlasgow Caledonian University

It will be used to develop advanced treatments for conditions ranging from foot and ankle problems to amputations.

The 3.7 million euro a-footprint project is being led by Glasgow Caledonian University (GCU).

The human foot is particularly difficult to model because of its complexity.

Researchers worked in partnership with the Maastricht University and Danish biomechanical firm AnyBody Technology on what had been named the Glasgow/Maastricht Foot Model.

It is estimated that 200 million Europeans suffer from disabling foot and ankle conditions and the model should lead to more efficient orthotic devices, cutting recovery times and reducing symptoms.

It will also have aplications in treating flat feet or foot drop - which prevents recovering stroke patients from moving their ankles and toes.

GCU's Professor Jim Woodburn, who is the project co-ordinator, said: "Previous to this development, most computer models of the human body ended in a black rectangle - the foot was simply too complicated to model. The Glasgow/Maastricht foot is a game-changer.

"It opens the door to a huge range of applications, including the manufacture of better and more efficient orthotics, resulting in quicker recovery times, reduced symptoms and improved functional ability for those suffering from conditions which afflict the foot and lower leg."

The simulation can be used to test potential cures as well as developing new orthotic devices, using 3D printing techniques.

Source: http://www.bbc.co.uk/news/uk-scotland-glasgow-west-19660736

Tuesday 18 September 2012

Sport prostheses and prosthetic adaptations for the upper and lower limb amputees: an overview of peer reviewed literature


Abstract

Background: Sport prostheses are used by both upper- and lower-limb amputees while participating in sports and other physical activities. Although the number of these devices has increased over the past decade, no overview of the peer reviewed literature describing them has been published previously. Such an overview will allow specialists to choose appropriate prostheses based on available scientific evidence rather than on personal experience or preference.

Objective: To provide an overview of the sport prostheses as they are described by the papers published in peer reviewed literature.

Study Design: Literature review.

Methods: Four electronic databases were searched using free text and Medical Subject Headings (MESH) terms. Papers were included if they concerned a prosthesis or a prosthetic adaptation used in sports. Papers were excluded if they did not originate from peer reviewed sources, if they concerned prostheses for body parts other than the upper or lower limbs, if they concerned amputations distal to the wrist or ankle, or if they were written in a language other than English.

Results: Twenty-four papers were included in this study. The vast majority contained descriptive data and consisted of expert opinions and technical notes.

Conclusion: Data concerning the energy efficiency, technical characteristics and special mechanical properties of prostheses or prosthetic adaptations for sports, other than running, are scarce.

Clinical relevance An overview of the peer reviewed literature will enable rehabilitation specialists working with amputees to choose a prosthesis that best suits their patients' expectations on the available scientific evidence. Identifying the information gaps present in the peer reviewed literature will stimulate new research and eventually broaden the base of scientific knowledge.


Source: http://poi.sagepub.com/content/36/3/290.abstract


 

Development of a simple stance-control system for persons with poliomyelitis and an associated gait analysis

A simple stance-control system (SSCS) was developed, which is a new device attached to the upper lateral frame of a carbon fiber-reinforced plastic knee-ankle-foot orthosis (carbon KAFO). The SSCS consisted of two pressure sensors beneath the heel and metatarsal phalangeal joints, connecting cables, microcomputer, motor controlling the lever of Swiss-lock knee joint, and battery box. Normally the SSCS is off, and the Swiss-lock knee joint is mechanically fixed in the extended position, whereas the SSCS is on during the swing phase according to the information from the pressure sensors, and the Swiss-lock knee joint is released by pulling up the lever. Therefore, a patient using a carbon KAFO with SSCS can flex his/her knee joint during the swing phase and to maintain it in the extended position during the stance phase. The safety while using the SSCS was confirmed in four healthy men and the gait pattern was measured by using a three-dimensional motion analysis and force plate system. These results revealed that the SSCS attached to a carbon KAFO did not unlock the Swiss-lock knee joint on the five conditions in daily living activities, and enabled a patient to control his/her lower limb during the stance phase and flex it during the swing phase.

Source:  http://ieeexplore.ieee.org/xpl/articleDetails.jsp?arnumber=6275704

On page(s): 169
Conference Location :  Kobe
Print ISBN: 978-1-4673-1617-0
INSPEC Accession Number: 12948666
Digital Object Identifier :  10.1109/ICCME.2012.6275704
Date of Current Version :   23 August 2012
Issue Date :   1-4 July 2012

Functional Gait Analysis Before and After Delayed Military Trauma-Related Amputation A Report of Three Cases

Barri L. Schnall, MPT, LT Scott C. Wagner, MD, Jenna D. Montgomery, BS, Marilynn Wyatt, PT, MA,
and MAJ Benjamin K. Potter, MD

The current conflicts in Iraq and Afghanistan have produced
a large number of service members with severe
combat-related injuries. Eighty-two percent of service
members with combat-related injuries have sustained extremity
trauma, which accounts for 54% of wounds overall1.
Of all the lower-extremity amputations performed at military
treatment facilities, approximately 13% (125 of 975) were the
result of delayed or ''elective'' procedures2. Recent studies have
shown that the outcomes of extensive salvage procedures for
severely injured limbs are not necessarily definitive in a nonmilitary
population3 and that early amputation can be preferable
to limb salvage in many such instances3-12.
Some military and nonmilitary population studies have
considered a delayed amputation as occurring within as little as
twenty-four hours postinjury, while other studies have cited a
range over years4,13,14. Up to 15% of combat-related amputations
have occurred later than twelve weeks postinjury, and the military
medical community has adopted this as a reasonable timeframe
during which initial operative efforts at limb salvage can be attempted
2,14. Given the incidence of trauma-related amputation in
the active duty military population, as well as the likely underreported
frequency of similar scenarios in civilian trauma settings
3,8,15-17, the goal of this report is to provide an analysis of gait in
combat-injured patients before and after delayed amputation.
Our institutional review board approved the retrospective review
of the data presented in this manuscript. The three patients included
in this case series were informed that data would be submitted
for publication, and they all gave consent.



Thursday 6 September 2012

Oscar Pistorius could have run with longer blades at the Paralympics, says prosthetics supplier - Telegraph

Oscar Pistorius could have run with longer blades at the Paralympics, says prosthetics supplier - Telegraph
A clinical prosthetics specialist for the company that supplies both Oscar Pistorius and Alan Oliveira with their running blades says Pistorius would have been perfectly within his rights to experiment with longer blades at the Paralympics to achieve greater speed.

Oscar Pistorius - could have run with longer blades at the Paralympics, says prosthetics supplier


Wednesday 5 September 2012

Posterior tibial tendon dysfunction and flatfoot: Analysis with simulated wa...

via Gait & Posture - Articles in Press by Kota Watanabe, Harold B. Kitaoka, Tadashi Fujii, Xavier Crevoisier, Lawrence J. Berglund, Kristin D. Zhao, Kenton R. Kaufman, Kai-Nan An on 8/31/12

Highlights: ► We examined the flatfoot motion utilizing a dynamic foot-ankle simulator. ► Magnetic tracking system monitored the cadaver foot bone movements 3-dimensionally. ► Kinematics in the intact condition were consistent with normal gait analysis data. ► Kinematics altered in the flatfoot condition in coronal and transverse planes. ► The simulated flatfoot was consistent with patients data with flatfoot.Abstract: Many biomechanical studies investigated pathology of flatfoot and effects of operations on flatfoot. The majority of cadaveric studies are limited to the quasistatic response to static joint loads. This study examined the unconstrained joint motion of the foot and ankle during stance phase utilizing a dynamic foot–ankle simulator in simulated stage 2 posterior tibial tendon dysfunction (PTTD). Muscle forces were applied on the extrinsic tendons of the foot using six servo-pneumatic cylinders to simulate their action. Vertical and fore-aft shear forces were applied and tibial advancement was performed with the servomotors. Three-dimensional movements of multiple bones of the foot were monitored with a magnetic tracking system. Twenty-two fresh-frozen lower extremities were studied in the intact condition, then following sectioning peritalar constraints to create a flatfoot and unloading the posterior tibial muscle force. Kinematics in the intact condition were consistent with gait analysis data for normals. There were altered kinematics in the flatfoot condition, particularly in coronal and transverse planes. Calcaneal eversion relative to the tibia averaged 11.1±2.8° compared to 5.8±2.3° in the normal condition. Calcaneal-tibial external rotation was significantly increased in flatfeet from mean of 2.3±1.7° to 8.1±4.0°. There were also significant changes in metatarsal-tibial eversion and external rotation in the flatfoot condition. The simulated PTTD with flatfoot was consistent with previous data obtained in patients with PTTD. The use of a flatfoot model will enable more detailed study on the flatfoot condition and/or effect of surgical treatment.


AGE OF DIAGNOSIS AND PROGNOSIS OF IDIOPATHIC SCOLIOSIS UNRELATED TO INFORMATION ON HEREDITY

A Grauers a , b , A Danielsson c , MK Karlsson d and P Gerdhem a

Author Affiliations

paul.gerdhem@karolinska.se

Abstract

Purpose To compare information on heredity among patients with idiopathic scoliosis.

Methods 1440 patients with idiopathic scoliosis were recruited. Information on prevalence of scoliosis among relatives was obtained by questionnaire.

Results 1256 (87%) were women and 184 (13%) were men. 204 (14%) of the participants were juvenile (4-9 yrs) at time of diagnosis. 1236 (86%) were adolescents (10-19 yrs) at time of diagnosis.

141 of the 204 patients (69%) with juvenile scoliosis had been treated (73 brace, 68 surgery) and 817 of the 1236 patients (66%) with adolescent scoliosis had been treated (490 brace, 327 surgery).

23% had at least one parent and 13% had at least one grandparent with scoliosis. When comparing female and male patients there was no difference in proportion of parents with scoliosis (p=0.97, Chi-square) or grandparents with scoliosis (p=0.35). 26% of patients with juvenile scoliosis had at least one parent with scoliosis compared to 22% for patients with adolescent scoliosis (p=0.23). 18% of patients with juvenile scoliosis had at least one grandparent with scoliosis compared to 12% for patients with adolescent scoliosis (p=0.04).

When dividing the patients into groups according to treatment (observed, brace, or surgery), there was no difference in proportion of parents with scoliosis (p=0.59) or in proportion of grandparents with scoliosis (p=0.99).

Conclusion It is unlikely that information on heredity is of importance for the prognosis of idiopathic scoliosis. We found no difference in heredity among patients with juvenile and adolescent scoliosis or between males and females.

http://www.bjjprocs.boneandjoint.org.uk/content/94-B/SUPP_XXXI/23.abstract