Sunday 31 March 2013

A pilot study to assess the effectiveness of orthotic insoles on the reduction of plantar soft tissue strain

Musab Ibrahim
,
Rana El Hilaly
,
Mona Taher
,
Ahmed Morsy

Clinical Biomechanics

Abstract

Background

Plantar ulcers pose a frequent serious complication in the neuropathic foot. Previous studies suggested that ulcer initiation occurs within the plantar soft tissue rather than on the plantar surface. This study investigated the effectiveness of different shaped silicone insoles on the reduction of both plantar soft tissue strain and pressure. The authors have found no previous experimental studies on the effectiveness of insole shape on reducing plantar soft tissue strain during standing.

Methods

A custom molded silicone insole which allowed passage of ultrasound to the plantar surface of the foot was prototyped for this study. Soft tissue strain was computed from soft tissue thickness measured using ultrasound in five conditions: unloaded, barefoot, wearing a prefabricated silicone insole, wearing the custom molded silicone insole alone then with a metatarsal pad. Plantar pressure was measured for the same conditions.

Findings

The custom molded insole was found to significantly reduce soft tissue strain and plantar pressure relative to both the barefoot condition and the prefabricated insole under the second and third metatarsal heads. The metatarsal pad was found to significantly reduce soft tissue strain but not significantly affect plantar pressure.

Interpretation

A custom molded silicone insole can effectively reduce both soft tissue strain and plantar pressure and is thus preferable to a prefabricated insole. It is suggested that quantifying the reduction of soft tissue strain is an essential design requirement for orthotic insoles since plantar pressure may not be a sufficient indicator of the effectiveness of an insole in preventing ulcer initiation.

Source: http://www.clinbiomech.com/article/S0268-0033(12)00222-7/abstract

Thursday 21 March 2013

Brain implant points to advanced prosthetics

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A compact, self-contained sensor recorded and transmitted brain activity data wirelessly for more than a year in early stage animal tests, according to a study funded by the US National Institutes of Health.

In addition to allowing for more natural studies of brain activity in moving subjects, this implantable device is claimed to represent a potential major step toward cord-free control of advanced prosthetics that move with the power of thought. The report is in the April 2013 issue of the Journal of Neural Engineering.

For people who have sustained paralysis or limb amputation, rehabilitation can be slow and frustrating because they have to learn a new way of doing things that the rest of us do without actively thinking about it,' said Grace Peng, Ph.D., who oversees the Rehabilitation Engineering Program of the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of NIH. 'Brain-computer interfaces harness existing brain circuitry, which may offer a more intuitive rehab experience, and ultimately, a better quality of life for people who have already faced serious challenges.'

Wednesday 20 March 2013

Drainpipe prosthetics in war torn Syria

Mr Qurashi Credit: Dudley Group NHS Foundation Trust

A doctor from Dudley has returned from Syria where he has been fitting prosthetic limbs made from drainpipes to war victims.

Mr Qurashi, who works at Russells Hall Hospital, occupied a makeshift clinic and workshop helping men, women and children who lost limbs during the two-year war that has so far claimed thousands of lives.

A Turkish businessman has donated the drainpipes which are melted down at high heat in an oven and moulded against a plaster cast of the amputated leg. They are then fitted into place with metal pins and leather straps.

The artificial feet are made from recycled rubber.

Source: http://www.itv.com/news/central/topic/prosthetics/

Sunday 17 March 2013

Effect of different orthotic concepts as first line treatment of plantar fasciitis

^a Department of Foot and Ankle Surgery, Schoen Klinik Munich Harlaching, Harlachinger Strasse 51, 81547 Munich, Germany¹
^b Outpatient Clinic for Orthopedic and Trauma Surgery, Altstadtring 6, 91161 Hilpoltstein, Germany
^c Florida Orthopaedics Institute, 13020 Telecom Parkway North, Tampa, FL 33637, USA

http://dx.doi.org/10.1016/j.fas.2012.12.008,

Abstract

Background

Evaluation of the effectiveness of three different types of prefabricated foot orthotics in the treatment of plantar fasciitis.

Methods

Prospective, randomized head-to-head trial in 30 adults (21 women, 9 men) with plantar fasciitis without any anatomic alterations. Three different prefabricated orthotics were tested (thin, non supportive orthotic (NO); soft supportive foam orthotic (FO); foam covered rigid self-supporting plastic orthotic (PO)). The follow up was 3 weeks. Main outcome measures were maximum and average pain (VAS), duration of pain per day, walking distance and subjective comfort.

Results

There was no significant effect of NO on maximal pain and average pain. FO and PO had a significant effect on pain levels (p < 0.05) whereas PO was superior concerning pain reduction and the time until the onset of effect (p < 0.05).

Conclusions

PO are superior regarding pain reduction and pain free time when compared to FO. NO did not demonstrate a significant effect in the test setup used.

http://www.sciencedirect.com/science/article/pii/S1268773113000209

Saturday 9 March 2013

Prosthetics study to improve mobility of amputees

Research by the University of Salford, University of Manchester and Blatchford's Endolite Technology Centre will help to enhance the mobility of people with above-knee amputations by improving the energy efficiency of prosthetic legs.

When walking with a single prosthetic leg, above-knee amputees typically use up to 60% more energy than people who are able-bodied, causing fatigue and a 40% slower walking speed. These difficulties can hinder an amputee's mobility and, as a result, affect their quality of life.

The energy storage and return capabilities of prosthetic legs are crucial to improving an amputee's gait and mobility, but most prostheses only store and return significant energy below the knee and in an uncontrolled way.

To overcome these problems the team of engineers and prosthetists will explore the potential for using hydraulic technology to harvest and store energy from the parts of the prosthesis that absorb power, and then return that energy to the parts that do useful propulsive work.

The results will be used to develop new prosthetic leg designs which have increased functionality and require less energy from the amputee.

http://www.salford.ac.uk/home-page/news/2013/prosthetics-study-to-improve-mobility-of-amputees

NHS Change Day – a single day of collective action to demonstrate how small changes can have a big impact

On the 13 March 2013 NHS Change Day will bring together the individual creativity, energy   and innovative thinking of thousands of NHS staff from across clinical and non-clinical areas   of work, in a single day of collective action to improve care for patients, their families and   their carers.   Change Day is an NHS grassroots initiative devised and driven by new young and emergent   clinical and managerial leaders from primary and secondary care across the NHS in England,   who want to make this call to action the single largest simultaneous improvement event in   the NHS.     It is an ambitious programme of activities aimed at galvanising and engaging the frontline in   the process of improvement through individuals and teams pledging to make a change in   their practice which will improve patient experience and/or clinical outcomes by spreading   and adopting best practice and championing innovation. This will be a country wide event   covering the whole of the UK and will coincide with Healthcare Innovation Expo at Excel in   the same day.          The idea of NHS Change Day is create a mass movement of people working in the NHS   demonstrating the difference they can make - by one simple act – and proving that large   scale improvement is possible in the NHS. The aim is for 65,000 people to take part, 65   being the number of years the NHS has been in existence.          Those who wish to take part can go to the NHS Change Day website at   http://www.changemodel.nhs.uk/changeday and make their pledge online, join in the   discussions on the forum and become part of the growing list of active supporters and   organisations taking part on the day.

Launch of consultation on legislation on indemnity insurance

A consultation is launched on legislation that would mean all regulated healthcare professionals have to hold indemnity or insurance to practise.

The consultation will run from 22 February to 17 May 2013 on draft regulations on the requirement for all regulated healthcare professionals to hold an insurance or indemnity arrangement as a condition of their registration with the relevant regulatory body.

The vast majority of healthcare professionals are already covered by their employer's arrangements. In the first instance, it will be for each individual healthcare professional to assure themselves that they are covered by an insurance or indemnity arrangement appropriate to their scope of practice.

Health Minister Dr Dan Poulter said:

"We believe all regulated healthcare professionals should hold insurance or indemnity to ensure the patients they treat are fully protected if things don't go according to plan.

"We are changing the law to make sure that this is the case. This will mean that in the rare cases where a patient suffers harm as a result of negligence, they are able to seek compensation.

"This should increase patient confidence and improve safety overall."

The department has asked some specific questions in the consultation document but please provide comments on any aspect of the consultation package.

There are a number of other provisions of the directive which have yet to be transposed into UK law and which will be consulted upon separately. The UK is required to be compliant with the directive from 25 October 2013. The department is undertaking the consultation on behalf of all UK health administrations.

Legislation in respect of the Pharmaceutical Society of Northern Ireland remains the responsibility of the Northern Ireland legislature and is subject to a separate consultation in Northern Ireland.