LimbPower Holding Primary & Junior Games at Stoke Mandeville Stadium

Following the huge success of last year's inaugural Junior Games, LimbPower are proud to be holding this fantastic event once again at Stoke Mandeville Stadium, birthplace of the Paralympics. The weekend will introduce young amputees and the young ambulant disabled to a range of sporting activities in a safe, friendly and inclusive environment.

Saturday 5th October will see those aged 5-11 able to try out a variety of sports including athletics, cycling, football, tennis and basketball in 'Have a Go' sessions under the guidance of experienced mentors and instructors from each sport's governing body. The emphasis is on fun while encouraging the children to have a go at sports and socialise with their peers.

On Sunday 6th October the older children aged between 11-18 will be able to have a go at key Paralympic sports, with instruction from qualified coaches and experienced athletes. They will be able to try out a wide range of sports including; athletics, Powerlifting, basketball, sitting volleyball, archery, football, cycling, swimming and tennis. They will be able to have fun and also perhaps find some hidden talents. We may even discover the Paralympians of the future!

"We're thrilled to be able to run this event again and offer the same opportunities to children that we have been offering to adults at the Amputee Games" said Kiera Roche, LimbPower Chairman. "Last year was such a great success, and we're hoping to reach even more young people and give them the chance to challenge what they think they are capable of."

Juliette Woolf, mother of Rio Woolf who took part last year, commented; "The 2012 LimbPower Primary Games were life-changing for Rio - he absolutely loved trying all the different para-sports on offer and making friendships with other "children with special arms and legs" which will last a lifetime - they had an instant bond!"

The Primary & Junior Games will help young amputees to learn new skills, have fun and importantly to discover their potential through sport. Anyone interested in taking part should contact Kiera Roche from LimbPower on: 07502 276858 or kiera@limbpower.com Alternatively registration forms can be downloaded from the website at www.limbpower.com/junior-games/

Surgical versus non‐surgical interventions in patients with adolescent idiopathic scoliosis

Surgical versus non‐surgical interventions in patients with adolescent idiopathic scoliosis

J Bettany‐Saltikov, HR Weiss, N Chockalingam… - The Cochrane Library, 2013

... Whilst scoliosis-specific exercises use internal corrective forces (ie muscles), braces use external
corrective forces ... However, some braces (called soft braces) are made of material similar to elas-
tic bands ... of the brace are used to straighten the spine and derotate the pelvis and ...

Retrospective Cohort Study ofthe Economic Value of Orthotic and Prosthetic Services

Medicare recipients given orthotic and prosthetic devices were more likely to remain active in the community and avoid facility-based care than similar Medicare patients who didn't receive such devices, a retrospective study found.

For example, patients receiving lower-extremity orthoses had fewer hospitalizations and emergency department (ED) admissions, and had about 10% lower Medicare costs after 18 months (P<0.05). Comparable Medicare savings were seen in patients with spinal orthoses and they also relied less on facility-based care (P<0.05).

The study results will be used to urge Medicare and other payers to make it easier for patients in need of prosthetics to receive them, the Amputee Coalition, a Manassas, Va.-based advocacy group that commissioned the study, said Tuesday.

The advocates said patients who receive orthoses and prosthetics will save Medicare money in the long run.

Although they relied less on facility-based care, patients receiving the orthotic and prosthetic devices did have more falls and fractures, and average Medicare episode payments weren't always lower. The increase in falls was most likely due to increased mobility because of the device, according to Allen Dobson, president of Dobson DaVanzo & Associates in Vienna, Va., the consulting firm that conducted the study.

"The increased physical therapy among O&P [orthoses and prosthetic] users allowed patients to become less bed-bound and more independent, which may be associated with higher rates of falls and fractures, but fewer emergency room admissions and acute care hospital admissions," the report concluded. "This reduction in health care utilization ultimately makes O&P services cost-effective for the Medicare program and increases the quality of life and independence of the patient."

Dobson, a former research director at the Centers for Medicare and Medicaid Services (CMS), and colleagues examined CMS data from 2007 to 2010 for patients who either had an amputation within the last year or who met predetermined etiological diagnoses. Patients who received a lower-extremity or spinal orthotic or prosthetic device were compared with those who hadn't received such devices.

The study compared healthcare utilization, Medicare payments, and negative outcomes such as fall and emergency department admissions for up to 18 months after receiving the device.

Generally, patients were found to be more mobile and therefore able to receive the physical therapy and rehabilitation required, and to avoid facility-based care.

With the data in hand, advocates hope it will be easier for patients to receive authorization for the devices.

"Insurers want to see the data that the healthcare system is better off if the service is provided," Susan Stout, interim president and chief executive of the Amputee Coalition, said in a call with reporters. "Now that the study is completed, we intend to use the information contained in the study to achieve fair insurance coverage for prosthetic devices."

Providers must prove the medical necessity of devices before insurers will pay for their use, a step which can be burdensome to patients and physicians. Insurers also have a tendency to provide the least expensive prostheses rather than one that maximizes a patient's mobility.

"For the first time, we can actually use the data ... that clearly demonstrates the efficiency and the efficacy of the services that we provide," Thomas Kirk, PhD, president of theAmerican Orthotic & Prosthetic Association, said in a call with reporters. "Not only are we providing services that can help out patients, we are also helping the American taxpayers save money."

While payers don't deny the devices, a number of patients are underserved by insurers, the advocates said on the call Tuesday. "Many payers have seen the cost of a prosthesis in a vacuum rather than seeing it as actually contributing to the overall improved health of the patient," Kirk said.

The authors hope to publish the results in a medical journal later.

Source: http://www.medpagetoday.com/PublicHealthPolicy/Medicare/41260

Link to report: http://www.amputee-coalition.org/content/documents/dobson-davanzo-report.pdf

Effect of rocker shoes on pain, disability and activity limitation in patients with rheumatoid arthritis

Masumeh Bagherzadeh Cham, Mohammad Sadegh Ghasemi, Bijan Forough, Mohammad Ali Sanjari, Mozdeh Zabihi Yeganeh, Arezoo Eshraghi

Abstract

Background: Rheumatoid arthritis is a chronic inflammatory joint disease which affects the joints and soft tissues of the foot and ankle. Rocker shoes may be prescribed for the symptomatic foot in rheumatoid arthritis; however, there is a limited evidence base to support the use of rocker shoes in these patients.

Objectives: The aim of this study was to evaluate the effectiveness of heel-to-toe rocker shoes on pain, disability, and activity limitation in patients with rheumatoid arthritis.

Study design: Clinical trial.

Methods: Seventeen female patients with rheumatoid arthritis of 1 year or more duration, disease activity score of less than 2.6, and foot and ankle pain were recruited. Heel-to-toe rocker shoe was made according to each patient's foot size. All the patients were evaluated immediately, 7 and 30 days after their first visit. Foot Function Index values were recorded at each appointment.

Results: With the use of rocker shoes, Foot Function Index values decreased in all subscales. This reduction was noted in the first visit and was maintained throughout the trials.

Conclusion: Rocker shoe can improve pain, disability, and activity limitation in patients with rheumatoid foot pain. All the subjects reported improved comfort levels.

Clinical relevance The results of this study showed that high-top, heel-to-toe rocker shoe with wide toe box was effective at reducing foot and ankle pain. It was also regarded as comfortable and acceptable footwear by the patients with rheumatoid foot problems.