Webinar 3 - Integration in Action: Breaking down Boundaries - Save the date 5 February 2015

Save the date - 5 February 2015 - 1:00-1:50 

 

Webinar 3 - Integration in Action:  Breaking down Boundaries  

 

We are delighted to announce a third webinar, provided by NHS Clinical Soft Intelligence Service in partnership with the Royal College of Speech and Language Therapists and supported by the Chartered Society of Physiotherapy to the Improving Rehabilitation Services Community of Practice.

 

This webinar will explore two examples of how service providers have carried out service improvements across health, social care and the voluntary sector.

 

Following the webinar, participants will be aware of:

·        alternative ways of engaging with partner organisations to deliver good rehabilitation

·        how these services overcame barriers and be able to consider ways in which they are applicable to their own circumstances

 

Speakers will include

Dr Karen Robb – Regional Lead for Rehabilitation - London

Bernadette Kennedy - St. George's Healthcare NHS Trust

Dr Joanne Fillingham – Regional Lead for Rehabilitation – Midlands and East

Alison Shortman - Staffordshire and Stoke On Trent Partnership Trust

 

To find out more and to register for this webinar, please go to:

http://tinyurl.com/CSIweb3a

 

Participants have the opportunity to submit questions on this topic to our speakers before and during the webinar. 

Please note places are limited.  Unfortunately webinar content currently cannot be viewed on mobile devices.

Please refer to the RCSLT’s webinar guide for participants for more information on participating in a webinar, and technical requirements

 

If you have any relevant examples of great services, guidelines or resources which you have produced or know of, we would be delighted to hear about them on the NHSCSI on line forum. 

Trulife - Senior Orthotist Opportunities

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HCPC - Chair of Council Role

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Lancashire Teaching Hospitals - Senior Orthotist

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Dorset Hospitals, Orthotist, Dorset

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Peacocks - Experienced Orthotists

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National Institute for Health Research (NIHR) funded Masters in Clinical Research

The University of Brighton are now recruiting for NIHR fully funded (SUBJECT TO AGREEMENT BY NIHR) places for the MRes (Clinical Research) course, starting in September 2015. Funding includes salary costs and course fees for full time over one year or part time route over two years.

Click here to view more information.

Prosthetic developments worth watching

http://www.onlinetmd.com/medical-device-design-prosthetic-developments-emerson-1315.aspx#.VKxm2IqsWhZ

Pledge reinforces NHS leaders commitment to a healthy engaged workforce

http://www.nhsemployers.org/news/2014/12/pledge-reinforces-nhs-leaders-commitment-to-a-healthy-engaged-workforce

Satisfaction with cosmesis and priorities for cosmesis design reported by lower limb amputees in the United Kingdom: Instrument development and results

Nicola Cairns,  Kevin Murray,  Jonathan Corney,  Angus McFadyen

Abstract

Background: Amputee satisfaction with cosmesis and the importance they place on cosmesis design have not been published in the literature.

Objectives: To investigate the current satisfaction levels of amputees in the United Kingdom with their cosmesis and the importance placed on attributes of cosmesis design to inform future cosmesis redesign.

Study Design: Cross-sectional questionnaire study.

Methods: Questionnaires were administered to lower limb amputees in the United Kingdom. Satisfaction scores and the overall importance ranking of cosmesis features were calculated. Statistically significant relationships between two demographic, satisfaction or importance variables were tested using Fisher's exact tests (one-tailed) at a significance level p = 0.05.

Results: Between 49% and 64% of respondents reported neutral or dissatisfied opinions with the cosmesis features (greater than 50% for five of the nine features). The three most important features identified were shape matching the cosmesis to the sound limb, free prosthetic joint movement underneath the cosmesis and natural fit of clothing over the cosmesis.

Conclusions: The results indicate that current cosmesis satisfaction levels of amputees in the United Kingdom are below what the medical device industry and clinical community would desire. The most important cosmesis features identified by the sample can be used to direct future cosmesis design research.

Clinical relevance The findings will enable the medical device industry to improve cosmesis design in the areas that are important to amputees. The findings also counter anecdotal opinions held by clinicians, providing an opportunity for them to evaluate any preconceptions they harbour and how this might influence their clinical work.

Source: http://m.poi.sagepub.com/content/38/6/467.full

Secretariat Festive Opening Hours

The Secretariat will close at 5pm on Tuesday 23 December and will re-open on Monday 5 January 2015. 

The Secretariat staff would like to wish you all a very Merry Christmas and Happy New Year.

The Management of Diabetic Foot Ulcers Through Optimal Off-Loading Building Consensus Guidelines and Practical Recommendations to Improve Outcomes

Robert J. Snyder, Robert G. Frykberg, Lee C. Rogers, Andrew J. Applewhite, Desmond Bell, Gregory Bohn, Caroline E. Fife, Jeffrey Jensen, James Wilcox

Background: We sought to develop a consensus statement for the use of off-loading in the management of diabetic foot ulcers (DFUs).

Methods: A literature search of PubMed for evidence regarding off-loading of DFUs was initially conducted, followed by a meeting of authors on March 15, 2013, in Philadelphia, Pennsylvania, to draft consensus statements and recommendations using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to assess quality of evidence and develop strength of recommendations for each consensus statement.

Results: Evidence is clear that adequate off-loading increases the likelihood of DFU healing and that increased clinician use of effective off-loading is necessary. Recommendations are included to guide clinicians on the optimal use of off-loading based on an initial comprehensive patient/wound assessment and the necessity to improve patient adherence with off-loading devices.

Conclusions: The likelihood of DFU healing is increased with off-loading adherence, and, current evidence favors the use of nonremovable casts or fixed ankle walking braces as optimum off-loading modalities. There currently exists a gap between what the evidence supports regarding the efficacy of DFU off-loading and what is performed in clinical practice despite expert consensus on the standard of care.

Source: http://www.japmaonline.org/doi/abs/10.7547/8750-7315-104.6.555 

Effects of Custom-Molded and Prefabricated Hinged Ankle-Foot Orthoses on Gait Parameters and Functional Mobility in Adults with Hemiplegia: A Preliminary Report

Pardo, Vicky; Galen, Sujay; Gahimer, Julie E.; Goldberg, Allon

JPO Journal of Prosthetics & Orthotics:

January 2015 - Volume 27 - Issue 1 - p 33-38

doi: 10.1097/JPO.0000000000000053

Abstract

Introduction: Hinged ankle-foot orthoses (AFOs) have been shown to improve gait and functional mobility in both adult and pediatric populations with neurological disorders. Hinged AFOs provided to clients can either be prefabricated or custom-made. To date, there have been no studies comparing a custom-made articulated AFO (C-AFO) with a prefabricated articulated AFO (P-AFO) and the effects that they have on gait and functional mobility in individuals with hemiplegia after a stroke.

Materials and Methods: The purpose of this study was to determine if there were any differences in the gait and functional mobility parameters of patients with hemiplegia when wearing the C-AFO or the P-AFO and also to determine if there was a difference in the braced versus not-braced conditions. Fourteen participants with hemiplegia completed tests that assessed spatiotemporal gait parameters using the GAITRite walkway. In addition, participants completed tests to assess weight-bearing symmetry during sit-to-stand (using the Balance Master), stepping capabilities using the maximal step length (MSL) test, and functional mobility using the timed up and go test (TUG). Data were analyzed using a repeated measures analysis of variance with Bonferroni adjustments for multiple comparisons.

Results: There were no significant differences (P > 0.05) between the two braced conditions for the gait parameters, the TUG, the sit-to-stand symmetry, and the MSL. There were significant differences between the braced (C-AFO or P-AFO) and the shoes-only conditions for the gait parameters (gait speed, stride length, step length, and gait symmetry of the uninvolved leg) and for the functional mobility assessments (TUG and MSL-involved leg).

Conclusions: This preliminary study has shown that there was no significant difference in any of the gait or functional mobility parameters when wearing the C-AFO or the P-AFO, provided that the P-AFO provides optimal support and fits the individual's anatomical dimensions well. Significant differences in both gait and functional mobility measures were observed between the shoes-only and braced conditions. The results of this study also demonstrated that wearing a hinged AFO does contribute to a better gait and functional mobility in people who have had a stroke.

Source: http://journals.lww.com/jpojournal/Abstract/2015/01000/Effects_of_Custom_Molded_and_Prefabricated_Hinged.8.aspx 

WHO/Europe | Rehabilitation: key to an independent future for children with poliomyelitis in Tajikistan

Representatives of the Ministry of Health and Social Protection and a WHO disability-rehabilitation team in Tajikistan in collaboration with representatives of the International Society of Prosthetics and Orthotics conducted follow-up activities from 22 September to 8 October 2014 to support the implementation of intervention and follow-up plans for children and adults with chronic paralysis caused by poliomyelitis (polio). The plans were developed in March 2014 at rehabilitation camps organized to assess the needs of people, mostly children, who had contracted polio during a large outbreak in Tajikistan in 2010.

Working with the Ministry of Health and Social Protection, the team met children and adults with polio, visited the republican orthopaedic centre, trained doctors in 3 locations and visited the Department of Traumatology of Karabolo Hospital in Dushanbe.

As the main outcomes of the mission, the team:

• described the importance of continuous referral and follow-up for children with polio;
• provided the first training in Tajikistan on postoperative rehabilitation therapy;
• trained local orthopaedic surgeons in 12 complicated operative procedures;
• technically monitored 24 children’s orthoses (externally applied devices designed for and fitted to the body) and suggested corrective measures; and
• helped design a system for guaranteed regular follow-up of children with polio.

A member of the rehabilitation team said that timely rehabilitation interventions – such as physical therapy, occupational therapy, orthoses, wheelchairs, crutches and, if required, surgery – can make tremendous changes in the life of a person with polio. Using polio as an entry point, the aim was to build a system of rehabilitation for all people with disabling conditions that will help give them equal opportunities and a greater chance to live life with dignity.

Long-term effects of paralysis due to polio

After the first, six-month, acute stage of polio, gradual recovery of some muscle strength is possible with the help of gentle exercises and positioning. After 2–3 years, however, further significant recovery of muscle strength is unlikely. At this point, rehabilitation interventions with assistive devices can greatly contribute to functional independence.

All of the children who contracted polio during the 2010 outbreak are now in this chronic phase of rehabilitation, which will last for the rest of their lives.

Looking to the future

The recent mission comprised the second phase of a three-year project focused on community-based rehabilitation of people with disabilities and the development of human resources in this field. The project is supported by the United States Agency for International Development (USAID). In the first phase (March 2014), the team assessed 360 people with polio, mostly children, who represented the majority of known confirmed cases with paralysis due to the 2010 outbreak, and developed rehabilitation plans to address their needs.

These plans include therapeutic interventions and the identification of appropriate assistive devices. In choosing exercises and assistive devices, the aim is always to ensure the maximum of independence, comfort and confidence with the minimum of support. Many of the children may also require operations to correct or prevent deformities, although giving urgently needed orthotic and physiotherapy interventions now can decrease some children’s need for surgery in the next few years.

Source: http://www.euro.who.int/en/countries/tajikistan/news/news/2014/12/rehabilitation-key-to-an-independent-future-for-children-with-poliomyelitis-in-tajikistan

Opcare - Junior Prosthetist Vacancies

For full details of this vacancy please click here

Indicators of Future Ulceration in Diabetes Patients of Low-Moderate Foot Risk

Davida Louise O'Brien, Claire M. Buckley, Frank Hill, Maria Horgan, Ivan J. Perry and Magdalena Tyndyk

Abstract

Background & Aim: Diabetes Mellitus can cause serious health problems including foot complications. Peripheral neuropathy affects the outer appendages, most commonly the lower limbs. Ulceration of the feet has a high possibility of advancement to amputation; thus greatly diminishing quality of life. This study investigates if patients with diabetes, who are at low-moderate risk of foot disease, have any underlying biomechanical signs which may indicate that they are at risk of future ulceration.

Methods: Twenty patients with Diabetes Mellitus at low-moderate risk of foot disease and 32 healthy individuals participated in this study. All participants completed a self-administrated questionnaire (assessing sociodemographic

and lifestyle factors) and underwent a clinical foot screening examination (plantar sensation, pedal pulses and ankle range of motion), gait assessment (spatio-temporal parameters) and barefoot plantar pressure analysis. Results between the 2 groups were compared.

Results: Major differences were observed in area of plantar pressure distribution, walking speed and foot alignment between low-moderate risk participants with diabetes and healthy controls. Low-moderate risk participants with diabetes recorded elevated dynamic plantar pressure in regions of metatarsal heads and the heel. Plantar pressure was correlated with arch type and foot alignment (p<0.05). Dissimilarities were not observed for lifestyle behavior and ankle range of motion.

Conclusion: This pilot study demonstrated a group of patients with diabetes at low-moderate risk of foot disease showing significant differences in biomechanical measures that are linked to callus/ulcer formation. Risk factors for ulceration previously reported for high risk patients with diabetes also affect patients with low-moderate foot risk.

Source: http://esciencecentral.org/journals/indicators-of-future-ulceration-in-diabetes-patients-of-lowmoderate-foot-risk-2329-910X-2-155.pdf

Biomechanical Effects of Valgus Knee Bracing: A Systematic Review and Meta-Analysis

• Rebecca F. Moyer, PT, PhD^a, 
• Trevor B. Birmingham, PT, PhD^a, ,  (Dr.), 
• Dianne M. Bryant, PhD^a,
• J.Robert Giffin, MD, FRCS(C)^b, 
• Kendal A. Marriott, BScKin^c, 
• Kristyn M. Leitch, PhD^d

Abstract

Objective

To review and synthesize the biomechanical effects of valgus knee bracing for patients with medial knee osteoarthritis.

Methods

Electronic databases were searched from their inception to May 2014. Two reviewers independently determined study eligibility, rated study quality and extracted data. Where possible, data were combined into meta-analyses and pooled estimates with 95% confidence intervals (CI) for standardized mean differences (SMD) were calculated.

Results

Thirty studies were included with 478 subjects tested while using a valgus knee brace. Various biomechanical methods suggested valgus braces can decrease direct measures of medial knee compressive force, indirect measures representing the mediolateral distribution of load across the knee, quadriceps/hamstring and quadriceps/gastrocnemius co-contraction ratios, and increase medial joint space during gait. Meta-analysis from 17 studies suggested a statistically significant decrease in the external knee adduction moment during walking, with a moderate-to-high effect size (SMD=0.61; 95%CI: 0.39, 0.83; p<0.001). Meta-regression identified a near-significant association for the knee adduction moment effect size and duration of brace use only (β, -0.01; 95% CI: -0.03, 0.0001; p=0.06); with longer durations of brace use associated with smaller treatment effects. Minor complications were commonly reported during brace use and included slipping, discomfort and poor fit, blisters and skin irritation.

Conclusions

Systematic review and meta-analysis suggests valgus knee braces can alter knee joint loads through a combination of mechanisms, with moderate-to-high effect sizes in biomechanical outcomes.

Keywords

• knee osteoarthritis; 
• valgus knee brace; 
• biomechanics; 
• knee adduction moment; 
• systematic review;
• meta-analysis

Source: http://www.sciencedirect.com/science/article/pii/S1063458414013417

Guy's and St Thomas' NHS Foundation Trust, x2 Orthotists, London

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NHS England¹s clinician survey on patients taking a more active role in their healthcare

Patients with long term conditions self-manage their condition at home the majority of the time. They have different levels of knowledge, skills and confidence in managing their own health and care – we describe this as the patient's 'activation' level.

 

Clinicians have different training, orientations and views about a patient's role in their care which results in different approaches when working with people with long term conditions. NHS England is carrying out this survey with doctors, nurses and allied health professionals to understand these views and approaches. It will help us to develop a baseline of clinicians' attitudes across the range of professionals and understand their support needs in this area.

 

Your response is very important and the survey will take less than 10 minutes to complete. To complete the survey, please go tohttps://www.surveymonkey.com/s/CS-PAM_AHPs

 

The survey closes on 12 December. All responses are anonymous and not associated with any personally identifiable information. Aggregated results will be published and shared with stakeholders.

Snapshot of good practice - Rehabilitation Service Improvement

As part of the Improving Rehabilitation Services Community of Practice (IRS COP), NHS Clinical Soft Intelligence Service (NHSCSI) wishes to support BAPO members to raise the profile of local service improvements, no matter how big or small. Some of you have already identified examples good practice which can be shared.  Please download the snapshot of good practice proforma complete and return to katherine.andrews@nhs-commissioning.net. The responses will form a "snapshot" database composed of the succinct descriptions and contact details provided. This collation will be shared with the IRS community as well as the NHS England Improving Rehabilitation Services programme team. 

 

 

BAPO Conference & Exhibition - Register Now Using Early Bird Discount

 

ONLY 6 DAYS REMAINING FOR EARLY BIRD DISCOUNT

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Making rehabilitation work better for people - 1 December 2014 - Webinar Content for Comment

Dear Colleague

 

Further to our recent webinar invite, we would welcome your comments on the attached webinar draft outline in terms of the subject and areas you would wish to see covered in the presentations and question and answer session.

 

Please note that this webinar is not meant to highlight individual professions' best practice but focus on the overarching messages and themes for a very wide-ranging audience. There will be opportunities and we would encourage professional bodies to signpost these more specific examples via posting on the on line forum

 

If you would like to see your ideas reflected in the forthcoming webinar series, please email Carol Cahill at cahillc@csp.org.uk with your suggestions about the subject areas you would like discussed, as well as any questions for inclusion in the Q & A sessions.

New Evidence Update on Lower Limb Peripheral Arterial Disease

Click here to view document

Webinar - Making Rehabilitation Work Better for People - Save the Date 1 December 2014

Save the date - 1 December 12.45- 1.30

Webinar - Making Rehabilitation Work Better for People

 

The webinar will be of relevance to everyone with an interest in improving rehabilitation services. It will consider how changes can be made that better support people to return to meaningful occupation, including education and work. It will also share information about NHS England's Improving Rehabilitation Services programme and how you can get involved.

 

This is the first of four webinars (other dates are 19^th January, 5^th February, 2^nd March) which 'The Improving Rehabilitation Services Community of Practice' will hold over the next few months that offer learning and an opportunity to interact and discuss ideas in a live format. Please click on the link to view a longer communication which includes more detail about the content of the webinar:  Webinar Information

 

To Register (and submit a question) click here

Participants have the opportunity to submit questions on this topic to our speakers before and during the webinar. 

 

Please note places are limited.  Unfortunately webinar content currently cannot be viewed on mobile devices.

 

Please refer to the RCSLT's webinar guide for participants for more information on participating in a webinar, and technical requirements.

 

If you are new to webinars, please allow plenty of time prior to the start to familiarise yourself with the technical requirements.

If you can't join us live, a recording of the webinar will be made available after 1 December 2014 via the Community of Practice and the COP forum.

 

NHS Clinical Soft Intelligence Service has developed this webinar with NHS England and it is produced in collaboration with the Royal College of Speech and Language Therapists.

Sherwood Forest Hospitals - Band 5 Orthotist

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Sherwood Forest Hospital - Senior Orthotist - Nottinghamshire

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Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy

S. Morrison, S.R. Colberg, H.K. Parson, A.I. Vinik

Journal of Diabetes and its Complications

Abstract

Aims

For older adults with type 2 diabetes (T2DM), declines in balance and walking ability are risk factors for falls, and peripheral neuropathy magnifies this risk. Exercise training may improve balance, gait and reduce the risk of falling. This study investigated the effects of 12 weeks of aerobic exercise training on walking, balance, reaction time and falls risk metrics in older T2DM individuals with/without peripheral neuropathy.

Methods

Adults with T2DM, 21 without (DM; age 58.7 ± 1.7 yrs) and 16 with neuropathy (DM-PN; age 58.9 ± 1.9 yrs), engaged in either moderate or intense supervised exercise training thrice-weekly for 12 weeks. Pre/post-training assessments included falls risk (using the physiological profile assessment), standing balance, walking ability and hand/foot simple reaction time.

Results

Pre-training, the DM-PN group had higher falls risk, slower (hand) reaction times (232 vs.219 ms), walked at a slower speed (108 vs. 113 cm/s) with shorter strides compared to the DM group. Following training, improvements in hand/foot reaction times and faster walking speed were seen for both groups.

Conclusions

While falls risk was not significantly reduced, the observed changes in gait, reaction time and balance metrics suggest that aerobic exercise of varying intensities is beneficial for improving dynamic postural control in older T2DM adults with/without neuropathy.

http://www.sciencedirect.com/science/article/pii/S1056872714001226

Prosthetist Vacancies - Opcare - Roehampton, Newcastle & Cambridge

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Clinical Audit Awareness Week

HQIP is pleased to confirm details of this year's Clinical Audit Awareness Week(CAAW) webex sessions. The free, interactive lunchtime webinars have this year been designed around the classic Clinical Audit Cycle and will run everyday during CAAW from 20-24 October 2014 at 1-1.30pm. 

Further details can be found on the following link:

http://www.hqip.org.uk/clinical-audit-awareness-week-webinar-booking/?utm_medium=email&utm_campaign=eBulletin+2014-10-21&utm_content=eBulletin+2014-10-21+CID_b2634dcb0e3ad84bd86cd3c4cdc7527c&utm_source=ebulletin&utm_term=Its%20Clinical%20Audit%20Awareness%20Week

Trulife - Orthotist - North West London & The North West/Midlands

Click here to view the Job Advert.

BAPO Conference & Exhibition 2015 - SpeakEasy

Opcare Job Advertisement - 3 x Orthotist positions, England

To find out further information on the positions available please click on the following link:

Opcare Orthotist Positions, England

UNISON NHS Agenda for Change Action

UNISON is asking it's NHS employed members to take industrial action over NHS pay offer.  There will be strike action from 7am-11am on Monday 13 October 2014 followed by 4 days of action short of strike action from 14 October – 17 October. 

UNISON asks that if a member is employed directly by an NHS organisation on Agenda for Change terms and conditions then they are covered by the action and able to show support.  Members who choose to strike would lose pay as a result.

If a member is self employed, or employed under a contract for services, then they are not covered by the action. If this is the case we would ask that they do not cross picket lines or cover the work of striking workers. These BAPO members cannot be asked to strike or take action short of strike action. 

It is unlikely that any workplaces will close as a result of the strike however if so then any BAPO members should be informed by their employer and receive their full normal pay.
 
UNISON and other trade unions will likely be maintaining picket lines at entrances to workplaces. Pickets are allowed to peacefully persuade workers and others not to cross the picket line but anyone who decides to cross must be allowed. Anyone crossing the picket line will also likely be asked to not undertake any duties of to cover those who are on strike. 

Of course it is an individual decision and BAPO members can explain that they have not been balloted and are not on strike.  

The background to the strike is here http://www.unison.org.uk/at-work/health-care/key-issues/nhs-pay/home/ . 

BAPO Conference & Exhibition 2015 - Call for Posters

Ankle-foot orthoses in children with cerebral palsy: a cross sectional population based study of 2200 children

Ankle-foot orthosis (AFO) is the most frequently used type of orthosis in children with cerebral palsy (CP). AFOs are designed either to improve function or to prevent or treat muscle contractures.

The purpose of the present study was to analyse the use of, the indications for, and the outcome of using AFO, relative to age and gross motor function in a total population of children with cerebral palsy. 

Methods: A cross-sectional study was performed of 2200 children (58% boys, 42% girls), 0-19 years old (median age 7 years), based on data from the national Swedish follow-up programme and registry for CP. To analyse the outcome of passive ankle dorsiflexion, data was compared between 2011 and 2012.

The Gross motor classification system (GMFCS) levels of included children was as follows: I (n = 879), II (n = 357), III (n = 230), IV (n = 374) and V (n = 355). 

Results: AFOs were used by 1127 (51%) of the children. In 215 children (10%), the indication was to improve function, in 251 (11%) to maintain or increase range of motion, and 661 of the children (30%) used AFOs for both purposes.

The use of AFOs was highest in 5-year-olds (67%) and was more frequent at lower levels of motor function with 70% at GMFCS IV-V. Physiotherapists reported achievement of functional goals in 73% of the children using AFOs and maintenance or improvement in range of ankle dorsiflexion in 70%. 

Conclusions: AFOs were used by half of the children with CP in Sweden.

The treatment goals were attained in almost three quarters of the children, equally at all GMFCS levels. AFOs to improve range of motion were more effective in children with a more significant decrease in dorsiflexion at baseline.

Author: Maria WingstrandGunnar HägglundElisabet Rodby-Bousquet
Credits/Source: BMC Musculoskeletal Disorders 2014, 15:327

http://7thspace.com/headlines/489888/ankle_foot_orthoses_in_children_with_cerebral_palsy_a_cross_sectional_population_based_study_of_2200_children.html

BAPO Conference & Exhibition 2015 - Registrations Open

AHP Healthy Conversations

Public Health England are looking to better understand the extent to which AHPs engage in healthy conversations with clients and related issues including potential barriers and training support needs.

Please complete the survey below to register your views as a Prosthetist/Orthotist

https://www.surveymonkey.com/s/AHPSurvey2014

The effectiveness of combined bracing and exercise in adolescent idiopathic scoliosis based on SRS and SOSORT criteria: a prospective study

Recently an RCT confirmed brace efficacy in adolescent idiopathic scoliosis (AIS) patients. Previously, a Cochrane review suggested also producing studies according to the Scoliosis Research Society (SRS) criteria on the effectiveness of bracing for AIS.

Even if the SRS criteria propose a prospective design, until now only one out of 6 published studies was prospective. Our purpose was to evaluate the effects of bracing plus exercises following the SRS and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) criteria for AIS conservative treatment. 

Methods: Study design/setting: prospective cohort study nested in a clinical database of all outpatients of a clinic specialized in scoliosis conservative treatment.Patient sample: seventy-three patients (60 females), age 12 years 10 months +/-17 months, 34.4+/-4.4 Cobb degrees, who satisfied SRS criteria were included out of 3,883 patients at first evaluation.Outcome measures: Cobb angle at the end of treatment according to SRS criteria : (unchanged; worsened 6[degree sign] or more, over 45[degree sign] and surgically treated, and rate of improvement of 6[degree sign] or more).Braces were prescribed for 18-23 hours/day according to curves magnitude and actual international guidelines.

Weaning was gradual after Risser 3. All patients performed exercises and were managed according to SOSORT criteria.

Results in all patients were analyzed according to intent-to-treat at the end of the treatment. Funding and Conflict of Interest: no. 

Results: Overall 46 patients (49.3%) improved.

Seven patients (9.6%) worsened, of which 1 patient progressed beyond 45[degree sign] and was fused. Referred compliance was assessed during a mean period of 3 years 4 months+/-20 months; the median adherence was 99.1% (range 22.2-109.2%).

Employing intent-to-treat analysis, there were failures in 11 patients (15.1%). At start, these patients had statistically significant low BMI and kyphosis, high thoracic rotation and higher Cobb angles.

Drop-outs showed reduced compliance and years of treatment; their average scoliosis at discontinuation was low: 22.7[degree sign] (range 16-35[degree sign]) at Risser 1.3 +/- 1. 

Conclusions: Bracing in patients with AIS who satisfy SRS criteria is effective. Combining bracing with exercise according to SOSORT criteria shows better results than the current literature.

Author: Stefano NegriniSabrina DonzelliMonia LusiniSalvatore MinnellaFabio Zaina
Credits/Source: BMC Musculoskeletal Disorders 2014, 15:263

http://7thspace.com/headlines/478452/the_effectiveness_of_combined_bracing_and_exercise_in_adolescent_idiopathic_scoliosis_based_on_srs_and_sosort_criteria_a_prospective_study.html

--

Jonathan

BAPO Bulletin September 2014

 

 

BAPO Bulletin September 2014

 BAPO Short Courses

 

Spaces available - book quickly to avoid disappointment

 

Paediatric Gait Analysis and Orthotic Management: A Segmental Kinematic Approach - Elaine Owen MSc SRP MCSP
16^th-17^th October, 2014, Venue- Mercure Goldthorn Hotel, Wolverhampton

The course explores a fresh approach to the observation and analysis of normal gait and standing, and the classification and management of gait disorders. The biomechanics of normal gait and standing, and the pathological gaits of disabling conditions will be extensively reviewed, with particular reference to orthotic management. Pre-gait analysis and orthotic management assessment will be demonstrated. The emphasis of patient cases will focus on cerebral palsy, myelomeningocoele and other neurological conditions. Participants will gain a knowledge of the aims of orthotic management and how to achieve them through: the biomechanics of ankle-foot orthoses, the influence of footwear, varieties of ‘AFO Footwear Combination’ design, tuning ‘AFO Footwear Combinations’ to optimise gait and extensive video examples.

 

Orthotic treatment of Neurological Conditions
Friday 14^th November, 2014, Venue- Peacocks Medical, Newcastle

Developed to support clinicians to consolidate and update their clinical knowledge with neurological conditions, this one day course is aimed at level 5/6 clinicians.  This course gives an intensive overview of orthotic treatment interventions and principles for a wide range of neurological conditions.  Common interventions to compliment orthotic treatment will be discussed along with the role of specialise orthotic skills such as FES.

World Obesity Survey 

This survey developed by the International Association for the Study of Obesity (Now World Obesity Clinical Care) aims to build a better understanding of how obesity is currently managed and to identify educational and other priorities to improve outcomes for people who are overweight or obese.  It takes 5-10 minutes to complete and is a good opportunity to raise awareness of the contribution of AHPs.  Please encourage relevant members to contribute.

http://staging.n24i.com/novosurvey/index.cfm?UnqRef=3CBCB2FF-C9E6-40B2-BCE7-F7DB51DD655D

Regional Meetings

BAPO have recently hosted some regional meetings in the North East of England on the 29th July and Scotland on the 12th August. Read the reports in the upcoming BAPOmag for more details. These are the first in a series of meetings, with plans for meetings in the south of England and Wales. Please look out for more details and how to get involved.

 

Allied Health Professionals Survey

Following the success of Making Every Contact Count (MECC) initiative in supporting people to lead healthier lives in NHS settings, the Royal Society for Public Health is working in partnership with Public Health England to explore the potential for Allied Health Professionals (AHPs) to engage in “healthy conversations” with their clients in order to improve the health and wellbeing of their patients and clients.

In collaboration with Allied Health Professional Bodies, we are keen to hear from AHPs to better understand the extent to which professionals already engage in healthy conversations with their patients or clients and some of the challenges they might face.

We would really appreciate it if you could spare five minutes to complete a short survey to help direct our research.

www.surveymonkey.com/s/AHPSurvey2014 

 Professional Indemnity

As you may be aware the government have now introduced legislation that
requires all HCPC registrants, apart from social workers in England, to
hold appropriate professional indemnity cover as a condition of
registration with the HCPC.

This will not affect the majority of registrants as they will already be
indemnified either through their employer, BAPO Indemnity Insurance, directly
with an insurer or a combination of these. It is, however important that
each HCPC registrant has the appropriate level of cover for their practice.

HCPC have published guidance for registrants, -Professional indemnity and your registration, which is available on their website here:

http://www.hcpc-uk.org/assets/documents/10004776Professionalindemnityandyourregistration.pdf

HCPC have also put together some Frequently Asked Questions which are
available here: http://www.hcpc-uk.org/registrants/indemnity/

 

Fundamental standards: improving quality and transparency in care

The government has announced legislation which introduces fundamental standards for health and social care providers. Subject to parliamentary approval, they will become law in April 2015.

The new measures are being introduced as part of the government’s response to the Francis Inquiry’s recommendations and are intended to help improve the quality of care and transparency of providers by insuring that those responsible for poor care can be held to account.

https://www.gov.uk/government/news/fundamental-standards-improving-quality-and-transparency-in-care

HCPC CPD audit process webinars

The HCPC will be running free CPD audit process webinars on Thursday 25

September 2014.

This online event will focus on the Health and Care Professions Council's
audit process and how this links to your HCPC registration and CPD and will
provide detailed information on how to put your CPD profile together

The presentation will last around 40 minutes, followed by the opportunity
to ask representatives from the HCPC questions about the audit (via the
webinar portal).

We will be running two sessions on 25 September 2014:

1pm - 2.30pm
4pm - 5.30pm

If you would like to register for these events, please click here

Further details about the webinar, including the link to join on the
day and how to send in questions, will be sent to those registered 1 week
before the event.

You can find further details on CPD and registration on our webpage -
http://www.hcpc-uk.org/registrants/renew/