Webinar 4 - Managing Relationships for Transition - Save the date Monday 2 March 2015

Monday 2 March 2015 – 13:00-13:50

This fourth and final webinar, provided by the NHS Clinical Soft Intelligence Service in partnership with the Royal College of Speech and Language Therapists and supported by the Chartered Society of Physiotherapists, will explore two examples of how rehabilitation service providers have carried out service improvements across a pathway.  In particular the webinar will discuss how they are improving transition for people who use the service.
 
The speakers will discuss the issues around:

·        enablers and obstacles to improving transition for people at different points in a pathway

·        issues pertinent to working in partnership to improve transitions between rehabilitation services in different organisations

·        ensuring the sharing of skills and expertise across providers to ensure effective transition

 

To find out more and register, go to http://www.tinyurl.com/NHS4a for a place at this webinar and to submit any initial questions around this topic. You are also able to submit questions during the webinar.

Buchanan Orthotics - Orthotist

Please click here to view job advertisement.

The Influence of Foot Orthoses on Patellofemoral Pain Syndrome: A Systematic Analysis of the Literature

Ahlhelm A, Alfuth M

Abstract

Background: The patellofemoral pain syndrome (PFPS) is one of the most commonly encountered disorders involving the knee. The symptoms often lead to a reduction of physical activities resulting in sport- and job-related disabilities and the potential occurrence of severe disorders. Different theories for the development of the syndrome exist which result in different therapy modalities. A change in foot posture and its effect on lower limb kinematics seem to be one potential risk factor for the development of the syndrome. This leads to the assumption that foot orthoses might be a potential therapy device. Objectives: The aims of this study were to outline the state of evidence for the treatment of PFPS with foot orthoses and to identify the effect of foot orthoses on PFPS. Study Design: A systematic review of clinical (CT) and randomized controlled trials (RCT) was undertaken. Methods: A systematic search for studies (CT, RCT) was conducted using the databases of Medline (PubMed), Cochrane library, and PEDro. The relevance for further analysis of studies was reviewed on the basis of title and abstract. An additional search was undertaken using the reference lists of the included studies and additional literature as well as the PubMed function "related articles". Results: 11 studies were included in this analysis. The effect of different types of foot orthoses on pain, function and kinematics of the lower limb and muscle activation of selected lower limb muscles was analysed. Significant effects on pain and function were determined. A slight effect on kinematics of the lower limb and muscle activation of selected lower limb muscles was identified. Conclusion: Foot orthoses seem to be an effective treatment device in the therapy for PFPS. An immediate and long-term reduction in pain and an improvement of function occurred following the intervention. There was just a slight change in lower limb kinematics and muscle activation of selected lower limb muscles. The relationship between biomechanical effects of orthoses and pain still seems to be unclear.

Source: http://www.ncbi.nlm.nih.gov/pubmed/25675398 

NHS Lothian - Head of Technical Services

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BAPO Conference 2015 Accommodation Bookings

Please note that  the online link for Conference 2015 accommodation bookings is due for release on 16 February, after which time there will be just a limited choice of hotels available via Reservation Highway and the rate will not be guaranteed.

Therefore if you haven’t already secured your accommodation for Conference 2015 please book as soon as possible via www.reservation-highway.co.uk/bapo15

Kent and Medway NHS - Prosthetic Team Leader

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CSP - Improving Adult Rehabilitation Services Community of Practice – Soft intelligence Summary Bulletin

Following up on our requests for snapshots of good practice, we wanted you to share with you the first bulletin capturing the thoughts or 'soft intelligence' of the Improving Rehabilitation Services Community of Practice (IRSCOP).

Members are encouraged to enter the debate by adding comments to what people are saying about improving rehabilitation services and are invited to:

• Feedback on the themes within the bulletin that are either missing or upon which you have a different perspective
• Share what action you are taking in relation to these themes (however big or small)

How to submit feedback & comments
I would be very happy to receive feedback from members. Alternatively, comments can either be emailed to katherine.andrews@nhs-commissioning.net or posted on the discussion forum (making these anonymous if requested)

Feedback will be used to enrich the emergent themes and populate the next Soft intelligence Bulletin. We are grateful for your assistance.

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