BAPO 2013 Call for Posters - Chance to win £100!

For full details on how to submit a poster for BAPO Conference & Exhibition 2013 please see below, further details at www.bapo.com

Printed Prosthetics

Traditionally, amputees have been offered one-size-fits-all prosthetics – functional but not particularly attractive. Now technology is blurring the line between medical devices and sculpture.

http://www.euronews.com/2013/02/13/printed-prosthetics/

 

CAD tools for designing shoe lasts for people with diabetes

J Antonio Bernabeu, M Germani, M Mandolini… - Computer-Aided Design, 2013

... 2.3. Orienting and measuring the foot and the last. The InfoHorma (IH) software aims to extract
standard measurements from the geometrical shapes of digitised 3D feet or last models after
they have been aligned. ... 2.4. Modifying last geometry to ensure optimal foot–last fitting. ...

http://www.sciencedirect.com/science/article/pii/S001044851300002X 

Improvements announced in NHS prosthetic care for war veterans

NHS services across the country are set to benefit from additional funding to improve prosthetic and rehabilitation services for ex-servicemen and women.

The government is making £11 million available over the next 2 years to ensure veterans are able to access a high level of prosthetic and rehabilitation care.

Nine NHS facilities across the country will receive a share of up to £6.7 million of the funding. They will be able to use this specifically to access the latest technology and provide the highest quality of prosthetic care for veteran amputees. The centres are:

• Bristol: Disablement Services Centre, North Bristol NHS Trust
• Leicester: Leicester Specialist Mobility Centre, provided by Blatchford Clinical Services on behalf of PCTs
• Sheffield: Mobility and Specialised Rehabilitation Centre, Northern General Hospital
• Carlisle: Disablement Services Centre, Cumberland Infirmary, North Cumbria University Hospitals NHS Trust
• Preston: Specialist Mobility & Rehabilitation Centre, Lancashire Teaching Hospitals NHS Foundation Trust
• Stanmore: Stanmore Prosthetic Rehabilitation Unit, Royal National Orthopaedic Hospital Trust
• Portsmouth: Prosthetic Regional Rehabilitation Department, Portsmouth Hospitals NHS Trust
• Birmingham: West Midlands Rehabilitation Centre, Birmingham Community Healthcare NHS Trust
• Cambridge: Addenbrooke's Rehabilitation Clinic, Cambridge University Hospitals NHS Foundation Trust

Other services will benefit too, with a £1million fund to ensure that all prosthetics services across England improve. The remainder will go towards providing prosthetics.

Announcing the funding, Health Minister Dr Dan Poulter said:

"Ex-servicemen and women who have been injured in the line of duty deserve the very best possible care from the NHS.  This is why we are making more funding available to improve veterans' prosthetic limb services – and £22 million in total between 2010 and 2015 to support veterans' physical and mental health. 

"We want to ensure that our Armed Forces veterans have access to the very best healthcare services at specialist prosthetic and rehabilitation centres across the country. In time, these NHS centres will achieve the same high standards of care for veterans that are offered by Armed Forces rehabilitation centres, such as Headley Court." 

Today's announcement is in response to recommendations made by Dr Andrew Murrison MP in a report, commissioned by the Prime Minister, about the provision of prosthetics for military amputees.

Dr Murrison recommended that a small number of multi-disciplinary centres should provide specialist prosthetic and rehabilitation services in England to ensure veterans have access to a similar, high quality of care to that which the Armed Forces provides.

Dr Jeff Lindsay, a Consultant in Amputee Rehabilitation at the West Midlands Rehabilitation Centre, Birmingham Community Healthcare NHS Trust, said:

"Our aim is for ex-service men and women to maintain their level of independence, function and capabilities as they move from the military into civilian life. 

"The additional funding will enable us to offer the highest possible standards of prosthetic provision and care for these brave men and women, as they leave the armed forces and their care is transferred to the NHS.

"Furthermore, the additional funding will help to enhance both the knowledge and skills of our expert staff and improve available facilities for the benefit all patients, both ex-servicemen and women and civilians alike." 

The additional funding and improvements that this will bring will mean that civilian amputees will also be able to benefit from advanced care in centres across the NHS in England.

The NHS Commissioning Board will work with military charities and the NHS to finalise the amount each service will receive.

Clinical Responsibility and the Healthcare Professional BAPO short course 11th May 2013 BAPO Secretariat

Due to technical difficulties please use the link below for further information on the 'Clinical Responsibility and the Healthcare Professional' BAPO short course.

Further Information

Clinical Responsibility And The Healthcare Professional - (Medico Legal) - BAPO Short Course on Saturday 11th May 2013

held at BAPO Secretariat Unit 64, Sir James Clark Building Abbeymill Business Centre Paisley PA1 1TJ

For further information on the Clinicial Responsibility And The Healthcare Professional BAPO Short Course, please follow link below: http://gallery.mailchimp.com/e99b59101e344f80e38400f12/files/Flyer_Medico_Legal_NEW_FORMAT_11.02.13.docx

NHSAcronym – the handy app at your fingertips

Download the new NHSAcronym app to your iPhone or iPad so you have the definition of over 500 commonly used acronyms in the NHS at your fingertips. Just search 'NHSAcronym' in the iTunes app store.

Life After Stroke Awards - Professional Excellence Award

The Stroke Association organises the Life After Stroke Awards to recognise the courage and determination of those people whose lives have been affected by stroke. The 2013 Life After Stroke Awards will be held on 26 June at The Dorchester, London.

  

This year sees the introduction of a new category – The Professional Excellence Award – you may like to nominate a colleague who has provided exceptional service in the provision of stroke care or prevention.

 

Nominations for the Life After Stroke Awards 2013 are open until 1 March 2013. Visit www.stroke.org.uk/lasa to nominate now. If you would like to be sent a nomination form in the post please email lasa@stroke.org.uk.

The Stroke Association has announced that Apprentice star, Businesswoman and West Ham boss, Karren Brady, is the charity's first Life After Stroke Awards Patron. She said: "I am thrilled and delighted to be the first LASA Patron and am calling on everyone affected by stroke to nominate someone they know for these very special awards.

BRITISH ASSOCIATION OF PROSTHETISTS AND ORTHOTISTS NOMINATIONS FOR EXECUTIVE COMMITTEE

At the Annual General Meeting in Telford on 23 March 2013 the elections for Executive Committee members will take place.

Three members of the committee have or will stand down, namely: Nigel Jones, John Head and Suzanne Faulkner.  One member wishes to stand for election, namely: Nicola Eddison.  The following members will remain on the committee; Steve Mottram, Jonathan Bull, Pamela Coulton, Sandie Waddell, Ian Jones and Paul Charlton thus nominations are invited for four vacancies.

A nominee must be a fully paid up Full Member and their nomination must be proposed and seconded by two current Full Members of the Association.

Nominations should be signed by the nominee, proposer and seconder.  A summary of no more than 100 words should be attached, indicating:

·        who the nominee is

·        what they have done for the profession

·        why they wish to be elected

·        and how they see the profession and the Association going in the next two years

This should be addressed to the Secretary at the BAPO Secretariat to arrive by Friday 8 February 2013 (extended deadline date).  It would be appreciated if nominations could be sent in as soon as possible.

BAPO Conference 22-24 March 2013 Telford

Click to download the latest Conference Information

Critical Appraisal Skills BAPO Short Course 19 April 2013 Staffordshire University

For further information on the 'Critical Appraisal Skills' BAPO Short Course please follow the link below.

Further information

BAPO Short Course Kinesio Taping 21 & 22 June 2013

For further information on the 'Kinesio Taping' BAPO short course please follow the link below.

Further Information

Jeremy Hunt challenges NHS to go paperless by 2018

The NHS should go paperless by 2018 to save billions, improve services and help meet the challenges of an ageing population, Health Secretary Jeremy Hunt will say today. In a … Read more → - Jeremy Hunt challenges NHS to go paperless by 2018 

Outcomes

Responsiveness of the Manchester-Oxford foot questionnaire (MOXFQ) compared with AOFAS, SF-36 and EQ-5D assessments following foot or ankle surgery 

J. Dawson, I. Boller, H. Doll, G. Lavis, R. Sharp, P. Cooke, and C. Jenkinson J Bone Joint Surg Br 2012;94-B 215-221 

Quote: The responsiveness of the Manchester–Oxford Foot Questionnaire (MOXFQ) was compared with foot/ankle-specific and generic outcome measures used to assess all surgery of the foot and ankle. We recruited 671 consecutive adult patients awaiting foot or ankle surgery, of whom 427 (63.6%) were female, with a mean age of 52.8 years (18 to 89). They independently completed the MOXFQ, Short-Form 36 (SF-36) and EuroQol (EQ-5D) questionnaires pre-operatively and at a mean of nine months (3.8 to 14.4) post-operatively. Foot/ankle surgeons assessed American Orthopaedic Foot and Ankle Society (AOFAS) scores corresponding to four foot/ankle regions. A transition item measured perceived changes in foot/ankle problems post-surgery. Of 628 eligible patients proceeding to surgery, 491 (78%) completed questionnaires and 262 (42%) received clinical assessments both pre- and post-operatively. The regions receiving surgery were: multiple/whole foot in eight (1.3%), ankle/hindfoot in 292 (46.5%), mid-foot in 21 (3.3%), hallux in 196 (31.2%), and lesser toes in 111 (17.7%). Foot/ankle-specific MOXFQ, AOFAS and EQ-5D domains produced larger effect sizes (> 0.8) than any SF-36 domains, suggesting superior responsiveness. In analyses that anchored change in scores and effect sizes to patients' responses to a transition item about their foot/ankle problems, the MOXFQ performed well. The SF-36 and EQ-5D performed poorly. Similar analyses, conducted within foot-region based sub-groups of patients, found that the responsiveness of the MOXFQ was good compared with the AOFAS.

This evidence supports the MOXFQ's suitability for assessing all foot and ankle surgery.

Foot posture is associated with morphometry of the peroneus longus muscle, tibialis anterior tendon, and Achilles tendon

Foot posture is associated with morphometry of the peroneus longus muscle, tibialis anterior tendon, and Achilles tendon Murley 2013 Scandinavian Journal of Medicine & Science in Sports Wiley Online Library

G. S. Murley, J. M. Tan, R. M. Edwards, J. De Luca, S. E. Munteanu, J. L. Cook

Scandinavian Journal of Medicine & Science in Sports

Abstract

The aim of this study was to investigate the association between foot type and the morphometry of selected muscles and tendons of the lower limb. Sixty-one healthy participants (31 male, 30 female; aged 27.1 ± 8.8 years) underwent gray-scale musculoskeletal ultrasound examination to determine the anterior-posterior (AP) thickness of tibialis anterior, tibialis posterior, and peroneus longus muscles and tendons as well as the Achilles tendon. Foot type was classified based on arch height and footprint measurements. Potentially confounding variables (height, weight, hip and waist circumference, rearfoot and ankle joint range of motion, and levels of physical activity) were also measured. Multiple linear regression models were used to determine the association between foot type with muscle and tendon morphometry accounting for potentially confounding variables. Foot type was significantly and independently associated with AP thickness of the tibialis anterior tendon, peroneus longus muscle, and Achilles tendon, accounting for approximately 7% to 16% of the variation. Flat-arched feet were associated with a thicker tibialis anterior tendon, a thicker peroneus longus muscle, and a thinner Achilles tendon. Foot type is associated with morphometry of tendons that control sagittal plane motion of the rearfoot; and the peroneus longus muscle that controls frontal plane motion of the rearfoot. These findings may be related to differences in tendon loading during gait.

Adaptable prosthetics for amputees

Approximately one in every 1,000 people in the UK is an amputee. Many lose their limbs as the result of tragic accidents or due to active military combat and for some amputees losing a limb is a loss of freedom.

Bryce Dyer (pictured) is part of a team of design engineers and clinicians studying prosthetics at BU’s Design Simulation Research Centre: “Many prosthetic limbs remain unused simply because they can be so uncomfortable over time,” he says.

Fitting a false limb is currently “a bit of a black art” says Dyer. Prosthetists traditionally require decades of experience to do their job successfully and are dependent upon the subjective feedback of patients, with no other method of measuring fit. Additionally, current technology does not allow for changes in volume – patients’ stumps may swell and contract. “It’s like having your feet change size on a daily basis and expecting your shoes to still fit comfortably,” says Dyer.

Led by Professor Siamak Noroozi, the BU team are turning an academic concept into a practical product that could lessen the misery of thousands of amputees.

They are creating a ‘smart socket’ – a lower-limb prosthetic which can adjust itself to fit the changing shape of the limb stump it connects with. The design team say the fit will be so comfortable that amputee servicemen may even be able to return to active combat.

Calling on combined expertise, BU’s School of Design, Engineering and Computing is using artificial intelligence to create a self-learning system that will measure interactions between socket and limb stump during the fitting and wear.

“It is very much at a research and development stage,” says Dyer. Currently the team are also attempting to miniaturise the technology to make it light and portable as well as incorporating wireless technology.

BU scientists have teamed with commercial partners at prosthetics and orthotics supplier Chas A Blatchford & Sons, who work with the Ministry of Defence Medical Rehabilitation Centre in Surrey, where injured soldiers are sent following service in Afghanistan and Iraq.

“One of the great things about this industrial partnership is that we will be able to get feedback from the very kind of people we are trying to help,” says Dyer.

With better fitting false limbs, medical costs will fall, say BU designers. Prosthetists will be able to get it right first time and will require less experience to be able to do their job properly. Being agile enough to return to active service is a huge bonus for the rising numbers of amputee soldiers. “It will get them back in the field rather than being retired early or restricted in what they can do,” says Dyer.

Understanding how elite sprinters perform with artificial limbs or “blades” and how different types of prostheses compare is central to another strand of Dyer’s research. “Paralympic running world records are still being set on a near annual basis – the sport hasn’t settled down yet. I’m looking at how individuals should be grouped together or separated – how to give the fairest possible race.”

As well as informing future Paralympic Committees, the research will apply to disability in sport in general. Should someone who’s lost both limbs compete against a runner missing just one limb, for example? And how should technology be categorised, when variations in quality of false limbs may create substantial differences among international athletes?

“Some 30 years ago, it was all about enabling disabled people to take part in sport,” says Dyer. “But now the quality of performances and the sums of money involved are so great, there’s much more at stake. We don’t want to restrict technology but we need to find a way to measure it.”

Source: http://buresearchchronicle.org.uk/theme/technology/adaptable-prosthetics-for-amputees/

Triple Amputee takes on the Dakar Rally 2013

Ex-paratrooper Tom Neathway lost both legs and an arm in an explosion in Afghanistan but is tackling this grueling 5,000-mile race across South America.

This is the 34th edition of the race, which started in Lima on January 4 and ends in Chile on January 20.

There is the fund-raising side. Tom will be raising hopefully £1million for Help For Heroes and Tedworth House, one of the five recovery centres set up in partnership between the Ministry of Defence, Help for Heroes and the Royal British Legion.

Source: http://www.mirror.co.uk/sport/other-sports/dakar-rally-2013-preview-tom-1519172#comments

UK's first hand transplant operation

A former pub landlord from West Yorkshire has become the first person in the UK to have a hand transplant.

Mark Cahill, who is 51, had been unable to use his right hand after it was affected by gout.

This procedure allowed very accurate restoration of nerve structures and is believed to be the first time this approach has been used, surgeons said.

Consultant plastic surgeon Professor Simon Kay, who led the surgical team, said: "This operation is the culmination of a great deal of planning and preparation over the last two years by a team including plastic surgery, transplant medicine and surgery, immunology, psychology, rehabilitation medicine, pharmacy and many other disciplines.

"The team was on standby from the end of November awaiting a suitable donor limb, and the call came just after Christmas.

Doctors say he is making good progress after an eight-hour operation at Leeds General Infirmary.

It is still very early to assess how much control of the hand will be gained - so far he can wiggle his fingers, but has no sense of touch.

Source: http://www.bbc.co.uk/news/health-20898940

http://news.sky.com/story/1033091/hand-transplant-completed-for-first-time-in-uk

Failings in diabetes care 'cost thousands of lives'

'Diabetes care depressingly poor, say MPs', is the headline on the BBC News website. This is the damning verdict of a parliamentary report into standards of diabetes care in the NHS. The Public Accounts Committee reported that (in the words of the Daily Mail), "24,000 with diabetes 'are dying needlessly'".

The report was published by the Public Accounts Committee (PAC) – an influential group of MPs who have been given an oversight role to help ensure that taxpayers get value for money.

Based on official figures and spoken and written evidence from independent diabetes experts and officials, the PAC has set out recommendations for improved diabetes care in the NHS.

The report indicates that the NHS spent an estimated £3.9 billion on diabetes services in 2009/10. However, 80% of the costs are estimated to come from the management and treatment of avoidable diabetes-related complications, such as kidney disease and foot ulcers.

The report highlights that the number of people with diagnosed and undiagnosed diabetes is 3.1 million, set to rise to 3.8 million by 2020. This projected increase is likely to have a significant impact on NHS resources, the committee says.

The report accepts that there is consensus about what needs to be done for people with diabetes. However, progress in actually delivering the recommended standards and achieving treatment targets has been 'depressingly poor', it says.

 

Who produced the report?

The report, 'Department of Health: The management of adult diabetes services in the NHS' has been published by the PAC.

The PAC is made up of MPs appointed by the House of Commons, and is responsible for overseeing government expenditures to ensure transparency, value for money, and accountability in government financial operations.

 

What are the main findings?

The main findings of the report are:

• an estimated 80% of the costs of diabetes come from the management and treatment of avoidable diabetes-related complications (such as diabetic eye disease and kidney disease)
• the Department of Health estimates that up to 24,000 people with diabetes are dying each year from causes that could be avoided through better management of their condition
• only half of people with diabetes receive all the basic tests to monitor their condition, and failure to carry out these simple checks heightens the risk of developing complications
• less than one in five people with diabetes have achieved the recommended levels for blood glucose, blood pressure and cholesterol
• despite the Department of Health improving information on diabetes, this information is not being used effectively to assess and improve the quality of care
• many people with diabetes develop avoidable complications because they are not effectively supported to manage their condition and do not always receive care from appropriately trained professionals across primary and secondary care
• the projected increase in the diabetic population could have a significant impact on NHS resources

The report states that the reasons these problems have arisen include:

• the fact there is no strong national leadership – each Primary Care Trust is largely 'left to their own devices' when it comes to how they decide to tackle diabetes
• there are no effective accountability arrangements for commissioners (those in charge of allocating funds to particular services)
• there are no appropriate performance incentives (rewards, usually financial, designed to encourage best practice) for the providers of diabetes care

Source: http://www.nhs.uk/news/2012/11November/Pages/Failings-in-diabetes-care-cost-thousands-of-lives.aspx

£5 million for veterans in need of new prosthetics

The Department of Health has £5 million available to spend on new prosthetics centres for veterans in 2013. The money is part of a £22 million package to support veterans' physical and mental health from 2010 to 2015.

So far this year, 32 veterans applied to get high specification prosthetic equipment, such as computer controlled knee units and specialist feet. The Department of Health has committed to funding clinically appropriate prosthetics for any veteran in England who has lost a limb in the service of their country.

There are currently an estimated 1,335 veteran amputees in the United Kingdom with the majority living in England. The Government wants to raise awareness of this funding so that all veterans who have lost a limb in the service of their country can benefit from the extraordinary, life-changing work the NHS can do with prosthetics. Find out more