Friday 30 August 2013

Suspended without pay

HCPC REGISTRATION RENEWAL REMINDER
DEADLINE:  30 SEPTEMBER 2013



Can you afford to be suspended without pay?  46% of P&O registrants still have not re-registered with HCPC.  All registrants must re-register by 30th September 2013 or you will be unable to practice as a Prosthetist or Orthotist.  Re-registration only takes 5 minutes and can be done simply online on the HCPC website.
 
http://www.hpc-uk.org/aboutregistration/theregister/

Paediatric Gait Analysis and Orthotic Management - BAPO Run Short Course - 8th & 9th November 2013


This Course Aims to: 
Explore 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. In addition live patient demonstrations will help participants refine their clinical decision making skills involved in gait analysis and orthotic design.

                                                          Paediatric Gait Analysis and Orthotic Management

Friday 23 August 2013

Register as a stakeholder for a Clinical Reference Group

Registration is now open for anyone with an interest in the work of the Specialised Services Clinical Reference Groups (CRGs).  To become a stakeholder in a particular CRG you will most likely be a patient, carer, a member of the public, a member of a voluntary organisation, or a clinical or non-clinical professional.


Tuesday 20 August 2013

Physiotherapy to Complement Orthotic Treatment


This course aims to:
Share how physiotherapists look at patients regarding an assessment and detail what elements of that assessment may lead to the involvement of orthotics.
Explore reasoning behind physiotherapy intervention, namely core stability, flexibility, strength, pathology, neurological involvement etc.
The event will be delivered by tutors who are also active clinicians using audio/visual aids as appropriate. We may call upon willing delegates to participate in the direct delivery of the syllabus. There will group discussions and case studies.
Contact hours: 6 hours plus 2 hours of independent reading

Sunday 18 August 2013

Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford Foot Model

Matthias Höslemail, Harald Böhm, Christel Multerer, Leonhard Döderlein

Treatment of asymptomatic flexible flatfeet is a subject of great controversy. The purpose of this study was to examine foot function during walking in symptomatic (SFF) and asymptomatic (ASFF) flexible flatfeet. Thirty-five paediatric and juvenile patients with idiopathic flexible flatfeet were recruited from an orthopaedic outpatient department (14 SFF and 21 ASFF). Eleven age-matched participants with typically developing feet served as controls (TDF). To study foot function, 3D multi-segment foot kinematics and ankle joint kinetics were captured during barefoot gait analysis. Overall, alterations in foot kinematics in flatfeet were pronounced but differences between SFF and ASFF were not observed. Largest discriminatory effects between flatfeet and TDF were noticed in reduced hindfoot dorsiflexion as well as in increased forefoot supination and abduction. Upon clinical examination, restrictions in passive dorsiflexion in ASFF and SFF were significant. During gait, the hindfoot in flatfeet (both ASFF and SFF) was more everted, but less flexible. In sagittal plane, limited hindfoot dorsiflexion of ASFF and SFF was compensated for by increased forefoot mobility and a hypermobile hallux. Concerning ankle kinetics, SFF lacked positive joint energy for propulsion while ASFF needed to absorb more negative ankle joint energy during loading response. This may risk fatigue and overuse syndrome of anterior shank muscles in ASFF. Hence, despite a lack of symptoms flatfoot deformity in ASFF affected function. Yet, contrary to what was expected, SFF did not show greater deviations in 3D foot kinematics than ASFF. Symptoms may rather depend on tissue wear and subjective pain thresholds.





--

Jonathan 


Saturday 17 August 2013

Prosthetic finger out of Bicle Parts

Colin MacDuff invents prosthetic finger out of BICYCLE partsDaily Mail
Mr Macduff constructed the prosthetic device using leftover bike parts, ... but doctors told him that there were no prosthetics for finger amputees available.

Friday 16 August 2013

NICE Stroke Rehabilitation Guideline

This guideline offers evidence-based advice on the care of adults and young people aged 16 years and older who have had a stroke with continuing impairment, activity limitation or participation restriction.



NICE has published good practice guidance on patient group directions (PGDs)

The guidance has been developed to help individuals and organisations who are considering the need for, developing, authorising, using and/or updating PGDs to ensure they are appropriate, legal and that relevant governance arrangements are in place within commissioning and provider organisations.

The guidance underlines that supplying and/or administering medicines under PGD should be reserved for situations where this offers an advantage for patient care without compromising patient safety and where there are clear governance arrangements and accountability.

Thursday 15 August 2013

Physiotherapy to Complement Orthotic Treatment Saturday 12th October 2013

For further information on the 'Physiotherapy to Complement Orthotic Treatment' BAPO Short Course please follow the link below:

Further Information

Please note that the cancellation date of this course is 2 September 2013.  If you wish to book a place on the BAPO short course then please do so at your earliest convenience.

Friday 9 August 2013

The clinical management of diabetic foot in the elderly and medico-legal implications

Claudio Terranova, Andrea Bruttocao

Abstract

Diabetic foot is a complex and challenging pathological state, characterized by high complexity of management, morbidity and mortality. The elderly present peculiar problems which interfere on one hand with the patient's compliance and on the other with their diagnostic-therapeutic management. Difficult clinical management may result in medico-legal problems, with criminal and civil consequences. In this context, the authors present a review of the literature, analysing aspects concerning the diagnosis and treatment of diabetic foot in the elderly which may turn out to be a source of professional responsibility. Analysis of these aspects provides an opportunity to discuss elements important not only for clinicians and medical workers but also experts (judges, lawyers, medico-legal experts) who must evaluate hypotheses of professional responsibility concerning diabetic foot in the elderly.

Sunday 4 August 2013

The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy

The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy

TL Lin, HM Sheen, CT Chung, SW Yang, SY Lin… - … of Foot and Ankle Research, 2013
... However, what the four insole conditions will be, the configurations, and possible biomechanical
effects, were not told. ... 18. Menz HB: Two feet, or one person? Problems associated with statistical
analysis of paired data in foot and ankle medicine. Foot 2004, 14(1):2–5. 19. ...

Monday 29 July 2013

How Effective Is Orthotic Treatment in Patients with Recurrent Diabetic Foot Ulcers?

Maria Luz Gonzalez Fernandez, PhD, Rosario Morales Lozano, PhD, Maria Ignacia Gonzalez-Quijano Diaz, PhD, Maximo Antonio Gonzalez Jurado, PhD, David Martinez Hernandez, MD and Juan Vicente Beneit Montesinos, MD

Abstract

Background: We assessed the efficacy of customized foot orthotic therapy by comparing reulceration rates, minor amputation rates, and work and daily living activities before and after therapy. Peak plantar pressures and peak plantar impulses were compared with the patients not wearing and wearing their prescribed footwear.

Methods: One hundred seventeen patients with diabetes were prescribed therapeutic insoles and footwear based on the results of a detailed biomechanical study and were followed for 2 years. All of the patients had a history of foot ulcers, but none had undergone previous orthotic therapy.

Results: Before treatment, the reulceration rate was 79% and the amputation rate was 54%. Two years after the start of orthotic therapy, the reulceration rate was 15% and the amputation rate was 6%. Orthotic therapy reduced peak plantar pressures in patients with reulcerations and in those without (P < .05), although a significant decrease in peak plantar impulses was achieved only in patients not experiencing reulceration. Sick leave was reduced from 100% to 26%.

Conclusions: Personalized orthotic therapy targeted at reducing plantar pressures by off-loading protects high-risk patients against reulceration. Treatment reduced the reulceration rate and peak plantar pressures, leading to patients' return to work or other activities. (J Am Podiatr Med Assoc 103(4): 281-290, 2013)

Source: http://www.japmaonline.org/content/103/4/281.short

Thursday 25 July 2013

THE MANIC MARAFUN!

The Manic Marafun is a 26 mile challenge, but with a difference.  Each participant only has to do one mile, or four laps of the track at the wonderful Stoke Mandeville Stadium, and to make it even more appealing, they can choose from a variety of wacky ways in which to complete it.  Whether it be running, walking backwards, cycling, scooting, pushing a day chair or even doing the wheelbarrow with a friend, there are plenty of options for completing your mile and having fun while you do it!

This is a family day, and there will be a delicious BBQ and children's entertainment to ensure that everyone has a great time, whether you are the finely honed athlete about to tackle a mile of skipping, or just there to watch the antics and socialise with friends.

The Manic Marafun will be held on the 24th August and is open to everyone.  To take part in the Marafun itself there is a registration fee of just £10 for adults and £1 for children, so now's the time to dream up a suitably 'Manic' way of completing your mile and sign up! 

To find out more and register for this event simply visit http://www.limbpower.com/events/

Monday 22 July 2013

Interested in £4 million?

The Health Foundation wants to make care safer by closing the gap between best practice and current delivery of care. 

We have £4 million on offer to support up to nine project teams to implement and evaluate tested, evidence-based patient safety interventions at scale. 

Types of project could include (but are not limited to):

  • approaches to build skills in improving patient safety
  • interventions to improve reliability of clinical care
  • creating the conditions for the delivery of safer care.

Applicants will need to demonstrate a strong track record in designing, delivering and evaluating improvement projects. 

Due to the range of skills and experience required, we anticipate applications will come from groups of organisations working together. The skills required include quality improvement, evaluation and clinical/service expertise. 

Projects will also need to include an organisation that can influence wider practice and opinion. 

Interested? 

Applications open on 3 June 2013 and close at 12 noon on 23 September 2013. 

Visit www.health.org.uk/ctgptsafety to find out more. 

An Introduction to Podiatric Medicine for Healthcare Professionals Saturday 21st September 2013

For further information on the 'An Introduction to Podiatric Medicine for Healthcare Professionals' BAPO Short Course please follow the link below:

Further Information

Tuesday 16 July 2013

AFOs Improve Balance Confidence in Poststroke Hemiplegia Patients

Researchers at Northwestern University Prosthetics-Orthotics Center (NUPOC), Chicago, Illinois, and the U.S. Department of Veterans Affairs (VA) have found that AFO use improves balance confidence in patients with chronic poststroke hemiplegia.


Friday 12 July 2013

HCPC professional indemnity cover and registration

EU directive 2011/24/EU sets about member states being responsible for high quality care and as a result each state must have a mechanism to ensure that patients are protected from the event of harm.  In the UK this will mean that all healthcare professionals will have Professional Indemnity Insurance in place by Friday 25th October 2013.   Cover via an employer's indemnity arrangements is sufficient to meet requirement.   NHS employees should be covered under the clinical negligence scheme (CNS).  Sub contracted companies should hold sufficient arrangements.  Likewise, individuals who practice independently must hold cover.  The regulated professional must ensure that their indemnity arrangements in place are appropriate for the nature of their work that they undertake.   Voluntary work and Good Samaritan acts are not covered by employer insurance.   Healthcare professionals do not need reciprocal individual insurance. Vicarious liability is sufficient under this indemnity arrangement. 

In situations were persons are seen to be working outside their perceived scope of practice, it is difficult to avoid vicarious liability unless practitioner steps outside scope in areas of clear cut situations where policies are in place. 

Consultation on HCPC guidance for registrants launched on 10th June and closes on 2 August 2013 and can be found on the HCPC website.   http://www.hpc-uk.org/aboutus/consultations/index.asp?id=158 Guidance will then be published in September and sets out the responsibilities of a registrant, information about professional indemnity cover, how registrants can meet the requirement and how the HCPC will check that the cover is in place.  The requirement will be introduced in October 2013 and will be of a self-declaration upon renewal.  The HCPC will start checking cover is in place from 1 April 2014.  Failure to ensure appropriate cover is in place may mean administrative removal from the registrar or referral to fitness to practice.  

If you use insurance provided through your BAPO membership, it is still up to the individual registrant to provide the HCPC with details of indemnity insurance.  If you require Policy details, please contact the Secretariat. High-risk practice such as private work with sports persons or models will bring about increased risk and must be disclosed as an area of work.  All disclosures must be disclosed to insurers.  Area of practice is important when considering insurance and not scope of practice. 

 

NICE has updated its guidelines on falls

Healthcare professionals should consider patients aged 65 or older, and those aged over 50 with underlying conditions such as stroke, at high risk of falling while in hospital care, according to updated guidelines from NICE.

Falling is the leading cause of injury-related admissions to hospital in those over 65, and costs the NHS an estimated £2.3 billion per year.

A number of falls occur in hospitals, with nearly 209,000 reported between 1 October and 30 September 2012.

While many who fall only experience minor cuts or bruises, over the past year 90 people died, and around 900 experienced hip fractures and head injuries as a result of falls.

NICE has updated its guidelines on falls, to help reduce the number of older people who are falling over in hospitals.

NICE says that certain groups of inpatients should be regarded as being at risk of falling in hospital. These include all patients aged 65 years or older, and those aged 50 to 64 years who are judged by a clinician to be at higher risk of falling because of an underlying condition such as dementia or stroke.

For these patients, aspects of the inpatient environment that could affect their risk of falling should be systematically identified and addressed. These include flooring, lighting, furniture and fittings such as hand holds.

Healthcare professionals should also consider a multifactorial assessment and multifactorial intervention for patients at risk of falling in hospital.

These assessments should identify a patient's individual risk factors for falling in hospital that can be treated, improved or managed during their expected stay.

Such risk factors may include cognitive impairment, continence problems, a history of falls, postural instability and visual impairment.

Healthcare professionals should ensure that any multifactorial intervention carried out should promptly address the patient's identified individual risk factors for falling in hospital, and take into account whether the risk factors can be improved managed or treated during the patient's expected stay.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: "Falling over is a serious problem in hospitals, and unfortunately their likelihood increases with age as people become frailer. They can cause distress, pain, injury, a loss of confidence and independence, and in some cases, death."

He added: "While it would be virtually impossible to prevent all hospital falls from happening, our guideline calls for doctors and nurses to address the issues that will reduce the risk of their patients suffering avoidable harm. No two patients are the same and so a "one size fits all" approach will not work."

Michelle Mitchell, Director General of Age UK said: "The consequences of a fall in later life can be physically and emotionally devastating, potentially resulting in loss of mobility, independence and confidence.

"In addition to the pain caused to the individual, falls cost around £6 million a day in hospital and social care costs to treat."

He added: "Implementing these new guidelines to reduce falls in hospitals must be a priority for our health service, not only to improve patient safety, but to help save precious NHS resources."



Thursday 11 July 2013

A kinematic description of dynamic midfoot break in children using a multi-segment foot model

Jessica D. Maurer, Valerie Ward, Tanja A. Mayson, Karen R. Davies, Christine M. Alvarez, Richard D. Beauchamp, Alec H. Black

Gait & Posture, Volume 38, Issue 2 , Pages 287-292, June 2013

Abstract 

Midfoot break (MFB) is a foot deformity that occurs most commonly in children with cerebral palsy (CP), but may also affect children with other developmental disorders. Dynamic MFB develops because the muscles that cross the ankle joint are hypertonic, resulting in a breakdown and dysfunction of the bones within the foot. In turn, this creates excessive motion at the midfoot. With the resulting inefficient lever arm, the foot is then unable to push off the ground effectively, resulting in an inadequate and painful gait pattern. Currently, there is no standard quantitative method for detecting early stages of MFB, which would allow early intervention before further breakdown occurs. The first step in developing an objective tool for early MFB diagnosis is to examine the difference in dynamic function between a foot with MFB and a typical foot. Therefore, the main purpose of this study was to compare the differences in foot motion between children with MFB and children with typical feet (Controls) using a multi-segment kinematic foot model. We found that children with MFB had a significant decrease in peak ankle dorsiflexion compared to Controls (1.3±6.4° versus 8.6±3.4°) and a significant increase in peak midfoot dorsiflexion compared to Controls (15.2±4.9° versus 6.4±1.9°). This study may help clinicians track the progression of MFB and help standardize treatment recommendations for children with this type of foot deformity.


http://www.gaitposture.com/article/S0966-6362(12)00457-2/abstract?elsca1=etoc&elsca2=email&elsca3=0966-6362_201306_38_2&elsca4=elsevier



Conference 2013 Photographs

BAPO have a collection of around 500 photographs taken at this years conference.  We have now placed these in an online Gallery for you to see.  Please click the link to view the photographs.