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/

BAPO Conference & Exhibition 2015 - Call for Papers

HSE West - Orthotist vacancies Ireland

For full details of this job advert please click here

Halo Medical - Experienced Orthotists

For full details of this job advert please click here

Lancashire Teaching Hospitals - Senior Prosthetist & Senior Orthotist Positions

For further information regarding the latest vacancies please follow the link below.

Lancashire Teaching Hospitals Vancancy

Orthotic Treatment of Neurological Conditions

This event aims to:

Review orthotic principles of managing different types of neurological conditions

Provide up to date knowledge on orthotic prescription and interventions available to complement orthotic treatment.

For further information on the BAPO short course please follow the link below:

Orthotic Treatment of Neurological Conditions

Guidance Framework for personalised care and population health

Resource to support nurses, midwives, health visitors and AHPs to access best evidence for practice and deliver their public health role.

Guidance can be found here:

https://www.gov.uk/government/publications/framework-for-personalised-care-and-population-health

The effect of knee orthoses on gait parameters in medial knee compartment osteoarthritis: A literature review

Maryam Maleki, Mokhtar Arazpour, Mahmoud Joghtaei, Stephen W Hutchins, Atefeh Aboutorabi, Ali Pouyan

Background: Knee osteoarthritis is a musculoskeletal condition which is most prevalent in the medial compartment. This injury causes considerable pain, disability, and negative changes in kinetic and kinematic parameters. The efficiency of unloader valgus brace as a conservative treatment for medial knee osteoarthritis is not well documented.

Objectives: The aim of this study was to review the previous research regarding the biomechanical effects of knee valgus braces on walking in medial compartment knee osteoarthritis patients.

Study design: Literature review

Methods: According to the population intervention comparison outcome measure methods and based on selected keywords, 12 studies were chosen according to (met) the inclusion criteria.

Results: The results indicated that treatment with knee braces was effective in decreasing pain, improving function, ameliorating improvement in range of motion, and increasing speed of walking and step length in conjunction with a reduction in the adduction moment applied to the knee.

Conclusion: Osteoarthritis knee braces may be considered for improvement of walking and treatment of medial compartment knee osteoarthritis.

Clinical relevance Knee braces are an orthotic intervention that could potentially be significant in assisting in improving the walking parameters and treatment of medial compartment knee osteoarthritis.

Source: http://poi.sagepub.com/content/early/2014/08/23/0309364614547411.abstract

Ankle-foot orthoses that restrict dorsiflexion improve walking in polio survivors with calf muscle weakness

H.E. Ploeger, S.A. Bus, M.A. Brehm, F. Nollet

Abstract

In polio survivors with calf muscle weakness, dorsiflexion-restricting ankle-foot orthoses (DR-AFOs) aim to improve gait in order to reduce walking-related problems such as instability or increased energy cost. However, evidence on the efficacy of DR-AFOs in polio survivors is lacking. We investigated the effect of DR-AFOs on gait biomechanics, walking energy cost, speed, and perceived waking ability in this patient group.

Sixteen polio survivors with calf muscle weakness underwent 3D-gait analyses to assess gait biomechanics when walking with DR-AFOs and with shoes only. Ambulant registration of gas-exchange during a 6-minute walk test determined walking energy cost, and comfortable gait speed was calculated from the walked distance during this test. Perceived walking ability was assessed using purposely-designed questionnaires.

Compared with shoes-only, walking with DR-AFOs significantly increased forward progression of the center of pressure (CoP) in mid-stance and it reduced ankle dorsiflexion and knee flexion in mid- and terminal stance (p  < 0.05). Furthermore, walking energy cost was lower (-7%, p = 0.052) and gait speed was higher (p = 0.005). Patients were significantly more satisfied, felt safer and less exhausted with the DR-AFO, compared to shoes-only (p  < 0.05). DR-AFO effects varied largely across patients. Patients who walked with limited forward CoP progression and persisting knee extension during the shoes-only condition seemed to have benefitted least from the DR-AFO.

In polio survivors with calf muscle weakness, DR-AFOs improved gait biomechanics, speed and perceived walking ability, compared to shoes-only. Effects may depend on the shoes-only gait pattern, therefore further study is needed to determine which patients benefit most from the DR-AFO.

Source: http://www.sciencedirect.com/science/article/pii/S0966636214005487