Page 2 > BAPO2016
WELCOME
FROM BAPO CHAIR
LYNNE ROWLEY
Welcome to BAPO Conference 2016
Welcome to Conference 2016 in this new venue for
BAPO. The Conference Committee have arranged a
fantastic programme for you this year with the theme
focusing on foot and ankle.
Always trying to stay ahead of current technology, we
introduced our conference App last year - if you haven’t
already done so, please download today for a full update
about what’s happening over the weekend.
CONTENTS
WELCOME FROM BAPO CHAIR LYNNE ROWLEY
3
FRIDAY TIMETABLE
5
TECHNICAL SESSION PROFILES
6
TECHNICAL SESSION ABSTRACTS
7
FRIDAY SPEAKER PROFILES
8
FRIDAY SESSION ABSTRACTS
10
SPEAKEASY12
SATURDAY TIMETABLE
13
SATURDAY SPEAKER PROFILES
14
We are very pleased to welcome the Chief Allied Health
Professions Officer for England, Suzanne Rastrick who
will open our main plenary on Friday discussing the 5
year forward plan and commissioning, how we can
adapt as a profession to meet the challenges ahead.
SATURDAY SESSION ABSTRACTS
18
SUNDAY WORKSHOPS
24
FREE PAPERS PROSTHETIC
27
FREE PAPERS ORTHOTIC
29
This year we have satellite technology being used for
the first time in our plenary with lecturers joining us
from the USA and Australia.
SPONSORS/SPONSOR PROFILES
31
EXHIBITOR LIST
35
EXHIBITION FLOORPLAN
36
We have already circulated a consultation document
for the Centre of Excellence Scheme and a discussion
document on BAPO Membership. The Executive
Committee have decided to open the doors to any
Prosthetists/Orthotists this year prior to the AGM so
their voice can be heard prior to the voting. We want
to include everyone in our discussions so please join us
and have your opinion count.
EVENTS38
*Please note while care has been taken to ensure that
information contained in this programme is true and correct at
the time of publication, changes in circumstances after the time
of publication may impact on the accuracy of this information.
Lynne
BAPO Secretariat
Sir James Clark Building
Abbey Mill
Business Centre
Paisley, PA1 1TJ
Tel: 0141 561 7217
Fax: 0141 561 7218
E-mail: [email protected]
www.bapo.com
BAPO2016
< Page 3
NETWORKING AREA
Ever wonder what BAPO does?
What is OETT?…
Join us in our Networking Area to have all your questions
answered. Your opportunity to meet with the Association
Chair, NHS, P&O Companies, Universities and BAPO Committee
Chairs.
Post questions, provide
feedback and join in the
conversation by following
the BAPO Twitter
Grab a coffee, head to the Social Zone to relax with colleagues
and discuss this year’s innovative programme. Visit our
Education Zone to learn how you can further your career
through post-graduate education.
@BAPO2
NETWORKING AREA TIMETABLE
Education Zone
Host
When
Salford University
Mark McAloon
During Exhibition View
Strathclyde University
Elaine Figgins
During Exhibition View
Education/Technician Comittees Mark Smith/Ian Adam
During Exhibition View
Diabetic App
Christian Pankhurst
During Exhibition View
Tell Us What You Think
BAPO
During Exhibition View
SPEED DATING / MEET THE PROFESSION ZONE
Session 1 / 5 tables
10am - 10:30
Session 2 / 5 Tables
10:30-11am
Session 3 / 5 Tables
12:15-12:45
Session 4 / 6 Tables
14:50-15:20
Chair of BAPO Lynne Rowley
Conference Committee Lauren Cox
NOMaG Matt Frederick
HCPC
John Innes
Education Committee Mark Smith
Education Committee Mark Smith
Steeper Group Andrew Nicol
Blatchfords
Mags Miller
OETT Duncan Ferguson
Professional Affairs Committee Conference Committee Paul Charlton
Lauren Cox
Chair of BAPO
Lynne Rowley
NHS Orthotist
Nick Gallogly
Technician Committee Ian Adam
Chair of BAPO Lynne Rowley
Professional Affairs Committee
Paul Charlton
Opcare Michael O’ Byrne
Peacocks Scott McNab
Salford University Mark McAloon
Strathclyde University
Elaine Figgins
Diabetic App Christian Pankhurst
Editorial Committee
Lauren Cox
Page 4 > BAPO2016
FRIDAY TECHNICIAN / GENERIC PROGRAMMES
Generic
Programme
12:00-12:30
Lounge 1 North
Technician
Programme
09:00 - 09:15
Lounge 1 South
N/A
09:15 - 10:00 10:00 - 10:30
10:30 - 10:45
National Training Programme for
Rehab Technicians
Ian Adam
Riostra Carbon Composites
Charlie Gough
Coffee
An Innovative Approach in Treating the OA Knee
Daniel Gelbart & Dr Thomas Schmalz
(Attendee lunch provided by Ottobock)
10:45 – 11:45
12:00 – 13:00
13:00– 13:30
Wet Lamination Fabrication
Rob Briggs
Orthotic Cast Rectification Workshop
Donna Fisher
Lunch
Arrival & Coffee
Generic
Lounge 1 North
Lounge 1 South
Programme
13:30 - 14:00
Commissioning of Services…. What is
the Impact for Orthotics and Prosthetics?
Suzanne Rastrick
14:05 - 14:35
The Choice between Limb Salvage and Primary Amputation
Deepa Bose
14:40 - 15:10
A Comparative Review of Prosthetic and N/A
Orthotic Care Pathways for the Management of Partial Foot Amputation in a Single Centre
Jamie Halliday
15:10 - 15:30
Break
15:30 - 16:00
The Orthotic Management of
Partial Foot Amputation Steve Osborne
16:05 - 16:35
Partial Feet - Prosthetic and Orthotic Solutions
Matthew Hughes
16:35 - 17:00
17:00 - 17:10
17.10 - 17:40
17.40 - 19:00
17.30 - 21:00
Multi-disciplinary Panel Q&A Session – Partial Foot
Set up/Prep for AGM
Open Forum (Non Member Entry)
AGM
Exhibition Opens
17:10 - 18:30
Speakeasy
BADGE COLOUR KEY
DELEGATES - FRIDAY ONLY
DELEGATES - FULL WEEKEND
VISITORS TO THE EXHIBITION ONLY - FRIDAY
BAPO2016
< Page 5
TECHNICAL SESSION PROFILES
IAN ADAM
Ian is employed as a Paediatric Orthotic Rehabilitation Technician by Greater Glasgow & Clyde Health
Board based at the Royal Hospital for Children in the new £1 billion South Glasgow campus. Previously
he was based at RHSC Yorkhill, but moved to the new site with the rest of the hospital in June 2015. He
has worked within orthotics for 31 years joining the NHS direct from school having been employed
under an NHS apprenticeship scheme. He has had previous input with the various Technician training
initiatives over the years. He is the current BAPO Treasurer and also chairs the Technician Committee.
CHARLIE GOUGH
Charlie Gough started Riostra Ltd in 2013 as a start-up company specialising in bringing composite
knowledge from the cutting edge industries of Formula 1 and America’s Cup yachting to a wider
market. Prior to starting Riostra, Charlie spent 8 years designing and building composite parts for 10
Formula 1 teams and 11 America’s Cup boats.
After receiving a BEng in Naval Architecture from Glasgow and Strathclyde Universities, he began his
career as a surveyor at Lloyds Research of Shipping then became a research fellow at Ship Stability
Research Centre. In 1999 he joined Safety at Sea conducting and analysing stability analysis on RoRo
ferries. Then moving to BAE Systems in 2003 as lead designer on Seamanship and weather deck
systems for the Type 45 Destroyer.
ROBERT BRIGGS
Robert started his Technician prosthetics apprenticeship with J E Hanger in 1986, then in 1990 he
worked for Steeper and later Ottobock at the Haywood hospital Stoke on Trent for 19 years specialising
in carbon fibre lamination. Finally still with Ottobock moving to Birmingham in 2009 to setup and
lead the carbon fibre orthotics manufacture specialising in high end products E-mags and cosmetic,
AFOs and KAFOs. Robert has been specialising in carbon fibre lamination since 1990 designing and
developing custom made prosthetic/orthotic devices. Robert is Ottobock Lamination Committee
leader and responsible for producing the UK Ottobock Prosthetics Workshop Lamination Manual.
Robert was the 2014 BAPO Technician of the Year award winner.
DONNA FISHER
Donna currently works as a Clinical Specialist in Orthotics and Prosthetics in IDS/Ottobock, Cappagh
National Orthopaedic Hospital, Dublin, Ireland.
She graduated from The University of Strathclyde, Glasgow with a BSc (Hons) P&O and more recently
an MPhil in Biomedical Engineering.
Donna leads the clinical team in IDS/Ottobock and enjoys mentoring new graduates and students.
She is a dual practising Prosthetist/Orthotist, with a special interest in Paediatric Orthotics and
complex orthotic clients and the rehabilitation of young active amputees.
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TECHNICAL SESSION ABSTRACTS
Technical
Session
Abstracts
FRIDAY 18 MARCH 2016
NATIONAL TRAINING PROGRAMME FOR REHAB TECHNICIANS
Ian Adam
09:15 – 10:00 – Lounge 1 South
Over the years there have been many different Technician training initiatives but we have never achieved a national training
scheme available to all. Back at the BAPO Conference in 2014 Adrian Stenson gave a talk on a new training scheme being
proposed by BHTA. I was asked by BHTA in November 2014 to assist them in putting this programme together. In the past 16
months we have looked at various training qualifications and training providers to achieve our aims. We have since formed
working relationships with SQA (Scottish Qualifications Authority) and GCC (Glasgow Clyde College) to develop a PDA
(Professional Development Award) in Rehab Technologies which we launch at Conference. This will be a nationally recognised
qualification taught using an online environment and workplace based units. This will make it easy for candidates to complete
without having to take time away from their workplace. In my presentation I will fully explain all aspects of the qualification
and allow you to see the Online Teaching Environment in action.
RIOSTRA CARBON COMPOSITES
Charlie Gough
10:00 – 10:30 – Lounge 1 South
K-plate is a new carbon fibre system that has the potential to revolutionise the production of carbon fibre parts by providing
rapid process times as well as being reformable, reusable and recyclable.
Typically, manufacture of carbon fibre has involved labour intensive wet layup, vacuum forming and resin infusion etc. All
processes are relatively time consuming and provide rigid thermoset structures that once cured are fixed. K-Plate is a system
of carbon and resin that is stable at room temperature, negating the need for cold storage and limited shelve-life. Its process
time can be below 5 minutes with pressure and temperature. Layers can be stacked with no concern of exotherm.
The resin system flows at temperature, becoming liquid, co-mixing with the subsequent layers and bringing them all together
as a laminate. Its main benefit however, is that K-Plate is thermoformable. It can be re-shaped as many times as required, ideal
for prototyping, or for adjustment post build or even re-use as another part. It has an excellent bond between the layers,
its interlaminate shear strength is equal to that of a toughened epoxy. Its epoxy based chemistry means that you can post
process it like any other thermoset epoxy for secondary bonding and painting.
WET LAMINATION FABRICATION
Rob Briggs
10:45 – 11:45 – Lounge 1 South
• How to avoid common problems • Tools and equipment
• Ways to achieving a consistent good finish
• Types of finishes
• Types of carbon used in wet lamination and why
• Slides and examples
ORTHOTIC CAST RECTIFICATION WORKSHOP
Donna Fisher
12:00 – 13:00 – Lounge 1 South
This workshop will present an overview of basic anatomy of the foot and ankle and common foot/ankle deformities. Common
conditions which may require orthotic treatment will be discussed and the challenges and goals of making an orthosis, from
a clinical perspective.
The principles of rectification of an Ankle Foot Orthosis (AFO) and Custom Orthotic Insole will be described.
This is an interactive workshop and following the overview presentation, a practical demonstration of rectification of an
AFO and Insole will be shown. The delegates will then have the opportunity to showcase their rectification skills or try new
techniques on demonstration casts.
This should stimulate some debate and the workshop will conclude with a Q&A session.
BAPO2016
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FRIDAY SPEAKER PROFILES
DANIEL GELBART
Born in Switzerland, 1986, Daniel Gelbart graduated from the Wirtschaftsmittelschule (Swiss Business
School) in Lucerne before studying Economics at the Zurich University of Applied Science. During
his studies, he obtained various internships in Switzerland, USA and China within the IT and Med
Tech industry. In 2008 Daniel started his Technical Orthopaedics degree at ABZ Zurich, graduating
in 2011 and during this time acquired his practical expertise at Hueskes Orthopädie AG in Basel.
Daniel joined Ottobock Healthcare GmbH in 2012 and worked in various international roles within
the Eastern Europe, Middle East and Africa region. Based at the Ottobock headquarters in Duderstadt,
Germany, Daniel’s last role was Business Development Manager - Indications & Neurostimulation. In
July 2015, Daniel joined Ottobock Healthcare PLC as Commercial Manager UK - Prosthetics, Orthotics
and Neurostimulation, based in London.
DR THOMAS SCHMALZ
Dr Thomas Schmalz is a graduated Physicist and holds a PhD in Biomechanics of Sports. Since 1994 he
has been working in the Ottobock Research Department. As head of the Biomechanics Laboratory his
main fields are gait analysis, applied research in prosthetics, orthotics, rehabilitation and orthopaedics,
EMG and metabolic energy consumption.
SUZANNE RASTRICK
Suzanne qualified as an Occupational Therapist (OT) from Oxford in 1986, and began her career in
the acute hospital sector, moving to practice in community and primary care where she then gained
her first general management role. She was one of the first Allied Health Professionals (AHPs) to
hold a substantive Director of Nursing post, and has since held these roles in both providing and
commissioning organisations in the NHS. She has also been Chief Executive of a Primary Care Trust
Cluster, and achieved authorisation for a large Clinical Commissioning Group with an integral
commissioning support unit.
She has a Non-Executive portfolio in the commercial and not-for-profit housing sector, and sits on a
number of national groups including NHS Employers Policy Board, Health Education England AHP
Advisory Group, and England Centre for Practice Development National Advisory Board. Suzanne was
appointed as Chief Allied Health Professions Officer (CAHPO) for NHS England on 1 September 2014.
This role also has key professional leadership relationships to the Department of Health as well as to
Health Education England.
Page 8 > BAPO2016
DEEPA BOSE
Friday
Speaker
Profiles
Ms Deepa Bose qualified as a doctor from the University of Calcutta in 1990.
She subsequently went to the UK for higher training.
She passed the FRCS examination from the Royal College of Surgeons of England and then entered
the Welsh regional training programme in Trauma & Orthopaedics. Upon completion of orthopaedic
training, she underwent subspecialist training in bone infection and limb reconstruction at the Nuffield
Orthopaedic Centre in Oxford.
In 2008 she was appointed as a locum consultant in St. George’s Hospital, a major trauma centre in London.
In 2009 she was appointed as a substantive consultant in University Hospitals Birmingham, where
she currently works. Her practice includes general trauma, major trauma and post-traumatic limb
reconstruction (osteomyelitis, malunion, non-union, limb lengthening).
She also has a keen interest in medical education. She completed an MSc in Medical Education from
Cardiff University in 2010. She is now Chair of the Specialist Training Committee for core surgical training
in the West Midland region. She is also involved in teaching and assessment of postgraduate orthopaedic
training in Birmingham, and is an examiner for the undergraduate surgical OSCEs at Birmingham
University. In addition, she has been an examiner for the College of Surgeons of East, Central & Southern
Africa since 2008.
Ms Bose has a desire to promote and encourage teaching in orthopaedics in developing nations and she
gained the Diploma in Medical Care of Catastrophes from the Worshipful Society of Apothecaries in 2011.
She has been on the International Emergency Trauma Register of the UK since 2012.
JAMIE HALLIDAY
Jamie graduated from the University of Strathclyde with MSci in 2012.
Initial graduate experience gained at Charing Cross Hospital, London and currently practicing as an
Orthotist at Queen Mary’s Hospital, Roehampton, an internationally recognised rehabilitation centre of
excellence providing care for South West London.
Areas of expertise include: management of complex orthopaedic and neurological conditions; foot and
ankle deformities; with a special interest in paediatric orthotics.
Primary focus is to improve client’s abilities and quality of life by applying strong knowledge of
biomechanics and implementing evidence based methods for orthotic clinical practice.
STEPHEN OSBORNE
Since graduating as a Prosthetist/Orthotist Stephen has worked mainly within the field of Orthotics. He
has worked in a variety of areas within orthotics gaining extensive general experience and has become
more specialised, in particular, in the field of lower limb orthotics. He has extensive experience in working
with both adults and children in rehabilitation and sports. He has an interest in treatment of partial foot
amputations and pressure problems that arise in this group. He has developed specialist skills in clinical
measurement of the lower limb having used plantar pressure measurement systems in his practice for
nearly 10 years. He is currently a visiting fellow lecturer at Stafford University.
MATTHEW HUGHES
Matthew Hughes joined Dorset Orthopaedic after graduating from the University of Salford with a degree
in prosthetics and orthotics in 2001.
As a clinician, Matthew developed silicone clinical partners for Dorset Orthopaedic around the world
and has often presented and lectured on the use of silicone in prosthetics and orthotics. He also worked
closely to help develop new everyday silicone solutions for patients.
In 2012 Matthew was appointed clinic manager at Ringwood’s clinical Headquarters, overseeing the
day to day running and hands on treatment of prosthetic and orthotic clients. Matthew was recently
promoted to clinical services development director in 2015.
Matthew has been nominated for several awards and in 2014 won the Individual Professional Award at the
Limbless Association P&O awards for outstanding service.
BAPO2016
< Page 9
FRIDAY SESSION ABSTRACTS
FRIDAY 18 MARCH 2016
AN INNOVATIVE APPROACH IN TREATING OA KNEE
Daniel Gelbart & Dr Thomas Schmalz
12:00 – 12:30 – Lounge 1 South
The medical indication of Gonarthrosis/Gonarthritis and the different treatment possibilities of what technical orthopaedics
offers to reduce pain and stop the progression of the disease.
COMMISSIONING OF SERVICES… WHAT IS THE IMPACT FOR ORTHOTICS AND
PROSTHETICS?
Suzanne Rastrick
13:30 – 14:00 – Lounge 1 North
The session will outline how commissioning of health services works in England; with messages for all the UK Home Countries
on how health policy and priorities shape how Orthotists and Prosthetists might consider their practice, whatever sector
they work in. It will also note challenges and opportunities for the profession arising from The NHS Five Year Forward View
(October 2014). Reference will be made to the publication by NHS England of Improving the Quality of Orthotic Services in
England (October 2015: publication awaited)
THE CHOICE BETWEEN LIMB SALVAGE AND PRIMARY AMPUTATION
Deepa Bose
14:05 – 14:35 – Lounge 1 North
The field of post-traumatic limb reconstruction is both complex and challenging.
The decision to save a badly injured limb or to reconstruct it is not straightforward. There are no hard and fast rules. Various
scoring systems exist which purport to streamline the decision-making, but every patient and every limb is individual, and
guidelines can only help to a certain extent.
This is a multidisciplinary decision, and should not be taken lightly, given the graveness of the consequences for the patient.
Many factors, including the anatomy of the injury, the patient and the capabilities of the surgeon and institution have to be
considered. I will present some of the factors to be taken into account when deciding whether to save or amputate mangled
limbs. I will use some case presentations to illustrate the talk.
There will be time for questions and answers afterwards.
A COMPARATIVE REVIEW OF PROSTHETIC AND ORTHOTIC CARE PATHWAYS FOR
THE MANAGEMENT OF PARTIAL FOOT AMPUTATION IN A SINGLE CENTRE
Jamie Halliday
14:40 – 15:10 – Lounge 1 North
Background :
People who undergo a partial foot amputation, or have a congenital absence of part of the foot, will frequently rely on prosthetic
or orthotic intervention to restore walking function, or prevent further complications such as ulceration. Management of
partial foot amputation can be challenging and a wide variety of approaches may be used.
Aim:
To define and compare current prosthetic and orthotic care pathways for the management of partial foot amputation in a
multidisciplinary rehabilitation centre.
Page 10 > BAPO2016
Friday
Session
Abstracts
Method:
Subjects were identified by searching the clinical software system and surveying Prosthetists and Orthotists at the centre.
Inclusion criteria required at least one metatarsal head absent through acquired amputation or congenital absence.
Clinical notes for identified subjects were reviewed.
Results:
31 subjects (34 amputations) were identified. Care pathways differ between prosthetics and orthotics, including; access
to x-rays, diagnoses, amputation level and cause, treatment, cost, reviews and outcome measures. Proximal partial foot
amputations were treated in prosthetics while majority of distal amputations were treated in orthotics. The most common
prescription in prosthetics was silicone prosthesis whilst orthotics used therapeutic footwear and foot orthoses, often
combined with a carbon ankle foot orthosis. Reviews and outcome measures were performed less often in prosthetics.
Discussion & Conclusion:
Little is known about current prosthetic and orthotic care pathways for the management of partial foot amputation in the
UK. Defining current care has enabled this centre to make specific recommendations for improvement. The cause of much
of the variation between prosthetic and orthotic pathways remains unclear.
THE ORTHOTIC MANAGEMENT OF PARTIAL FOOT AMPUTATION
Stephen Osborne
15:30 – 16:00 – Lounge 1 North
Partial foot amputation, when compared with a trans tibial amputation, does allow the patient the opportunity to walk
unaided. However, this level of amputation does create its own challenges for the patient and for the Prosthetist or
Orthotist. Ulceration can be a significant problem due to a number of issues such as less well perfused tissues, a lower
contact area and muscle in balance creating higher than normal pressures over the residuum. The provision of orthoses
and footwear need to be designed to reduce pressures particularly when the patient has an ulcer on the foot. The orthoses
ideally should also allow the individual to walk as normally as possible to reduce the chance of other musculo skeletal
problems developing. Having achieved all of these goals the orthoses provided needs to be aesthetically pleasing to the
patient who often feels conscious of the loss of part of the foot. A good prescription can allow patients to get back to their
day to day lives without suffering multiple episodes of ulceration and allow the affected foot to be more functional. The
presentation will illustrate some the different design possibilities and some case studies of patients who received different
treatment methods.
PARTIAL FEET - PROSTHETIC AND ORTHOTIC SOLUTIONS
Matthew Hughes
16:05 – 16:35 – Lounge 1 North
MULTI-DISCIPLINARY PANEL Q&A SESSION – PARTIAL FOOT
Deepa Bose, Steve Osborne & Matthew Hughes
16:35 – 17:00 – Lounge 1 North
This session will see all of the Friday afternoon speakers come together to form a multi-disciplinary panel. Questions will be
opened up to the floor and discussions around the treatment of partial foot amputation will be welcomed. Share personal
experiences whether positive or negative to help engage with the session.
BAPO2016
< Page 11
SPEAKEASY
FRIDAY 18 MARCH •17:10 – 18:30 - LOUNGE 1 SOUTH
SPEAKEASY - THE GRADUATE FORUM
Open to those who graduated in 2013-2015 (and current students), this session provides delegates the opportunity to view
presentations by senior Orthotist, Rhianedd Petford-Pierce and three recent graduates sharing information, insight and
experiences. This will be an interactive event, with audience members encouraged to ask questions, share experiences and
engage in discussions with peers in a relaxed and informative environment.
This will be a great opportunity for those at the beginning of their careers to participate in the BAPO Conference, whilst
providing the opportunity to network and discuss experiences.
PRECEPTORSHIP IN ORTHOTICS AND PROSTHETICS
Rhianedd Petford-Pierce- Senior Orthotist, Steeper
Rhianedd will open this years Speakeasy with a presentation on preceptorship, with the focus being
on what a graduate should expect from a mentor and what a mentor should expect from a recent
graduate. There will also be time for questions on this topic.
SPEAKERS
Gwen Griffith
Voluntary Open Vs Voluntary Closing Hand
Jessica Makwana Pain Pathways
Emily Jameson
Using Silicone in Orthotics
Page 12 > BAPO2016
SATURDAY PROGRAMME
Prosthetic
Programme
09:00 - 10:00
10:00 - 10:30
Lounge 1 North
Satellite Talk (Australia)
Deliberations about the Benefits and Complications of Partial Foot Amputation
Dr Michael Dillon
Exhibition View
10:30 - 12:00
Surgery for Childhood Sarcomas of The
Lower Limb. Which is Better – Amputation, Limb Sparing or Rotationplasty?
Mr Rod Duncan
Clinical Management and Surgical Treatment of Congenital Lower Limb Deficiency
Mr Peter Calder
12:00 - 13:00
Exhibition View
13:00 - 13:40
Free Papers
13:45 - 14:45
14:45 - 15:30
Ossur Keynote
Experiences from Standardised Methods in
Surgery, Treatment and Rehabilitation of Persons Having a Lower Limb Amputation
Dr Anton Johannesson
Exhibition View
15:30 - 16:30
16:30 - 17:30
3D Printing – Open Bionics; The Low Cost Robotic Hand
Joel Gibbard & Samantha Payne
Elevated Vacuum Dependent Changes in
Residual Limb Circulation and Skin Health: Introducing a new Vacuum System for Above Knee Amputees
Peter Thomas & Mike O’Byrne Jnr
Orthotic
Programme
09:00 – 09:45
09:45 – 10:30
Lounge 1 South
10:30 – 11:00
Exhibition View
Treating Club Foot – What’s New?
Naomi Davis
Free Papers
11:00 – 12:00
OETT Keynote
Custom-made Footwear for Patients with Diabetes: Biomechanical and Clinical Evidence
Dr Sicco Bus
12:00-13:00
Exhibition View
13:00-13:40
13:45-14:45
14:45 – 15:30
Casting Techniques for Wound Healing and Offloading in the Management of Foot Disease in Diabetes
Willie Munro
Juvenile Idiopathic Arthritis – An Update
Liz Clayton
Exhibition View
15:30 – 16:30
16:30 – 17:30
Effect of Orthotic Geometry and Materials on Foot Tissues and Function
Prof Chris Nester
Satellite Talk (USA)
Tissue Stress Theory: Changing the Paradigm of Biomechanical Therapy for the Foot and Lower Extremity
Dr Kevin Kirby
SUNDAY WORKSHOP
10.00-12.00
Jaguar Club Lounge
Prosthetic Workshop
Paediatic Prosthetics – Problem solving
Vincent MacEachen
Morven McAlinden
Andrew Sharpe
Alison Morton
10.00-12.00
Jaguar Club Suite
Orthotic Workshop
The Symbiotic Relationship between Structural and Functional Instability in the Foot and Ankle
Simon Dickinson
Fiona Monaghan
Christopher Cox
Laura Barr
BADGE COLOUR KEY
DELEGATES - FULL WEEKEND
DELEGATES - SATURDAY ONLY
VISITORS TO THE EXHIBITION ONLY - SATURDAY
BAPO2016
< Page 13
SATURDAY SPEAKER PROFILES
PROSTHETIC SPEAKER PROFILES
DR MICHAEL DILLON
Dr Michael Dillon is a Senior Lecturer in prosthetics and orthotics at La Trobe University and an
Honorary Research Fellow at the Royal Melbourne Hospital. Michael has worked as a Prosthetist
in both public and private settings. For the last decade, he has taught subjects designed to help
Prosthetists and Orthotists become informed consumers of research evidence.
Dr Dillon’s research has made important contributions to our understanding of partial foot amputation
and the influence of prosthetic and orthotic intervention. His recent research has helped develop a
better understanding about the outcomes of partial foot amputation with a view to inform difficult
decisions about lower limb amputation.
MR ROD DUNCAN
Rod Duncan was appointed to the Royal Hospital for Sick Children in Glasgow in 1997, having
undertaken general orthopaedic training in Newcastle upon Tyne and specialist paediatric training in
London. Rod treats children with sarcoma in the context of the Scottish Sarcoma Network (SSN) and
is a core member of the SSN National MDT and the Yorkhill Paediatric Tumour Board. He takes part
in a six monthly paediatric prosthetic clinic with his colleagues at WESTMARC. In addition Rod has
a general paediatric orthopaedic practice, involving the usual mix of normal variants, clubfoot and
DDH. Rod has two grown up sons and spends his leisure time trying to stave off the effects of ageing
with mixed results.
MR PETER CALDER
Peter Calder is a Consultant Paediatric and Limb Reconstruction Surgeon. He was appointed as a
Consultant at the Royal National Orthopaedic Hospital in January 2005 and began practicing at the
Portland Hospital for Women and Children in February 2006. He also undertakes clinics at Treloar
School and College for people with physical disabilities.
Mr Calder treats children with all non-spinal orthopaedic conditions including hip disorders,
neuromuscular conditions, feet disorders and limb deformity correction and limb lengthening in
both congenital and acquired conditions. He also sees adult patients with limb deformity including
shortening, mal-union and non-union of fractures. He has extensive experience in external frame
techniques including both the Ilizarov and Taylor Spatial Frames.
He qualified from St Bartholomew’s Hospital in 1993. He undertook his general surgical training on
the St Bartholomew’s basic surgical rotation before becoming a Specialist Orthopaedic Registrar on
the Royal London training programme. During this period his interest in Paedictric Orthopaedics and
in particular limb reconstruction began under the tutorship of Mr Mark Paterson and Mr Matthew
Barry. He undertook the National Paediatric Orthopaedic Fellowship based at Great Ormond Street
Hospital under Mr Robert Hill and the Royal National Orthopaedic Hospital with Miss Deborah
Eastwood and Mr Hashemi-Nejad. He also undertook a Masters Ilizarov Fellowship at the International
Reconstructive Centre in Kurgan, Russia, the origin of the Ilizarov ring external fixator.
He has published in peer review journals on paediatric and limb reconstruction topics including
several chapters in orthopaedic textbooks. He is frequently invited to lecture on courses both for
paediatric conditions including deformity correction and external fixation application. He is a member
of the British Society for Children’s Orthopaedic Surgery and the British Limb Reconstruction Society.
Page 14 > BAPO2016
Saturday
Speaker
Profiles
DR ANTON JOHANNESSON
Dr Anton Johannesson is a European certified Prosthetist and Orthotist who graduated from the
University of Jonkoping in Sweden in 1990. He was previously the founder (1993), partner and
the CEO for 7 years of Orthopaedic Technology Inc. in Kristianstad, Sweden. In 2009 he finished
his PhD in Orthopaedics from the University of Lund, Sweden. The title of the Thesis was “Lower
Limb Amputation in Patients with Vascular Disease” and this work has contributed to a better
understanding of the importance of well-defined post-operative treatment after limb amputation.
He is, since 2013, serving as a Clinical Manager Prosthetics at Össur Nordic doing implementation
of new techniques and education within the service part of the company.
JOEL GIBBARD
Joel has been working with robotic hands for many years. From Indiegogo to the TEDx stage,
he’s always looking for new ways to share his ideas. Through Open Bionics, Joel hopes to get
his products out to the people he’s been developing them for. Joel was recently named Britain’s
Design Engineer of the Year, Founder of the Year, and was short-listed for The Engineering Hall of
Fame. Joel has also won multiple innovation awards for his ground breaking work with 3D printed
robotic hands.
PETER THOMAS
Peter graduated from Salford University in 2014 and initially worked as a Prosthetist at the
Specialised Ability Centre Manchester. He is currently working in a dual role, which involves clinical
practice at the Exeter Mobility Centre and as clinical support on behalf of Ortho Europe for the UK
and Ireland.
During this period he has been heavily involved in lower limb elevated vacuum systems along
with the introduction and evaluation of a number other cutting edge prosthetic appliances.
MIKE O’BYRNE JNR
Mike graduated from Salford University in 2014. He initially gained experience working in the
Nuffield Orthopaedic Centre in Oxford and is currently practicing as a Prosthetist at Queen Mary’s
Hospital, Roehampton. He has developed a special interest in the use of CADCAM in prosthetic
practice, and carries out on site CAD training across the UK and Ireland.
Mike is involved with active vacuum trials for Ortho Europe, and has seen first-hand the benefits
of its use.
BAPO2016
< Page 13
< Page 15
SATURDAY SPEAKER PROFILES
ORTHOTIC SPEAKER PROFILES
NAOMI DAVIS
Naomi qualified from Nottingham University in 1988. Orthopaedic surgery appealed but every time
she mentioned it, there followed something like ‘Hmm, not many women in orthopaedics….’. Never
one to be put off by a challenge, Naomi found a place on the training rotation in Manchester and did
further fellowships in Paediatric Orthopaedics at home and in Toronto. Naomi took up a consultant
post in Manchester in 2001 and early the next year did the first of many visits to Dr Ponseti’s unit in
Iowa. Guided by him, Fred Dietz and other international proponents of the Ponseti technique have
developed care for children with clubfoot and have treated nearly 1000 children with foot deformities.
They hold regular educational events and travel widely to help support other services.
DR SICCO BUS
Dr. Sicco Bus is senior investigator and head of the Human Performance Laboratory at the Academic
Medical Center, department of Rehabilitation in Amsterdam. Sicco is chair of the study group of
Neurovascular Complications of Diabetes in the Netherlands, chair of the Prevention Working Group
and Secretary of the Footwear and Offloading working group of the International Working Group on
the Diabetic Foot, which are tasked with the development of practice guidelines.
WILLIE MUNRO
William qualified as an Orthotist in 1981. William was engaged as a clinical associate at the National
Centre for Training and Education in Prosthetics and Orthotics at the University of Strathclyde. This
role provided an opportunity for teaching at undergraduate and postgraduate levels as well as
teaching in the clinic as a student training supervisor.
In 1991 William established a new practice and the focus of this was to specialise in the orthotic
treatment of diabetic foot disease. This combined with research into the manufacture and materials
required to offload both the biomechanics and tissue mechanics of the foot, saw the start of a
professional relationship with Dr Derek Jones that resulted in numerous publications and invitations
to present on the aspects of engineering related to diabetic foot disease.
As a result, the widely recognised short course on Diabetic Foot Disease was initiated at the University
of Strathclyde and has a faculty that includes Professor Mike Edmonds. Subsequently members of this
faculty have been invited to form the Klaveness Academy in Norway.
William currently serves on the editorial board of The Diabetic Foot Journal in the UK and is a member
of the Scottish Foot Action Group, which was set up to advise the Scottish Government on the
management and treatment of diabetic foot disease in Scotland.
Page 16 > BAPO2016
Saturday
Speaker
Profiles
LIZ CLAYTON
Liz Clayton has worked in Paediatric Physiotherapy since 1983, in a variety of both acute and
community settings. She has worked as an Advanced Physiotherapist in Paediatric Rheumatology
for 10 years, based at the Great North Children’s Hospital, Newcastle-upon-Tyne. Her clinical
caseload includes a mix of patients with inflammatory and non-inflammatory conditions, both
within the hospital, as outpatients and at outreach clinics across the North of England. She is an
active member of British Society for Paediatric and Adolescent Rheumatology (BSPAR) and of the
Association of Paediatric Chartered Physiotherapists (APCP).
Whilst in Paediatric Rheumatology, Liz has been involved in the development of the pGALS
screening tool and the pREMS assessment. She has also contributed to Paediatric Musculoskeletal
Matters (PMM), an evidence-based online resource targeted at Doctors, which aims to raise
awareness, knowledge and skills to facilitate early diagnosis and referral to specialist care when
needed. Liz has authored chapters in the Oxford Handbook of Paediatric Rheumatology and
carried out collaborative research into the Assessment of MSK abnormalities in children with
Mucopolysaccharidoses using pGALS, published in 2014.
PROF. CHRIS NESTER
Professor Chris Nester is a Podiatrist by first degree and now leads the Foot and Ankle Research in
the School of Health Sciences at the University of Salford, UK. Chris has published over 85 journals
papers, had 12 PhD students complete their studies, and led projects with colleagues in the USA,
Sweden, Switzerland, China, Australia and across central Europe. Chris has secured over £5.8
million in research funds including EU funded SSHOES, SMARTPIF, SOHEALTHY and INGA projects,
which are advancing the use of biomechanical data in the design of footwear and foot orthoses.
Other sponsorship is from the UK government Technology Strategy Board, NHS innovation funds
and direct industry sponsorship.
DR KEVIN KIRBY
Dr. Kevin Kirby has authored 26 articles in peer-reviewed journals, five book chapters, and four
books on foot and lower extremity biomechanics and orthosis therapy, all of which have been
translated into Spanish language editions. He has invented the subtalar joint axis palpation
technique, anterior axial radiographic projection, supination resistance test, maximum pronation
test, medial heel skive and lateral heel skive orthosis techniques, and Subtalar Joint Axis Location
and Rotational Equilibrium Theory of Foot Function. He has lectured internationally on 36
occasions and has also lectured extensively throughout the United States on foot and lower
extremity biomechanics topics.
BAPO2016
< Page 17
SATURDAY PROSTHETIC SESSION ABSTRACTS
SATURDAY 19 MARCH 2016
DELIBERATIONS ABOUT THE BENEFITS AND COMPLICATIONS OF PARTIAL FOOT
AMPUTATION
Dr Michael Dillon (Satellite Presentation, Australia)
09:00 – 10:00 – Lounge 1 North
Emerging evidence suggests that as the incidence of transfemoral and transtibial amputation declines, partial foot amputation
is becoming more common.
While many people would see this shift to more distal amputation as a positive improvement, people with partial foot
amputation have disproportionately high rates of complications and secondary amputation compared to those with an initial
transtibial amputation.
Despite the high rates of complications and secondary amputation, partial foot amputation is often preferred to transtibial
amputation given the belief that, if successful, the outcomes will be better.
The emerging research evidence highlights that gait, mobility, energy expenditure and quality of life are actually very similar
in people with partial foot and transtibial amputation.
While further research is needed to support this understanding, the emerging research provides cause to rethink our
assumptions about the benefits and complications of partial foot and transtibial amputation. With a better understanding
of the emerging evidence, we can help people make truly well-informed decisions about amputation at the partial foot and
transtibial levels, so that more first amputations can also be final ones.
SURGERY FOR THE CHILDHOOD SARCOMAS OF THE LOWER LIMB. WHICH IS
BETTER – AMPUTATION OR ROTATIONPLASTY?
Mr Rod Duncan
10:30 – 12:00 – Lounge 1 North
The session will give an overview of the decision making process that goes into the surgical management of children and
young people with sarcoma. It will also give insight into the information which is available that can be presented to families
when they are confronted with the choice of limb sparing procedures or amputations for their child. In particular the session
will endeavour to give an overview of what function and quality of life can be expected in the long term for children who have
had either amputations, limb sparing surgery or rotationplasty for cancer.
CONGENITAL LIMB DEFORMITY – WHAT CAN YOU DO? WHAT SHOULD YOU DO?
Mr Peter Calder
10:30 – 12:00 – Lounge 1 North
Page 18 > BAPO2016
Saturday
Prosthetic Session
Abstracts
EXPERIENCES FROM A STANDARDISED METHODS IN SURGERY,
TREATMENT AND REHABILITATION OF PERSONS HAVING A
LOWER LIMB AMPUTATION
Dr Anton Johannesson (Össur Keynote Speaker)
13:45 – 14:45 – Lounge 1 North
In the beginning of the 90´s a surgical and rehabilitation program for lower limb amputees was introduced
in Sweden. More than twenty years later the program still consists of, e.g. sagittal incision and compression
therapy using silicone liner. We have made some changes like the use of removable vacuum rigid dressing after
trans-tibial (TT) amputation instead of plaster cast and also direct manufacturing prosthetic technique (DS) for
the trans-femoral (TF) amputees. This method has given more amputees the possibility of becoming prosthetic
users and more of them are able to return back to their own home.
Ever since people started to make prostheses they were prepared as a type of “plug fit” socket design, where
the suspension was often some type of belt. Now this type of fitting has recently had its renascent, namely the
Sub-ischial prosthetic socket (SIPS), now with different suspension alternatives.
Using DS after TF amputation, as part of a standardised treatment, has not only decreased the days to prosthetic
fitting but also questioned our traditional way of doing TF-sockets. This type of socket design questions the
claim that optimal skeletal contact, i.e. Ischial Ramus Containment (IRC), is the main factor to obtain pelvic
stability? But is it logical to explain the function of a certain socket design with only one parameter (during
full loading)? Or is the alternative to describing a socket design as an interface during a full gait cycle instead?
The gait analysis when comparing these different socket designs raises questions: How can it be that we are
obtaining the same walking pattern with SIPS compared with IRC? Why are we are not seeing any difference
in walking pattern when comparing traditional socket design with no socket design (i.e. osseointegration)?
The discussion goes on regarding IRC vs. SIPS, or is the optimal socket design the HiFidelity socket and its
“osseosyncronisation” or is the next trend the socket concept from LIM Innovation?
3D PRINTING – OPEN BIONICS; THE LOW COST BIONIC HAND
Joel Gibbard & Samantha Payne
15:30 – 16:30 – Lounge 1 North
Prosthetics has come a long way in the past 20 years, but the advanced technology that can be so life changing
is still so expensive. Open Bionics is creating low-cost, advanced robotic hands for amputees everywhere,
enabling amputees to gain greater independence and to encourage young amputees to feel good about their
differences. This talk will document some of the success and failures on the journey towards creating affordable
bionic hands.
BAPO2016
< Page 19
SATURDAY PROSTHETIC SESSION ABSTRACTS
ELEVATED VACUUM DEPENDENT CHANGES IN RESIDUAL LIMB CIRCULATION
AND SKIN HEALTH: INTRODUCING A NEW VACUUM SYSTEM FOR ABOVE KNEE
AMPUTEES
Peter Thomas & Mike O’Byrne Jnr
16:30 – 17:30 – Lounge 1 North
Abstract
This talk is going to outline recent research in the benefits of active vacuum focusing primarily on the study, ‘Elevated Vacuum
Dependent Changes in Residual Limb Circulation and Skin Health’.
The focus will then shift to the development of an active vacuum system for above knee amputees, ‘The One System’, and
discuss the outcomes observed.
Elevated Vacuum Dependent Changes in Residual Limb Circulation and Skin Health
Background
Qualitative studies focusing on elevated vacuum suspension sockets have found improvements in skin health (1) and
wound healing (2, 3) on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. The
purpose of this work is to provide quantitative results of vacuum dependent changes on residual limb circulation and skin
health. Non-invasive measurement protocols were developed that leverage out-of-socket skin health tests (transepidermal
water loss (TEWL), surface electrical capacitance (SEC), cutometry (CTY), and torsional ballistometry (TB), out-of-socket
circulation imaging (hyperspectral imaging (HI) and laser speckle imaging (LSI)), and insocket probe-based circulation tests
(transcutaneous oxygen measurement (TCOM), laser doppler flowmetry (LDF)).
Aim:
The purpose of this work was to employ these techniques to characterize residual limb health in response to long-term use of
a vacuum suspension socket.
Method:
Ten unilateral amputee subjects (5 transfemoral and 5 transtibial) were enrolled in the study. A crossover design was employed,
such that half of the subjects were randomized to begin the study with their current, non-vacuum prosthesis (Group A) while
the other half began testing with the vacuum socket (Group B). After 16 weeks, subjects in Groups A and B crossed over to
use either the vacuum socket or their original prosthesis respectively. Residual limb measurements were acquired at baseline
(week 1), mid-point (week 8), and final (week 16) time points. Skin health data were expressed as mean ± standard error of the
mean and statistical significance was established using a student’s t-test (p<0.05).
Results:
The use of vacuum socket technology reduced both skin surface hydration and water loss compared to non-vacuum controls
in Group A in areas of high socket pressure but the effect was damped within Group B. Skin biomechanics were less strongly
affected by vacuum suspension, however some differences in elasticity were found. Reactive hyperemia (increase in blood
flow after period of occlusion) was consistently observed when comparing pre- to post-activity StO2 values from the residual
limb of amputees. After 16 weeks of use, however, reactive hyperemia was significantly attenuated in subjects under elevated
vacuum suspension conditions as compared to suction controls. While not statistically significant, there was a general trend
for reactive hyperemia to increase over the 16 weeks under suction conditions.
Discussion & Conclusion:
This work represents first efforts to quantitatively assess skin health and circulation in response to elevated vacuum suspension.
The results suggest vacuum suspension leads to improved circulation and skin health. Further work is needed to explore these
findings in more detail with a larger study population. This research was funded by the U.S. Department of Veterans Affairs
(VA118-12-C-0038).
References:
1. Ferraro C. J Prosthet Orthot; 23, 78-81, 2011.
2. Brunelli S. Orthopadie Technik; 2, 2-8, 2009.
3. Traballesi M. Dis Rehab: Ass Tech; 4, 373-375, 200
Page 20 > BAPO2016
-
Come along to the BAPO stand
and join in the Friday fun at our
vintage fairground with games to
test your skills and candyfloss and
doughnuts to keep you going
Take part in our
‘Beat the wire’ competition for
the chance to bag yourself
a Fitbit!
On Saturday join us for a chat, meet
with BAPO Committee Chairs, find
out more about what BAPO does
and if you can help - we might even
treat you to a coffee and pastry!
BAPO2016
< Page 21
SATURDAY ORHTOTIC SESSION ABSTRACTS
SATURDAY 19 MARCH 2016
TREATING CLUB FOOT – WHAT’S NEW?
Naomi Davis
09:00 – 09:45 – Lounge 1 South
The basic tenet of the Ponseti Method is that it is well researched, practiced and honed to perfection by Dr Ponseti himself and
shouldn’t be changed or the results in children will suffer. However, there have been advances and deeper understanding of
the technique allowing even the most difficult clubfeet (atypical/complex feet) to be treated effectively.
The technique has spread internationally and as more clinicians use it, we learn more about outcomes and how to assess
them. For those children who have deformity associated with other conditions, we are developing new protocols.
Some advances in orthotics have improved compliance. There are new designs for the boots and bar orthosis, there is
increasing evidence to support the use of AFO’s in some, more challenging cases and new appliances have been introduced
that require assessment.
Our understanding of the underlying causes of clubfoot is starting to improve. The hunt for the clubfoot gene (or genes)
continues and good animal research models show some potential.
Behind all of this, the understanding of the anatomy of the foot, the technique of manipulation, careful cast application and
the dedicated use of appropriate orthotics remain vital to success in treating children with clubfoot deformity successfully.
CUSTOM-MADE FOOTWEAR FOR PATIENTS WITH DIABETES: BIOMECHANICAL AND
CLINICAL EVIDENCE
Dr Sicco Bus (OETT Keynote Speaker)
11:00 – 12:00 – Lounge 1 South
Foot disease is a major problem in patients with diabetes mellitus. Every 30 seconds someone in the world loses a leg because
of diabetes. A foot ulcer precedes most amputations. Increased mechanical pressure on the foot during ambulation is an
important risk factor for foot ulceration. Therefore, reduction of these pressures is important both in the prevention and
treatment of these chronic wounds. For ulcer prevention, custom-made footwear is commonly prescribed to diabetic patients,
in particular to those that have healed from a plantar foot ulcer and have foot deformity that limits the use of standard
footwear. Custom-made footwear aims to redistribute pressures on the foot and reduced pressure at locations that are a high
risk for ulceration (pressure points).
Studies on ulcer prevention focus mainly on secondary prevention of foot ulcers (recurrence). The effectiveness of custommade footwear to prevent ulcer recurrence has over recent years gained major interest from several large-scaled investigations.
We recently finished a trial on the effectiveness of in-shoe plantar pressure measurements to improve custom-made footwear
and prevent ulcer recurrence in high risk diabetic patients. Another trial in the US assessed the effect of pressure and shape
based innovative custom-made inlays on the prevention of foot ulcer recurrence in diabetes. The results from these trials
provide important insight into the role of pressure relief and adherence in the development and prevention of foot ulcers
in diabetes and have important implications for clinical practice. The outcomes of these trials and other studies have been
integrated in the 2015 practice guidelines of the International Working Group on The Diabetic Foot.
CASTING TECHNIQUES FOR WOUND HEALING AND OFFLOADING IN THE
MANAGEMENT OF FOOT DISEASE IN DIABETES
Willie Munro
13:00 – 13:40 – Lounge 1 South
The aim of this presentation is to provide Orthotists with clinical and practical casting interventions and solutions, when
dealing with the complications of foot disease in diabetes.
The presentation will address the implications of pathological changes in the vascular and neuropathic foot, Charcot
Neuroarthropathy and ulceration.
There will be an introduction and practical application of casting options, including instruction in the use of casting materials
and tools used in the manufacture of casts.
The presentation will provide an underpinning of the knowledge and practical application of casting as a valued treatment
option when dealing with foot disease in diabetes.
Page 22 > BAPO2016
Saturday
Orthotic Session
Abstracts
JUVENILE IDIOPATHIC ARTHRITIS – AN UPDATE
Liz Clayton
13:45 – 14:45 – Lounge 1 South
This short presentation will provide an overview of Juvenile Idiopathic Arthritis and its current management.
It will also consider the impact of ongoing problems on mobility and range of movement in the developing child and into
adult life.
EFFECT OF ORTHOTIC GEOMETRY AND MATERIALS ON FOOT TISSUES
AND FUNCTION
Prof. Chris Nester
15:30 – 16:30 – Lounge 1 South
This lecture is based on published research and work at the University of Salford and will explore why foot orthotic
geometry and material properties are the only parameters you need to be specific to adjust the application of load to the
sole of the foot. This includes how orthotic geometry and materials affect loading of the foot skin, subcutaneous fat and
foot muscle tissues, joint moments, muscle and passive soft tissues forces, and eventually joint movements.
TISSUE STRESS THEORY: CHANGING THE PARADIGM OF BIOMECHANICAL
THERAPY FOR THE FOOT AND LOWER EXTREMITY
Dr Kevin Kirby
16:30 – 17:30 – Lounge 1 South (Satellite Presentation, USA)
The history of custom foot orthosis therapy, including Dr. Merton Root’s Subtalar Joint Neutral Theory, will be reviewed
along with the more recent and increasingly popular Tissue Stress Theory that is now being used by podiatric biomechanics
specialists from around the world as a more efficient and mechanically-logical method by which to order custom foot
orthoses for patients. Rather than rely on unreliable static measures of “rearfoot deformities” and “forefoot deformities”
as proposed in Dr. Root’s Subtalar Joint Neutral Theory, Tissue Stress Theory is based on determining which specific
anatomical structures are injured and determining the nature of the pathologic loading forces acting on that structure
during weightbearing activities in order to design an optimal treatment plan. The treatment plan may include using premade orthoses, customised pre-made orthoses or custom foot orthoses, stretching, strengthening, alterations in shoes,
changes in training methods, and others, all with the ultimate goal of reducing the pathological forces on the injured
structures, improve gait function and prevent further injury from occurring within the patient. In this webinar, Dr. Kirby will
detail the biomechanics and engineering terminology and biomechanical concepts that are required to fully understand
Tissue Stress Theory and its clinical application in foot orthosis therapy.
BAPO2016
< Page 23
SUNDAY WORKSHOPS SPEAKER PROFILES
SUNDAY 20 MARCH 2016
PROSTHETIC
ALISON MORTON
Alison qualified in 1988 from Strathclyde and has worked in Glasgow since then. Alison treats all levels
of lower limb prosthetics and is solely responsible for the paediatric lower limb prosthetic patients at
WestMARC. Cases of interest include Van Nes rotationplasties.
VINCENT McEACHEN
Vincent qualified in 2001 from Strathclyde and has worked in Newcastle and currently Glasgow.
Vincent treats all levels of upper and lower limb prosthetics and is responsible for most upper limb
paediatric cases at WestMARC. A lot of the cases he treats are for custom made appliances for specific
activities.
MORVEN McALINDEN
Morven graduated from Strathclyde University in 1996 and worked as a Prosthetist in Newcastleupon-Tyne. In 1999, Morven transferred to the Royal National Orthopaedic Hospital in Stanmore,
where she became the assistant manager in 2001, and more recently appointed as the Prosthetic
Clinical Lead.
Morven deals with all levels of amputation, on patients of all ages, though has a special interest in
paediatric patients and upper limb prosthetics. Morven presents annually at the BSRM Prosthetic
Course, on topics of upper limb prosthetics and congenital limb deficiency. Earlier this year, along
with other members of the multidisciplinary team, we hosted a symposium at ISPO France, relating to
the prosthetic and surgical treatment of congenital limb deficiencies.
ANDREW SHARPE
Andrew Sharpe, Principal Prosthetist, qualified in 1982 and has worked at the West Midlands
Rehabilitation Centre at Birmingham for 40 years. He has always had a keen interest in paediatrics
and continues to be focused on the demanding requirements for rehabilitation of children who
have recovered from the devastating effects of meningococcal septicaemia and the role of special
interface liners.
He is a key member of the interdisciplinary team at Birmingham and was instrumental in setting up
the then only dedicated paediatric prosthetic clinic over 17 years ago.
He is also a member of the team looking at Intraosseous Transcutaneous Amputation Prostheses ITAP.
Page 24 > BAPO2016
ORTHOTIC
Sunday
Workshop
Speaker Profiles
SIMON DICKINSON
Simon qualified as an Orthotist in 1996 from Salford University. He began his career at the Nuffield
Orthopaedic Centre in Oxford where he quickly developed a passion for lower limb orthotics and
biomechanics and became an extended scope practitioner. Following his time in Oxford he then
worked for 6 years for Trulife in the West Midlands where he worked as a Clinical Specialist Orthotist
and continued his extended scope work as an Honorary Consultant in lower limb biomechanics and
orthopaedics.
In 2008, Simon became Clinical Lead and Head of Service for Orthotics at Nottingham University
Hospitals NHS Trust. During his time in Nottingham, Simon led a whole service redesign of the
orthotics service whilst continuing in his extended scope role. During this period he also became
chairman of NOMaG and an expert in orthotics for the Department of Health. In September 2014
Simon left his NHS role to become Clinical Director of TalarMade, where he is now responsible for
product development, research and education.
Simon has lectured many times at national and international conferences and is a regular presenter
at BAPO conference. He is also one of 4 Orthotists who worked collaboratively to create the Directory
of Evidence Based Orthotic Practice (DEBOP) and is the creator and facilitator of BAPO’s “Assessment
Diagnosis and Treatment of Musculoskeletal (MSK) Foot and Ankle Problems for Orthotists” course.
FIONA MONAGHAN
Fiona is Orthotic Manager for Buchanan Orthotics and has been involved extensively with the MSK
DEBOP (Directory of Evidence Based Orthotic Practice) throughout 2015 in which she took on the role
of co-ordinator. This progressed to being part of the trainers programme for Assessment Diagnosis
and Treatment of Musculoskeletal (MSK) Foot and Ankle Problems for Orthotists which continues into
2016.
Fiona graduated from Strathclyde University in 2002 and commenced employment in Manchester
Royal Infirmary and Royal Manchester Children’s Hospital before joining Buchanan Orthotics. She
has a specialist interest in lower limb biomechanics as well as her role as Clinical Manager. She has
externally examined for final year exams at Strathclyde University and enjoys mentoring students
within her clinical team.
CHRISTOPHER COX
Christopher is a full time Orthotist based in NHS Lanarkshire in Scotland having graduated from
the University of Strathclyde with a 1st class honours degree, and has been working in specialist
combined Orthotic/Surgical, Orthopaedic foot and ankle clinics for the last 3 Years. Christopher has
also been working privately in a Sports Biomechanics clinic for the last 4 years. Christopher’s key
interests are lower limb biomechanics and he is currently an MSK Trainer for the BAPO sponsored
course; Assessment Diagnosis and Treatment of Musculoskeletal (MSK) Foot and Ankle Problems for
Orthotists. Outside of work and the development of his clinical knowledge he is a keen fitness enthusiast.
LAURA BARR
Laura is an Extended Scope Practitioner in Orthopaedics, and an Orthotist working in NHS Greater
Glasgow and Clyde. She graduated from the University of Strathclyde in 2007 and during her
employment in GGC, developed a specialist interest in the areas of MSK conditions of the foot & ankle
and diabetes care & management. She has presented on the subjects of foot & ankle biomechanics
and diabetes at national and international conferences, and has taught throughout the UK as a trainer
on the BAPO MSK diagnosis and treatment course for Orthotists. Laura also has an interest in the use
of CADCAM for insoles, and in 2015 as part of her role in developing a standardised training program
for Orthotists in GGC, was invited to participate as part of the UK team at the 1st international Paromed
summit.
BAPO2016
< Page 25
SUNDAY WORKSHOP ABSTRACTS
SUNDAY 20 MARCH
PROSTHETIC WORKSHOP
PAEDIATRIC PROSTHETICS - PROBLEM SOLVING
10:00 - 12:00 - Jaguar Club Lounge
Alison Morton, Vincent McEachen, Morven McAlinden and Andrew Sharpe
This year a team of experienced upper and lower limb paediatric Prosthetists will be presenting complex, unusual and
interesting case studies for discussion. They will look at both congenital and acquired limb loss, complex unilateral amputations
as well as multiple limb absence. How the requirements of the prosthesis change with time and specialist devices to allow
children to be children, do sports and play instruments.
ORTHOTIC WORKSHOP
THE SYMBIOTIC RELATIONSHIP BETWEEN STRUCTURAL AND FUNCTIONAL
INSTABILITY IN THE FOOT AND ANKLE
10:00 - 12:00 - Jaguar Club Suite
Simon Dickinson, Fiona Monaghan, Laura Barr and Chris Cox
Structure of session: Group sessions *4 (20 minutes each)
Group 1: . . . . . . . . . . . . . . Ankle Joint . . . . . . . . . . . . . . Simon Dickinson
Group2: . . . . . . . . . . . . . . .Midfoot . . . . . . . . . . . . . . . . . Laura Barr
Group 3: . . . . . . . . . . . . . . 1st Ray . . . . . . . . . . . . . . . . . . Fiona Monaghan
Group 4 . . . . . . . . . . . . . . MTH . . . . . . . . . . . . . . . . . . . . Chris Cox
Target Audience: Students and qualified Orthotists with an interest in foot & ankle function. Also relevant for those people
who have attended the BAPO MSK course.
The “normal” foot comprises of 26 bones and 33 joints. It is an incredibly complicated structure which evidence now tells us
varies significantly from one person to another.
Our undergraduate education relating to foot function has been focused on “STJ Neutral” theory and the principle that the
foot has a “normal” or “neutral” position. This STJ Neutral approach, suggested in 1977, has been widely accepted and applied
for many years in university based education programmes around the world, despite an increasingly strong body of evidence
over the last 25 years proving that this approach and methodology is fundamentally flawed and unreliable.
Despite this ever increasing body of evidence and the move towards “Soft Tissue Stress” theory, some clinicians are still preprogrammed into the belief that foot orthoses change the foot’s alignment, and this alignment change results in improvements
in a patients symptoms, despite evidence clearly demonstrating that foot orthoses do not make significant changes in
alignment (kinematics), but do significantly change the load and moments being generated around joints (kinetics).
This seminar will discuss and demonstrate the structural and functional mechanisms which provide stability to the joints
of the feet. It will discuss the variations in normal anatomy and the impact this has on joint function. Clinical tests will be
demonstrated to show how to accurately assess and understand the relationship between structural instability and functional
compensation. It will also demonstrate how abnormal function can lead to changes in structural instability.
Page 26 > BAPO2016
PROSTHETIC FREE PAPER SESSIONS
Prosthetic
Free Paper
Sessions
NEW SOCKET TECHNOLOGY FOR HIP DISARTICULATION PATIENTS
‘THE SILICONE BIKINI SOCKET’ A CASE STUDY
Lynzy Holding, Senior Prosthetist, RSL Steeper
Aims/Objectives: Traditionally Hip disarticulation sockets have been manufactured using a combination of blocked leather,
flexible plastics and laminates.
At Aintree Hospital we have moved onto using silicone as the socket interface for this level of amputation, which has improved
comfort for patients but it is still heavy and requires a lace up or Velcro fastening.
Only 2% of all amputations are at the hip disarticulation level, so Prosthetist’s do find it challenging to develop a consistent
prosthetic fitting. Hip disarticulation prostheses have a high rejection rate due to weight, increased energy requirements, and
more importantly the socket interface which is usually very bulky and uncosmetic.
The energy requirements for the hip disarticulation amputee have been estimated to be as much as 200% greater than those
for normal human ambulation.
After thoroughly researching some new developments in the USA with my patient it was decided to develop a new socket
technology for hip disarticulation patients. ‘The Silicone Bikini Socket’ was designed using our already popular silicone
interface along with new ‘Iliac Stabilisers’ manufactured by Martinbionics USA with a view to improving function, comfort and
proprioception for my patient.
The presentation is a case study of one male patient with an amputation at hip disarticulation level. His current prescription is
a silicone socket combined with the Ottobock Helix hip and C Leg. He reported his silicone socket to be very comfortable but
found during swing phase the leg would lose purchase on his residual limb resulting in a slight visible ‘drop off’. To combat this
the patient would support his prosthesis with dorsal palm. This habitual support left him with callous hard skin on his hand.
Methods: A cast was taken using elasticated bandage and required 2 Prosthetists to ensure optimal shape capture. The cast
must clearly define the ASIS and PSIS prominences.
Once the cast is taken the rectification is aggressive and must drastically reduce the original size of the positive model to
achieve the best outcome when using the Bikini Style suspension.
The residuum is compressed between the’ lliac Stabilisers’ and the base of the socket tightly this prevents lost motion between
the socket and the patients residual limb during swing phase therefore energy expenditure is also reduced.
Stability of the new socket still relies primarily on the alignment, comfortable axial support, and suspension so a test socket
was manufactured for a dynamic trial within the parallel bars.
Results: The final socket was manufactured from silicone with the core plate being the only rigid part the socket edges were
flexible and cut back to the shape of a ‘bikini’ to provide support to the bony anatomy only allowing the soft tissue to expand
into the open sections.
The socket was effective in greatly improving range of motion, proprioceptive feedback and cosmetic appearance underneath
clothing. The patient immediately reported that the prosthesis now felt ‘a part of him’ it was much more comfortable to wear
and visibly improved his gait. It can be donned and doffed at the flick of a clip. His confidence has improved and he no longer
feels he needs to support the limb with his hand at swing phase.
Conclusion: We now have a strong, comfortable socket which supports the patient throughout the gait cycle.
We have solved the ‘drop off’ issue at swing phase, the flexibility of the proximal edges allows a greater range of movement
and is more forgiving when the patient is sitting down. The advances made are presented for consideration by other teams as
a possible solution for Hip Disarticulation patients.
BAPO2016
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PROSTHETIC FREE PAPER SESSIONS
PROSTHETIC PROBLEM SOLVING IN PAEDIATRIC LDFP PROVISION: A CASE STUDY
David Logan, Prosthetist, Royal National Orthopaedic Hospital
Since 2012 I have been working with a young child (BS) with Longitudinal Deficiency of the Femur Partial (LDFP) (formerly
PFFD). The presentation of the LDFP was unusual in that the deficiency occurred in the shaft of the femur instead of the more
common femoral neck location. I have documented with photographs and videos the treatment we have provided since his
initial referral.
Initially, the patient’s mum (MH) was very reluctant to consider surgical intervention so we began with a basic extension
prosthesis. MH was eager for BS to wear shoes, so the second and third iterations of the prosthesis had trials of different style
of foot (Pedilan and leather foot and an adapted SACH foot respectively).
Working with MH and the MDT, it was decided surgical intervention was appropriate. BS had his pseudoarthrosis (cartilagenous
bridge in femoral shaft) fused, his knee fused and foot removed in an ankle-disarticulation amputation. This resulted in an end
bearing residual limb which ended at mid-shin level and was stiff from hip down. This length discrepancy will reduce as BS
grows, ending up with what can be functionally treated as a knee-disarticulation amputation with space for knee components.
The limbs provided post-amputation are also documented and discussed. They are a more basic pelite liner with laminate
socket and paediatric foot.
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ORTHOTIC FREE PAPER SESSIONS
IDENTIFICATION AND MANAGEMENT OF TIBIALIS POSTERIOR
TENDON DYSFUNCTION IN PRIMARY CARE
Nick Gallogly, Clinical Lead Orthotist, MSc BEng BSc MBAPO
Orthotic
Free Paper
Sessions
Profile
Nick is the service and clinical lead for the Royal Berkshire Hospital. He was awarded an MSc in Clinical Biomechanics
from Staffordshire University in 2014. He is a member of OETT and provides clinical advice to the ombudsman relating
to orthotic cases. His main research interests focus on tibialis posterior tendon dysfunction.
Abstract
Tibialis posterior tendon dysfunction (TPTD) has been described as a sudden or progressive loss of strength of the
tibialis posterior tendon. Current research suggests that patients arrive into secondary care having missed opportunities
of diagnosis and earlier intervention. The overall aim of the research was to identify the current knowledge of general
practitioners in the identification and management of TPTD with the specific aims of identifying if there is a training
need to improve diagnosis.
A questionnaire was developed and was sent out to GP`s across Berkshire who regularly refer to the local hospital. It
highlighted a general lack of knowledge, but identified four main areas of weakness. A learning program was developed
based on the results of the questionnaires which involved hands on workshops, presentations and the development of
a pathway and information leaflet. A second round of questionnaires was sent out 6 weeks after the information sheet
had been circulated.
The results showed an overall improvement in the knowledge of the condition. This improved knowledge will improve
the prognosis of many patients with this condition as well as reduce the need for costly imaging and surgical intervention.
This research also supports the need for a similar intervention nationally.
How the research is being implemented
An information leaflet on TPTD is emailed out to GP`s every 6months which included a pathway of referral. All referrals
with a TPTD diagnosis are given urgent referral status and orthopaedics as a result have seen a reduction in surgical
intervention over the past 2 years.
THE DEVELOPMENT OF AN INNOVATIVE MUSCULOSKELETAL (MSK) FOOT AND
ANKLE PATHWAY
Nicola Munro, Board Project Manager for MSK Foot and Ankle Pathways, NHS Greater Glasgow and Clyde
Profile
Nikki Munro graduated from NCPO in 1993 and is an Advanced Specialist Orthotist in NHS Greater Glasgow and Clyde.
She is clinical team lead in the specialist areas of Diabetes and Adult Neuro rehab. She is currently seconded as NHSGGC
MSK Foot and Ankle Pathways Project Manager.
Abstract
Orthopaedics are overrun with MSK referrals. Less than 60% of orthopaedic referrals require a surgical opinion. Most can
be treated by AHPs particularly Orthotists, Podiatrists and Physiotherapists. NHS commissioners want pathways to divert
MSK patients to AHP services. Pathways set up with no input from Orthotists focus on and develop other professions.
In my health board I applied for and gained a secondment as project manager responsible for pathway development.
Using Change Acceleration Program methodology I established a stakeholder group.
We found that AHPs are quick to deliver a device or treatment without allowing time for recovery, managed by the
patient. We identified that diagnosis, self-management advice and reassurance should be delivered by all levels of AHP
staff. We formed evidence based pathways and identified interventions which should not be delivered.
The pathway we developed is innovative because it does not require a diagnosis to be made by the GP to enable the
referral to be streamed. Instead, it enables self-management and uses an escalation process to manage more complex
patients.
We identified the training needs of each profession to deliver the pathway. Orthotists are now prescribing basic exercises,
learning how to order imaging and moving towards administering some drugs.
This project is now in the implementation stage. The learning and education gaps of staff have been assessed and
training needs are being met ahead of the launch of the pathways. 2 launch events will take place in March 2016. From
April all AHPs in NHSGGC who see Patients with MSK Foot and Ankle problems will follow the pathways.
BAPO2016
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ORTHOTIC FREE PAPER SESSIONS
WHICH IS THE BETTER TYPE OF ANKLE FOOT ORTHOSIS FOR PEOPLE WITH STROKE?
RESULTS OF THE AFOOT TRIAL.
SF Tyson, N Thomas, P Tyrrell, K Woodward-Nutt, S Plant, A Vail. University of Manchester
Abstract
Purpose: An ankle foot orthosis (AFO) can improve mobility after stroke, but there is little research comparing orthoses to inform
clinicians which to use.
Method: Randomised controlled trial involving community-living stroke survivors with limited mobility comparing the effects
of an off-the-shelf or a bespoke AFO on patient satisfaction, mobility; falls risk and adverse events, assessed at baseline, 6 and 12
weeks after the AFO was fitted.
Outcomes: 139 participants were recruited. Patients improved in all outcomes with an AFO compared with none but there were
no differences between groups (p<0.005) except falls risks which was lower in the off-the-shelf AFO group (p=0.003). Only 68%
of participants’ were (very) satisfied with their AFO. The main complaints were discomfort; skin problems; difficulty doffing and
donning; poor fit; restricted choice of clothes and shoes, and excessive rigidity and bulkiness. The main perceived benefit of the
AFO was improved foot and ankle alignment which prevented foot drop and thus improved mobility. Particpants felt steadier,
more confident and less likely to fall with an AFO.
Conclusion: No differences in mobility, patient satisfaction or adverse events between an off-the-shelf AFO and bespoke AFO
were found. Thus we recommend that the cheaper, off-the-shelf AFO should be prescribed in the 1st instance for most stroke
survivors. Further research into AFO design to improve user satisfaction is needed.
Implementation: This is the largest randomised controlled trial of AFO after stroke to date, and the largest to compare AFO
designs. The results will inform national clinical guidelines for stroke and clinical decision-making.
Precis
Sarah Tyson is Professor of Rehabilitation at the University of Manchester. Her research focuses on stroke rehabilitation particularly
balance and mobility problems and assistive technologies. She has over 120 publications and £4million of research funding from
the government, research councils, medical charities and professional bodies.
THE USE OF STABILOMETRY DATA IN THE FINE TUNING OF GROUND REACTION
ORTHOSIS: A CASE STUDY
Graham Dunn Bsc(Hons), Senior Orthotist, Blatchford Clinical Services
A 15 year old patient with a diagnosis of congenital neuropathy, heart disease and developmental delay is the subject of the case
study. She has a GMFCS of III equivalent and was adopting an increase crouched gait pattern.
Using the Footwork Pro pressure plate a number of dynamic and static assessments were undertaken in a regular clinical setting.
Using Static Stabilometry data it was possible to quantify sway in coronal and sagittal planes and to compare various tibial
inclinations in footwear combinations and orthosis rigidity to find the most stable combination.
This data was also used to ensure that the ground reaction orthosis had suitable rigidity to provide a suitable knee extension
moment. This trial and error approach using quantifiable data made it possible to achieve the optimal outcome of stability to
mobility that was important to the patient.
This case has demonstrated the impact that such computerised equipment can have on patient outcomes. It has also been used
as an example for the treatment of further patients using a more streamlined and methodical protocol.
Page 30 > BAPO2016
Sponsors
BAPO would like to thank our Event Sponsors:
ALGEOS
DJO GLOBAL®
DOUGLAS BADER FOUNDATION
LIMBCARE
MEDI UK
THE ORTHOTIC EDUCATION
& TRAINING TRUST
ORTHO EUROPE
ÖSSUR
OTTOBOCK
RENACE
TALARMADE
BAPO2016
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SPONSOR PROFILES
ALGEOS
Algeos are a family run business that provide a friendly, efficient service and aim to exceed expectations and provide the best possible
customer service. Algeos design, manufacture and stock a large range of products, many sold under our own brand: Aortha. Algeos
stock a wide range of efficiency solutions to make your working life easier, save time, productivity and money. Algeos has been
supplying the Orthotic and Prosthetic market for over 20 years. We supply semi-finished Foot Orthotics, Prosthetic Manufacturing
Supplies, Sheet Materials, CAD-CAM Consumables, Machinery and various Adhesives for all forms of O&P manufacture.
Algeos O&P prides itself on offering top quality products and unsurpassed services. Our aim is to become a ‘one stop shop’ for all
Orthotics and Prosthetics requirements. We can supply bespoke materials, lamination, machinery service and repair contracts, global
sourcing, education and training, finance and leasing. We will be showcasing our large range of materials, Aortha Adhesives and
Algeos NEW Machinery range at the show. Visit our stand for further information and product demonstrations throughout the show.
For further information on any of our products or services please contact us.
DJO GLOBAL®
DJO Global® is a leading global developer, manufacturer and distributor of high-quality medical devices and services that provide
solutions for musculoskeletal health, vascular health and pain management. The Company’s products address the continuum of
patient care from injury prevention to rehabilitation after surgery, injury or from degenerative disease, enabling people to
regain or maintain their natural motion.
Our products are used by orthopedic specialists, spine surgeons, primary care clinicians, pain management specialists, physical
therapists, podiatrists, chiropractors, athletic trainers and other healthcare professionals. In addition, many of the Company’s medical
devices and related accessories are used by athletes and patients for injury prevention and at-home physical therapy treatment.
The Company’s product lines include rigid and soft orthopedic bracing, hot and cold therapy, bone growth stimulators, vascular
therapy systems and compression garments, electrical stimulators used for pain management and physical therapy products. The
Company’s surgical division offers a comprehensive suite of reconstructive joint products for the hip, knee and shoulder. DJO Global’s
products are marketed under a portfolio of brands including Aircast®, Chattanooga™, CMF™, Compex®, DJO Surgical, DonJoy®, Empi®
and ProCare®.
For additional information on the Company, please visit www.DJOGlobal.com
For updates and news, follow DJO Global UK on Twitter @DJOGlobalUK
DOUGLAS BADER FOUNDATION
THE DOUGLAS BADER FOUNDATION FORMED IN 1982 in memory of a man who was a legend in his own lifetime as much for his
RAF and World War 2 exploits as for the many disabled with limb loss and those with disabilities he inspired by living his life as fully
as possible. His skill as an aviator and contribution as an outstanding leader and fighter ace during WW2, along with his continuous
attempts to escape prisoner of war camp after he was shot down, were immortalised in the book and film ‘Reach for the Sky‘.
BADER GRANTS provides practical support for the pursuance of achievements by those with disabilities. BADER BRAVES supports
children with limb loss and other physical disabilities by offering unique experiences and improving life-skills to increase confidence.
BADER INFORMATION ON LIMB LOSS (BILL) Online resource created to guide individuals with congenital or acquired limb loss and
their friends, family and carers through the emotional, physical and psychological process of coming to terms with limb loss. TEAM
BADER Enabling amputees and other disabled and able bodied to participate in Fund Raising Sporting and Other Activities.
‘A disabled person who fights back is not disabled….but inspired’
LIMBCARE
Limbcare is the leading charity in the UK, providing complete help and support to amputees and the limb-impaired through“ Limbcare
Services” . A young Charity with a big heart and old fashioned values offering empathy not sympathy to all amputees their families,
friends and carers.
Page 32 > BAPO2016
Sponsor
Profiles
MEDI UK
medi UK provide a comprehensive range of the highest quality functional orthopaedic braces and joint compression supports. We
specialise in knee ligament, OA off-loading and patellar supports.
medi’s M4s range of off-loading braces are an accepted and proven alternative therapy in the treatment of OA. Soft braces such as
Genumedi, Levamed, Achimed and Epicomed provide low profile support and compression for joint stability and swelling control.
Arm, hand and wrist supports, together with shoulder and back orthoses, including the clinically proven and original ‘Spinomed’ brace
for Osteoporosis, give medi one of the widest ranges of braces on the market.
We offer free next working day delivery on all products. For a full brochure or customer support, contact us at medi UK Ltd Plough
Lane Hereford HR4 0EL
Tel. 01432 373500 www.mediuk.co.uk / shop.mediuk.co.uk
THE ORTHOTIC EDUCATION & TRAINING TRUST
The Orthotic Education & Training Trust was originally set up by the Department of Health and the British Surgical Trades Association,
in partnership with the British Institute of Surgical Technologists, to provide a private fund which now provides postgraduate training
and education for Orthotists, Orthotic Managers and Orthotic Technicians in many forms of sponsorship:• Short Course Assistance sponsorship
• BAPO Conference Orthotic Keynote speaker and Student of the year award sponsorship
• Technicians Training Day sponsorship at the BAPO conference and Orthotic Technician training project Pump Priming support
• Overseas orthotic led projects and Specialised International event Support
• New for 2014 are the OETT Short Term Orthotist Fellowships
ORTHO EUROPE
Ortho Europe, established in 1990, is a major European manufacturer and distributor of prosthetic and orthotic product. Headquartered
in the UK, with offices in France and Netherlands and distributors across Europe and the rest of the World. Ortho Europe are leaders
in the provision of custom-made solutions to the marketplace. They use the latest in CAD CAM machinery and highly-skilled and
experienced technicians to provide custom made footwear, insoles, and a full range of orthotic and prosthetic devices. Ortho Europe
also have an experienced high definition silicone service which provides solutions to customers across Europe.
ÖSSUR
We are excited once again to support this year’s BAPO Conference in Coventry. This is a fantastic opportunity for us to engage with our
customers and fellow colleagues in a different environment.
We are launching a number of new innovative products and we invite you to our stand for a demonstration with our clinical specialists
and users, whom you’ll see walking the floors of the show with their new prosthetics.
The Össur UK office is based in Stockport and we pride ourselves on the service we offer our customers. Our goal is to offer consistent,
high-quality customer service. Through value-added services and educational programs, we build close and long-lasting relationships
with our customers.
We look forward to seeing you on the stand.
OTTOBOCK
Ottobock is a world leading supplier of high quality, innovative and practical solutions that restore human mobility and help people
to rediscover personal independence. Ottobock is part of the Ottobock global group of companies established in the UK in 1976.
Its wide product range includes high quality prosthetic and orthotic components, wheelchairs, rehabilitation and mobility products
available through the country’s leading clinics and dealers. For private patients, Ottobock offers a full range of rehabilitation services
at our private clinics across the country. With a highly motivated and skilled team of professionals offering expert advice, product
sales, service, support and medical care, Ottobock solutions enhance the physical comfort, confidence and mobility of the individual.
BAPO2016
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SPONSOR PROFILES
RENACE
Renace is at the leading edge of orthotic scanning solutions and we are continuing to develop our systems to encompass a greater
range of braces.
Having worked in partnership with Scottish health boards for a number of years we have successfully integrated both Rodin and
Paromed systems into the clinical service environment producing electronic adult and paediatric AFO’s, KAFO’s, body jackets, helmets
and insoles. Digitisation has improved accuracy, efficiency and most of all patient experience. We are now working in partnership with
NHS units in the UK, driving forward best practice and value for money solutions.
The Renace footwear range has been revitalised using enhanced materials and processes to improve quality and fit. PU sole units and
10 last choices per size offer a flexible and effective solution for patients who require stock, modular and bespoke footwear.
Our current focus on developing scanning processes for footwear is proving successful and providing enhanced fit and patient comfort.
TALARMADE
Talarmade are a global manufacturer and supplier of innovative Orthopaedic Bracing and Pressure Redistribution devices, operating
across a number of market sectors.
Owned and managed by professionals from the fields of Orthotics and Podiatry, our organisation has evolved significantly in recent
years on all levels due to significant investment in our infrastructure and product development.
As well as further developing our range of products and services, we have developed an unrivalled team who are on hand to support
our ever growing customer base – from in-house and field customer support and next day delivery to enhanced training and education.
Talarmade are currently very proud to support the MSK Education programme nationally, and are currently developing our Education
Hub across all clinical specialities we work with.
New on our stand this year is our new insole ranges – Basis, Elite, RSO, Gaitway and our newly developed Talarmade ‘Additions Kit’.
We will also be introducing the Turbomed FS3000 - a revolutionary drop foot device, and Prolevo – an innovative range of Pressure
redistribution products for the prevention and treatment of pressure related injuries.
We look forward to meeting customers – old and new.
Page 34 > BAPO2016
Exhibitor
List
EXHIBITOR LIST
Stand Number Name
Stand Number Name
1, 2 & 3
BAPO
36
4
Medi UK
37DJO
DM Orthotics Ltd
5Trulife
38
Talarmade Ltd
6 & 7
39
Benecare Medical
40
Pierdro B.V.
41
Equip to Move
42
Burton Waters
43, 44 & 45
Steeper Group
Promedics Orthopaedics
8Delcam
9, 10, 23 & 24
DeNovo Healthcare
11 & 12
Ottobock Healthcare Plc
13Renace
14Chaneco
15 & 16
Beagle Orthopaedic
17 & 18
Algeos
19, 20 & 21
Össur
21a
Pro-Fit Technologies Ltd
22
Bolton Brothers Ltd
25 & 26
Orthotic Composite
27
Script Media
46Limbpower
47, 48 & 49 Ken Hall Ltd
50 & 51
T&S Orthotics Ltd
52Juzo
53
Taurus Footwear and Leathers Ltd
54Medalin
55
Jobskin Ltd
28Shoemaster
56
North Sea Plastics Ltd
29 & 30
Thuasne
57 & 58
Reed Medical
31
CUI Wear
59
Allard Support UK Ltd
32
Salts Techstep
60, 61 & 62
Chas A Blatchford
33 & 34
Otho Europe
63
Sevilla Components Ltd
35
Kenward Orthopaedic Ltd
64
Polymer Systems Technology Ltd
BAPO2016
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EXHIBITION FLOOR PLAN
Page 36 > BAPO2016
Exhibitor
Floor Plan
BAPO2016
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EVENTS
OPEN FORUM
FRIDAY 18 MARCH 2016
17:10 - 17:40 - LOUNGE 1 NORTH
We invite non-members to join a discussion about BAPO, its functions and structure from 17:10 until
17:40 with the business of the Association beginning at that point for members only.
AGM
FRIDAY 18 MARCH 2016
17:40 - 19:00 - LOUNGE 1 NORTH
The Annual General Meeting of the Association will include the formal business of BAPO as laid
down in the Constitution. There will be reports from Office Bearers of the Association, voting on
important issues and an opportunity for questions from the membership.
TECHNICIAN
OF THE
YEAR
AWARD
TECHNICIAN OF THE YEAR AWARD
FRIDAY 18 MARCH 2016
19:00 - BAPO STAND
Join Ray Edwards MBE, Limbcare Chairman at the BAPO stand for the presentation of this year’s
award.
FRIDAY EVENING SUPPER
FRIDAY 18 MARCH 2016
19:30 - E-ON LOUNGE
We invite you to join us in the E-on Lounge to enjoy the relaxed atmosphere and buffet, kindly
sponsored by medi UK.
FRIDAY EVENING DISCO
FRIDAY 18 MARCH 2016
21:00 - MIDNIGHT - LEGENDS LOUNGE
Algeos O&P are sponsoring the BAPO disco. Make sure you are there to join in the fun. We will
dance the night away with a DJ, complimentary drinks and maybe some quirky Aortha glow
sticks.
SATURDAY EVENING P&O PARTY
SATURDAY 19 MARCH 2016
19:00 - 01:00 - LEGENDS LOUNGE
Don’t forget your party outfits beginning with P or O please.
Outdo other party outfits for the opportunity to procure our prize!
PRIZE GIVING CEREMONY
SATURDAY 19 MARCH 2016
19:00 - 01:00 - LEGENDS LOUNGE
Join us on Saturday evening to celebrate the achievements within the P&O industry.
Your efforts are recognised at the annual prize giving ceremony with presentations to include
the BAPO Lifetime Achievement Award & Free Paper winners.
Page 38 > BAPO2016
DELEGATE REFLECTION FORM
Please complete this assessing your own attendance at each session
Session title:
Session title:
Presenter:
Presenter:
What are the key messages I have learned from this session?
What are the key messages I have learned from this session?
How would I apply what I have learned to my workplace?
How would I apply what I have learned to my workplace?
How do I make this happen?
How do I make this happen?
BAPO2016
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