CONFERENCE PROGRAMME

Welcome from BAPO Chair - Sophie Hill

Contents

Dear Colleagues,

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Welcome to the BAPO Annual Conference 2008 at the De Vere Whites Hotel, Bolton. This year the conference will provide the high standards of hospitality to which you have become accustomed. Your Conference Committee and the Secretariat staff, led by Lynne Rowley and Lorna Graham respectively, have organised another superb programme of events. This year Dr Rickard Brånemark will be presenting the Otto Bock Lecture on Osseointegration and the Orthotic Education and Training Trust Lecture will be given by Dr Michelle Eagle on Neuromuscular Disorders. These key note speakers provide an excellent start to Saturday’s clinical programme. Alongside the clinical programme is the technical programme, which is being held on the mezzanine level. Steve Hill from the USA is presenting on the Fabrication of the FullStride Stance Control System and Anthony MacKinnon presenting Risk Assessment in the Workplace. On Saturday afternoon there is a practical work shop on composites presented by Kevin Moore and sponsored by A. Algeo Ltd. The social programme kicks off on Friday evening with the exhibition opening at 6pm followed by the Icebreaker sponsored by Össur. On Saturday night the social programme continues with the DJO UK Ltd Casino Party Night. The AGM is being held on Sunday morning at 10am and there will also be the opportunity to ask questions of the EC at the EC Forum on Friday afternoon. This is a great opportunity to help you meet your CPD requirements, especially for those of you registered with the HPC. Remember to write a reflection on what you have learnt during the conference weekend and how it will potentially affect your practice. You may wish to use the reflection forms at the back of this conference programme for this. Thank you to the sponsors and exhibitors for their continued support and to you for your attendance. I wish you a stimulating and enjoyable weekend. Sophie Hill BAPO Chair

BAPO CONFERENCE 2008

Welcome from BAPO Chair - Sophie Hill p3 Timed programme at a glance

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Plenary speaker biographies

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Keynote Speakers

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Parallel session descriptions

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Demo Area Timetable

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Sponsor Profiles

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Exhibition Floor Plan List of Exhibitors p34 Exhibitor Profiles

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Events

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Delegate learning outcome forms

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BAPO Secretariat Sir James Clark Building Abbey Mill Business Centre Paisley, PA1 1TJ Tel: 0845 166 8490 Fax: 0141 561 7218 E-mail: [email protected]

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Let it shine for BAPO! Your professional association is involved in many areas of activity from promotion of the professions and representation at government level to producing a quarterly magazine and relies on people like you, volunteers, using their expertise and talents in many different areas. What’s your talent? What can you bring to BAPO? Our aim on the BAPO stand this year is to celebrate your talents so come and have your picture taken with your talent. Want to see how? Then visit the stand and let your talent shine.

Involved in promoting the profession? Need some advice or help? Come and visit us at the BAPO stand. We can provide you with presentations and resources to help you. Come and speak to us about your ideas and what you’re up to- we’re here to help!

Come and meet our new Mascot! Enter the competition to chose a name for the new BAPO Mascot and find out what he’s all about!

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BAPO CONFERENCE 2008

TIMED PROGRAMME

EXHIBITOR REGISTRATION On arrival, exhibitor personnel attending the Conference must report to the BAPO reception desk to register on an individual basis. The desk will be open to exhibitors during the following times:Friday 14 March Open 10:00 hrs Saturday 15 March Open 08:30 hrs NB: there is no Exhibition Programme on Sunday 16 March.

Closes 19:30 hrs Closes 17:00 hrs

EXHIBITOR ACCESS, SET-UP AND BREAKDOWN Please do not arrive before 19.30hrs on Thursday 13 March 2008 ACCESS After unloading exhibitor lorries should make their way to car park C which is the designated parking area for exhibitors. SET-UP The Exhibition Programme will officially open at 18:00hrs on Friday 14 March 2008 and exhibitors must ensure that their stand is set up before 16:00hrs on that day. You will have access to the Exhibition programme area to set up your stand on Thursday 13 March 2008 from 19:30hrs until 22:00hrs and on Friday 14 March from 10:00hrs until 16:00hrs. Under no circumstances will exhibitors be allowed to set up their stand at any other time during the Conference. Please note that if your company’s stand is not set-up by 16:00hrs on Friday 14 March 2008, you will not be able to exhibit and a “No-Refund Policy” will be exercised. BREAKDOWN Please do not pack up before 16:00hrs on Saturday evening when the Exhibition closes, as this would disrupt the area for delegates wishing to visit other stands. You have from 16.00hrs until 23:59hrs on the Saturday evening to break your stand down and pack up. You should therefore ensure that you have sufficient staff to enable you to break down your stand in that time as baPo ltd will not accept responsibility for any additional charge made by the De Vere Whites Hotel for stands not cleared by 23.59hrs.

CLINICAL PROGRAMME - FRIDAY 14TH MARCH Friday

Hall of Fame

13.00-13.55hrs

Your CPD Obligations and the HPC Audit Process Richard Hirons

14.00-15.00hrs

Intelligent Orthotic Knee joints Dr Jim Campbell

15.00-15.30hrs

Tea/Coffee

15.30-16.30hrs

Ankle/foot biomechanics discussion group Dr Greg Quinn, Simon Dickinson, Mark Gallagher

16.35-17.35hrs

Lion of Vienna A

Lion of Vienna B

Prosthetic shape capture discussion group Tony McGarry, Dr Arjan Buis and Dr Kevin Murray

Developments and changes to the undergraduate curriculum in the P&O Programme Elaine Figgins

A physiotherapists guide to prosthetic knee and gait training principles Helen Scott and Christine Divers

Algorithms for AFO footwear combinations and the angle of the ankle in the AFO. Do you agree? Elaine Owen

EC Question time

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CLINICAL PROGRAMME - SATURDAY 15TH MARCH Saturday 09.00-10.00hrs Otto Bock Lecture Dr Rickard Brånemark MD, MSc, PhD Bone Anchored Amputation Prosthesis 10.05-11.00hrs OETT Lecture Dr Michelle Eagle PhD MSc MCSP Neuromuscular Disorders: Hope for the Future, optimum care for today 11:00-11:30hrs Tea/Coffee Hall of Fame

Lion of Vienna A

11:30-12:30hrs Paralympics 2012 Prosthetics to Podium Nik Diaper

Lion of Vienna B

Mezzanine Level

Orthotic Management of an Infant with Aplasia Cutis Congenita. Steve Mottram Management of Severe OA of the Knee using a Customised Off Loading Knee Orthoses. William A Munro

Pre-clinical evaluation of Why do we need Risk novel socket materials Assessments? Brian McLaughlin Tony MacKinnon The development of an observational gait score for lower limb prosthetics Elaine McCurrach The Effect that a Congenital Upper Limb Deficiency Has on a Child and his/her Parent(s). Does a prosthesis help? Marnie Punchard

A review of the orthosis provision through the Scottish National Brachial Plexus Injury Service, Victoria Infirmary, Glasgow Brian McLaughlin

A case note analysis of Upper-X liner use in upper limb prosthetics Sophie Young

12:30-13:30hrs Lunch 13:30-14:30hrs Spasticity Management Dr Morcos, Paul Charlton Dr Rory O’Conner, Richard Sealy

Footwear ? Are we missing something? Steve Osborne 14.35-15.30hrs Diagnosis of Foot Conditions and Evidence Based Management Simon Dickinson and Thomas Ramsay.

Mental Loading and energy expenditure during level walking: A comparison between the C-leg, SNS and 3R60. Dr Margrit R Meier

The Limbless Soldiers and their Prosthetic Service- a look at DMRC Headley Court, 1 year on. Alan Tanner

Does spinal bracing have to be Martin Mathews rigid?M Working with Digital Radiography Ian Berryman Evidence based treatment of idiopathic adolescent scoliosis- SpineCor Approach Mathew Nolan

Introduction to ischial containment casting John Ross

Design Concepts of the Crow Walker and Offloading AFO's' Elaine Nelson and Bill Moritz

15.30-16.00hrs Tea/coffee 16.00-17.00hrs An introduction to ‘Touch Bionics’ David Gow

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Fabrication of the FullStride Stance Control System Steve Hill

BAPO CONFERENCE 2008

A. Algeo Ltd Composites Workshop Kevin Moore

SPEAKER PROFILES

POSTGRADUATE ORTHOTIC SUPPORT NETWORK A MEETING FOR ORTHOTISTS/PROSTHETISTS IN THEIR FIRST YEARS OF PRACTICE With attention being drawn at this years AGM to the decline in BAPO membership, it is important to highlight that some of this may be accounted for by people leaving the profession altogether. Having graduated just two years ago several peers have done just that, each time prompting reflection and re-evaluation of the work that we do. The initial chapters of any career are hugely influential and there is undoubtedly potential for Orthotists at this stage to become vulnerable. It is proposed that a Post Graduate Orthotic Support Network is initiated. The aim is to have meetings attached to existing Orthotic events for recent graduates to network and share challenges and experiences. As well as physical meetings, a network of e-mail and personal contacts will be developed to support new members of our profession through the initial years.

Our first meeting is ; Saturday 15th March 2008 - 17:15hrs Lion of Vienna suite A Reebok Stadium, Bolton BL6 6JW

Otto Bock Lecture Keynote speaker - Dr Rickard Brånemark

M.D., MSc, PhD

Dr Brånemark graduated from Göteborg University, Sweden in 1987 with a MSc in Technical Physics and an MD. He became a specialist in orthopaedics in 1995 and his PhD thesis in 1996 was entitled ’a Biomechanical study of Osseointegration’ He founded Integrum -A swedish medical technology company developing devices for direct skeletal anchorage of amputation prostheses in 1998. He has been a director at the Centre of Orthopaedic Osseointegration, at Göteborg University, Sahlgrenska University Hospital for the last 9 years. His present research includes experimental studies on osseointegration and osseoperception and the clinical evaluation and biomechanical analysis of bone anchored prostheses.

OETT Lecture Keynote speaker - Dr Michelle Eagle

PhD MSc MCSP

Michelle has consulted on the clinical evaluation of patients for international trials of new therapies for muscular dystrophies and is a member of the international steering committee for the FOR DMD trial which aims to find the optimum steroid regime for DMD. She is the UK representative in two workshops (respiratory management, exercise and orthoses (physical therapy) run by the United States Centre for Disease Control to develop guidelines for management in DMD. Michelle qualified in 1982. Initially specialising in Rheumatology and gaining a masters degree in the assessment of Ankylosing Spondylitis she started working with neuromuscular diseases in 1990. She is now consultant physiotherapist for the Newcastle Muscle Centre which hosts the national clinic for limb girdle muscular dystrophies and which cares for both adults and children with inherited NMD in the northern region. Michelle has published on the management of various NMD particularly Duchenne muscular dystrophy (DMD) and her PhD in 1996 was on the impact on survival of nocturnal ventilation in DMD.

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PLENARY SPEAKER BIOGRAPHIES Dr James H Campbell

Ph.D., CO, FAAOP

Jim received his undergraduate prosthetic and orthotic education at Strathclyde University; he attended the NCTEPO in Glasgow from 1976-1979. In 1996 he received a Ph.D. from the Bioengineering Unit at Strathclyde. Dr Campbell has spent the majority of his career working in North America and is currently Executive Vice President of Becker Orthopedic, Troy, Michigan. Current collaborative domestic and international research projects are focused in the areas of Quadriceps Insufficiency; Humeral Head Dislocation in Athletes; Management & Rehabilitation of TBI & Stroke Patients. He is currently (2004-2007) a member of the Board of Directors for the American Academy of Orthotists & Prosthetists (AAOP) and is currently the Chair of their Educational Development Council. He served as the Editor in Chief for the Journal of Prosthetics and Orthotics from 2000-2003, and is a reviewer for several journals including Prosthetics and Orthotics International and Transactions on Neural Systems & Rehabilitation Engineering. Dr Campbell has authored several book chapters and journal articles, a recipient of the Thranhardt award in 2000 he continues to lecture extensively. In Nov 2005 he was invited to present the inaugural OETT guest lecture at the UK ISPO meeting in England, his presentation was titled, The Contemporary Orthotic Management of Quadriceps Weakness: Component Design, Clinical Application & Measured Outcome.

Paul T. Charlton

MSc, MBAPO

Paul qualified as an Orthotist from Salford in 1983. A major part of his career has been adopting techniques developed in cerebral palsy to adult neurological conditions. This led to an interest in neurology and spasticity management. Paul enjoys sharing developed ideas in various presentations to multi disciplinary audiences. He has published his work and been involved in research resulting in award of a Masters degree in 2005. Paul is also chairman of ISPO UK NMS.

Dr Greg Quinn FCPodS FRSA Managing Director - Talar Made Orthotics Ltd • Podiatric Surgeon – Holywell Health Centre Qualified from Manchester in 1984. Awarded academic prize for distinction in Anatomy. After graduating he developed a post-graduate training courses in lower limb biomechanics. Whilst at Chesterfield Royal Hospital he supported the Medical, Orthopaedic and Rheumatology departments and established the Podiatric Surgery service. Obtained Primary Fellowship in Podiatric Surgery, gaining a distinction and awarded the Alan Procter Award for academic achievement. Acted as a Primary Fellowship Mentor and served as a Primary Fellowship Examiner until 1997. Completing his surgical training in 1995 becoming the first UK Podiatry examination candidate to employ internal fixation techniques. Appointed a Fellow of the Surgical Faculty of the Society of Chiropodists and Podiatrists. Appointed Clinical Director of Holywell Healthcare in Chesterfield, Derbyshire. He practices as a Podiatric Surgeon and Specialist in lower limb rehabilitation providing surgical and biomechanical treatment to NHS and private patients. Appointed in 2001 as a Civilian Consultant Podiatrist to the Ministry of Defence and the Army Training and Recruitment Agency in the UK. Appointed in 2006 as a Fellow of the Royal Society of Arts. His particular clinical interest is the multi-disciplinary approach to lower limb pathology. He is the co-founder and Managing Director of Talar Made Orthotics where he is responsible for product design, research and education. 8

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MBAPO

Martin Matthews qualified as an Orthotist in 1981 from Salford College of Technology (now University of Salford). He quickly developed an interest in paediatrics with a keen interest in scoliosis management and neurological dysfunction. After his move to Norwich in 1991 he developed his expertise in scoliosis management and having trained in Boston he returned to the UK to run Boston Brace training courses on a yearly basis since then. In 1996 he became involved in the research and development of dynamic Lycra orthoses. In 2000 he began his research masters degree at the University of East Anglia researching the use of dynamic Lycra orthoses in the treatment of diplegic crouch gait walkers. He has had papers published on neurological AFOs, the use of Lycra orthoses in hand function and recently in the ISPO journal a paper on Scoliosis management using dynamic Lycra orthoses.

Ian Berryman

SR.Orth. HND (Orth.& Pros.), PgD (Orth. Biomech.), PgD (Pros. Biomech).

I have been a practising Orthotist both inside and outside the NHS for 20 years, spending the majority of my time as a Paediatric Orthotist. I have been in my current position as Scoliosis Orthotist for Southampton University Hospital NHS Trust, under the employment of Gilbert and Mellish Ltd, for 4 years, where I work full time in the fields of Scoliosis and Children’s Spinal Deformity.

Dr Fayez Morcos

MBBCh, FRCP, CertMHSC

Consultant in Neurological Rehabilitation The Pennine Acute Hospitals NHS Trust. Spasticity management is one of my main clinical inputs to patients with neurological impairment. I regularly treat patients with focal spasticity using botulinum toxin injections. I built an experience in localising the muscles that need to be injected with botulinum toxin using electromyography, nerve (muscle) stimulation and ultrasonography. I provide training/mentoring about the methods of accurate localisation of different muscles of the body.

Elaine Nelson BSc(Hons) & Bill Moritz Since graduating from Strathclyde University in 2003 Elaine practised in both Orthotics and Prosthetics within a private health system based in Chicago, USA, with Hanger Orthopaedic group. She specialised in lower limb Orthotics such as stance control KAFO’s, Neurophysiological design AFO’s and FES rehab. She was also involved in limb salvage off-loading Orthoses working along side Dr William Ennis the president, and a founding board member for the Association for the Advancement of Wound Care (AAWC). She thanks her work colleagues in the USA for allowing her to move forward with her orthotic practice and use advanced Orthotic components, carbon fibre designs and the WalkAide system. She has since returned to the UK and joined the Trulife team in 2007 as Lead Orthotist in the North London, East Anglia and Hertfordshire region. With access to their research gait lab she aims to help encourage advanced Orthotic designs and treatment strategies throughout the company. Her previous work colleague Mr Bill Moritz, C.O. from Chicago, Illinois, shall be co-hosting the session. Mr Moritz has a strong background in Orthopaedics and has been practicing in sports medicine for over 30 years. Bill was the owner of MBI Sports Protection Products, a lab dedicated to sports orthoses and protection devices. At present he is in his eighth year as a manager for Hanger P&O USA and works closely with specialised orthopaedic consultants within his clinics.

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SPEAKER PROFILES

Martin Mathews

Mathew Nolan Mathew qualified in 1996 from City of Westminster College and began working in a general adult orthotic clinics around Sheffield. The following year Addenbrookes Hospital in Cambridge beckoned with a mix of specialised diabetic, rheumatology, scoliosis and paediatric clinics. It was here that his interest in scoliosis management and paediatrics developed, leading to his search for a full time paediatric position. In 1998 he secured a role at the Sheffield Children’s Hospital (SCH) and began working within the established MDT. Over the last 9 years he has become a full time Paediatric orthotist with special interests in Scoliosis, Limb reconstruction, CP management and CTEV. The approach to the management of Adolescent Idiopathic Scoliosis (AIS) at SCH has evolved from a Boston style approach through bespoke distraction braces and finally to the dynamic Spine-Cor brace. For the last two years he has also been the training manager for Blatchford developing the post grad training structure and coordinating training in general for clinicians and technicians. Last year he presented the initial fiveyear treatment results form the Spine-Cor brace at SCH in Poland, which are comparable with the published results from Montreal.

Dr Rory O’Conner Rory O’Connor is a Senior Lecturer in Rehabilitation Medicine at the University of Leeds and Consultant Physician in Rehabilitation Medicine at the National Demonstration Centre for Rehabilitation in Leeds. His clinical interest is the management of long-term conditions encompassing amputee, neurological and pain rehabilitation. Having completed an MD at the Institute of Neurology in Queen Square in London, his research focuses on vocational rehabilitation and outcome measurement in rehabilitation. He has a particular interest in undergraduate and postgraduate rehabilitation learning and teaching and he contributed to the recent British Society of Rehabilitation Medicine publication on undergraduate education.

Elaine Owen

MSc SRP MCSP

Elaine Owen qualified as a Physiotherapist in 1974 and since 1983 she has been Head of the Community Paediatric Physiotherapy Department for North West Wales, UK. She has postgraduate qualifications in Lower Limb Orthotic Biomechanics (University of Strathclyde) and Clinical Gait Analysis (University of Strathclyde). She has undertaken the ‘Gait Analysis Instructional Course” of the European Society of Movement Analysis of Adults and Children (ESMAC). She has an MSc in Rehabilitation studies, University of Strathclyde, which included a thesis about orthotic management of neurological conditions and normal gait. She takes an eclectic view of the management of neurological disabilities but with an emphasis on a biomechanical approach to rehabilitation. For 10 years she has used the Orthotic Research and Locomotor Assessment Unit (ORLAU) transportable video vector gait laboratory at Bangor for gait analysis, orthotic and physiotherapy management of children and adults.

Richard Sealy Richard Sealy works as a Senior Neuro-Physiotherapist based at The Wolfson Neuro Rehabilitation Centre, part of St George’s NHS Trust in London. Richard has a specialist interest in orthotic management of neurological impairment in adults, working extensively within the acute and rehabilitation services. He currently works within an interdisciplinary neuro orthotic clinic based at The Wolfson. Richard’s specialist experience has lead to lecturing both nationally and internationally with involvement in research and development of interdisciplinary working within neuro orthotics. He is currently studying for an MSc at Strathclyde University with the focus on Orthotic Management. 10

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Prosthetist / Orthotist, Senior Research Fellow at the National Centre for Prosthetics and Orthotics. Dr Arjan Buis has been working overseas for a number of years and returned to the UK in 2001 to take up research again. His main interest is the body/device interface in general and his current research is focused on prosthetic socket fit related issues in relation to engineering principles.

Christine Divers

BSC MCSP

Christine Divers is the Deputy Head Therapist at the Golden Jubilee National Hospital (GJNH) in Clydebank near Glasgow. She started working in amputee rehabilitation 18 years ago and has worked in a variety of settings including acute surgical, limb fitting centre and prior to current position treated young traumatic amputees from overseas in a private setting. Currently works in the rehabilitation of established out patient amputees. She is particularly interested in exercise therapy in the prevention and treatment of long term musculoskeletal overuse problems and pain in amputees, in particular back pain.

Elaine Figgins

BSc(Hons) MBAPO

Elaine Figgins is currently a Reader in prosthetics and orthotics, Director of Undergraduate courses and the Course Leader at the National Centre for Prosthetics and Orthotics in the University of Strathclyde, Glasgow, UK. She graduated with a first class Honours degree in Prosthetics and Orthotics in 1990, and has since dedicated her professional life to teaching at both undergraduate and postgraduate levels, as well as maintaining her clinical speciality of paediatric orthotic practice in arthrogryposis. She is the orthotic medical advisor for TAG, The Arthrogryposis Group for patient/ users in the UK. Her research areas include arthrogryposis, contracture management and teaching and learning.

David Gow Director of Technology, Touch Bionics David Gow is a Chartered Engineer and Scientist working in the NHS in Edinburgh. He has specialised in artificial arm development since 1981 when he began work in the Bioengineering Centre following a spell at Ferranti (Scotland). Following the experimental development of the World’s first electrically powered shoulder in 1998, David successfully launched the first spin out company from the NHS in Scotland, TouchEMAS (now TouchBionics) in 2002. David is currently Director of Technology of TouchBionics and continues to combine this with his role as Director of Rehabilitation Engineering Services at the SMART Centre in Edinburgh. He is the inventor of the I-Limb system and ProDigits, launched as the world’s first articulating hand and partial hand system in July 2007.

Richard Hirons

MSc, MBAPO

Richard is a Prosthetist working as a Clinical Specialist for the orthopaedic company Össur providing clinical and technical support to his customers and colleagues. Part of his responsibility is to co-ordinate internal training for the staff of Össur, including the clinical team and facilitating their CPD obligations. Richard’s professional interests are currently centred on his involvement with the Health Professions Council for whom he works as a Partner.

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SPEAKER PROFILES

Dr Arjan Buis

Tony McGarry, BSc(hons) MBAPO Lecturer, National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow After graduation from the NCTEPO in 1992 Tony worked as a prosthetist and an orthotist in both Oxford and Aberdeen. In 2001, he joined the teaching staff in the NCTEPO and is mainly concerned with teaching lower limb prosthetic modules. One of his main tasks at the National Centre has been to develop the trans-femoral undergraduate module. He is also undertaking a PhD entitled “Evaluation of a contemporary CAD system” which he hopes to conclude next year.

Dr Kevin Murray Lecturer, National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow Dr Murray has been teaching lower limb prosthetics at the National Centre since 1984. and until recently has been responsible for the provision of clinical placement training of 6-8 students/year at the National Centre’s clinical facility in the Southern General Hospital. He graduated with a Higher Diploma in prosthetics and Orthotics in 1977 and in 2002 completed his PhD which developed an ultrasonic method of analysing residual femoral motion within trans-femoral sockets during gait. He has been involved in a variety of research projects over recent years including the European Funded MAPS project which developed a sensor socket that could transmit pressure, oxygen and activity data during activities of daily living to the prosthetic centre for analysis. He has presented and published the results of his research both nationally and internationally and he continues to maintain an ongoing clinical commitment.

John Ross

Bsc(Hons)

Graduated from Strathclyde University in 1993 with a BSc (Hons) in Prosthetics and Orthotics. Since graduating he has worked in Prosthetics at a number of UK centres and John’s role within Blatchford now encompasses Prosthetic research and development within the company. He works in the sales and marketing department where he is a technical advisor and runs training courses throughout the world. John has been involved in prosthetic related research for several years and first presented a paper at BAPO in 1996. Since then he has presented papers at annual scientific meetings both in the UK and in Europe and has previously been awarded the BLESMA award for best scientific paper at the ISPO UK Annual Scientific Meeting. Most recently he presented and ran a transfemoral seminar at the Uniting Frontiers Conference in Guatemala.

Helen Scott MCSP Helen Scott is a team leader and clinical specialist Physiotherapist based at Westmarc, a regional prosthetic service in Glasgow. She has worked with lower limb amputees on and off in various settings for 25 years. Currently two thirds of her clinical time is spent in the rehabilitation of both primary and established in and out patient amputees. She is particularly interested in the treatment and prevention of long term overuse injuries, instrumented gait assessment and multidisciplinary treatment planning for complex patients and just recently, the treatment of paediatric amputees.

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Alan Tanner has been working in the Prosthetic industry for 40 years, having completed an apprenticeship at J.E. Hanger from 1967 - 1972. Alan moved to Chas. A. Blatchford & Sons in 1976 following his desire to work more closely with the amputees that he had been making limbs for, for these previous 10 years. After 13 years at Blatchford, Alan was promoted to Manager when Blatchford won the S.E. London contract at Dulwich - this centre eventually became Crystal Palace, which Alan managed for a total of 18 years. For the last 20 months, Alan has concentrated his efforts at the Defence Medical rehabilitation Centre, Headley Court, attending to the needs of our returning injured servicemen. Eventually, relinquishing his post as manager at Crystal Palace gave him more time to focus on the needs of this demanding service. Recently promoted to Clinical Specialist, Alan gratefully acknowledges the strong help & support received from each of you, from Blatchfords & each of the major companies, who have had input to this service; clinicians, admin, sales & management. Thank you all.

Simon Dickinson Simon qualified as an orthotist/prosthetist from Salford University in 1996. Initially he worked for the NHS as an orthotist in Oxford and developed a special interest in Foot & Ankle Orthopaedics and Biomechanics and was involved in Orthopaedic triage. Simon now works for Trulife as a clinical specialist orthotist and is Trulife’s UK training manager. He is actively involved in Orthopaedic Triage, Gait Analysis, Dynamic Pressure assessment and Research & Development. He is also part of BAPO’s education committee and is committed to promoting the role and clinical practices of the orthotist. Simon spends a great deal of time teaching in all areas of Lower Limb Orthotics and Biomechanics and is a regular presenter at BAPO conferences. He has also lectured at the annual conference for the podiatry/chiropody association as well as medical conferences.

Thomas Ramsay Since graduating from the University of Salford in 2003, I have been working in South Wales. Here, amongst other things I have been developing a specialist interest in foot and ankle biomechanics. This has been furthered since being appointed to the orthopaedic triage team. In addition to this I have a strong interest in paediatrics and also spend a portion of my time in Trulife's TORAD gait laboratory where I see a variety of patients who require a more indepth assessment then normal clinical time allows.

Kevin Moore BSc Director of education and Product Specialist Bachelor of Science Washington State University In 2004 Kevin began working with Comfil to develop a composite material for the O and P industry that is safe, durable and easy to work with. The rights for the Comfil material were bought by a Swedish company Centri AB where Kevin is now employed as the composite material specialist and director of education. Kevin continues his close working relationship with Comfil to develop new materials while working at Centri to integrate them into new O and P products.

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SPEAKER PROFILES

Alan Tanner

Steve Hill

CEO

Professional Experience: May, 1982-May, 2006 1982-1994 1994-2003 2003-2006 May, 2006-Present-

OTS Corporation Technician, Lab Manager Director of Education Director Mktg. & Edu. Delphi Ortho Owner, CEO

Professional Credentials: BOC Orthotist - 1996 ABC Orthotist - 2001 Professional Memberships & Activities: O&P Almanac Advisory Board BOC Items Writers Committee BOC VPE (Video Practical Exam) Examiner BOC Facility Inspector Secretary & Co-Founder, OPTA (Orthotic Prosthetic Technological Association) Lecturing Experience: Hundreds of lectures given since 1994 Twenty five + articles published in three industry magazines

Tony MacKinnon Tony served a four year construction apprenticeship with Dumbarton County Council. He moved to Clydebank District Council to take up a post of Building Inspector. It was at Clydebank District Council Tony became involved in Heath and Safety as the Nalgo Union Heath and Safety Steward. Tony Left Clydebank District Council to take up a post as a Clerk of Works with Strathclyde Regional Council. With the disbandment of the Region, Tony was transferred to Strathclyde Police working out of Pitt Street as a Property Services Officer. Tony’s main roles were overseeing contractors Heath and Safety procedures. Another of Tony’s roles was to examine and abseil all police owned radio masts for defects throughout Strathclyde. Educated to Diploma level in Safety Management, Tony is a member of The International Institute of Risk and Safety Management and the Institute of Occupational Safety and Health. He now operates a very successful Health & Safety Consultancy service. Tony MacKinnon lives in Dunbartonshire with his wife, daughter and grandson.

Nik Diaper Nik Diaper is the ParalympicsGB/English Institute of Sport Performance Profiler. He completed his Masters in Exercise Physiology at Manchester Metropolitan University, and has been working in Paralympic sport since 2002. Prior to his current role, Nik was part of the physiology team that supported the GB Wheelchair Tennis squad at the 2004 Paralympics in Athens. Nik’s current role involves determining the desirable characteristics for elite Paralympic performance with a view to informing talent identification and development. Nik and his colleagues are currently looking to recruit the next generation of Paralympic athletes ahead of the London 2012 Paralympic Games.

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Otto Bock Lecture - Bone Anchored Amputation Prosthesis Dr Rickard Branemark MD MSc PhD Saturday 09:00 – 10:00hrs - Hall of Fame Osseointegrated Amputation Prostheses The number of problems related to suspension of conventional socket prostheses has lead to a desire to have the artificial limb attached directly to the residual skeleton and in the history surgical attempts have been made to achieve this, but have been unsuccessful with problems related to loosening and/or deep infections. The discovery that implants made of commercially pure titanium can provide a stable anchorage of the implant in the bone tissue was made by Professor Per-Ingvar Brånemark during the 1950’s and the concept of osseointegration has been in successful clinical practice for dental applications since 1965. The word osseointegration is defined as the “direct anchorage of an implant by the formation of bony tissue around it without growth of fibrous tissue at the bone-implant interface”. The method of osseointegration is also successfully used for permanently skin-penetrating applications in the head and neck area including treatment with bone-anchored hearing aids and for anchorage of prosthetic ears and eyes. Treatment with major bone-anchored amputation prostheses using osseointegration (OI-prostheses) has been performed in Sweden since 1990. More recently centres in the United Kingdom, Australia, Spain, France and Hungary have started to use the treatment. In 1999, a prospective clinical investigation named OPRA (Osseointegrated Prosthesis for the Rehabilitation of Amputees) was started at the Sahlgrenska University Hospital in Göteborg, Sweden on patients treated with transfemoral OI-prostheses. In accordance with the OPRA protocol patients are treated in two surgical sessions followed by rehabilitation with a total treatment period of approximately 12 months. At the first surgery (S1) a titanium implant (fixture) is inserted in the residual bone and left unloaded for about six months. At the second surgery (S2) a titanium rod (abutment) is inserted into the distal end of the fixture and is then penetrating the skin. The external prosthesis is connected to the abutment with an attachment device. After S2 the patient undergoes a period of rehabilitation during four to six months with gradually increased weight bearing and prosthetic activities. The risks associated with the treatment are loosening, deep infection, superficial infections, skeletal fracture and mechanical failure of the implant system. The benefits are in many instances related to the removal of the socket as attachment of the prosthesis to the stump. The amputee no longer has skin sores, pain when loading, and problems with stump volume changes. Further, normal sitting comfort and normal hip range of motion can be expected. All these changes lead to a significantly improved quality of life for the individual with a transfemoral amputation.

Neuromuscular Disorders: Hope for the Future Optimum Care for Today Dr Michelle Eagle PhD MSc MCSP Saturday 10:05 - 11:00hrs Hall of Fame Neuromuscular Disorders: Hope for the Future, optimum care for today Ever since 1987 when the gene for Duchenne muscular dystrophy was discovered, a cure has always been ‘just around the corner’. In 2007 we are at the most exciting phase in the history of NMD where new compounds are being tested in patients to change the course of the disease. However the last 20 years has not been without progress. Management of neuromuscular disorders has improved dramatically increasing life expectancy and quality of life. For example the average age of survival for DMD in the 1960s was only 14 years of age and now living until the age of 30 is common. In this presentation I will discuss the optimum care for people with neuromuscular diseases, concentrating on the most common disease, DMD and include current thoughts on exercise, orthoses, wheelchairs, surgery, respiratory and cardiac management. I will also introduce you to the research trials that are currently ongoing including trials of antisense oligonucleotides in DMD which aim to partially restore dystrophin, the PTC 124 trial for patients with stop codon mutations in DMD and the myostatin inhibition trial for adults with various muscle disorders which was recently completed in Newcastle and in the US.

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KEYNOTE SPEAKERS

KEYNOTE SPEAKERS

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PARALLEL SESSION ABSTRACTS

SESSION ABSRACTS

Your CPD obligations and the HPC Audit process Richard R Hirons Friday 13:00-13:55hrs - Hall of Fame Richard is a Prosthetist working as a Clinical Specialist for the orthopaedic company Össur providing clinical and technical support to his customers and colleagues. Part of his responsibility is to co-ordinate internal training for the staff of Össur, including the clinical team and facilitating their CPD obligations. Richard’s professional interests are currently centred on his involvement with the Health Professions Council for whom he works as a Partner. A recent HPC exercise involved requesting Partners to volunteer submitting a test CPD profile for assessment, so both the profiles and auditing process could be evaluated in anticipation of mandatory CPD auditing. This process begins in July 2008 with Chiropodists and Podiatrists. Prosthetists and Orthotists are now in the period where recording of CPD activities is mandatory and will be subject to random auditing from September 2009 as part of the re-registration process. Richard will illustrate some of the requirements and implications of creating a CPD profile, including why he chose to volunteer for this exercise, the results of the audit and offer examples of how Prosthetists and Orthotists in all areas of work can satisfy their CPD requirements.

ORTHOTICS The Contemporary Orthotic Management of Quadriceps Weakness: Component Design, Clinical Application & Measured Outcome Dr James H Campbell Friday 14:00-15:00hrs - Hall of Fame Individuals with quadriceps weakness present with a complex and varied set of problems that often require the provision of a knee ankle foot orthosis (KAFO) and the use of stance- and swing phase–influencing orthotic knee joints. Successful clinical application of KAFO’s with these orthotic joints requires an understanding of the technical features of each joint as well as an understanding of the biomechanical deficit that is being replaced. Accurate individual selection protocols have been developed and will be discussed. Designed specifically for patients with quadriceps weakness, this new family of stance controlled orthotic joints allows the orthotic knee joint to lock and resist knee flexion at a point approximating initial contact (the beginning of first rocker) and unlock, allowing knee flexion, at a point approximating heel off (the beginning of third rocker). This arrangement permits some individuals with lower limb paralysis to more closely mimic normal gait than is possible in a locked KAFO. If an orthotist is considering using an orthotic knee joint with these dynamic load–triggered locking and unlocking characteristics, every aspect of the evaluation process must be carefully performed. Special attention must be paid to the patient’s ability to be trained to use this technology, as well as his or her cognitive ability to understand and apply it. Physical and possibly occupational therapy programs should be considered after fitting in order to achieve an optimal outcome. This presentation will attempt to provide a broad over view of contemporary component design and construct a matrix, or frame of reference, that allows prescription to be informed and, irrespective of clinical diagnosis based upon the biomechanical principles of joint motion, the underlying design of the orthosis and its impact on the joint. Concerning measured outcome the author will consider if the biomechanical tradeoffs or consequences imposed by a KAFO are outweighed by the benefits of its use, and if so how is this determined?

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Ankle Foot Biomechanics Discussion Group Dr Greg Quinn, Simon Dickinson, Mark Gallagher Friday 15:30-16:30hrs - Hall of Fame The evolutionary adaptation of the human foot renders its structure suited to upright bipedal gait. Normal variations in morphology, particularly with regard to the longitudinal medial arch, can induce differences in the way normal and abnormal function is manifested. By understanding what is required of the foot to work as an integral part of the lower limb in humans, we can better understand how rearfoot and forefoot function are interdependent. In addition we can rationalise how inherited foot structure renders each foot type more susceptible to particular injury. A method of classification of foot types and how they meet the functional demand of gait is presented along with a guide as to how this might influence orthotic prescription protocols.

Algorithms for AFO combinations and the angle of the ankle in the AFO. Do you agree? Elaine Owen Friday 15:30-16:30hrs - Lion of Vienna B This session will provide a forum for debating the findings of 10 years routine use of the ORLAU transportable video vector gait laboratory for assessment of paediatric gait. These findings have been summarised in published algorithms for the design and tuning of AFO footwear combinations and for the selection of the sagittal angle of the ankle in the AFO.While the principles have been developed from mainly paediatric experience they are equaly applicable to adults. Publications: Owen E (2002) Shank angle to floor measures of tuned ‘ankle-foot orthosis footwear combinations’ used with children with cerebral palsy, spina bifida and other conditions. Gait & Posture 16: Supp 1, S132-S133 Owen E (2004) The point of ‘point-loading rockers’ in ankle-foot orthosis footwear combinations used with children with cerebral palsy, spina bifida and other conditions Gait & Posture 20S, S86 Owen E (2004) Tuning of ankle-foot orthosis combinations for children with cerebral palsy, spina bifida and other conditions. Proceedings of ESMAC Seminars 2004 Owen E, Bowers R, Meadows CB (2004) Tuning of AFO-Footwear Combinations for Neurological Disorders. In: Conference Proceedings. International Society for Prosthetics and Orthotics (ISPO) 11th World Congress, Hong Kong : ISPO: 278-279 Owen E (2004) "Shank angle to floor measures” and tuning of “Ankle-foot orthosis footwear combinations” for children with cerebral palsy, spina bifida and other conditions. MSc thesis. Glasgow : University of Strathclyde . Owen E (2005) A clinical algorithm for the design and tuning of ankle-foot orthosis footwear combinations (AFOFCs) based on shank kinematics. Gait & Posture 22S: S36-S3 Owen E (2005) Proposed clinical algorithm for deciding the sagittal angle of the ankle in an anklefoot orthosis footwear combination. Gait & Posture 22S: S30-S39

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Our ability to practice our skills in the presence of increased tone can be limited considerably by the magnitude and tolerance of corrective and realigning forces. We are in danger of making the situation worse as pain from excessive corrective forces may well be the stimulus to increasing intensity of abnormally increased tone. Most of us are aware of the potential benefits of effective spasticity management. This seminar looks at the best way we can interact with the management alternatives by gaining better understanding of what they are and what they do. Paul Charlton will give a brief outline of how orthosis may have an influence , Richard Sealy will describe the physiotherapy approach while Dr Morcos and Dr O Conner will detail the action of the more common interventions and enlighten us to some of the less common or well known interventions. Each formal presentation will be limited to ten minutes allowing for twenty minutes questions and discussion.

Diagnosis of Foot conditions and Evidence Based Management Simon Dickinson and Thomas Ramsay Saturday 14:35hrs-15:30hrs - Hall of Fame Abstract not recieved by required deadline.

Does Spinal Bracing have to be Rigid? Martin Mathews Saturday 14:35hrs-15:30hrs - Lion of Vienna B Historically we have used rigid bracing to control scoliosis effectively in most cases. However, when dealing with neuropathic curves the orthotist often find that they are treating the result rather than the cause. This results in the scoliosis often progressing with the Cobb angle continuing to increase past the point of bracing. This paper will discuss the merits for using dynamic orthotic options in the treatment of this condition and will offer a possible way of reducing this progression by effecting the cause- an imbalance of spinal muscle control. It could be possible to hypothesis that this concept could be used in the treatment of early idiopathic scoliosis.

Working with Digital Radiography Ian Berryman Saturday 14:35hrs-15:30hrs - Lion of Vienna B My talk encompasses how Digital Radiography has changed the way I undertake, store and analysis my work, picking up on some of the advantages and disadvantages I have discovered on the way. It is an area where as Orthotists we receive limited official training but in practice offers lots of potential to our work. The talk is not intended to be a step-to-step guide in using Pacs or Traumacad but a discussion about how they can be used. I do not profess to be an expert in digital radiography but I hope to offer both an insight to some and empathy to others.

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SESSION ABSRACTS

Spasticity Management Paul Charlton, Richard Sealy, Dr Morcos and Dr O’Conner Saturday 13:30hrs-14:30hrs - Hall of Fame

Evidence Based Treatment of Adolescent Idiopathic Scoliosis SpineCor Approach Mathew Nolan Saturday 14:35hrs-15:30hrs - Lion of Vienna B This session will inform Orthotists about current treatment methods for Adolescent Idiopathic Scoliosis (AIS) used by Blatchford’s clinical team at the Sheffield Children’s Hospital. The presentation of the SpineCor treatment of AIS and the scientific evidence supporting this approach will encourage critical evaluation of when and how AIS is treated. Using the SRS guidelines we facilitate fair comparison between treatment options and encourage future research. SpineCor is an established treatment in a centre renown for its leading edge approach to the management of AIS, providing an alternative and arguabley improved treatment option compared to rigid Orthoses.

Design Concepts of the Crow Walker and offloading AFO’s Elaine Nelson and Bill Moritz Saturday 16:00hrs-17:00hrs - Lion of Vienna B This session shall be an interactive workshop looking at design considerations of various off-loading type orthoses such as bivalve interlocking AFO’s and crow walkers. Total contact casting is the ideal treatment for wound care however some patients require to wear an orthosis long term to protect and prevent reoccurrence of skin breakdown from pressure. Total contact insoles and shoe designs provide a percentage of plantar surface pressure relief however there are groups of patients that require more effective off loading. Different properties of materials can change internal pressure distribution like polyurethane and gel infused liners. Carbon fibre provides a light weight alternative shell that provides durability and the option of intimate proximal off loading. We shall look at patella tendon bearing concepts and how this can be utilized in AFO designs. There can be problems when trying to achieve a true total contact fit such as fluctuating oedema and ulcerations. A patient must be stabilized in shape before applying an intimate orthotic design and the patient’s skin composer and circulation thoroughly examined. Wound care patients are only one group, when you have a patient with a foot or ankle orthopaedic problem and they are a non-surgical candidate an orthoses can promote ambulation with restriction of motion and off loading proximal to the area in question. Shank alignment and rocker sole positioning are crucial to influence the biomechanics of gait. A patient must be able to ambulate in these solid ankle design orthoses with as little disruption to normal biomechanics as possible to protect other joints of the body and promote low energy expenditure.

PROSTHETICS Prosthetic shape capture: Discussion forum. Tony McGarry, Dr Arjan Buis, Dr Kevin Murray Friday 14:00hrs-15:00hrs - Lion of Vienna A It is generally accepted that the quality of fit of a prosthetic socket affects the function of the device. While we may not fully understand what comprises a “good prosthetic socket fit”, we do know this may be compromised by errors during casting and rectification. Traditional methods of shape capture are plagued by inherent difficulties in quantifying and recording the modifications used to produce comfortable sockets. With traditional techniques, the biggest issue in socket design is in capturing an appropriate shape and volume match of the residual limb. The challenge is to develop techniques that offer good solutions and also enable the prosthetist to quantify the procedure and the results. CAD/CAM techniques have been introduced in the hope that they would reduce errors in the production process and be used to give a better understanding of what constitutes an optimal prosthetic socket fit. The aim of this forum is to discuss current methods of shape capture, define socket fitting criteria and report on how prosthetic CAD systems are currently being used in the UK. 20

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The ultimate goal of prosthetic fitting and gait training for the person with a transfemoral amputation is safe, functional and energy efficient gait with as normal a walking pattern as possible (Broomhead et al 2003). This can be a challenge for the multidisciplinary team to achieve and for the patient to maintain. The outcome for each person will be influenced by the choice of prosthetic knee unit, the immediate and long term exercise therapy (including core stability training) and gait training they receive. It can be a challenge for physiotherapists and prosthetists to work together with these patients, often because of time and geographical restraints. Outcome can also be limited by the physiotherapist’s lack of knowledge regarding the gait training requirements of different prosthetic knees and the prosthetist’s lack of understanding of the physiotherapist’s role particularly in the long term. The goal of the talk is to give an overview of this topic from a physiotherapy perspective, to promote joint working and to familiarise the audience with a clinical guide that is now available (Divers and Scott 2006).

Paralympics 2012 - Prosthetics to Podium Nik Diaper Saturday 11:30-12.30hrs Hall of Fame Great Britain has a proud Paralymipic heritage, finishing 2nd in the medals table at the last 2 Paralympic Games. At the 2004 Paralympic Games in Athens, Great Britain was represented by 169 athletes. Of this number, 18 were amputees and they competed in only 7 out of a possible 13 sports available to amputees. In order to preserve Britain’s Paralympic status and address this relative under-representation of amputees in Paralympic sport, ParalympicsGB are looking to recruit more amputees ahead of the London 2012 Paralympics. From a performance perspective, amputee athletes are highly trainable and can often make a rapid progression into high level Paralympic sport, depending on their training history prior to injury. However, for a variety of reasons, many amputees as well as specialist staff are not aware of their eligibility for Paralympic sport. The aim of this session is therefore to inform the audience of the Paralympic opportunities available to amputees with a view to increasing the participation of these individuals in Paralympic sport. It is hoped that those who attend this session will leave with a greater awareness of Paralympic sport as well as the knowledge to potentially unearth a future Paralympian.

The Limbless Soldiers & their Prosthetic Service a look at DMRC Headley Court 1 year on. Alan Tanner Saturday 14:35hrs-15:30hrs - Lion of Vienna A The objective of my paper is to inform the audience of my experience to date as lead clinician for the newly established Prosthetic & Orthotic service to H.M. Forces. Defence Military Rehabilitation Centre is the M.O.D. centre in Surrey, that now not only provides a clinical service to amputees but also manufactures all of the limbs that are provided, on site. It is no more than one year since the start of the partnership between Chas.A. Blatchford & Sons and the M.O.D.. In this time we have successfully managed an increase in clinical sessions from 1 to 8 per week, in order to meet the needs of an ever increasing service. Given a target of 12 months in which to train servicemen in the craft of limbmaking and to achieve 100% in-house manufacture, the target was actually reached within six months.

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SESSION ABSRACTS

Transfemoral amputee prosthetic knee prescription: does physiotherapy have a role? Christine Divers, Helen Scott Friday 15:30hrs-16:30hrs - Lion of Vienna A

Of the 71 servicemen & women amputees currently serving in H.M. Forces, we have so far met 50. Comprising 28 primary patients -many from recent conflict - and 22 established amputees - survivors of conflict in such places as Northern Ireland and The Falklands. This latter group having chosen now to receive their service provision at Headley Court; with the primary cohort unfortunately increasing in size weekly it is perceived this could lead to a need for further clinics each week. The daily Prosthetic & Orthotic clinical service has been managed primarily between two clinicians and has been supported with an extremely strong & versatile team who have visited Headley Court on an as-need basis, based on their discipline and expertise. Four military personnel have recently undergone in-house training led by an extremely strong team from Crystal Palace Prosthetic Workshops, backed up with external training from appropriate sources to ensure an intimate knowledge of all limb systems and manufacturing techniques, for upper and lower extremity and Orthotics. This, coupled with the extensive range of Prosthetic & Orthotic components available, amounts to an extremely effective service tailored to the needs of the highly active individual whose daily activities in the demanding environment of Headley Court will in many cases, undoubtedly help send them back to a fully active career in H.M. Forces. My paper will discuss clinic structures and timescales for limb provision within this Service, - currently surpassing our target by supplying trial socket same day -and will give an overview of the many & varied components most frequently used - plus an insight into an individual’s typical day at Headley Court. Described by the C.O. as a ‘Gold Star’ service we will hopefully move from strength to strength as we continue our association with staff, clinicians and users of the service at Headley Court.

Introduction to Ischial containment Socket Casting John Ross Saturday 16:00hrs-17:00hrs - Lion of Vienna A Through the years there has been a transition in socket design for transfemoral amputees from the plug fitting, pre quad, quadrilateral and the latest ischial containment. Traditionally we have been taught the basics at University with the emphasis on quadrilateral sockets, however best practice guidelines that we now work towards lead us to the conclusion that Ischial Containment Sockets are in fact best for our patients, and some evidence will be shown to support this claim. When considering an ischial containment socket there are many socket shape variations such as: SABOLICH, UCLA, LONG and prefabricated brims such as IPOS being used in the UK, and this array of shapes and theories has been one of the disadvantages of the Ischial Containment Socket. The use of anatomical shapes are not new, in the past Thomas Canty, Ivan Long and Carl Motis made some attempts to create an anatomical A/K socket, even predating Radcliffe by some 20 years. Some techniques use the traditional Scarpas triangle shape while others create an acute angle under the ischial tuberosity as described by Sabolich, and some do not use either, these inconsistencies often cause confusion to the uninitiated. It is very important to consider the angle of the ischial ramus. The ischial tuberosity and part of the ramus as well as the medial aspect of the ramus are encapsulated within the medial aspect of the socket brim. From the authors experience of teaching Ischial containment sockets it is that the ischial ramus is at an angle and not following the line of progression that most practitioners initially struggle with! Although the trim lines of a conventional ischial containment socket are usually above the ischial level, the height of the brim will depend on each individual, most recently with the publicity surrounding the MAS socket there has been a turn towards lowering the posterior wall of the socket to allow a better cosmetic result. Generally with the MAS socket the medial wall is lowered to avoid pressure on the ramus, pressure below the ischium on the posterior wall provides good gluteal support, while lowering the posterior wall, around the gluteals, allows a greater range of motion for the wearer and an improved gluteal cosmesis. The technique to be demonstrated will show a simple procedure for taking an Ischial Containment Socket, which while allowing good control of the residual limb and prosthesis will give an improved cosmetic appearance at the trim lines of the socket, and a greater range of motion. The aim of the presentation is to remove the stigmatism of Ischial Containment sockets being difficult to cast and fit and allow a series of simple steps to be taught that will allow most patients a comfortable and cosmetically acceptable socket. 22

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The I-Limb hand represents a major change in the design and clinical application of electrical hand prostheses. Using a combination of innovative electromechanical design and control concepts, the hand can provide the user with a choice of gripping postures, which reflect the most commonly used prehensile patterns observed in humans. The hand initially has been designed to be backward compatible with first generation myoelectrical controllers using standard industry wide electrodes for 2-channel control. This allows users and clinicians to evaluate immediately the functional and aesthetic properties of the I-Limb without the need for extensive and intensive training. This presentation will set out the features of the I Limb system in context and illustrate the clinical opportunities presented by new technology.

TECHNICIANS Why do we need Risk Assessments? Tony MacKinnon Saturday 11:30hrs-12:30hrs - Mezzanine Tony’s talk will be about what is required by law regarding risk assessments. When the first H&S legislation was introduced and how the workplace has changed over the years taking into account E.U. Legislation and Migrant workers under the Treaty of Rome 1957? How important risk assessments are within any organisation? The difference between Criminal law and Civil law in Health and Safety terms? What could go wrong if a risk assessment is not carried out on the task/activity and what the human and financial cost would be the organisation or persons who have been injured at work? We are hoping to carry out an actual live Risk Assessment of a process within an Orthotic/Prosthetic unit using photographs and relevant information, during Tony’s talk. If anyone is wondering how to carry out risk assessments then this talk is for you.

Fabrication of the FullStride Stance Control System Steve Hill Saturday 13:30hrs-14:30hrs - Mezzanine This didactic presentation will demonstrate the step-by-step fabrication techniques of a new stance control system from Becker Orthopedic. Named FullStride, it will allow a greatly simplified stance control application to a wider range of patients without the cost or complications associated with other stance control systems. By the end of the lecture the participant will understand its general application and complete fabrication protocol.

A. Algeo Ltd Practical Session Kevin Moore Saturday 14:35hrs-15:30hrs - Mezzanine Thermo Formable Composites is a vacuum forming technique and materials used to work Comfil® thermoplastic composites. Comfil® material is a reinforced thermo formable plastic that combines the properties of carbon, aramid, and glass fibre with the formability of plastic and a healthy solvent free working environment. Consolidation of a brace using Comfil® is done in an oven under vacuum using the TFC technique. Since the material is not cured with a chemical reaction the final product can be reformed to ensure a perfect fit to the patient.

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SESSION ABSRACTS

An Introduction to Touch Bionics David Gow Saturday 16:00hrs-17:00hrs - Hall of Fame

FREE PAPER SESSIONS - ORTHOTIC Orthotic Management of an Infant with Aplasia Cutis Congenita. Steve Mottram, MBAPO Registered Orthotist (UK) Saturday 11:30hrs-12:00hrs - Lion of Vienna A Speaker profile Steve received his Diploma in Orthotics in 1982 and since that date has worked in all aspects of orthotics. He has been employed as a contracted orthotist managing up to 15 orthotists and he has also worked as a clinic manager within the UK National Health Service. More recently he has been involved in product support and management whilst maintaining a regular clinical commitment. Steve now manages one of Technology in Motion from Ossur’s clinics based in Leeds. He is registered with the UK Health Professions Council (HPC). Abstract Aplasia cutis congenita is the incomplete formation of the skin covering, usually on the vertex of the skull and can also involve incomplete formation of the skull vertex bones. This presentation is in the form of a case study which describes an infant who has the condition and continues on to describe the management and outcomes to date. The case concentrates on early infancy describing the treatment goals and outcomes which are to ensure normal development of the skull shape and to provide protection from injury and to maintain skin viability during the infant’s early years.

Management of Severe OA of the Knee using a Customised Off Loading Knee Orthoses. Martin Buchan F.R.C.S, William A Munro MBAPO, Derek Jones PhD., MBA Saturday 12:00hrs-12:30hrs - Lion of Vienna A Speaker profile William Munro is a practising Orthotist in Scotland. He has served for almost 2 terms as HPC elected representative for P &O. He is a visiting lecturer at Strathclyde University and specialises in management of the diabetic foot. This study reports on the results of using a custom made knee orthosis as an alternative to surgical intervention and in four patients with valgus/varus deformity in excess of 20 degrees. Various orthosis designs exist for the management of patients with osteoarthritis of the knee. Custom or off-theshelf unloader knee orthoses are used in relieving pain in patients with uni-compartmental osteoarthritis during weight bearing activities. Although these designs can be mechanically successful, patient tolerance may be low due to a higher concentration of pressures being exerted by straps or condylar pads. This is especially so with severe deformity and can severely limit the duration over which an orthosis can be tolerated. The Varum Valgum adjustable stress (V-VAS™) custom knee orthosis is a new concept for treating patients who present with medial or lateral compartmental arthropathies. Its design incorporates features intended to increase both effectiveness and compliance for the patient. Instead of using a narrow frame as seen on most designs it uses a total contact cuff on the thigh and tibia along with an adjustable self aligning polycentric joint system to create four points of pressure instead of three. With two points of pressure being applied as a counter force and two points of pressure applied as the corrective force, there is no need for a condylar pad. The system’s self-aligning, polycentric hinge design, has a means of linearly adjusting the varum or valgum angle (depending on which compartment is affected) without causing mechanical joint binding. Patients liked the fact that the design allowed the structure to closely follow the knee of the knee without binding. The paper will describe the design principles and report on the specific findings in four severe cases. Radiological assessment before and after use and the decrease in pain on movement are the primary methods of measurement of clinical effectiveness. The use of orthoses as a cost effective and satisfactory outcome to a clinical episode will be assessed and discussed.

A review of the orthosis provision through the Scottish National Brachial Plexus Injury Service, Victoria Infirmary, Glasgow Brian McLaughlin BSc(Hons), MBAPO Saturday 13:30hrs-14:00hrs - Lion of Vienna A Speaker profile Brian McLaughlin graduated from the National Centre in 1999 and began working as a prosthetist in Glasgow. He took up a lecturing post at the National Centre in 2004 where he has been involved in clinics, teaching and research. His main areas of interest are lower limb prosthetics and upper limb orthotics.

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Footwear ? Are we missing something? Steve Osborne Saturday 13:30hrs-14:30hrs - Lion of Vienna A Footwear and insole provision is thought to be up to 50% of the Orthotic spend in the UK. Anecdotally it also appears to be the largest area of criticism that others level at us. Little postgraduate training is available in this area and what is available is poorly attended. Even at BAPO conferences few people feel comfortable to talk about things that we feel is part of our every day work. Research into footwear provision and its effectiveness if mainly done by other professions and does not always contribute greatly to helping us do our work better. The manufacturers of shoes in the UK have been under cost pressures for a number of years and the number of companies supplying shoes is reducing at the same time where government targets for waiting lists are demanding that footwear is rapidly available. This is particularly relevant in bespoke footwear where finding skilled staff is becoming an increasing difficult task. On main land Europe footwear provision is more of a priority and more money is available to produce high quality footwear. This footwear can be designed to function with as much control as an Ankle Foot Orthosis if required. It tends to be quite sophisticated in design sometimes even incorporating composites within their construction. The provision of footwear needs to have a greater emphasis placed upon it. More research needs to be undertaken into how we design and adapt footwear and more postgraduate training needs to be utilised to improve our standards. Footwear manufacture and the skills required to produce it need to have more emphasis placed upon it to ensure skills and capacity is maintained for the future. Footwear can provide great benefits for our patients and we need to continually improve how we provide this service.

FREE PAPER SESSIONS - PROSTHETIC Pre-clinical evaluation of novel socket materials Brian McLaughlin BSc(Hons), David Simpson CEng Saturday 11:30hrs-11:55hrs - Lion of Vienna B Speaker profile Brian McLaughlin graduated from the National Centre in 1999 and began working as a prosthetist in Glasgow. He took up a lecturing post at the National Centre in 2004 where he has been involved in clinics, teaching and research. His main areas of interest are lower limb prosthetics and upper limb orthotics. Abstract The most critical component of any prosthesis is the socket. Each socket is a tailor-made device, designed to fit the unique geometry of the patient’s residual limb. It is the socket which determines the comfort and performance of the prosthesis and ultimately whether or not the device will be worn. Creating the unique socket is often the most time consuming and costly aspect of the manufacturing of prostheses. The National Centre is currently examining the potential advantages of employing computer aided design (CAD) combined with rapid prototyping technologies for the production of prosthetic sockets. Fused Deposition Modelling (FDM) offers the potential to produce usable prosthetic sockets quickly and at a reasonable cost. An FDM machine consists of a build platform housed in a heated chamber. A heated nozzle produces an extrusion of semi-molten plastic materials which is moved under the control of a computer to build a 3-dimensional model of the CAD file. This paper will discuss the results of testing the mechanical properties of a number of novel FDM materials. The mechanical properties of these materials will be compared with fibre reinforced resin and polypropylene materials which are routinely used in the production of prosthetic sockets.

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SESSION ABSRACTS

Abstract The Brachial Plexus Injury (BPI) Service at the Victoria Infirmary, Glasgow is a designated National Service for Scotland. The aim of this service is "to provide specialist multidisciplinary integrated management for assessment, surgical reconstruction and rehabilitation for patients with brachial plexus injury". To date more than 150 patients have been referred to the clinic. The National Centre for Prosthetics and Orthotics (NCPO) has provided orthotic support to the clinic since its initiation. This paper presents the results of a detailed review the orthotic provision through this service. A systematic review of the clinical notes of every patient fitted with a Brachial Plexus Orthosis (BPO) was carried out. The information gathered included; the demographic profile of the patient group, nature of the original injury, corrective surgery carried out, Disabilities of the Arm, Shoulder and Hand (DASH) Score and the orthotic prescription. A number of studies (1, 2) have sought to utilise the DASH Score to indicate the effectiveness of interventions for a number of upper-limb conditions, including BPI. Initial findings in this study indicate the potential effectiveness of this tool when prescribing and reviewing a BPO. However, further work is required before definitive guidelines may be produced. References: Davidson, J. (2004) Disability and Rehabilitation 26(14/15): 917-923 Gummersson, C et al. (2003) BMC Musculoskeletal Disorders 4(11)

A case note analysis of Upper-X liner use in upper limb prosthetics Sophie Young, CPO Saturday 13:30hrs-14:00hrs - Lion of Vienna B Speaker profile With current clinical practise based at WestMARC, Southern General Hospital and previous employment at Stanmore Royal National Orthopaedic Hospital, Sophie is both a qualified educationalist and experienced specialist in upper limb prosthetics. Sophie graduated from and is presently working at the National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow. Purpose A pilot study aimed to establish current prescription practise and use of Upper-X liners in a local population. Method Clinical notes of the total population (n=36) of upper limb amputees provided with an Upper-X liner by the NCPO will be reviewed. Ethical approval has been obtained and presented data will be anonomised. Key data to be extracted include: • Age, date of amputation, level of amputation, generic prescription (ie cosmetic, body powered or myoelectric) • Frequency of liner provision and subsequent cost of prescription • Reason for discontinuaton of use (if appropriate) • Additional relevant information including issues of donning, skin irritation, suspension, rotation, ROM and patients subjective opinion of the liner Outcomes A systematic data set will be created for use in the development of an evidence base in this area. Resulting data will informing future research and may ultimately lead to evidence based practise. Conclusions At present there are no known set standards for the use of Upper-X liners in the UK (or elsewhere) on which to base prescription practise. Instead prescription is based entirely on personal preference. This pilot study therefore intends to address this issue.

Mental Loading and energy expenditure during level walking: A comparison between the C-leg, SNS and 3R60. Dr Margrit R Meier, Dr Andrew H Hansen, Dr Steven A Gard Saturday 14:00hrs-14:30hrs - Lion of Vienna B Abstract: Introduction: Literature seems to be inconsistent concerning the effect of microprocessorcontrolled knee joints on energy expenditure. The study’s objective was to determine if an applied mental task (MT) had an influence on energy expenditure. The Total Heart Beat Index (THBI) was used to estimate energy expenditure. Design: In a cross-over design 12 persons with a unilateral transfemoral amputation were fitted with three different knee joints—Otto Bock C-leg, Otto Bock 3R60, SNS CaTech—while walking at three different self-selected speeds over level ground, with and without a MT. Results: The participants’ mean age was 46 years, with a mean time since amputation of 21 years. For normal speed no statistical significant differences existed between the different tasks and different joints. At fast speeds, statistical significant differences were found only with MT. THBI results indicate that during normal walking and no MT, the C-leg seemed to be more efficient than the 3R60. But such a difference was not seen between the SNS and the C-leg. At fast speeds, the significant difference disappeared and all knees appeared to be similarly efficient irrespective of MT. Conclusions: The results indicated that a MT did not affect gait efficiency but narrowed the overall speed range.

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Speaker profile Elaine McCurrach is the Principal Prosthetist in the SMART Centre, Astley Ainslie Hospital, Edinburgh. Since graduating from University of Strathclyde (1994), Elaine practiced as a Prosthetist in the private sector and the NHS. Elaine has contributed to the prosthetic profession by supporting BAPO as EC Member and Secretary. Abstract This paper describes the on-going development of an observational gait analysis (OGA) system customised for prosthetic subjects. The system aims to assist clinicians involved in amputee rehabilitation by setting out a systematic framework for gait analysis, as well as providing a summary score indicative of gait quality. The system comprises a pro-forma on which seventeen specific features of gait are scored, either as 0 for within the normal range, 1 for a moderate deviation from normal, or 2 for a marked deviation from normal. The overall score is then computed from the sum of the scores of the individual items. The items included were those considered most pertinent to amputee gait and were obtained from the literature and the opinions of professionals in both the prosthetics and gait analysis fields. Initial stages of development have concentrated on optimising intra- and inter-observer repeatability, and factors influencing the repeatability of the system have been identified and addressed. Although further work is still to be done on the validation of the system against other measurement systems, and also investigation into its sensitivity, results so far suggest that the system may offer clinicians a more consistent and objective approach to OGA.

The Effect that a Congenital Upper Limb Deficiency has on a Child and his/her Parent(s). Does a prosthesis help? Marnie Punchard MSc DipCOT. Saturday 12:20hrs-12:45hrs - Lion of Vienna B Speaker profile Marnie is the Lead Prosthetic Therapist at Exeter Mobility Centre. She has worked there as an Occupational Therapist with Children with Congenital Upper Limb Deficiencies for the past ten years. This research project was part of a Masters degree in Occupational Therapy which she obtained in 2007 Abstract The aim of this research project is to explore the experiences that a congenital upper limb deficiency (CULD) has on a child and his/ her parent(s), in relation to the use or non-use of a prosthesis. This research was part of an MSc course and received a favourable ethical opinion from the Regional Ethics Committee, taking into account the sensitive issue of involving children. The qualitative approach of grounded theory was used in this research, with nine children and their parent(s) providing information in a semi-structured interview. The transcripts of the interviews were coded using open coding, 39 concepts were identified, these were explored and placed into nine categories during axial coding. The categories were named as: functional ability; physical impact; social impact; psychological impact; healthcare; prosthetics; ability to adapt and compensate and advice to others. The process of selective coding identified links between these categories and resulted in a visual model that summarises the findings of this research. The researcher believes that the visual model will enable occupational therapists and other professionals to be better informed regarding the experiences that a congenital upper limb deficiency has on a child and his/ her parent(s), and the options open to them.

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SESSION ABSRACTS

The development of an observational gait score for lower limb prosthetics Elaine McCurrach, Susan Hillman, Alison Richardson, Janet Herman, Anthony McGarry, James Robb Saturday 11:55hrs-12:20hrs - Lion of Vienna B

WORKSHOPS

Denovo Healthcare Ltd Denovo Healthcare Ltd (Stand 16) are please to offer a range of exciting workshops aimed at introducing the Orthotist and Prosthetist to new products and advances.

Saturday 16 March 2008 - Executive Box level 2 11.00 – 11.45

Managing Drop Foot Without Compromising Range Of Motion This workshop gives the Orthotist an opportunity to evaluate the new Centri Dynamic Walk Orthoses designed to minimise the restrictions on the range of motion of the ankle whilst offering the control necessary to manage drop foot.

12.15 – 13.00

Controlling Varus Foot Deformity and Maintaining Compliance The Orthotist will have the opportunity to discuss case studies and evaluate the new wide range of footwear options available from NIMCO Footwear aimed specifically at controlling Varus Foot deformities

13.30 – 14.45

Dynamic management of Quadriceps Insufficiencies. A chance to see the advances made with the BASKO Swing Phase Lock, evaluate case studies and try the test orthoses for yourself.

15.15 – 16.00

The Diabetic Footwear Solution A look a the difficulties faced when fitting diabetic feet and a solution offered with the new Xsensible range of Diabetic footwear, made with patented stretch leather.

16.30 – 17.15

Below Knee Cosmesis For The Active A workshop demonstrating how to apply the durable MCV Centri Dream Skin Cosmesis. The Prosthetist will have the opportunity to test the durability and ease of application of this cost effective alternative. Please Register to attend these workshops at Stand 16 and receive your complementary USB Memory Stick Don’t miss these opportunities. Limited spaces available so book early

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DEMO AREA TIMETABLE

A short presentation on the features and benefits of stability footwear, and when to use them. We will also be talking about choosing footwear for sensitive feet including an introduction to the brand new Piedro Adult Footwear range.

RSLSteeper Select Myo Electric System Presenters: John Ronald, Bruce Rattray Saturday 11:00hrs-11.30hrs This presentation will provide a detailed overview of the recently launched RSLSteeper “Select” Myo Electric system and its features and patient benefits. Specific information will be provided regarding selection, performance characteristics, hand programming to suit individual patients needs, power option developments utilising Lithium Polymer technology, control options harnessing the latest dual notch filter electrode performance and system connection options.

RSLSteeper Accent Patient Adjustable Foot Presenters: Carl Chatfield, Tim Verral Saturday 12:00hrs- 12:30hrs This presentation will provide a detailed overview of the Accent patient adjustable foot manufactured by College Park and supplied in the UK by RSLSTEEPER. The workshop will also include selection and fitting information as well as a patient demonstration to show the adjustment and performance of the design.

Gilbert & Mellish - Introduction to the Solidus Solicare Soft Adult Footwear Range Presenter: Mr Robert Hannis Saturday 14:00hrs-14:30hrs A product demonstration of the new Solicare Soft Footwear range from Solidus, which includes therapy, diabetic and Soft comfort shoes.

Promedics - Spinal Orthoses Presenter: Stijn Langenaken Saturday 14:45hrs- 15:15hrs An option to provide custom made orthoses at primary consultation.

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DEMO AREA

Gilbert & Mellish - Stability Footwear & Footwear for Sensitive Feet Presenter: Mrs Bertine Veenhuizen Saturday 10:00hrs-10:30hrs

SPONSORS

A. Algeo Limited

DeNovo Healthcare

DJO UK Ltd

Douglas Bader Foundation

Gilbert & Mellish

Limbless Association

Mobilis Healthcare

North Sea Plastics

Orthotic Education Training Trust

Ossur

Otto Bock Healthcare PLC

Remploy

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SPONSOR PROFILES

SPONSOR PROFILES

A. Algeo Ltd (Algeos) are as always, proud to be sponsors of this years’ BAPO conference. The Algeos business covers a wide range of specialist medical professions including: Prosthetics, Orthotics, Diabetic Footcare, Podiatry, and to a lesser extent Physiotherapy and Occupational Therapy. At the time of writing, the company’s product portfolio totals over 7000 products and includes several key European agencies for high-technology medical materials. Please come and see us in the Exhibition Hall where we will be showcasing and demonstrating our latest range of Carbon Composite materials, as well as new foot orthotics and appliance components. DeNovo Healthcare Ltd is a young dynamic and professional company focused on bringing modern concepts and ideas to the market. As a patient centred company we aim to offer you the both the best service, quality and value possible. We are proud to be the exclusive distributor for Nimco Footwear, Fillauer, Centri and Basko Healthcare products. Our exciting range of Nimco children’s footwear offer you and your patients a huge choice of styles and colours through our personalised pair programme - quality delivered quickly and on time! The Centri Dynamic Walk Orthoses is a strapless below knee orthoses designed to manage drop foot whilst offering maximum planter and dorsi flexion of the ankle, making driving a car with the orthoses easy. The durable MCV Centri Dream Skin Cosmesis, Absolute Prosthetic Liners and suspension sleeves offer the Prosthetist durable and cost effective alternatives. With the Basko Swing Phase Lock IQ Knee joint now well established as the international leader for managing uncontrolled knee flexion we are proud to be able to offer a central fabrication option for your orthoses, as well as inhouse training if you prefer to manufacture these in your own workshops. We invite you to visit us at Stand 16 and view these and other exciting products and find out how we can help you. DJO UK Ltd combines the DonJoy® and Aircast® product range with Procare® at this year’s BAPO conference. The recent merger with ReAble ™ and the global integration of the new DJO, provides some exciting developments. From Aircast®, we will exhibit the well established Walker® range, alongside products specialising in foot and ankle problems. Products such as the AirHeel for plantar fasciitis and Achilles tendonitis. The DonJoy® range builds upon our expertise in the development of knee products. We will have the new Trupull Lite patellofemoral brace and the TROM Advance, alongside DonJoy’s ligament and OA bracing range. Procare® is our hospital product range and has a wide variety of cost effective supports for everyday use. All of the new products will be incorporated into our new 2008 DJO catalogue. Specialist paediatric products will also be in the new dedicated Paediatric Catalogue for 2008, and both of these catalogues will be distributed at BAPO. Welcome to BAPO 2008, we wish the conference every success and it’s our pleasure to sponsor the Casino Party on the Saturday, which we hope you will enjoy. DJO UK Ltd www.djo.co.uk

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G&M Launches New Adult Footwear Range at BAPO 2008! Gilbert & Mellish Ltd (G&M) are once again proud to be exhibiting at this years BAPO exhibition. Established for over 50 years, G&M and are a wellknown, reputable company for high quality products and excellent customer service. G&M are delighted to announce the launch of a brand new range of adult orthopaedic footwear from manufacturers Piedro and Solidus. Piedro have produced high quality children’s orthopaedic footwear for many years, their innovative styles, colours and quality have proved extremely popular with clinicians and children throughout the UK. The new adult range is no different, offering outstanding quality in a variety of stylish designs to suit today’s modern lifestyles. The addition of the Solicare Soft range from Solidus enables G&M to offer extremely lightweight and soft orthopaedic, diabetic and therapy models to complete our new, modern and very stylish footwear range that will meet all of your patients needs. Whichever footwear style you choose, our footwear, including all of our summer sandals, offers either 6mm or 10mm deep, fully removable footbeds. To find your style visit us on stands 60-63, where you will be able to see our new range alongside many other new orthotic bracing products. We look forward to seeing you there. Limbless Association Technician Scholarship Award After many years of sponsoring the best free paper presented by a Technician at conference the Limbless Association, celebrating their 25th Anniversary, have decided to take their sponsorship at conference to a higher level. The result is the brand new Limbless Association Technician Scholarship Award. This award of a trip to Orthopadie+Reha Technik in Leipzig, Germany which is being held from 21st-26th May 2008 will be presented to an Orthotic or Prosthetic Technician during the prize giving at conference. Raymond Edwards, Acting CEO of The Limbless Association, who are very excited about this new Technician award said “As the leading limbloss charity we are very proud to be associated with BAPO in awarding the Technician Scholarship as 2008 will be our 25th Anniversary”. We believe that this new award, which is the biggest ever award for technicians in the history for BAPO will become a regular event and be the award that all technicians will strive to win. The Limbless Association through our Outreach Programme and Help Bureau, enables limbless persons of all ages, with the support of their family and carers, to achieve rehabilitation and to sustain independence at home, hospital, in education, employment and in the community. TOGETHER WE CAN ACHIEVE MAXIMUM POTENTIAL

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Mobilis welcomes you to BAPO 2008 ! Hopefully you have found your welcome pack upon arrival at your hotel, which we hope ensures your weekend’s survival !!! Inside your pack you will have also found a safe code …. Come and visit our stand, enter your code into our safe and see if YOU are our lucky prize winner….

SPONSOR PROFILES

The Mobilis stand is definitely not to be missed this year! Featuring our full breadth and range of expertise. Our bespoke manufacturing capability of County Footwear, Cox Ortho, Halo Healthcare will all be on show, as well as a live on stand demonstration by biomechanics expert, Martin Haines from Mobilis Performance, who will be demonstrating how pelvic screening can influence orthotic prescription…. ... and it doesn’t stop there either .. you can also pick up a copy of our brand new catalogue and see a selection from our full range of exciting new products. The Iceross Seal In liner from Össur is an innovative socket solution for many amputees, providing effective and convenient socket suspension without the complexities of locks or supplementary sleeves. As a result of a major re-development, there is now a new Iceross Seal In TT version offering a much improved suspension with greater freedom of movement and simple maintenance. Re-designed hypobaric sealing membranes now feature five integral seals towards the distal end of the liner. The new design is better able to conform to complex residual limb shapes and fit more accurately to the inner socket wall. This provides a more reliable socket suspension during changing conditions such as flexing and extending. The stabilising matrix supports the seals during donning by preventing stretching of the liner and elongation of the soft tissue. This combination of efficient sealing and soft tissue control provides maximum socket stability, minimising unwanted soft tissue movement. It is known that excessive tibial displacement can cause risk to soft tissue (Lilja 1998). Sockets with internal seals have demonstrated the least movement compared to those with external seals and distal connections (Karlsson 2007). For more information visit www.ossur.com Otto Bock® Healthcare Plc are major Sponsors of 3 significant categories within the BAPO conference, namely the Keynote Speaker Lecture, Technicians Innovation Award and the Travel Fellowship. The Otto Bock / BAPO Travel Fellowship is joint funding available to assist BAPO members and Associate students to enhance their education and professional development in both the prosthetic and orthotic fields via travel. This can take several formats, one of which could be the opportunity to study a particular practice / technique being applied in another country, the chance to attend a conference where a specific topic is being addressed or even a general conference where papers are being presented in one special area.. Consideration will also be given for other travel options within the professional boundaries if a sufficiently good case is put forward.

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EXHIBITION FLOOR PLAN

EXHIBITOR LIST Company Name A Algeo Ltd Stands 25, 26 Anatom Ltd Stands 20 BAPO Stands 70, 81, 71 Bolton Bros Ltd ACI UK Ltd Stands 46 British Polio Fellowship Stands 72 BSN Medical Ltd Stands 28 BTS Bioengineering Stands 79 Buchanan Orthotics Ltd Stands 17 Chaneco Stands 13, 14 Chas A Blatchford Stands 48, 49, 50, 51 DeNovo Healthcare Ltd Stands 16 DJO UK Ltd Stands 52, 53 DM Orthotics Ltd Stands 6 E & E Accessories Ltd Stands 7 34

Fromme OrthopaedieSchuhtechnik Stands 23 Gilbert & Mellish Ltd Stands 60, 61, 62, 63 Health Professions Council Stands 73 Intavent Orthofix Ltd Stands 18 Jane Saunders & Manning Ltd Stands 9 Kare Orthopaedics Ltd Stands 30 Ken Hall Ltd Stands 66, 69 Kenward Orthopaedic Ltd Stands 22 Klaveness UK Ltd Stands 19 Langer Stands 15 Medalin Ltd Stands 24 Medi UK Stands 77, 78 Mobilis Healthcare Group Stands 1, 2, 3, 4, 5

North Sea Plastics Ltd Stands 31 Ortho Europe Ltd Stands 56, 59 Ossur UK Ltd Stands 54, 57 Otto Bock Healthcare Plc Stands 42, 45 Paromed Vertriebs GmbH & Co KG Stands 67 Peacocks Medical Group Ltd Stands 10, 11 Pedors Shoes Stands 47 Polymer Systems Technology Ltd Stands 68 Prestige Rehabilitation Ltd Stands 74, 75 Promedics Ltd Stands 80 Realistic Prosthetics Ltd Stands 55 Reed Medical Stands 43 Relief Orthotics Ltd Stands 64, 65

BAPO CONFERENCE 2008

Remploy Healthcare Stands 36, 39 RSLSteeper Stands 40, 41 Salts Healthcare Ltd Stands 29 Shoemaster Stands 8 Silipos Stands 12 SPT Technology Inc Stands 37 T & S Orthotics Ltd Stands 21 Talar Made Orthotics Ltd Stands 32, 33, 34, 35 TouchBionics Stands 58 Townsend Bracing UK Ltd Stands 27 Trulife Stands 44 Vivomed Ltd Stands 38 Wharncliffe Publishing Ltd Stands 76

EXHIBITOR PROFILES A. Algeo Ltd A. Algeo Ltd (Algeos) are proud suppliers to the Orthopaedics and Prosthetics markets. We specialise in sheet materials, components and tools for orthotics and other orthopaedic appliances. At this year’s conference we will be showcasing and demonstrating our latest range of Carbon Composite materials, as well as new foot orthotics and appliance components.

EXHIBITOR PROFILES

Anatom Superfeet® Premium Insoles add new products to their Trim-to-Fit™ range, the Orange & Berry. Both have an integrated forefoot cushion with a new rear foot stabilising cap moulded to give an even better fit in today’s narrower fitting running shoes etc. The Berry is the first full length specific ladies version. Superfeet® also introduce their new DMP™ insole, great for sensitive feet & diabetics. The Customfit™ range using the patented Bio - Vac™ moulding system will also be on display. Technical Support & advice will be provided by Andy & Kenny will be in attendance and look forward to meeting you on the stand.

Assistive Technologies Assistive Technologies is the vital reference for healthcare professionals, experts and associated businesses who are involved in using technology for rehabilitation and mobility improvement. The magazine brings the latest news, insights, expert comment and product information to all clinicians, therapists and equipment suppliers who have a professional interest in helping people with disabilities lead more mobile and independent lives. It covers the disciplines of orthotics, prosthetics, rehabilitation, robotics and orthopaedics as well as treatment through associated specialists in fields such as occupational therapy, podiatry, physiotherapy and mobility engineering; holding associate relationships with key organisations influential in the development and maintenance of high standards within the industry.

BSN Medical Established in April 2001 as a joint venture between Beiersdorf and Smith & Nephew, BSN medical is one of the world’s leading suppliers of health care products. You may not know BSN medical but you will be very familiar with our leading and trusted brands –Gypsona*, Orthoglass* and Elastoplast*. Our wide Actimove range of orthopaedic soft goods are designed with patient comfort, anatomical fit and cost effective treatment in mind. The Actimove Sling is popular for its non stretch material and ease of use. Whilst our Genu knee immobilisers provide excellent fit for reduced pain after trauma or surgery. Join us on stand 28 to try out these and many others for yourself!

BTS Bioengineering BTS Bioengineering designs and manufactures surface EMG equipment as well as products for motion capture and analysis which are suitable for a variety of clinical and research applications including optoelectronic plethysmography for respiratory assessments and posture, gait and full biomechanical analysis for neurological or orthopaedic assessments, for determining rehabilitation needs and in sports and exercise science research. The company is able to provide integrated multi-factorial systems. On its stand BTS will be showing the PocketEMG system and the new FREEEMG the latter being completely cable-free." Thank you enjoy the weekend.

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Chaneco Chaneco are very pleased to release a new orthotic product catalogue at BAPO 2008. There are many new and exciting products, which compliment one of the largest ranges of stock orthotics available in the UK. All have been hand picked from leading manufacturers worldwide. There has been great emphasis on quality and price, these linked to our custom manufacturing and free next day delivery, make us the perfect choice. Also new for 2008, at long last, is an excellent range of paediatric stock and modular footwear. Please visit stands 13 & 14 for a closer look Email: [email protected] or Telephone: 01604 709999

CSM3D CSM3D, is a software company with over 30 years experience in supplying CAD/CAM solutions to the shoe industry, for footwear design, development and manufacture. It is supported by a worldwide distribution network and has over 2,200 licenses in 450+ companies located in over 45 countries. The Shoemaster system is developed in the UK at our offices in Street, Somerset and has over the last 10 years become a standard within the Orthopaedic footwear industry and is currently used by numerous Orthopaedic footwear manufacturers in the UK and in Europe. CSM3D are keen to promote the use of new technologies within the Orthopaedic footwear industry and encourage the use of footscanning, pattern engineering and direct cutting solutions.

DeNovo Healthcare Ltd DeNovo Healthcare Ltd is a young dynamic and professional company focused on offering the best service, quality and value possible by bringing modern concepts and ideas to the market. As the exclusive distributor for Nimco Footwear, Fillauer, Centri and Basko we offer you and your patients a huge range products including: Nimco Children’s Footwear in many styles and colours, the Centri Dynamic Walk Orthoses for drop foot management, the durable MCV Centri Dream Skin cosmesis and the Basko Swing phase lock IQ Knee joint with a central fabrication option. Please visit us at Stand 16 to view these and other many exciting products.

DJO UK Ltd DJO UK Ltd combines the DonJoy® and Aircast® product range with Procare® at this year’s BAPO conference. The recent merger with Reable ™ and the global integration of the new DJO, provides some exciting developments. From Aircast®, we will exhibit the well established Walker® range, alongside products specialising in foot and ankle problems. The DonJoy® range builds upon our expertise in the development of knee products. Procare® is our hospital product range and has a wide variety of supports for everyday use. We will also have our new 2008 DJO catalogue and our specialised Paediatric Catalogue at the conference.

D.M.Orthotics Ltd D.M.Orthotics Ltd have existed for three years manufacturing dynamic Lycra orthoses (now rebranded DMO), compression burns garments and orthopaedic soft goods from our Redruth manufacturing facility using state of the art CADCAM equipment. The company is committed to ongoing high level research and development in areas of neurological dysfunction and general orthotic managements using fabrics. Showing at conference for the first time to promote the brand, products and our mission statement “ Dedication to innovation and excellence ensures quality without compromise”. Visit the booth to see the alternative way to control the unstable shoulder.

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Gilbert & Mellish Ltd New Adult Orthopaedic Footwear Range for 2008! G&M are a well-known and established company within the orthotic industry who provide a comprehensive range of orthopaedic products including the very popular Piedro children’s footwear.

Kenward Orthopaedic LTD Kenward Orthopaedic LTD have been manufacturers of stock/modular, custom made footwear and insoles since 1993. We can meet all your patients needs relating to footwear please come and visit us at our stand number 22 to see our new range of footwear.

Medi – first for quality support, service and innovation. As an Orthotist you will appreciate the years of dedicated experience Medi offers. Your patients will benefit from practical, reliable products. Medi – supporting life. New for 2008 White is the new black. Experience the new M4s ligament knee brace; top build quality combined with Italian styling in prestiege white. Come along to take part in our annual Medi table football tournament and for your chance to win a track day in a white Audi R8, please steer yourself to stands 77 & 78 Also see our hosiery garments available now on FP10/GP10.

Mobilis The Mobilis stand is definitely not to be missed this year! Featuring our full breadth and range of expertise. Our bespoke manufacturing capability of County Footwear, Cox Ortho, Halo Healthcare will all be on show, as well as a live on stand demonstration by biomechanics expert, Martin Haines from Mobilis Performance, who will be demonstrating how pelvic screening can influence orthotic prescription…. ... and it doesn’t stop there either .. you can also pick up a copy of our brand new catalogue and see a selection from our full range of exciting new products. Enter our competition and meet our friendly team !

Össur Unloader® One Tibial Osteotomy is usually considered for younger patients with unicompartmental OA and other patient groups who are unsuitable for Total or Uni Compartmental knee replacement. Surgery involves resection of a wedge of bone to over correct the patients knee deformity. The line of weight transmission or H.K.A. axis now passes through the unaffected compartment of the knee with a resultant reduction in knee pain. The new Unloader® One OA knee brace from Össur is designed to achieve pain relief by unloading the compartment which is showing arthritic changes and pass load through the less affected side. Many OA knee braces are unnecessarily rigid as their design is often based upon ligament braces. The common issues with this style of brace are rotation, migration and poor patient compliance.

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EXHIBITOR PROFILES

In April 2008 G&M are launching a fantastic, brand new range of high quality adult orthopaedic shoes, boots and trainers from reputable, well-known manufacturers, Piedro and Solidus. Oozing with glamour, quality and style this range promises to bring a new and very fresh look to orthopaedic footwear in a variety of styles. So what’s your style? Visit us on stands 60-63 to find out!

In contrast the Unloader® One is a fresh new design tailored precisely to the holistic needs of the OA patient, thus providing flexible, lightweight and superior unloading ability. As a result patient compliance and pain relief is optimised. In summary the Unloader® One is an effective treatment regime which can deliver a similar outcome in terms of pain relief as a Tibial Osteotomy whilst avoiding the risks, cost and rehabilitation associated with a surgical treatment path. Pollo F E, Jackson R W, Knee Bracing for Unicompartmental Osteoarthritis, Perspectives on Modern Orthopaedic, Volume 12 Number 1 January 2006

Otto Bock® Healthcare Come and meet the Otto Bock® Healthcare Prosthetic & Orthotic Teams on Stands 42 & 45 at this years BAPO Conference. The Otto Bock® teams are looking forward to this annual event and the opportunity to meet and talk with you about the latest innovative Otto Bock® products. This year we will be launching our new 3R60 EBS PRO knee joint which is smaller in size and, with a weight of 845 grams, is also lighter than its family member the ‘3R60’. Proximally there are four different modular adapters available for the joint, thus enabling fitting for many transfemoral amputations.

Paromed People that want to help shape tomorrow’s world need vision, forward-thinking and the ability to put ideas into practice. Paromed’s innovative technologies and service concepts are ideally suited to handle these future issues. As the leading provider of foot assessment systems and integrated insoles production, we work closely with the orthopaedic industry, therapists and scientists. The Paromed programme is a modular system (analysis, scanning, modelling and milling) for providing highly efficient foot care. These features enable you to render care to your clients in the easiest, most efficient and most accurate manner possible.

Peacocks Medical Group Peacocks Medical Group offers a complete Orthotic service. Our clinical service is second to none, encouraging assessment with a view to offering options of best treatment modalities to compliment treatment regimes. Our manufacturing base delivers quality products through experienced technicians who can discuss and offer technical solutions to clinical challenges. Procurement of stock orthoses is comprehensive, efficient and competitive. Our innovative product lines fill gaps where existing providers struggle to meet clinical needs. This is supported by delivery of training and education to compliment effective use of our interventions. Peacocks are represented at all levels of the profession and industry.

Pedors Shoes Pedors Shoes features the use of seamless stretch neoprene to minimize the likelihood of abrasion and trauma to the foot in a shoe environ. Pedors new range of Stretch Walkers have been designed to accommodate most custom AFO’s. The new T2 shoe-a light weight hybrid shoe design-includes a neoprene forefoot and a semisurgical opening to accommodate edema, deformity or bulky wound care bandaging. There is a 1/4" removable insert that can be modified or replaced with a custom orthotic. The firm lightweight sole is carved to a heel to toe rocker shape that is very effective as it is or it can easily be customized to the patients offloading or gait requirements.

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Promedics Ltd Promedics Ltd began business as a family owned manufacturer of Orthopaedic Soft goods some 20 years ago. During this time, having expanded its product portfolio greatly, the company has become recognised as a quality provider of goods and services to the Orthopaedic market. During 2008, we at Promedics will be focusing on the products available for our Orthotic customers. We are therefore delighted to announce that we will be running a number of regional workshops throughout the year and invite you to discuss any interest that you may have at our stand (number 80). We look forward to seeing you soon.

Push Braces At Conference we will be presenting the new award winning PUSH ORTHO ACL KNEE BRACE. This exceptional brace is designed to relieve mobility problems associated with anterior cruciate ligament dysfunction. Its design combines compressive support with a functional frame. The compressive support exerts a comfortable pressure on the knee, and positions the brace, while the Non-Ax™ stabilisation system supports the functioning of the ACL without impeding the knee’s natural movement. The new ACL brace complements the existing range of PUSH Care, Ortho and Med orthopaedic braces and PSB sports braces from Europe’s most innovative brace manufacturer.

Remploy Healthcare Remploy Healthcare is a leading UK manufacturer and supplier of footwear and mobility aids. With several decades' experience, Remploy has established itself at the forefront of the development and design of healthcare products and services. The Tivoli adult footwear range from Remploy offers distinctive styling and an innovative last design for improved fit. Addressing the market’s demand for style and fashion as well as quality, support and comfort, the Tivoli utilises the expertise of skilled Remploy craftsmen to deliver a stock, modular or made to measure solution to both prescriber and end user. For more information visit www.remployhealthcare.com

Realistic Prosthetics Limited Realistic Prosthetics specialise in providing the finest quality, upper limb cosmetic covers at highly competitive prices. Continuous research helps us to produce and maintain a range of cosmetic gloves that have full skin detail, as well as lifelike high definition nails and shading. The colours and special pigments we use, combine together to give our cosmetic gloves a unique natural appearance, we call this unique finish RealSkin™. Our RealSkin™ cosmetic glove range was launched in November 2000. We are market leaders for quality and value; “the best gloves I have ever seen” is a common quote.

RSLSteeper RSLSteeper is one of the largest suppliers of prosthetics, orthotics and assistive technology solutions in the world. Our patients are our focus and we are pleased to announce two new developments at BAPO 2008. • Select Myo Electric Hand system. A new upper extremity system that offers, flexibility, performance and ease of use, developed to be used as a standalone system or to be integrated with existing systems from other manufacturers as plug-in replacements. • SpectroMatch colour matching technology. A unique electronic colour matching process for high definition silicone cosmesis that delivers a near perfect match to an individual’s skin shade.

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EXHIBITOR PROFILES

Vivomed Ltd are the UK distributors for leading Dutch manufacturer PUSH BRACES of Maastricht.

Salts Techstep Salts Techstep strive to be cutting-edge and technically advanced. Our products are a giant stride forward in high quality custom-made and stock orthotics. Quality We insist that high standards are met in the design, manufacture and distribution of our products. Reliability We aim to be reliable and trusted by appreciating that complete confidence is of paramount importance to our customers. Service All customer contact is treated with the care, respect and efficiency needed to ensure total satisfaction every time. The Result We aspire to provide the best solutions that our in-house expertise, accuracy and effective products can produce. Salts Techstep is part of the Salts Healthcare Group

Trulife Trulife are a global manufacturer of orthopaedic & physical rehabilitation products for orthopaedic, podiatric, orthotic and therapy professionals as well as a supplier of clinical orthotic service in the UK & Ireland. In addition to our wide range of orthopaedic products, we will be introducing the WalkAide system - an innovative wireless orthotic device for the treatment of drop foot. With over a decade in development, the WalkAide system uses the latest in Myo-Orthotics technology. Come see our live demonstrations on stand 44, where we will also be serving fresh coffee and a selection of pastries.

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EVENTS Following the success and popularity of the social programme during previous conferences, once again there will be ample opportunity for all attendees to mix in an informal atmosphere.

Exhibition Opening Ceremony Friday 14th March - Exhibition Hall 18:00hrs - 20:00hrs

EVENTS

Come and join us for some cheese and wine at the Exhibition Opening Ceremony sponsored by Ossur UK Ltd. Meet up with friends and enjoy the evening with magical live entertainment.

Icebreaker Friday 14th March - Lion of Vienna Suite 20:00hrs ‘til late At the close of the Exhibition for the evening why not join us in the Lion of Vienna Suite for and informal get together. With a full bar, hot buffet and live musical entertainment this is the ideal setting to catch up with friends and colleagues.

Casino Evening Saturday 15th March - Lion of Vienna Suite 19:00 for 19:30hrs ‘til 2:00am Saturday night again has an overall entertainment theme this year with the DJO Casino Evening. Guests can enjoy the fun of a lively casino then dance the night away with a live band “Elbow Room”. Come into the Hall of Fame Suite and join us for a hot buffet with a selection of dishes to suite every taste. Come chance your luck and soak up the fun party atmosphere. Dress code smart/casual.

Prize Giving Ceremony Saturday 15th March - Exhibition Hall 15:30hrs Your efforts are recognised at the annual Prize Giving Ceremony. Presentations will include the Otto Bock Lecture, The Limbless Association Technician Scholarship Award and the BAPO prize for the Best Innovative Stand at Conference.

AGM Sunday 16th March - Hall of Fame 10:00hrs The Annual General Meeting of the Association takes place in the Hall of Fame at 10:00hrs on Sunday 16th March in the Hall of Fame Suite and 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.

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DELEGATE REFLECTION FORM Please complete this assessing your own attendance at each session

Session title:

Presenter:

What are the key messages I have learned from this session?

How would I apply what I have learned to my workplace?

How do I make this happen?

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