National profile of foot orthotic provision in the United Kingdom, part 1 : practitioners and scope of practice.

Foot orthoses have been advocated in the management of a wide range of clinical foot and lower limb problems and are within the scope of podiatry, orthotic and physiotherapy practice. Previous reports into the provision of orthoses have consistently identified significant issues with services and devices, but data were never specific to foot orthoses. The aim of this first of a series of papers was to report the first ever national multi professional profile of foot orthosis provision in the United Kingdom. Quantitative and qualitative data were collected from podiatrists, orthotists and physiotherapists via an online questionnaire. The topics, questions and answers were developed through a series of pilot phases. The professions were targeted through electronic and printed materials. Data were captured over a 10 month period in 2016. A total of 499 responses were included in analysis, including 357 podiatrists, 93 orthotists and 49 physiotherapists. The results reveal wide ranging practices across podiatrists, orthotists and physiotherapists, provision of orthoses through different health care departments (uni and multidisciplinary), for different health conditions (acute and chronic), and involving different types of orthoses (prefabricated and customised). Foot orthoses in the United Kingdom are provided in areas of well recognised health and rehabilitation priorities. A wide range of orthotic devices and practices are employed and different professions provide foot orthoses in different ways

PECULIARITIES OF HIP JOINT PROSTHESIS IN PATIENTS WITH RHEUMATOID ARTHRITIS

The aim. To improve the results of treatment of patients with rheumatic lesions of the hip joint by choosing the best options for endoprosthetics and postoperative rehabilitation of pa-tients. Materials and research methods. The object of the study was 125 patients with RA with TBS lesion, who underwent TB TBS in the Department of Adult Orthopedics of the UzNII of Traumatology and Orthopedics and the Department of Traumatology of the Clinical Hospital No. 1 for the period 2011 to 2017. In the foreground of preoperative planning, patients received conservative treatment on an outpatient basis for 2 weeks from a rheumatologist. After normali-zation of the rheumatic test indices, the patients came to us for surgical treatment. All patients were divided into 2 groups - the main and control. The main group consisted of 75 patients; in addition to the traditional method of surgical treatment, they used a device developed by us to determine the depth of the acetabulum during surgery, which made it possible to atraumatically, accurately and quickly determine the landing depth of the acetabular component of the endoprosthesis. Also, after surgery, the developed splint was used to develop the TB joint. The control group included 50 patients who underwent traditional methods of surgical treatment and after surgery without using a tire to rehabilitate patients. The age of patients ranged from 18 to 75 years, on average - 38 years. Of the total number of 125 sick men, there were 50 (40%), women 75 (60%). Results. Evaluation of long-term treatment results showed that good results in the main group (81.5%) were significantly greater than the control group (75%). Unsatisfactory results were obtained in patients of the main (1.5%) and control groups (5%). Conclusion. In the treatment of patients with RA, the use of cementless endoprostheses provides the possibility of widespread introduction of TBS endoprosthetics. In patients with RA with severe osteoporosis, protrusive coxitis and defects in the walls of the acetabulum, the justi-fied method is TE TBS using bone cement

A systematic review of measures of self-reported adherence to unsupervised home-based rehabilitation exercise programmes, and their psychometric properties

BACKGROUND: Adherence is an important factor contributing to the effectiveness of exercise-based rehabilitation. However, there appears to be a lack of reliable, validated measures to assess self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises. OBJECTIVES: A systematic review was conducted to establish what measures were available and to evaluate their psychometric properties. DATA SOURCES: MEDLINE, EMBASE, PsycINFO CINAHL (June 2013) and the Cochrane library were searched (September 2013). Reference lists from articles meeting the inclusion criteria were checked to ensure all relevant papers were included. STUDY SELECTION: To be included articles had to be available in English; use a self-report measure of adherence in relation to a prescribed but unsupervised home-based exercise or physical rehabilitation programme; involve participants over the age of 18. All health conditions and clinical populations were included. DATA EXTRACTION: Descriptive data reported were collated on a data extraction sheet. The measures were evaluated in terms of eight psychometric quality criteria. RESULTS: 58 studies were included, reporting 61 different measures including 29 questionnaires, 29 logs, two visual analogue scales and one tally counter. Only two measures scored positively for one psychometric property (content validity). The majority of measures had no reported validity or reliability testing. CONCLUSIONS: The results expose a gap in the literature for well-developed measures that capture self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises

HeartHealth: new adventures in serious gaming

We present a novel, low-cost, interactive, exercise-based rehabilitation system. Our research involves the investigation and development of patient-centric, sensor-based rehabilitation games and surrounding technologies. HeartHealth is designed to provide a safe, personalised and fun exercise environment that could be deployed in any exercise based rehabilitation program. HeartHealth utilises a cloud-based patient information management system built on FIWARE Generic Enablers,and motion tracking coupled with our sophisticated motion comparison algorithms. Users can record customised exercises through a doctors interface and then play the rehabilitation game where they must perform a sequence of their exercises in order to complete the game scenario. Their exercises are monitored, recorded and compared by our Motion Evaluation software and real-time feedback is than given based on the users performance

Monolithic zirconia and digital impression: case report

The aim of this study is to present a clinical case of a full arch prosthetic rehabilitation on natural teeth, combining both digital work-flow and monolithic zirconi

A review of wrist splint designs for additive manufacture

Currently, patients with wrist ailments may be prescribed wrist splints to aid in their treatment regime. The traditional fabrication process of custom-made splints is skill dependent, time-consuming and the splints themselves pose numerous problems with regards to patient compliance. To overcome this, the use of Additive Manufacture has been proposed in recent years and there has been an increase in public awareness and exploration. Many of these developments have been as a result of the Maker-movement, the Internet-of-Things and development of more accessible technologies and infrastructures to enable production of AM builds; hobbyists, industry and academia are exploring the use of AM for splints, all with strengths and weaknesses. This paper highlights and describes specific examples of AM wrist splints currently available in the public domain and summarises strengths, weaknesses, opportunities and threats for the future implementation into the healthcare sector

Occupational Therapy Resource Guide for the Utilization of Three-Dimensional Printing

Many practitioners in the field of occupational therapy are unaware of the benefits and importance of implementing a three-dimensional (3D) printer in practice indicating that there is a need for occupational therapy involving the fitting, environmental modifications, and training on how to properly use a 3D printed prosthetic within the upper extremity. 3D printing is when a digital design is converted into a designed material that has a functional purpose and different materials can be used including metal, plastics, and composite materials (Thomas & Claypole, 2016). 3D printing has many unique and effective uses like creating adaptive devices, feeding devices, prosthesis, and splinting. While 3D printing is currently being implemented across certain pediatric populations creating prosthesis, a lack of evidence was noted regarding the use of a 3D printer throughout occupational therapy. (Burn, M. B., Anderson, T., & Gogola, G. R., 2016). This is unfortunate as 3D printing is an innovative field of study that can aid many populations in becoming more independent and functional in daily tasks while increasing quality of life. A comprehensive literature review on the populations that utilize printing was conducted. The lack of occupational therapy involvement in the transition process of creating and training for the use of a 3D prosthetic, yields the demand for occupational therapy services. The information obtained aided in the development of a resource guide containing the importance of occupational therapy services involved with the transition process of a 3D printing. The literature review led the authors to focus on the main areas of rehabilitation phases, splinting and prosthetics, adaptive equipment, 3D printers, printing filaments, and various safety considerations. The integration of occupational therapy in 3D printing will greatly ease the clients’ transitions during rehabilitation phases while increasing their level of function and quality of life. 3D printing is a cost effective, user-friendly, creative, and innovative approach to add to practice. 3D printing is an up-and-coming area of occupational therapy and has the potential to change lives

Looking through the 'window of opportunity': is there a new paradigm of podiatry care on the horizon in early rheumatoid arthritis?

Over the past decade there have been significant advances in the clinical understanding and care of rheumatoid arthritis (RA). Major paradigm changes include earlier disease detection and introduction of therapy, and 'tight control' of follow-up driven by regular measurement of disease activity parameters. The advent of tumour necrosis factor (TNF) inhibitors and other biologic therapies have further revolutionised care. Low disease state and remission with prevention of joint damage and irreversible disability are achievable therapeutic goals. Consequently new opportunities exist for all health professionals to contribute towards these advances. For podiatrists relevant issues range from greater awareness of current concepts including early referral guidelines through to the application of specialist skills to manage localised, residual disease activity and associated functional impairments. Here we describe a new paradigm of podiatry care in early RA. This is driven by current evidence that indicates that even in low disease activity states destruction of foot joints may be progressive and associated with accumulating disability. The paradigm parallels the medical model comprising early detection, targeted therapy, a new concept of tight control of foot arthritis, and disease monitoring

Computer-aided design to support fabrication of wrist splints using 3D printing: a feasibility study

Introduction: Issues contributing to poor patient compliance for splint wear include poor aesthetics, fit and performance. This paper describes a novel digitised splinting process using 3D printing in an attempt to overcome these issues. The output of the investigation was the creation of a specialised computer-aided design software workflow to support 3D printing, developed specifically for splinting practitioners in the UK, to enable them to design splints themselves for each individual patient. Method: A small-scale feasibility study was done, based on the current splinting process. A thorough literature review and physical engagement in current splinting practice was performed, highlighting key requirements for successful splint fabrication. Key requirements were then replicated in a virtual software environment. Opportunities for integrating new, novel features were explored. The key requirements were then refined into a specialised software workflow to replicate the splinting process. The specialised software was then evaluated by 10 practitioners. User trials of the software were performed, followed by semi-structured interviews. Audio recordings were transcribed and then coded to establish similar trends of opinions, and areas for future research. No patients or vulnerable participants were involved in the study. Results: All participants were able to use and navigate around the software prototype with relative ease. Strengths included potential simplicity in modelling more complex splints, but several areas for future research are identified, including cost analysis and materials development. Discussion: The digitised splinting process shows promise for the benefit of both practitioners and their patients, provided that future research and investment can overcome current limitations