Tag Archives: Clinical Biomechanics

Professor recognised for services to podiatry profession

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A Staffordshire University Professor has received a top honour recognising his contribution to the advancements of the podiatry profession.

Professor Nachiappan Chockalingam, Director of the Centre for Biomechanics and Rehabilitation Technologies, received an Honorary Fellowship from the Royal College of Podiatry at an event in the House of Lords.

This fellowship is conferred upon individuals who have made a substantive and significant contribution to the advancement of the podiatric profession in clinical practice, education, service management or research.

With support from colleagues and collaborators within the profession, Professor Chockalingam has contributed to the development of musculoskeletal podiatry in the United Kingdom. He has supervised and trained numerous podiatrists through the University’s post-graduate provision.

His globally recognised research on foot and footwear biomechanics has helped in scientific understanding of the mechanics of the foot and has provided evidence for clinical practice.

Receiving the honour, Professor Chockalingam said: “Receiving this fellowship is not just my own achievement; it represents the hard work of all the people I have worked with, from the podiatry profession and all those students for their dedication and unwavering belief in the power of knowledge and the pursuit of excellence.

“Throughout my academic and professional journey at Staffordshire University, I have been fortunate to work with some brilliant podiatrists who engaged with me in critical debates on scientific aspects of their clinical skill set. Some of these conversations have led to the development of seminal publications to provide evidence for practice.

He added: “With this honour comes a duty to contribute to the advancement of knowledge, to address pressing societal challenges, and to inspire others to follow their academic passions.”

Earlier this year, Professor Chockalingham was named a fellow of the International Society of Biomechanics (ISB) at their 29th global meeting in Fukuoka, Japan.  This fellowship recognised his distinguished professional achievement in biomechanics,  support for young researchers and his work to promote inclusive research amongst Allied Health Professionals.

Staffordshire University Vice-Chancellor Professor Martin Jones said: “We would like to extend our heartfelt congratulations to Professor Chockalingam on these latest honours which are so richly deserved. Nachi and his team are exponents of research excellence, he makes a huge contribution to our research culture here at Staffordshire University and we are enormously proud of all has achieved.

“Nachi brings together practicing clinicians and researchers with a view to improving patient care and the Staffordshire Conference in Clinical Biomechanics, now in its 21st year, is a big part of this. To have him recognised by his peers both here in the UK and internationally is the icing on the cake!”

Landmark study reveals critical shortage in UK prosthetic and orthotic workforce

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A Staffordshire University study has revealed a significant deficit in the number of prosthetists, orthotists, prosthetic and orthotic technicians, and support workers in the UK.

The report by the Center for Biomechanics and Rehabilitation Technologies (CBRT) was formally launched on 6 November 2023.

This research, commissioned by the British Association of Prosthetists and Orthotists (BAPO), found there are currently 631 orthotists and 295 prosthetists employed nationwide. However, an additional 142 to 477 prosthetists/orthotists are needed to meet World Health Organization standards of care.

“This workforce shortage is worrying,” said Professor Nachi Chockalingam, Director of CBRT and a senior author of the study. “With our aging population, demand for prosthetic and orthotic services will only increase. We urgently need strategies to grow and sustain this profession.”

The study also identified a lack of qualified technicians and support workers to support prosthetist/orthotist teams, with a shortage of 1,133 to 1,803 individuals by WHO benchmarks. Significant recruitment challenges were reported by both NHS and private sector employers.

“This landmark report provides the hard evidence we need to take action,” said Dr. Nicky Eddison, lead researcher. “Working with professional bodies, higher education institutions and the industry we must inspire the next generation and make prosthetics/orthotics an attractive career choice.”

The report highlighted concerning retention issues as well, with one in five prosthetists/orthotists indicating they may leave the field in the next five years. Key factors driving attrition include lack of career progression, poor work-life balance and lack of flexibility.

Another senior author Dr. Aoife Healy, added, “Prosthetist/orthotist is an incredibly skilled profession that allows for a high degree of creativity combined with cutting-edge technology to transform patients’ lives.”

Mr. Peter Illif, the Chair of the British Association of Prosthetists and Orthotists said, “We need to nurture these professionals so they feel valued and able to thrive throughout their careers. BAPO has pledged to implement the report’s recommendations around enhanced educational programs, expanded roles for prosthetic/orthotic associates, and greater collaboration to sustain the workforce.”

“With commitment from all stakeholders, we can build the prosthetic/orthotic workforce needed to provide quality care to all who require it,” Professor Chockalingam said. “We look forward to partnering across the health sector to make this vision a reality.”

The full report “Exploration of the UK Prosthetic and Orthotic Workforce’ which is also available on the BAPO website.

Watch the report launch event to hear more about the research from the study’s authors.

Professor Chockalingam attends a key stakeholder meeting at the WHO, Geneva.

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A gathering was hosted by the WHO Assistive Technology team in Geneva on March 28th and 29th, with the objective of evaluating the process, results, and distribution of the WHO rapid Assistive Technology Assessment (rATA) survey, as well as devising strategies to enhance this significant means of collecting data.

The rATA survey is designed to gather information from households at a population level, which includes assessing self-reported requirements, obstacles and demand related to assistive technology. This survey was conducted worldwide between 2019 and 2021 in 35 countries and contributed to the WHO-UNICEF Global Report on Assistive Technology, which was released in May 2022.

At the meeting, 28 stakeholders hailing from 18 different countries were assembled, all of whom were involved in the creation, delivery, and interpretation of rATA data. The participants shared their individual experiences and insights gained from collecting rATA data and collectively identified key measures to enhance the questionnaire’s effectiveness, streamline rATA implementation, offer more robust support for country implementation, fortify data management and analysis, and broaden the dissemination of rATA results.

To inform evidence-based policies and programs, measure progress in improving access to quality assistive products and services, and guarantee equal access to assistive technology for those in need, it is essential to invest in effective and efficient assistive technology data collection. Stakeholder representatives attending the meeting identified key measures to enhance the rATA questionnaire’s effectiveness and ensure equitable access to assistive technology for all. The outcome of this meeting will guide further development of rATA through the GATE Global Network on Measuring Access to Assistive Technology.

(The team at StaffsBiomech conducted the first UK rATA and the data were included in the WHO-UNICEF Global Report on Assistive Technology).

UK Prosthetic and Orthotic Workforce Survey: We need your help!

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Why are we conducting this survey?

We are undertaking research to gather information on the prosthetic and orthotic workforce in the UK. The study aims to capture a wide variety of demographic and work-related information about the UK prosthetic and orthotic workforce. Currently, workforce data for people working within the prosthetics and orthotics profession is incomplete resulting in an unknown national workforce picture, which prevents accurate service planning and projection requirements. The project has been funded by Health Education England through the British Association of Prosthetists and Orthotists (BAPO). The findings of the study have the potential to influence future service planning.

Who do we want to complete the survey?

We want to gather information on all individuals working within the prosthetic and orthotic profession which includes:

•            Prosthetists/Orthotists

•            Prosthetic/Orthotic technician

•            Prosthetic/Orthotic support worker

•            Prosthetic/Orthotic student/apprentice

Survey update

  • The survey has now been running for 4 weeks but we need your help to get more responses, from all professions across the UK. We know that there are 1,124 registered Prosthetists/Orthotists in the UK today and so far, we have only had responses from 30% of this population.
  • We have a low response from technicians, support workers, students, and apprentices.
  • We have a low response from Northern Ireland, Wales, and Scotland.

To complete the survey, click here or scan the QR code:

There is a chance to win a £100 retail voucher, the survey closes 18/11/22.

Staffordshire University Professor is set to deliver a keynote lecture at the next ISPO world congress in Mexico.

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International Society for Prosthetics and Orthotics (ISPO) organises biennial World Congresses. This is ISPO’s flagship conference and is a unique forum where the global community of professionals involved in the care of persons in need of prosthetic, orthotic, mobility and assistive devices comes together to learn about the latest scientific and clinical advances, products, innovative technologies, designs and materials in P&O care provision with the global health services.

The next world congress in 2023 is titled “Art and the Science” and will be held in Guadalajara, Mexico.

Four renowned international professionals Rosielena Jované, Sophie de Oliveira Barata, Professor Stefania Fatone and Professor Nachiappan Chockalingam will present keynote lectures around the congress theme The Art and the Science.

For more information on the congress please visit: www.ispo-congress.com/en/news/inspiring-keynote-speakers-expected-at-the-ispo-19th-world-congress

Here’s the preview from our own Nachi Chockalingam.

Classification System for Bespoke Thermoplastic Ankle Foot Orthoses

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Everyone agrees that not all Ankle Foot Orthoses (AFOs) are the same and they do not treat the same pathologies. Also different designs have varying effects on biomechanical function. However, the terms used to describe the different types of AFOs have not been fully classified and defined. This has led to the use of varying descriptions and acronyms resulting in poorly designed research studies (1,2) and a misunderstanding of research outcomes. The lack of classification has also resulted in generalisation on the effects of AFOs from research studies which have not been clear on the design of the AFO used or the presenting pathology it was used for (2), with some studies describing the AFO as “a standard AFO”, for which there is no definition. Standardised terminology and definitions for AFOs are critical in clinical practice, without these, there may be serious negative consequences, with the potential to cause harm.

We have now developed and validated a new classification system for different designs of bespoke thermoplastic AFOs.

Figure 1: Bespoke thermoplastic AFO classification chart.

The proposed classification system for bespoke thermoplastic AFOs, has an excellent inter- and intra-observer agreement. It will reduce the ambiguity of the description of the type of AFOs used in clinical practice and research. Furthermore, it makes reproducible comparisons between groups possible, which are essential for future evaluations of evidence-based orthotic care.

Read the full paper at:

https://www.sciencedirect.com/science/article/pii/S0958259222000219

References:

  1. Figueiredo EM, Ferreira GB, Maia Moreira RC, Kirkwood RN, Fetters L, Figueiredo E, Ferreira G, Moreira R, Kirkwood R FL. Efficacy of Ankle-Foot Orthoses on Gait of Children with Cerebral Palsy: Systematic Review of Literature. Pediatr Phys Ther. 2008;20(3):207-223. doi:10.1097/PEP.0b013e318181fb34
  2. Eddison N, Mulholland M, Chockalingam N. Do research papers provide enough information on design and material used in ankle foot orthoses for children with cerebral palsy? A systematic review. J Child Orthop. Published online July 3, 2017:1-9. doi:10.1302/1863-2548.11.160256

A practical tool for Footwear Assessment in clincs

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Footwear advice created from footwear assessment is often anecdotal based on individual clinical experience and interest. There is often no structured way to evaluate the shoe worn to clinic and a generalised opinion on footwear choice is given.

Isolated assessment of footwear can provide a number of challenges for clinicians as wider footwear choices made by patients often do not reflect the shoes worn to appointments. This creates an unrealistic view for the clinician and inaccurate assumptions are often made when issuing advice.

To assist clinicians in assessing shoes we have developed a simple valid clinical footwear tool.

This tool has been designed to help clinicians quantify and measure a full range of footwear in one appointment. The footwear tool also provides a systematic view to assess the quality of fit and design of the shoe whilst channelling the clinician towards developing individual footwear advice for the patient. The tool is multifaceted and addresses a number of parameters associated with good fit and footwear choice.

Our validation of the tool shows that it is reliable to use in the clinic and can be applied to a number of styles of shoes. There is minimal equipment required to use the tool and completion of the assessment takes a short period of time.

For further details read our publication in JFAR:

https://link.springer.com/article/10.1186/s13047-022-00519-6https://link.springer.com/article/10.1186/s13047-022-00519-6

Please contact Dr Branthwaite or Professor Chockalingam to download the tool and the instructions for use

Postcode Lottery for NHS Orthotics Patients

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Our latest paper published in the BMJ Open highlight large variances in appointment times, waiting times, product entitlements for patients, and product lead times across various NHS trusts.

Although some geographical areas provide shorter waiting times and wider access to assistive devices, other areas have very long waiting time which means that the service, particularly to the paediatric population is meaningless.

The NHS trusts seemed to be able to answer questions that reflect quantity of service above quality of service. However, the combination of the number of Trusts who declined to reply to the FOI request and those who replied with limited information, hindered the ability of this study to collate the data received to provide a fuller national picture of the Orthotic Service provision.

Although this paper confirms that many of the issues reported in previous reports on Orthotic Service provision are still evident, the result show that there have been some improvements.

Read the full paper here: https://bmjopen.bmj.com/content/9/10/e028186

Press Release: https://www.staffs.ac.uk/news/2019/10/postcode-lottery-for-nhs-orthotics-patients

My experiences at Staffordshire University and #StaffsBiomech

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Christopher Aitkins

The decision of where to study for a master’s degree was a difficult one. There seemed to be an endless choice of institutions, with a multitude of differing delivery models. I was working as a podiatrist and an undergraduate lecturer, I had both teaching and clinical commitments which I couldn’t escape for long periods and the idea of a purely online course seemed tempting; however, deep down I knew that work and life pressures would likely mean my studies may take a back seat. The MSc Clinical Podiatric Biomechanics course seemed ideal, the teaching was blended taught sessions on a weekend, so my day job didn’t need to suffer and there was online support available. This was a bonus as I live in the North East of England and the idea of popping in for a quick tutorial wasn’t possible.

The course was delivered by excellent teaching staff, people who were not only passionate about the subjects they specialised in, but were the authors of the current literature which I had been reading to develop my own clinical practice. In all honesty I was a little star struck, when I met some of them. I was determined not ask a “stupid question”, however, every tutor made me feel at ease and provide a safe and supportive environment which meant there were no “stupid questions”. The discussions that formed were insightful and helpful, led by the tutor guiding us to through the subject. This learning experience is one I have never encountered before and is one I try to model within any teaching sessions I deliver.

The support continued throughout my time studying with Staffordshire University, all my tutors were on hand with a quick reply to an email or to arrange a time for a telephone call which, they managed to fit around my working schedule. This support never wavered even when I started my dissertation. I had excellent guidance from day one; I had opportunity to spend time discussing with my supervisor my research idea, developing my methodology and setting a realistic time frame. At my first meeting my wife was 6 months pregnant with our 1st child. My tutor helped me set a timetable and deadlines which were achievable. Without this I feel, I would have made this process almost impossible for myself and possibly not finished at all. Balancing the demands to complete a research project, write a thesis and live with a new born was challenging. But my tutor had an excellent skill to allow me the space to progress and work, but check in exactly when I needed a boost, some encouragement or just the opportunity to share where I was up to. I completed my project and received a good grade; I was so proud of my achievement through whole duration of my study and felt I had completed a well-rounded piece of research. I have to admit I was surprised when my tutor suggested that I should publish my research. I had never published in a scientific journal, “that’s the sort of thing experts do” I thought. However, as I reflected, I realised that my research was worthy of publication. I had no idea where to start, but my tutors came to my rescue again providing me with the same level of support I had before ( For people who are interested in reading our work, please follow this link).

I am so glad I chose to study with Staffordshire University and the teaching team on MSc Clinical Biomechanics course. I have not only gained a qualification, but published researched, developed a professional network that are always happy to share and discuss learning and most importantly I have developed as clinician. It has not only helped my practice and patients but the experience has allowed me to grow as a professional.

Branthwaite, H., Aitkins, C., Lindley, S. and Chockalingam, N., 2019. Surface Electromyography of the foot: a protocol for sensor placement. The Foot. https://doi.org/10.1016/j.foot.2019.07.001

 

Explanatory model for diabetic foot ulcers

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First paper from the collaborative work between Dr Zulfiqarali G. Abbas and colleagues from the Muhimbili University of Health and Allied Sciences and Abbas Medical Centre in Dar es Salaam, Tanzania  and Professor Nachi Chockalingam and colleagues at Staffordshire University has just been published in the Journal of Diabetes and its Complications.

This particular work is part of a wide ranging research focusing on Diabetic foot and its complications and is led by Professor Roozbeh Naemi at Staffordshire. This research was aimed at identifying various parameters that will help explaining the presence of foot ulceration in patients with diabetes.

The work examined the biomechanical, neurological, and vascular parameters along with other demographics and life style risk factors that could explain the presence of foot ulcer in 1270 patients with diabetes. Although the data focused on patients in Tanzania, the results has  a global implication. 

The results of this study showed that the participants with ulcerated foot exhibit distinct characteristics in some of the foot related clinical observations. Swollen foot, limited ankle mobility, and peripheral sensory neuropathy were significant characteristics of patients with diabetic foot ulcer. In addition, the explanatory model outlined within this research clearly shows that only one out of three patients with ulcerated foot showed common characteristics that are typically considered as contributing factor to ulceration.

 

Can a combination of lifestyle and clinical characteristics explain the presence of foot ulcer in patients with diabetes?
Available Online 01 March 2019
Roozbeh Naemi, Nachiappan Chockalingam, Janet K. Lutale, Zulfiqarali G. Abbas