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Research carried out by the SESRC has resulted in the development of three novel devices that improve foot and lower limb circulation. These have been commercialised by Actegy Health Ltd.
Since 2008, impact arising from this research includes,
University of Salford researchers have transferred knowledge from research in the foot health devices sector into products and services in commercial and clinical settings, supporting a £100 billion global healthcare equipment and supplies industry, contributing to economies and to quality of life on a daily basis for those with foot and lower limb health problems, world-wide. The benefiting partners are part of global businesses and public and private sector clinical services and researchers have pioneered the connection of research to commercial foot health contexts on a unique scale:
Glasgow Caledonian University researchers have dramatically changed the manufacture of custom ankle-foot and foot orthoses through additive manufacturing (3D printing) combined with improved design personalisation. The research has beneficially impacted on health and well-being as new 3D printed orthoses have been designed and trialled with patients with positive outcomes reported. Moreover, European SME companies in the orthotic design and manufacture sector have benefitted through the commercialisation of new orthotic products and computer-based design optimisation software. The research has also led to raised global awareness of the capabilities of additive manufacturing for the orthotic sector and beneficially influenced manufacturing research and development funding at the European policy level.
Research by Ichiyama and colleagues has resulted in humans with severe spinal cord injury (SCI) recovering standing and stepping, combined with other major health benefits including restoration of urinary continence, bowel movements and sexual function. Specifically, Ichiyama and collaborators used a combination of epidural electrical stimulation of the spinal cord, pharmacological agents and rehabilitation training to enable animals with severe spinal injuries to walk again. This work was the necessary foundation for translation to humans with severe spinal injuries. The publicity surrounding these landmark clinical studies stimulated charitable donations and commercial investment in this new field.
The Orthotic Research & Locomotor Assessment Unit (ORLAU) (http://www.rjah.nhs.uk/ORLAU) has run multidisciplinary services to improve the function and lifestyle of severely disabled patients since 1975. New specialist clinical services have been established, based on research and development activity. The effectiveness of these services has been the subject of further investigations. Work has focused on the development of novel technology (in gait analysis and orthotics) and increasing understanding of human movement. Conditions treated include cerebral palsy, spinal cord injury, neuromuscular disorders, arthritis and stroke. Technological developments have led to licencing within the commercial sector. ORLAU has also contributed to the development of national and international clinical education and guidelines.
The University of Glasgow's Centre for Rehabilitation Engineering (CRE) has developed strategies and products that have influenced clinical practice in Spinal Cord Injury (SCI) worldwide. The CRE refined the concept of using Functional Electrical Stimulation (FES) for cycling and abdominal stimulation and defined its benefits to patients by establishing the nature of the medical benefits of the technology.
Working with clinical partners in the Southern General Hospital and Hasomed GmbH, the CRE co-developed FES products that are now used routinely in clinical rehabilitation. Hasomed sell ~500 units p.a. across the world, for use at home, in fitness centres and in SCI clinics to maintain health and wellbeing, thereby reducing patient morbidity and increasing their life expectancy.
Neuro-feedback, utilising a Brain Computer Interface for the treatment of pain associated with SCI, has also been developed into a clinical reality and a limited clinical trial has now shown its efficacy.
Since 1998 the University of Leeds has developed the Leeds Foot and Ankle STudies in Rheumatology (FASTER) programme — to drive improvements in UK musculoskeletal foot care services. Results from FASTER clinical trials and a national survey of podiatry services directly informed NICE guidelines on foot care in arthritis. FASTER's research also provided key evidence for a national consensus on standards of care and aided a shift in the treatment paradigm for foot care in arthritis patients. These standards and NICE recommendations are included in the latest Royal College of GPs curriculum. They have also informed government policies on commissioning for podiatry services throughout England. Since the inception of the FASTER programme independent reports suggest that access to foot health services for people with rheumatoid arthritis has increased from less than 50% immediately prior to FASTER, to nearly 80% of patients today.
This case study examines the long-term and ongoing relationship between an industrial collaborator (Chas A Blatchford & Sons Ltd) and researchers at the University of Roehampton. This systematic programme of biomechanical research on how prostheses perform in activities other than walking has had two significant outcomes. Firstly, this work has significantly improved prosthetic design, with four new prosthetic designs marketed worldwide. Secondly, it has increased awareness of — and importantly increased engagement with - exercise therapy for amputees among healthcare professionals (prosthetists and physiotherapists) and amputees themselves. This research has reached a wider audience including amputee charities and healthcare professionals, with whom we focus on mobility and movement rather than the prostheses.
This case study relates to Manchester Metropolitan University (MMU) research on musculoskeletal responses to microgravity conditions in spaceflight and the resulting applications and impacts. MMU's research and influence within the UK Space Biomedicine Consortium underpinned a shift in UK Government policy towards full participation in European Space Agency (ESA) programmes. Impacts have also resulted from the development of gravity-independent devices and exercise systems that have been tested by ESA and NASA within various "live" missions on board the International Space Station. MMU's research has also had a big influence on the organisational practices of the German Aerospace Centre (DLR) particularly around space physiology.
Footrot (FR) causes 90% of lameness in sheep. FR reduces productivity and lowers sheep welfare. Research at the University of Warwick, initiated in 1999 and still active, has led to the development of a novel management strategy for footrot in sheep: prompt antibiotic treatment (PAT) - sheep treated with intramuscular and topical antibiotics within three days of becoming lame with FR. This has resulted in a reduction in the overall prevalence of lameness in sheep flocks in England from 10% (2004) to 5% (2011) and 3% (2013). In 2011, evidence from research at Warwick on PAT was used by the Farm Animal Welfare Council of Great Britain to support their statement that it was feasible to reduce the prevalence of lameness in the national flock from 10% to 2% by 2021. From 2005 onwards, PAT has been disseminated to 50,000 sheep farmers through knowledge transfer (KT) by EBLEX, the levy body for sheep farmers in England using booklets, CDs and more than 100 on-farm events. More than 50% of farmers who had attended an EBLEX KT meeting on lameness stated that they had changed their management of lameness as a result of new information from the event. The Sheep Veterinary Society in the UK has adopted PAT as the recognised management approach for FR and a leading sheep vet in Germany has written a book promoting PAT. The work has been presented in Europe as part of Animal Welfare Research in an Enlarged Europe (AWARE), an EU-funded project educating all countries in the enlarged EU zone on animal welfare (http://tinyurl.com/o6onaxd). In 2012, the lead Warwick researcher Professor Green was awarded the Royal Agricultural Society of England medal specifically for `impact to the sheep farming community in reducing footrot in sheep'.