Thanks to Lotterywest sponsored-places, Post Polio was able to send 4 consumer representatives to the 30th Annual Scientific Meeting of the International Society for Prosthetics and Orthotics (ISPO), Australian National Member Society (ANMS) held 12-14 October 2006 for the first time in WA, at the Esplanade Hotel Convention Centre here in Fremantle.  Sandy Crameri (Orthotics RPRH), as the convenor and her committee of 8 others are to be congratulated on producing such an excellent conference and enabling WA professionals and patients to see this new and exciting research.

Other groups also sending reps were CMLA, Amputees in Action, Cerebral Palsy Assoc and the Meningitis Centre.  The attendance list shows 188 people.  47 were from WA, 6 from other countries, the rest (135) all came here from other Australian states.

This annual meeting is the primary conference for health professionals working in the area of prosthetics, orthotics and rehabilitation engineering in Australia and the theme this year was: “Patient Problems and Practicalities - Solving Clinical Issues in Patient Management”.

The scientific program featured invited speakers at the forefront in their respective professions, clinicians presenting free papers, manufacturers’ workshops and a trade exhibition featuring the latest develop-ments in products, materials and componentry.

Most of the speakers were absolutely brilliant. Not only were they leaders in their own fields but also they were enthusiastic, energetic and inspiring. The future looks bright for many patients if all the ongoing research achieves the goals set by these people and their staff.

One session had exciting news for those with polio affected legs. This presentation was about a product called the E-Knee. The product, new to WA but not to some polios in Vic, was a knee-ankle-foot orthosis using the 9001 E-Knee (Becker Orthopedic, USA) stance phase control knee joint.

Stance phase control orthotic knee joints provide knee stability while standing and allow knee flexion during swing phase when walking. Before they were introduced, clients had to walk with a straight knee KAFO that did not allow the knee to bend during walking.

When first introduced to Ron Bell, the Vic wearer of the E-Knee product we were not even aware that he had ever had polio! He stood straight, upright and walked without any visible impairment.

Ron’s story goes something like this:

Mr “B” contracted polio as a child in 1947 in Victoria. He spent a long period of time in hospital and both his legs were affected by the polio virus. After a lot of rehabilitation therapy he left hospital with mild weakness in his left lower leg. At the age of about 16 Mr B “threw away” his caliper and throughout his adult life he managed to walk and work without any orthosis or walking aids.

However in 1998 Mr B attended the Polio Services of Victoria (PSV) clinic at St Vincent's Hospital Melbourne after experiencing numerous falls.

He was prescribed and fitted with a below-knee solid Ground Reaction Ankle Foot Orthosis to provide him with stability and to minimise the risk of falling.

Seven years later, in 2005 Mr B became aware of progressive muscle weakness in his left leg, pain in his right hip, deteriorating gait and regular falls.

His knees were significantly flexed when walking. We viewed this on video footage taken of him. He almost looked like he was walking like a monkey.

After many trials were done, Mr B was finally fitted with his new KAFO with an E-Knee in Dec 2005. Mr B told us it took a lot of hard work, with regular physio, exercise and practice to get where he is now.  At 68, Mr B now looks terrific! He can  walk over rough ground and can also walk up and down stairs without difficulty. He also remarked that he is on his feet up to fifteen hours a day and has no problems with this!

By the way, Mr B’s orthosis came at a cost of $8,500 but his Lions Club raised the money to help him out.

Doctors, orthotists and physios from our Western Australian hospitals attended the conference, so we may be in for some pleasant surprises in future when we attend the clinics at Shenton Park. Let’s hope so!
 

E-KNEE - This first electronic stance control orthosis, allows orthotists to program the knee mechanism to lock at any degree of flexion or unlock in response to various conditions.  The E-Knee incorporates a microprocessor whose primary inputs come from a foot sensor positioned between the orthosis footplate and the patient’s foot or shoe to signal weight-bearing.  The knee locks upon ground contact; unweighting the footplate in the absence of a flexion moment unlocks it.  When the knee is locked, it can move to increased extension but not to further flexion.  The E-Knee can be used on patients with a higher level of disability than some mechanical SCOs, which require some degree of hip, knee or ankle and foot function to actuate.  Patients with even a completely flail limb are reported to be able to achieve improved gait with this design.   NOTE:  Exciting as this new technology is, it is still in its infant stage. Not all patients with lower limb paralysis will benefit from the E-Knee.  Patient selection criteria are still being determined.