With busy caseloads all round, LOC’s orthotists are always on the go. But they’re also very pro-active about raising awareness amongst their medical colleagues about how the latest orthotics can help patients. On the 15th June 2016, LOC orthotist Alan Hews and general manager Jo Wyatt joined forces to exhibit at BABICM 2016 Summer Conference – for the British Association of Brain Injury Case Managers. We spoke to Alan to find out what the event was all about, and how bespoke orthotics can assist in promoting mobility and rehabilitation after a brain injury or trauma.
LOC: You have a heavy caseload every week here in our Kingston upon Thames clinic. Why is it important to attend events like BABICM 2016 as well?
Alan: Yes, it’s certainly a challenge fitting everything in sometimes! I was in clinic all day on the Tuesday, then we (myself and Jo) travelled up on the Tuesday night and attended the event all day Wednesday before travelling back on the Wednesday evening - so it was a busy couple of days. But, although this conference wasn’t directly focused on orthotics, I think it was well worth doing. This was an event targeted towards case managers dealing with cases of brain injury, so we spent our time talking to delegates and making them aware that, when patients might benefit from orthotic provision, they can come to LOC for help. Orthotics can play a significant role in aiding mobility and building quality of life for these patients, so it was great to have the chance to liaise directly with the case managers who are at the sharp end of handling these cases, and to make them aware of what’s possible.
LOC: So when we’re talking about brain injury, what types of conditions does that refer to?
Alan: Cerebral palsy is one of the common brain injuries that can occur either before or after birth. We do a lot of work with cerebral palsy patients. Many brain injuries are traumatic. They can be a result of anything from a car accident to drowning - these types of injuries are known as hypoxic brain injuries, where the brain is deprived of oxygen. Brain injuries typically interfere with the brain’s ability to communicate with the spinal and nervous systems, leading to poor positioning, reduced mobility function and also the risk of trips and falls, which can in themselves further compound stability problems. The correct use of orthotics can help to stabilise the limb segment or to facilitate movement, which then gives the patient more independent activity and allows more active function.
LOC: And in these cases, what types of orthotic treatment tend to be most relevant?
Alan: By and large, we’re talking about the application of lower foot and ankle bracing as well as foot orthotics to assist patients who are experiencing contractures as a result of brain trauma. At BABICM 2016, we spoke to a lot of delegates about the potential of those treatments, but we also encountered a fair bit of interest around Lycra garments for patients who require additional stability, whether it be in their wheelchairs or during walking. The case managers who are dealing with brain injury patients liaise heavily with physical and occupational therapists, and those clinicians typically have patients who are in need of the orthotics we provide. So it was great to have the opportunity to signpost those case managers towards our ability to manufacture the devices they know will really help their patients.
LOC: What are the benefits of LOC being able to manufacture our own orthotic devices on-site?
Alan: It’s really all about the speed of provision and the quality of the product, along with the fact that orthotic interventions can potentially be a source of frustration for the patient if they’re poorly manufactured, ill-fitting or ineffective. Because we manufacture our devices onsite we can minimise those three bugbears. Imagine that you’ve got a patient who’s experienced an injury and their foot isn’t allowing them to mobilise in the way they were previously able to. If they then also have to struggle with the very device that’s intended to help them, that can further exacerbate an already difficult situation. The provision of timely and bespoke orthotics is a way of minimising that. If the case manager (on behalf of the patient) is well advised and supported in terms of their medical legal report then the cost of the orthotics can be covered, allowing them to access gold standard care. Of course, it depends on the individual case, but for us it’s about going on a journey with the patient that’s designed to achieve the best care and outcome that’s possible in those individual circumstances.
LOC: Helping patients who have experienced a brain injury or trauma must be a difficult experience for you personally. How do you cope with the emotional impact of seeing people, sometimes children, in such a tough situation?
Alan: You do feel it and it can undoubtedly be difficult. But, with time and experience, you become more capable of dealing with it. We’re professionals and our patients rely on us to make the right decisions for them, so it’s very important that you don’t let your personal feelings interfere with your clinical judgements. If I was in contact with people in these circumstances and I couldn’t do anything to help, then the tragedy would be even more difficult to bear. But I am able to help in a very practical way - and that ability to make a positive impact on people’s lives does help you to cope with the emotional impact of working with patients who have often experienced a sudden or serious accident that has profoundly impacted on their quality of life.
To find out more about the impact of orthotic treatment for brain injury, visit our paediatric orthotics or adult orthotics pages, or contact LOC directly for help and advice.