We are seeing a number of virtual reality applications in rehabilitation as ideas from the gaming world spill over into rehab. But how about technology from rehab finding it's way into gaming?

A paper by Lopes et al describes how researchers from the Hasso Plattner Institute in Potsdam Germany have been exploring how to add haptics to walls and other heavy objects in virtual worlds by using FES (Functional Electrical Stimulation).  When you think about it, a "sense of feeling" is normally missing from these virtual worlds - FES is one way of providing this sense.

Some 30% of stroke survivors suffer from severe upper limb paresis with a non-functioning hand and the outcomes for rehab, at least in the research literature, seem to be poor. The RehaDigit produces controlled passive movements of paralysed fingers with the aim of allowing therapists to concentrate on more complicated tasks whilst allowing more intensive therapy. The device moves the four fingers over a physiological range of movement whilst adding a controlled vibration to activate the sensorimotor system.

Denervated muscles require a different electrotherapy protocol to "conventional" FES but research has shown that technology such as the Stimulette Den2x from Dr Schuhfried can reverse the loss of tissue bulk and quality that results from a denervation injury.  Restoring tissue in this way can reduce the risk of pressure sores, improve circulation and dramatically improve appearance.

For decades now pressure sores have been recognised as a serious yet preventable world-wide problem.  Here we are in 2017 and we still are not doing enough to prevent these even though we know who is at risk and we know what factors elevate the risk.  In Scotland, the Diabetic Foot Action Group has been working hard to both raise the quality of care and consistency across Scotland.  As we described in our last article on CPR for the Diabetic Foot, a Scottish system audit identified potential savings of £15 million per year if even 75% of diabetic foot ulcers could be prevented. 

The NHS in Scotland could save £15m a year by implementing "CPR" for the diabetic foot. An audit organised by the Scottish Foot Action Group has shown the potential impact of taking the prevention of hospital-acquired diabetic foot ulcers seriously. By checking patients feet on admission, protecting the foot if at risk and referring for treatment if necessary. So often pressure relief devices like the PRAFO are looked on as a "cost" when this study clearly shows that using these devices can produce a massive saving both in money and distress when used thoughtfully and appropriately.

The costs of dealing with pressure and diabetic foot ulcers are staggering. Pressure relief orthotic interventions should be more widely understood and used.  We started Anatomical Concepts more than 20 years ago after I saw a great product (The PRAFO Ankle Foot Orthosis) which we still deal with today.  It's not quite as "sexy" as some of the products we deal with, but in terms of it's clinical signficance and impact it is by far the best product range we have.