NATIONAL CONGRESS 2019 24 - 26 OCTOBER CONGRESS PROCEEDINGS INNO VATION IN ACTION - AOPA
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National Congress 2019 INNOVATION IN ACTION 24 - 26 October Congress Proceedings
Acknowledgements
EXHIBITORS
AbilityMade Hy5 Maurice Blackburn Lawyers
Unit 1, 124 Regent Street JP Stewart Level 21, 380 La Trobe Street
Redfern NSW 2016 Fresh Medical Melbourne, VIC 300
Melissa Fuller +61 477 888 633 Simon Arsenis
hello@abilitymade.com jp@freshmedical.com.au SArsenis@mauriceblackburn.com.au
0405 942 267 1800 305 568
Konica Minolta
Advanced Surgical Amputee 4 Drake Avenue, Macquarie Park, NMO
Program (A.S.A.P) NSW, 2113 1846 Dandenong Rd
Alfred Hospital - The Plastic, Hand 02 8026 2339 Clayton, VIC 3168
& Faciomaxillary Surgery Unit Drew.Mackinnon@konicaminolta.com.au Paul Sprague
55 Commercial Rd, Melbourne VIC 3004 paul@neuromuscular-orthotics.com.au
outpatient@alfred.org.au Massons Healthcare 1300 411 666
03 9076 2025 Unit 15/111 Lewis Rd
Knowxfield, VIC 3180 OAPL
Department of Veterans’ Affairs Anton Karak 29 South Corporate Ave
(DVA) info@massonshealthcare.com.au Rowville VIC 3178
GPO Box 9998, Brisbane, QLD 4001 03 9898 0011 Jordan Ellis, Tomie Pfeiffer
Falene Rabjohns info@oapl.com.au
providerengagement@dva.gov.au Medi Australia Pty Ltd 1300 866 275
1800 555 254 83 Fennell St
North Parramatta NSW 2151 OPC Health
Evok3D Kylie Latu 151-159 Turner Street
43-45 Canterbury Rd kylie@mediaustralia.com.au Port Melbourne VIC 3207
Braeside, VIC 3195 pcoleman@opchealth.com.au
Joe Carmody Momentum Health 03 9681 9666
Joe.carmody@evok3d.com.au Technologies
1800 386 x2000 Traeger Court Business Park Orthomedico
6/28 Thynne Street 2/320 Curtin Ave West
Head to Foot Orthotics Bruce ACT 2617 Eagle Farm QLD 4009
39 Centre Way Richard Goward, Deb Smith
Croydon, VIC 3136 Nigel Freeman info@orthomedico.com.au
Tim Jarrott, Steve Joseph info@momentumht.com.au 1300 309 633
tim@htfo.com.au 02 6210 0060
03 98702284
2 AOPA | Congress Proceedings 2019
Acknowledgements
EXHIBITORS SPONSORS
Össur Australia CAFE TECHNICIAN WELCOME EVENT
26 Ross Street Össur Australia Ottobock
North Parramatta NSW 2151 26 Ross Street Suite 1.01 Century Corporate Centre
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jhalavaka@ossur.com Jayden Halavaka Baulkham Hills NSW 2153
02 8838 2800 jhalavaka@ossur.com Nat Kenyon
02 8838 2800 Nathaniel.Kenyon@ ottobock.com.au
Ottobock 02 8818 2800
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Australia Cascade Dafo, Inc Suite 1.01 Century Corporate Centre
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Lauren Fritzen Nat Kenyon
Taska laurenf@dafo.com Nathaniel.Kenyon@ ottobock.com.au
10 Nelson Street, 02 8818 2800
Riccarton, Christchurch 8011 Student Welcome event
New Zealand Ottobock
James Williams Suite 1.01 Century Corporate Centre
james.williams@taskaprosthetics.com 62 Norwest Boulevarde
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0409 699 302 / 1300 369 096 02 8818 2800
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3 AOPA | Congress Proceedings 2019
Welcome from 2019 AOPA Congress
On behalf of the Australian Orthotic Prosthetic Association (AOPA), it is my pleasure Congress Committee Members
to welcome you to the 9th AOPA Congress.
Jess Fox (Congress Convenor)
In 2019 we have increased our number of the highly successful workshops to allow delegates increased choice Lecturer Prosthetics & Orthotics
in their ability to engage in hands-on learning from the first day of the congress. This year we are featuring La Trobe University
14 workshops covering a broad range of topics and solutions, allowing attendees to explore the latest in
composite KO’s and KAFO’s, digital modelling, upper limb solutions, 3D scanning sytems, – to name but a few. Bronte George
Senior Orthotist
The main aim of the AOPA Congress is to provide an opportunity for all attendees to embrace learning from OAPL
a variety of general and specialist interest topics. The theme of the 2019 Congress is ‘Innovation in Action.’
This will feature in our two keynote addresses. Donna Markham will discuss how best, we as an industry, Timothy Muling
build a workforce for the future. Dr James McLoughlin will explore a theoretical frameork that utilises current Senior Orthotist
knowledge of motor control behaviour that aims to assits and enhance the design of rehabilitation strategies The Sydney Children’s Hospital
for gait and balance. These keynote presentations will be complemented by 64 conference presentations
and workshops – our biggest yet. There are further networking opportunities for all delegates provided by Meleita Finnigan
the exhibitor trade displays, corridors, hallways and coffee venues as well as the conference dinner. The 2019 Prosthetist/Orthotist
Congress program is extensive and will allow attendees to explore areas of interest and seek ideas from outside The Royal Children’s Hospital
of their own specialties.
Peter Kneebone
The ever evolving innovative technology within O&P coupled with the changes in funding strategies indicates Orthotist
progress and carries exciting opportunities for all. The responsibility lies with each one of us to embrace these Orthokids
opportunities and understand their potential impact. By developing new skills and adapting our working
environments we can harness the resources at our disposal to truly put innovation in action! Ongoing learning Dr Sarah Anderson
and development is vital so that we, as a profession, can continue to provide consumers with the best options Prosthetics and Orthotics Discipline Lead
available while enabling us to work safely and effectively in our workplace. La Trobe University
The AOPA Congress would not be possible without the support of our exhibitors and sponsors. Please spend
some time over morning tea, lunch and afternoon tea visiting the stands and learning about the exciting
developments in technology that are on offer.
Finally, a sincere thank you to members of the AOPA office and the Congress Convening Committee. The team
have spent many hours, days and weeks working to ensure that the 2019 Congress is a successful, enjoyable
and exciting event for all. We hope you leave with new ideas and thoughts for your future, inspired by insights
into products, materials and techniques that you can implement into your workplace in order to improve clinical
outcomes for the consumers of the O&P profession.
Jess Fox
2019 Congress Convenor
4 AOPA | Congress Proceedings 2019
KEYNOTE SPEAKERS
Donna Markham Dr James McLoughlin
Chief Allied Health Officer Neurological Physiotherapist
Safer Care Victoria A/Prof Flinders University
Donna is a qualified Occupational James McLoughlin is Director of
Therapist and has worked in healthcare Advanced Neuro Rehab, a neurological
for more than 17 years. Donna has led & vestibular rehabilitation clinic in
many significant allied health reforms, Adelaide, in addition to Associate
workforce development changes, and Professor at Flinders University. James
research projects. She is a mum of two has degrees in both physiotherapy &
boys and advocates for the important clinical neuroscience in addition to a PhD
role women play both at home and in researching gait & balance.
the workplace, particularly in executive
leadership. James has extensive clinical experience,
in addition to a strong background
Donna has worked in both public and in clinical teaching for both university
private health in a variety of senior programs and professional development
management and leadership roles, and was a finalist for the Telstra Victorian Young courses. James has a particularly strong interest in motor control and its role designing
Business Women’s Award in 2014. Donna is a graduate of the Williamson Community innovative physical rehabilitation strategies.
Leadership Program and the Australian Institute of Company Directors. She has an
adjunct academic appointment at Monash University.
5 AOPA | Congress Proceedings 2019
PROGRAM – THURSDAY 24TH OCTOBER
Conference Hall 1 (capacity 50) Conference Hall 2 (capacity 50) Conference Hall 3 (capacity 50) M 11 (capacity 40) M 12 & 13 (capacity 40) M 14 M 15 & 16
Workshop 1: Workshop 2: Workshop 3: Workshop 4: Workshop 5: Technician Student
Optimised Design and Technology of Look up Orthotist! Integrating digital modelling into lower What’s new in FES technology – a hands on workshop New innovations with Touch Solutions Stream Stream
Composite KO’s and KAFO’s Hosted by: NeuroMuscular Orthotics limb orthotic prescription Hosted by: OAPL Hosted by: Össur Hosted by: Hosted by:
Hosted by: OPC Health Presented by: Presented by: Jon Naft, Priya Armstrong, Hosted by: Ability Made AOPA AOPA
9:00 – 10:30 This workshop will give attendees the opportunity to try An overview and update of Touch Solutions, with practical
Dave Buchanan Ashleigh Jorgensen 3D scanning and digital modelling offer the latest in upper and lower limb Functional Electrical demonstrations featuring a new wrist option with smart
This workshop will be split into two The MyoPro is a powered orthosis the ability for increased customisation Stimulation technology. Learn how to use it, when to use it control technology.
separate sessions: The Knee Bracing designed to restore function to upper for the orthotics industry. This hands-on and how you can incorporate FES into your clinical practice.
technology will reflect on the geometry limbs affected by neurological conditions workshop will demonstrate the advantages
MORNING TEA of the anatomical knee joint, mechanical such as stroke, brachial plexus injury and of photogrammetry digital scanning
joints and the Rotor Study details and a cerebral palsy, providing a new upper compared to structured light scanning. Workshop 6: Workshop 7:
focussed KAFO section discussing the use limb orthotic management option for Participants will learn how digital Functional Solutions for Finger Amputees So you fell off a ladder, now what? An overview of orthotic
of unique knee joint geometry aligned Orthotists. modelling can be integrated with a management of common spinal injuries in an acute
with compositie properties to provide Hosted by: OAPL, Presented by: Aislinn Wyatt
This hands on workshop will showcase unique clinician prescription and see traumatic setting
a lightweight and clinically effective MyoPro design features, prescription demonstrations on the advances in material The partial-hand amputee population (predominantly
treatment, often bypassing the need to working-age men) has historically been underserved by Hosted by: Össur in collaboration with Alfred Health
11:00 – 12:30 criteria & software optimisation. properties for AFO design.
use other joint systems. prosthetics, often due to a lack of awareness of available Presented by a leading orthopaedic surgeon and orthotist
functional solutions. This workshop will discuss partial-hand from Victoria’s foremost trauma hospital, this workshop
solutions, indications for candidacy, and how NP prostheses, will cover the role of the orthotist, prescription considerations
in particular, are designed with this population in mind. and case studies and will conclude with a practical workshop
Including a hands-on demonstration of product education, based on Össur’s spinal portfolio.
patient intake, and device adjustments.
LUNCH Served in the Exhibition Hall
Workshop 8: Workshop 9: Workshop 10: Workshop 11: Workshop 12:
Smart Solutions for Upper Limb Enhancing patient outcomes through Stance control knee orthoses– an overview Evolving past the “stone” age How will the C-Brace: Second Generation improve your
Prosthetics lower limb orthotic innovation of principles, assessment techniques, Hosted by: Vorum and Momentum patient’s safety and independence?
Hosted by: OAPL Hosted by: NeuroMuscular Orthotics patient selection and keys to success Hosted by: Ottobock
Plaster is quickly becoming a thing of the past. Learn how you
OAPL and Motion Control, a division of Presented by: Paul Sprague and Darren Hosted by: Head to Foot Orthotics can utilise CADCAM and central fabrication to advance your With improvements in functionality, design and user
1:30 – 3:00 Pereira Presented by: Flora Versyk -
Fillauer, has the technology for even the practice or start your own service. friendliness, the C-Brace has been transforming the lives
most complex upper limb patients. Learn Presenters will share their expertise and Physiotherapist / Orthotist, Basko of many patients with lower limb paresis/paralysis. This
Healthcare, Netherlands How to’s for:
about the lightweight, body-powered showcase advanced tips/tricks using • Analysing costs; workshop will educate attendees about the advancements in
NEXO, Motion Control Myoelectric systems the Posterior Dynamic Element (PDE) in Do you shudder when you hear the phrase • Implementing Technology and; KAFO technology and who exactly can benefit from it.
with iOS interface, Utah Arm U3/U3+, and GRAFOs, including recreational use, cast ‘Stance control orthosis’? No longer – as • Considering fabrication services.
the innovative COAPT Pattern Recognition techniques and heel height options. an attendee you will gain all the tools
AFTERNOON system in this holistic workshop on Part 2 will focus on prescription, fitting necessary to gain successful outcomes.
TEA complete upper limb systems. & fine tuning of the XFT-G3 Functional We’ll provide a specific insight into the
Electrical Stimulation Orthosis. clever design of the SPL2, technical Workshop 13: Workshop 14:
tips and hands on practical experience. The worlds first truly weight bearing 3D scanning system for Massons Healthcare & WillowWood® Advanced Technology
Rehabilitation skills for assessment and trans-tibial amputees: Symphonie Acqua System DIGITAL Applications, Product and Research Developments
training will also be taught.
Hosted by: Ottobock Presented by: Andreas Radspieler Hosted by: Massons Healthcare
(Founder & CEO – Romedis GMBH) Massons CAD CAM technologies for O&P applications,
3:30 – 5:00 Using Magnetic Field Tracking, the worlds most advanced such as OMEGA® and Voxelcare will be discussed, along
casting system is now available in a plaster free solution, with the integration process and the various orthotic and
allowing fabrication of a 3D printed socket (or carved model) prosthetic device fabrication options at our Melbourne central
direct from the client scan. This workshop will introduce the fabrication facility, including FIOR & GENTZ AFOs and KAFOs.
Symphonie Acqua System, the Symphonie Acqua System WillowWood’s prosthetic research about socket motion, limb
Digital and the unique Symphonie Predictive Software. health, socket design and the impact on the amputee will
also be discussed.
6 AOPA | Congress Proceedings 2019
PROGRAM – FRIDAY 25TH OCTOBER
Time OPENING PLENARY
8:00 am Registrations Open
8:50 am Opening and Welcome Address
9:15 am Keynote address: Donna Markham, Chief Allied Health Officer, Safer Care Victoria – Building a workforce for the future
10:20 am MORNING TEA
11:10 am Building a workforce for the future: Education Innovation in prosthetics 11:10 am
Cultural competency training so graduates can provide a culturally sensitive and safe
Dr. Michael Dillon Rebecca Bowes Transtibial fitting complicated by polyostotic fibrous dysplasia and hypophosphataemic rickets: a case study
clinical service
Disability isn’t your source of inspiration: exploring how we teach disability culture in Developing a prosthosis to enhance artisitic capabilities: a complex case study with hemiparesis and
Beatrix White Kate Patton
university congenital limb deficiency
Adam Holden / Ben Lucas Prosthetics and Orthotics at USC: curriculum and developments Breanna Cramer Prosthetic foot design for rock climbing: a pilot study
More than funding: a critical review of the impact of the NDIS on changing perspective
Anthony Francis Jeremiah Vella The development of a low cost expulsion valve for developing nations
and practice as a basis for developing educational curriculum
More than fabrication: embedding digital technologies to improve clinical decision
Nathan Collins Phil Parish Design and deliver: innovation for para-cycling
making in Prosthetic and Orthotic education
12:30 pm Lunch
1:30 pm Innovation in paediatric orthotics Innovation in prosthetic research 1:30 pm
Ruth Baker Reducing variation in the management of DDH in children aged 0-6 months Dr. Sarah Anderson Experiences of a mobility clinic for people with limb loss
Elizabeth Tori Orthotic management of caudal regression syndrome in a paediatric patient Dr. Eliza Goddard A survey on what Australians with upper limb difference want in a prosthesis
Simon Lalor To helmet or not to helmet: a longnitudinal study of the asymmetric head Phoebe Thomson Symes amputation: is there an ideal limb length discrepancy?
3D helmet therapy in plagiocephaly - factors influencing predictability of reduction in
Ken Shaw Dr. Laurent Frossard Cost-effectiveness of provision of transtibial bone-anchored prostheses: the Queensland experience
cranial asymmetry
Koray Kilic Environmental and dynamic testing of 3D printed Ankle Foot Orthoses Leigh Clarke Health economic evaluation in prosthetics: a systematic review
2:50 pm Afternoon Tea
AOPA FORUM: When NDIS planning does not go to plan
3:40 pm
(Proudly supported by Maurice Blackburn Lawyers)
5:00 pm Close
5:15 pm AOPA AGM
6:30 pm Ottobock pre-dinner drinks
7:00 pm Congress Dinner. Proudly sponsored by Ottobock
7 AOPA | Congress Proceedings 2019
PROGRAM – SATURDAY 26TH OCTOBER
Time OPENING PLENARY
8:00 am Registrations Open
9:00 am Welcome
9:10 am Keynote address: Dr James McLoughlin, Neurological Physiotherapist, A/Prof Flinders University
10:20 am MORNING TEA
11:10 am Building a workforce for the future: Practice Innovation in prosthetic technology 11:10 am
Dr. Wesley Pryor Leadership for P&O in South East Asia Kodie Feher Predicting residual limb volume stabilisation: retrospective case note audit (pilot)
Orthotist/Prosthetist competency assessment using a portolio method: an
Louise Puli Mahboobeh Mehdikhani A new computer program for gait training of people with lower limb prostheses
exploration of reliability
Peter Kneebone The value of mentors and peers in transitioning from graduate to practitioner Alireza Mohammadi Paediatric soft bionic hand for children with upper limb loss
Characterisation of anthropomorphicity of transtibial bone-anchored prostheses: can we assess if a
Nigel Freeman Experiences of starting a new business in O&P Dr. Laurent Frossard
prosthetic foot behaves like a sound foot?
Implementation of orthotics Allied Health Assistant (AHA) competency package - fit
Fiona MacManus Raphael Mayer Repeatablity of 3D scanned transradial stump-sockets
and supply of prefabricated orthoses
Using scientific data to support NDIS applications: a case study on advanced
Marta Geada David Lee-Gow Intuitive control: upper limb prosthetics. what does this really mean?
components for a transfemoral bone-anchored prosthesis
12:45 pm Lunch
1:45 pm Innovation in orthotics International perspectives in O&P 1:45 pm
The effect of a mechanical stance control orthosis in an early stage of rehabilitation in Dr. Natasha Layton Global Report on effective access to Assistive Technology: The GReAT Summit 2019
Flora Versyck
order to improve standing, walking and activities of daily living Louise Puli Supporting national self-regulation of assistive technology practitioners through an international framework
Hannah Keane Identifying service gaps relating to vascular admissions for plantar ulcerations Dr. Wesley Pryor Unmet needs in an untapped market
Combined prosthetic and orthotic service delivery model with input into high risk
Sean Gray Jessica Landers The AOPA and NZOPA international collaboration: the NZOPA Education Portal
diabetes clinics
Jon Naft Clinical outcome measures for myoelectric upper extremity orthoses Rowan English Delivering prosthetic and orthotic services in a war zone
2:50 pm Afternoon Tea
3:40 pm CLOSING PLENARY: Supporting participants and practitioners
Dr. Natasha Layton / Melissa Noonan / Jackie O’Connor – My Assistive Technology Outcomes Framework - a collaborative tool for AT users and their practitioners
David Sinclair – Implications for participants and practices: the NDIS Quality and Safeguards Commission
Leigh Clarke – Application of the NDIS low cost AT code
David Sinclair – A summary of current TGA consultations
4:40 pm CLOSING CEREMONY
8 AOPA | Congress Proceedings 2019
EXHIBITOR SPACE
Café Össur Australia
Super A Össur Australia
Super B Ottobock
1 2 3 4 5 6 7
1 Konica Minolta Loading
Doc 3
2 Department of Veteran’s CATERING CATERING
Affairs
8
3 Maurice Blackburn Lawyers 17 16 15 19 18
4 Hy5 12 13 14 20 21 4m
CATERING
Össur
5 Evoke 3D Australia
Media
Wall
6-7 Massons Healthcare
Össur Café
8 AbilityMade START Ottobock 9
foundation lounge
9 Orthomedico
Entry
Entry
10 Ottobock Planning,
CATERING CATERING
Equipment & Materials
R
O
AT
L1
12 Medi Australia
L
CA
VE
27 26 25 24 22 10
ES
LE
13-16 OAPL
TO
17 Advanced Surgical Amputee Entry
Registration
Programme (ASAP)
18-21 OPC Health
22 NeuroMuscular Orthotics FOYER
2 X 3m Booths
24 Taska Prosthetics
25 Momentum Sports & 2 X 4m Booths
Rehabilitation Services
26 Urgoform
27 Head to Foot Orthotics 5 Meters
Available Booth
9 AOPA | Congress Proceedings 2019
Friday 25th October 2019
Opening address and Welcome Building a workforce for the animations and films, quizzes, and people telling
future: Education real stories, as well as an in-depth cultural atlas2 that
Keynote address provides country/cultural specific information such
Cultural competency training to ensure as expectations of modesty that extend the general
Building a workforce for the future graduates can provide a culturally sensitive and principles taught in the training program.
Donna Markham safe clinical service
Results
Chief Allied Health Officer, Safer Care Victoria Michael P Dillon1, Sarah P Anderson1 The course has been introduced as part of the usual pre-
Ms Markham will deliver the opening keynote address
1
Discipline of Prosthetics and Orthotics, Department clinical placement workshops for final year prosthetic/
titled “Building a workforce for the future”. This keynote of Physiotherapy, Podiatry, Prosthetics and Orthotics, orthotic students. Having completed the face-to-face
address will explore current allied health workforce and School of Allied Health, La Trobe University, Melbourne introduction prior to placement, students complete the
career pathway challenges, the changing practitioner online training while on clinical placement through the
Background
demographic and the future role and competency university’s Learning Management System. In this way,
La Trobe University requires all commencing students students are able to undertake this study and reflect on
requirements for allied health. Ms Markham has an
to complete an online program - Wominjeka La Trobe: their experiences working with cultural and ethnically
inspiring leadership journey to share and will challenge
Indigenous Cultural Literacy for Higher Education - diverse groups typical of Australia’s multicultural
us to consider how we can contribute to advancing the
which introduces Indigenous Australian history, culture population at the time they are most engaging.
orthotic/prosthetic profession in Australia.
and customs. The course emphasises the importance of Students participate in a second face-to-face workshop
a rich and relevant cultural heritage and makes the link after clinical placement where they are able to reflect on
to the broader graduate competency of cultural literacy. and discuss their encounters and experiences while on
The course helps students critically reflect on their own placement; thus extending their learning experience.
attitudes, values and beliefs.
Discussion and Conclusion
Aim
Embedding the SBS Cultural Competencies training
To broaden the cultural literacy of graduates such program has provided prosthetic/orthotic students with
that they can work with people from diverse cultures access to a high-quality curricula to develop the cultural
reflective of Australia’s multicultural population. competencies needed to work with a culturally diverse
population typical of Australia’s multicultural society,
Method
and thereby meet the requirements set forth by the
The Cultural Competencies training program1 is an Australian Orthotic Prosthetic Association’s Entry-Level
online or blended training course developed by SBS Compentancy Standards3.
in concert with Multicultural New South Wales, the
Australian MultiCultural Foundation, and International References
SBS (2019) https://cultural-competence.com.au/home
Education Services. The course features multimedia SBS (2019) https://culturalatlas.sbs.com.au/intro
learning modules that explore topics including: cross-
cultural communication, addressing stereotypes,
unconscious bias, diversity and the benefits of
multiculturalism in the workplace. The course includes
10 AOPA | Congress Proceedings 2019Friday 25th October 2019
Disability Isn’t Your Source of Inspiration: and the way I interact with the world around me. It is an So, this statement from a fellow P&O student started me
Exploring how we teach Disability Culture in integral part of my life. The exposure to disability culture thinking: What are we NOT teaching future healthcare
University has influenced the paths I’ve taken in life and it is a professionals about disability culture?
culture I am very passionate about.
Beatrix White I love my university and I love the course I am studying. I
4th Year Clinical Masters of Prosthetics and Orthotics Now, I know that my friend had the best intentions, and love what I am taught every day and I believe there is no
Student, La Trobe Univeristy I believe this is a pretty common way to express your other place I would want to learn P&O. However, there is
support of people with disabilities amongst people in one gaping hole in the curriculum that, as a person with
Introduction the community. However, the word ‘inspiring’ is a tricky a disability, I just cannot over look. And that is the way
One afternoon earlier this year I was sitting outside the one. I feel like it is often meant to be a compliment, but we’re educating students about disability culture.”
Health Science Clinic at university with some fellow P&O often it just comes across as patronising.
My presentation will explore what disability culture
students and we were engaging in a deep conversation
Let me ask this: When referring to a person with a is and the current curriculum surrounding disability
about our course. We were all talking about our hopes
disability as ‘inspiring’, if you take disability out of the culture in P&O. I will suggest how the curriculum needs
for the future and where we wanted to end up (in the
equation, what about that person is ‘inspiring’? to further challenge stereotypes and misconceptions
ideal world, of course).
students have around disability. I will further elaborate
If you were to describe an able-bodied person as on past work I have done to re-educate staff at the Royal
Suddenly the conversation switched to talking about
‘inspiring’ for getting out of bed in the morning, it’d Children’s Hospital Melbourne through my roles as the
people with disabilities. One of my friends piped up and
be patronising and a little uncomfortable, right? But Chair of the Youth Advisory Council and member of
said something along the lines of: “I was talking to a
experiencing disability makes this statement suddenly the Family Advisory Council and Community Advisory
friend the other day and they said how sad it must be to
acceptable? Council. Re-educating staff is one of the projects I
work with people with disabilities. To which I said: I don’t
find them sad at all. If anything, I find them inspiring.” worked closely with and it focused on how staff speak
And sure, there are people with disabilities who are
to patients; allowing patients autonomy over their own
inspiring in their own right. Dylan Alcott, the world
I know she meant to talk about disability in a positive healthcare outcomes; and treating the patient, not just
champion wheelchair tennis player, is inspiring for his
way by trying to explain how disability isn’t ‘sad’. But it their disability or illness. This has been a focus for my
performance, but not because of his disability.
is this word “inspiring” that I want to highlight. I have councils for the past few years. The outcomes show
heard it before in relation to describing people with Buying into the dichotomy of disability as either being that awareness of disability culture is not widespread
disabilities, countless times. I have even been described a sob-story or an inspiration; pitied or placed on a amongst health professionals, however it can be
this way. And I hate it. pedestal, is unhealthy and dehumanising. Where is the learned. Finally, I will suggest that disability culture
middle ground where people are just human? Because needs to occupy a larger platform in our course as the
Now, I am a person with a disability. I have severe university restructures our curriculum.
often people with disabilities are just using their bodies
scoliosis, two spinal rods, squashed lungs, and I’m 4’8
to the best of their ability. This dichotomy isn’t for the
(meaning I have to climb supermarket shelves just to
benefit of the person with the disability, but for their
reach the self-raising flour). I’ve been this way my whole
able-bodied peers to feel good about themselves for
life and with 19 spinal operations in total, I am tough as
saying so. As students who are going into to be working
hell, but I’m not ‘inspiring’.
so closely with people with disabilities, I believe more
Since I was a child, my whole world has been wrapped should be done to educate us.
up in disability culture. It is the way I express myself
11 AOPA | Congress Proceedings 2019Friday 25th October 2019
Prosthetics and Orthotics at USC: Curriculum best practice looks like, no matter the context. These Method
and Developments three transferrable skill sets can help prepare students Subjects: A working group was initiated following
for practice today and push professionalism and the feedback from La Trobe University’s Course P&O
Ben Lucas profession into the future. Advisory Committee (CAC) to identify, review and
University of the Sunshine Coast propose effective models of preparing undergraduate
Adam Holden In this presentation, we highlight some of the curricular
students to work within the NDIS system. The working
University of the Sunshine Coast strategies used to develop these areas at USC and
group consisted of people with disability, clinicians,
discuss some of the challenges experienced and lessons
Background local areas coordinator, NDIA staff and disability rights
learned. Discussion includes ways that USC is proposing
advocates.
Over the last four years, USC has been developing to engage industry more into the development of these
the program for prosthetics and orthotics. Part of the areas to improve the relevance of the curriculum for Results
development has been to focus on developing students graduate preparedness in clinical practice.
The NDIS working group initially identified 5 key skills,
to be graduates prepared for the future of not only P&O (report writing, goals and measurement, facilitating
practice, but to be valued members of the healthcare More than funding: A critical review of the
choice, ethical practice and understanding disability)
system in general. The curriculum continues to evolve to impact of the NDIS on changing perspective
and 2 complementary skills (applying rules, collaborative
focus on key areas and further work is being proposed and practice as a basis for developing
practice). These skill sets were then critically reviewed
to identify possible improvements to further align the educational curriculum to explore and identify specific examples and situations
curriculum with the graduate competencies and industry which could be applied to the learning situation of
expectations. Anthony Francis
La Trobe University undergraduate students.
Three key areas of focus for the program are: iscussion and Conclusion
D
Introduction
• interdisciplinary practice Beyond the changes to funding processes, the NDIS
• professional communication skills Our understanding of the context of disability and the
associated models of engagement with people with inherently presents an alternative model of health care
• d
evelopment of reflective practice for graduate provision based on the central role of the client in the
readiness. disability is critical to how we think, listen, talk and work
in clinical practice. The 2011 Australian government decision-making process. Feedback and interrogation of
The first area focuses on the development and productivity commission report ‘Disability Care and the areas of key importance to the NDIS model provide
challenges of incorporating a shared curriculum with support’ provided a detailed examination of the factors a basis for the development of educational resources
Occupational Therapy and through student placements related to the lived experience of disability and is to equip graduates and practicing clinicians to practice
in Interprofessional settings (e.g. podiatry, fracture foundational to our understanding of the development effectively. Development of a deeper understanding
clinics, rehab centres, etc.). Secondly, to prepare and implementation of the National Disability Insurance of the disability experience and the importance of
students for various situations in the workplace and scheme (NDIS). This presentation describes an approach empathetic and respectful engagement with consumers
with clients, communication skills are developed and to identifying and implementing a deep understanding is recommended for undergraduate training.
assessed in various ways throughout the curriculum. of the principles of the NDIS as part of La Trobe References
Lastly, reflective practice and understanding are being Universities commitment to preparing graduates for Productivity Commission Australia. 2011. Disability care and support productivity
commission inquiry report, Melbourne, Vic.: Productivity Commission
incorporated into the fabric of the program to prepare contemporary clinical practice
students to understand their role, how to critically
evaluate their own development, and understand what
12 AOPA | Congress Proceedings 2019Friday 25th October 2019
More than fabrication: Embedding digital technologies areas of Prosthetics and Orthotics have Clinical Presentation
technologies to improve clinical decision influenced the embedding of digital technologies Belinda, a 45 yo female who lives with her husband
making and outcome reporting in Prosthetic through all levels of the program curriculum. A and 5yo daughter, presented for an initial consultation
and Orthotic education framework of relating curriculum to clinical context following a left transtibial amputation due to a non-
will be addressed including examples such as AFO healing ulcer. Primary complications stemmed from
Nathan Collins alignment optimization reporting and pressure McCune Albright Syndrome (polyostotic fibrous
La Trobe University distribution management for lower limb Prosthetic and dysplasia) and hypophosphatemic rickets and included
Anthony Francis Orthotic clients. blindness, scoliosis, severe long bone deformation,
La Trobe University left knee joint malalignment of 30 degrees valgus with
Discussion and Conclusion
femoral rotation and patellectomy, multiple ORIFs,
Introduction The professional scope of practice and graduate poor healing, fragile skin and pain. Belinda had used
In a profession where technology is rapidly changing competency standards of the Australian Orthotic and underarm crutches since she was a teenager to manage
the way clinicians’ practice, educators are faced with Prosthetic Association (AOPA) provides a foundational pain as she suffered from multiple recurrent fractures.
the challenge of meeting current clinical expectations framework for curriculum development to meet the
whilst simultaneously preparing students to integrate needs of both clients and the profession. Consequently, Patient Care Plan
new technologies. Most discussion around technology the implementation of technology needs to extend Prosthetic Aims: We set the realistic goal of walking with
focuses on improved fabrication techniques, however, we beyond fabrication driven solutions to digital tools which crutches for task specific activities, rather than a primary
argue the importance of teaching and applying digital also support and enhance high level clinical decision mode of mobility.
technologies to improve the accuracy of assessment, making and outcome reporting. Further collaboration
clinical decision making and evaluation of interventions and dissemination of approaches to support the Time frame: We agreed that progressing slowly and
to assist graduates achieve the best client outcome. development of P&O training is recommended. using a considered approach to complications would
create the best opportunity for success.
This presentation aims to share our experience with Innovation in prosthetics
curriculum development that embeds and scaffolds Socket Design: Although the extreme knee angle
clinical technologies across our program with a focus on
Transtibial prosthetic fitting complicated and apparent instability warranted femoral support,
quantifying and reporting clinical outcomes to inform by polyostotic fibrous dysplasia and the location and tenderness of Belinda’s left femoral
clinical decision making and improve client outcomes. hypophosphatemic rickets: a case study hardware restricted this. It was also decided to
simplify the prosthesis as much as possible as to
Method Rebecca Bowes not overprescribe for potential complications. To
APC Prosthetics remain within funding restrictions and established
The role of Prosthetists and Orthotists in Australia has
evolved to extend beyond device provision to that Introduction considerations the initial prosthesis prescribed consisted
of informed and justifiable clinical decision making, of a silicone liner with pin suspension and carbon fibre
This case study outlines the innovations and
Consequently, our curriculum has developed to address foot, with alignment set to accommodate for Belinda’s
complications in a transtibial prosthetic fitting, due to
how technology informs our graduates ability to achieve knee angle. Using physical demonstrations and high
multiple complex pathologies, and the person centred
best practice and client outcomes. contrast iPhone photographs the cosmetic appearance
care focus that was undertaken to ensure treatment was
and function of Belinda’s prosthesis were discussed.
Iterative development informed by discussions with optimised.
stakeholders within the clinical, technical, and new
13 AOPA | Congress Proceedings 2019Friday 25th October 2019
Outcomes experienced a cerebrovascular accident resulting in left initial fitting, his usage has been limited due to a doffing
Primary prosthetic fitting side hemiparesis. limitation resulting from sweat accumulation.
was successful with Belinda
The patient was interested in receiving a custom- Discussion
being able to walk with
made prosthoses that would enable him to achieve With increased usage over a continued extended period
crutches for the first time in
his artistic goal of being able to go outside and draw of time it would help determine other benefits and
12 years. Accommodation
spontaneously, whilst holding his sketchbook in his left limitations, including whether, with future developments,
to the prosthesis did take
hand and a pencil in his right. it would be possible to achieve a stronger device that
time and was self-driven
by Belinda as no formal enabled adjustments for varying widths of pencils
The aim of this case study is to highlight the functional
prosthetic rehabilitation was and brushes. Leading to how this may influence other
impact a custom-made device can have on an individual,
undertaken. Belinda accepted individuals with similar interests.
including broadening their opportunities and increasing
the interesting cosmesis. independence. Conclusion
Donning proved difficult due
to pain when pushing into the Method Through trials an optimal outcome for this patient
prosthesis and persistent was achieved that met his functional goal, increased
Figure 1: Standing, demonstrating Multiple prototype devices were produced out of
distial tibial pain ensued. the severe genu valgus. his opportunities and independence. This is despite
varying materials and techniques; including 3D printed
This was addressed in the limited usage reported at the time of submission. It was
attachments, before a suitable design was manufactured
subsequent prosthesis where a lanyard and distal tibial gel important to consider what the patient valued during
out of Northvane that addressed his functional goal.
pad were utilised (Figure 1). Subsequent setbacks have the fabrication process to achieve this.
been experienced and continuing support provided. Proprioception was important to the patient and thus
considered when determining the optimal design. Prosthetic Foot Design for Rock Climbing; a
Conclusion Further, the cosmesis, pencil angle and location, Pilot Study
By focussing on person centred care with Belinda, her specifically between the thumb and first nubbin, to
Breanna Cramer1 and Jamie Villalon1
prosthetic journey has been a positive experience, create a natural feeling were valued. 1
La Trobe University, School of Allied Health, Human
through which she has been empowered to drive the Services and Sport
process at her own pace and influence the design and Prototype devices were trialled by the patient to
determine the positives and negatives of each to
outcomes of her rehabilitation. Introduction
achieve the optimal outcome.
Rock climbing is a sport which requires precision hand-
eveloping a prosthoses to enhance artistic
D
Results and foot-work to scale either natural rock formations or
capabilities: A complex case study with artificial rock walls. Conventional, commercially available
Each designs functionality and effectiveness was
hemiparesis and congenital limb deficiency prosthetic feet do not provide enough precision to
evaluated through patient feedback. In conjunction,
climb beyond simple beginner routes. The aim of this
Kate Patton clinician and technician experience and knowledge was
utilised to improve the outcome after each trial. The case study was to investigate design features and
La Trobe University, 4th Year Student
patient reported that the final outcome was comfortable fabricate a prosthetic foot to allow someone with a
Introduction and ideal for meeting his goal of being able to transtibial amputation greater control when climbing.
The presenting case is based on a 45 year-old artist who sketch with one hand. This led to a consequen tial
was born with a right partial hand deformity and at 6/52 improvement in his independence. However, since the
14 AOPA | Congress Proceedings 2019Friday 25th October 2019
Method in the sagittal plane, would provide smoother rock-over. We settled on a design using ABS plastic, syringe parts
Subjects: One 22-year old female with a right transtibial Its efficacy could be further evaluated by benchmarked for the valve and valve seat, stainless steel spring and
amputation. testing, robust studies and testing within a bigger two O-rings for under $4 AUD.
population.
Procedure: To gain a better understanding of the We have come to the conclusion the low cost FDM
challenges and limitations a conventional prosthetic Conclusion printers operated by diverse individuals won’t have
foot imparted, two research/planning sessions were This pilot study demonstrates proof of concept for a the abilty to deliver the volume required to effectively
conducted with the participant in an indoor climbing climbing specific prosthetic foot. implement the technology. Due to the finicky and
setting. Discussion in these sessions focused on design artisan nature of FDM 3D printing (each print is
features of both foot and socket that would better The development of a low cost expulsion valve effectively a one off component meaning reliability
enable the participant to climb. for developing nations will be difficult to maintain). This created the push to
move into injection moulding which 3D print optimised
The prosthetic foot was constructed by laminating Jerry Vella designs lend themselves to very effectively. At present
sheets of plywood together with epoxy resin. It was Freedom Prosthetics we are in contact with locally based injection moulding
shaped, then mounted on a SACH foot adaptor and companies to determine cost and design requirements.
sealed with resin, then covered in climbing shoe rubber. Introduction We already have contacts in Laos and Indonesia who
The completed foot was mounted on a pre-existing pin- It was brought to my attention by a colleague that in are very interested in trialling the valves when they are
locking socket and used by the participant for climbing developing countries and remote areas of Australia available.
both in- and out-doors. it was common for TF amputees to rely on silesian
harnesses and TES belts for suspension, this is due Discussion
Results to the expense of a suitable check valve that allows To date we have assembly tooling, dummies and the
The participant reported that the high, forward arch, donning with the use of a pull through. My colleague valve components designed and continuing work on
blunt toe, and short toe leaver of the prosthetic climbing enquired with me as to the possibility of 3D printing a designs more suitable for more exotic materials and
foot all offered increased control when climbing low cost valve. high-end printers (SLA and SLS) while we work on
compared to her standard walking foot. In addition, injection moulding production. Eventually we will have
the direct mounting of the foot to pylon, without any Method all designs publicly available with assembly and use
feature to replicate ankle movement, allowed for more I’m confident I don’t need to go into the benefits of skin instructional videos on youtube. This will enable anyone
stable and controlled transmission of force to the wall. fit sockets over harnesses and belts so my focus is on who has a 3D printer to manufacture and provide the
Use of a pin-locking liner was also reported to feel ‘more the designm development and testing of the 3D printed valve at low cost while injection moulded valves will be
secure’ and provide a greater knee flexion range when valve to date. made and distributed on a not for profit basis.
compared to the knee sleeve design of her every day
leg. I initially developed a handful of design criteria for the Conclusion
valve; waterproof, 3D printability, larger opening for low These developed low cost valves are showing a lot
Discussion cost donning aids, easily sourced low cost parts and of promise in their design and function but further
Specific features enhance performance on steep materials, additional 3D printable tooling, open source, implementation has slowed.
terrain but impede smooth gait. Future designs should optimized designs for different printers, materials or
minimize weight by applying climbing rubber only along manufacture methods.
contact zones. Additionally, a heel that is more rounded
15 AOPA | Congress Proceedings 2019Friday 25th October 2019
Design and Deliver: Innovation for para-cycling Prototype 2: aluminium custom bracket, designed sporting regulations give rise to O&P innovative design
in-house, local engineering utilised (Diag A), enabling for optimal client outcomes. Professional motivation
Phil Parish1 and Sally Cavenett1,2 socket to be attached to seat-post. to assist a sporting pursuit is readily available, the trial
1
Orthotics Prosthetics South Australia, SALHN, SA and error and process of design thinking and adding
Health 2Flinders University, College of Medicine and Challenge: Forces underestimated, bracket bends and to knowledge base can be equally used in everyday
Public Health twists. Greater power produced with design, required practise of prosthetic care.
forward translation of mount position.
Introduction Innovation in paediatric orthotics
Client A is an ex-National BMX rider who underwent Aim: Move socket forward to increase leverage on
transfemoral amputation resulting from a motor vehicle adapter at socket and seat-post. Reducing variation in the management of
accident. Recovery goals included return to cycling. DDH in children aged 0-6mths. A quality
 
South Australian Sports Institute (SASI) identified improvement project
Paralympic potential in road and track, triggering O&P
Ruth Baker, Felicity Williams, Tim Muling,
design innovation in the pursuit of this goal.
Oliver Birke
Prosthetic brief: design and manufacture a prostheses All SCH
for cycling to meet para-cycling regulations. Design
Introduction
research resulted in limited publications, lacking in
manufacturing detail. The orthotics dept at SCH sees 3-5 new babies each
Diagram A Diagram B
week with DDH. The preferred method of management
Approach and Process is a pavlik harness, however despite good evidence to
Initial manufacture commenced with analysis of bike Prototype 3: Utilisation of carbon strut with custom support management in a pavlik, there is little evidence
set up including seat position relative to prosthetic connectors for socket support. Reductions in track to show differing outcomes if the brace is worn for 4
brim; position of knee joint height, alignment angle, and road times, National Champion and Paralympic weeks or 12 months, 8 hours/ day or 24 hours/ day.
and control mechanism. Lever arm for power transfer to selection. World Title competitor in Sept 2017 with The department saw large variation in the prescribed
pedal, and suspension to pedal were explored. resultant UCI design approval. wearing hours or duration of treatment, dependant on
referrer, so a quality project was undertaken to try and
Prototype 1: Sub-ischial socket design, single axis knee Challenge: 1.3 kg, to be reduced. Success brought reduce this variation.
joint with custom cleat for attachment. Success at SA sponsored bike with seat-post shape change from oval
Road Championships brought about the potential for to tear-drop cross-section, requiring re-design. Method
re-classification to single leg riding (no prosthesis). This The project started with a driver diagram looking at
initiated socket support designs for this classification Prototype 4: Custom-built solid toe Mod III, direct- the main drivers for the variation we were seeing, and
group. manufacture to seat-post, with mounting bracket (Diag assessing possible interventions against risk, ease of
B), using 3D print dummy. Total weight 465gm. implementation and likely effectiveness.
Challenge: Union Cycliste Internationale (UCI) rules for
para-cycling were sought for mechanical attachments to Discussion Subjects: All of the referrals evaluated were orthotic
deliver socket height, shape and angle compliant with The unique characteristics and skills we hold as management of DDH in a child aged 0-6mths.
regulations. Prosthetists enable complex problems to be solved.
Understanding prior treatments or methods, and
16 AOPA | Congress Proceedings 2019Friday 25th October 2019
Procedure: Data was evaluated for variation based orthotists are providing the same quality of care and Gans I, Flynn JM, Sankar WN. Abduction bracing for residual acetabular
dysplasia in infantile DDH. J Pediatr Orthop. 2013;33(7):714-8
on age at referral, prescribed hours in brace/day, hip giving the parents the same information. It has meant Ibrahim DA, Skaggs DL, Choi PD. Abduction bracing after Pavlik harness failure:
stability and duration of treatment. The initial variation children are receiving the same level and quality of care an effective alternative to closed reduction and spica casting? J Pediatr Orthop.
2013;33(5):536-9
was so great it could not be quantified. no matter which doctor they are seeing.
Meena S, Kishanpuria T, Gangari SK, Sharma P. Traumatic posterior hip
dislocation in a 16-month-old child: a case report and review of literature. Chin J
An algorithm was developed to guide management Conclusion Traumatol. 2012;15(6):382-4
based on % coverage and AI angle. The algorithm was A clinical decision algorithm for the management of van de Sande MA, Melisie F. Successful Pavlik treatment in late-diagnosed
developmental dysplasia of the hip. Int Orthop. 2012;36(8):1661-8
presented to the orthopaedic surgeons from CHW and DDH in children aged 0-6 mths has successfully reduced Pollet V, Pruijs H, Sakkers R, Castelein R. Results of Pavlik harness treatment in
SCH and accepted by all orthopaedic surgeons for a significant variation in management within the SCH. A children with dislocated hips between the age of six and twenty-four months. J
trial. The algorithm was placed in the clinic rooms at further research project would be warranted to assess Pediatr Orthop. 2010;30(5):437-42
SCH and using the PDSA cycle modified as needed. Borowski A, Thawrani D, Grissom L, Littleton AG, Thacker MM. Bilaterally
whether this change in practice leads to any change in dislocated hips treated with the Pavlik harness are not at a higher risk for failure.
outcomes, further down the track. J Pediatr Orthop. 2009;29(7):661-5
Data Analysis: The same data was gathered following van der Sluijs JA, De Gier L, Verbeke JI, Witbreuk MM, Pruys JE, van Royen
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Humphry S, Thompson D, Evans R, Price N, Williams P. Newborn and infant dysplasia of the hip. J Bone Joint Surg Br. 2009;91(8):1090-3
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