VI Nordic P&O Congress in Iceland - Part Two

Reception:

The Asmundur Sveinsson Sculpture Museum with its modernistic works throughout was an interesting site for the opening evening reception.
The Asmundur Sveinsson Sculpture Museum with its modernistic works throughout was an interesting site for the opening evening reception.

Ossur hosted a very nice reception at the nearby Asmundur Sveinsson Sculpture Museum. The artist built this gallery-studio-home over a period of years based on his own vision of how such a structure should be constructed. Natural light streams in through many glass windows and skylights, and reflects off the stark white walls to light the entire structure. The dome-shaped center and surrounding white concrete building seems to fit well in the Reykjavik landscape, and was a very interesting location for what might otherwise have been just another boring industry cocktail party.

Sveinsson was born on a remote farm in Iceland in 1893, studied art in Copenhagen and the Academy of Fine Arts in Stockholm, and spent three years studying and working in Paris, before returning to the capital city where he lived and worked until his death in 1929. He bequeathed his home and studio, and the modernistic sculptures in wood, metal, and concrete within, to the City of Reykjavik.

For more information on this creative artist, go to www.listasafnreykjavikur.is/Asmundarsafn/asmundarsafn.en.shtml .

Exhibit Hall:

This Japanese knee combines a hyper-stable four-bar linkage with a hydraulic swing control cylinder.
This Japanese knee combines a hyper-stable four-bar linkage with a hydraulic swing control cylinder.

Most of the exhibits contained familiar US, German, and Scandinavian technology, although it is always intriguing to see multinational companies distributing products from people who would be considered competitors in the US market. As the old saying goes, "Necessity sometimes makes strange bedfellows"....

The only unique component that I spotted was a polycentric knee with hydraulic swing phase control called the "Magic Knee", which is apparently imported from Japan. As the position of the polycentric axes suggest, this is an extremely stable knee that requires significant effort to flex, somewhat reminiscent of the TehLin designs. I always wonder about the logic of combining a hyper-stable knee with cadence-responsive swing control, since those characteristics seem somewhat contradictory.

This new glove from Centri applies an ultra-thin "clear coat" that protects against stains to the familiar PVC glove for prosthetic hands.
This new glove from Centri applies an ultra-thin "clear coat" that protects against stains to the familiar PVC glove for prosthetic hands.

I did have a chance to look in more detail at several of the Centri items since they were a local supplier at this meeting. Their new coated PVC gloves look much better in reality than in a photo, and is worth closer examination. Through a proprietary method, Centri has been able to apply an ultra-thin, clear protective coating over the traditional PVC stock glove.

The coating is actually vaporized and then deposited as an incredibly thin layer that adds only one gram of total material to the entire glove, which is good because the coating material costs several thousand US dollars for one gallon! This process was originally developed to protect electronic circuit boards, but in this prosthetic application it adds impressive stain resistance to the other well-known characteristics of PVC gloves: decent appearance, low manufacturing costs, reasonable flexibility, and good durability against abrasion or tearing. Since this "hybrid" glove is far less costly than silicone equivalents and more abrasion resistant as well, it may prove to be a very practical addition to our upper limb armamentarium.


This miniature expulsion valve from Fillauer screws into either a pyramid adapter or a special laminated housing, to provide suction suspension for upper limb and lower limb prostheses.
This miniature expulsion valve from Fillauer screws into either a pyramid adapter or a special laminated housing, to provide suction suspension for upper limb and lower limb prostheses.

Centri is now owned by Fillauer, so they displayed many of the Fillauer products as well. This was my first chance to take a close look at their micro-valve, which looks quite useful. It is a simple one-way expulsion style suction valve that can be screwed into their threaded pyramid adapter, or into a fairly small housing that may be laminated into various sockets. It should work particularly well for providing suction suspension of roll-on liners, as well as in pediatric and upper limb "push in" suction sockets.

One unique piece of software I noticed at the Nordic meeting was the Empower SMART™ program for quality assurance in the rehabilitation of transtibial and transfemoral amputees. The acronym stands for Standardized Multi-disciplinary Amputee Rehabilitation & Training.

This is a software-driven approach to coordinate five phases of prosthetic management:

  1. Pre-operative treatment
  2. Amputation and immediate post-operative treatment
  3. Active post operative treatment
  4. Prosthetic fitting
  5. Follow-up

A group of Scandinavian CPOs have developed a Quality Assurance Program for amputee management and are marketing it to P&O facilities and hospitals.
A group of Scandinavian CPOs have developed a Quality Assurance Program for amputee management and are marketing it to P&O facilities and hospitals.

Empower is a wholly owned subsidiary of OSSUR, and they have a fledgling web site at www.empower-health.com/template47.asp . The director is Catarina Löwenadler, who is a Scandinavian prosthetist-orthotist, and the employers include another CPO as well as a part-time physician.


This handy "pocket pen" contains a Semmes-Weinstein filament for testing sensation that can be unfolded in clinic whenever it is needed.
This handy "pocket pen" contains a Semmes-Weinstein filament for testing sensation that can be unfolded in clinic whenever it is needed.

I didn't have sufficient time to learn about the program in detail, but what I found intriguing was that the CPOs were trying to drive the QA process rather than waiting passively for someone else to implement such controls. It will be interesting to see if this approach proves successful in the Scandinavian world and if it is exported to other parts of the world.

Most CPOs are aware of the Semmes-Weinstein filaments that can be used to objectively determine when sensation in the diabetic foot is sufficiently diminished that the skin is at risk. One of the exhibitors was importing a clever "filament pen" that was made by a US supplier.


Scandinavian Orthopedic Laboratories is a prosthetic-orthotic facility providing clinical, research, and commercial gait analysis evaluations from their facility in Sweden. They have been using the on-site gait lab to refine the effectiveness of prostheses and orthoses for their patients, and had an exhibitor's booth offering various scientific tools to enable other CPOs to gather objective data about patient outcomes.
Scandinavian Orthopedic Laboratories is a prosthetic-orthotic facility providing clinical, research, and commercial gait analysis evaluations from their facility in Sweden. They have been using the on-site gait lab to refine the effectiveness of prostheses and orthoses for their patients, and had an exhibitor's booth offering various scientific tools to enable other CPOs to gather objective data about patient outcomes.

Perhaps the most unique exhibit at this meeting was that manned by Scandinavian Orthopedic Laboratories personnel, since it featured a full complement of gait lab software and hardware, a microprocessor-controlled step counter, remote heart telemetry devices, and other methods to gather objective data from prosthetic and orthotic patients. More information about this interesting phenomenon will follows in the summary of Bengt Soderberg's lecture, which will appear in a future Corner.



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