Institute of Orthopaedics
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- Musculoskeletal Regeneration Steering Group (MRSG)
ASPIRE Centre for Rehabilitation Engineering and Assistive Technology (CREATe)
ASPIRE Training Center in Stanmore
Dr Rui Loureiro email address to follow shortly
Dr Tom Carlson: email@example.com lecturer
Dr Anne Vanhoestenberghe: firstname.lastname@example.org lecturer
Dr Susan Alexander
Dr Catherine Holloway
This research group investigates the basic science of movement, not just in humans but many species. By understanding the underlying mechanisms of movement, and the extremes in performance that different species have evolved, the Centre can also develop ways to maximise performance in humans through conditioning and training. The team have developed a wide range of performance measuring devices that can be used in the field to study the movements of animals ranging from ostriches to kangaroos to elephants, in their natural environments. The technologies they have developed are now being used to study the challenges faced by people with disabilities in our built environment. These technologies can also be used to enable people to live independently and safely at home in so-called "Smart Houses".
Disability Biomechanics and Systems Integration
A key focus of this group is the prevention of secondary complications of disabilities, particularly spinal cord injury. The Centre has four main areas of research at present:
Pressure ulcer prevention
Although people with spinal cord injury face particular risks for developing pressure ulcers, this problem is in fact much larger, with as many as 20% of inpatients in district general hospitals throughout Europe and beyond experiencing pressure ulcers. The ACDS team is tackling the problem on several fronts:
- Development of new methods for measuring the properties of cushions and mattresses and understanding how these properties influence pressure ulcer risk. Recent work has included using a new technology (radiographic stereo analysis, RSA) for modelling the internal stresses within cushions and tissues so that the effective of particular materials and designs can be accurately predicted.
- Using advance pressure mapping and spectroscopic methods assess how the configuration of profiling beds and tilt in space wheelchairs affect vulnerable tissues.
- Using new opto-electronic technologies we are developing methods for assessing pressure ulcer risk so that resources can be directed to help patients at greatest risk for developing pressure ulcers.
Immediately after a spinal cord injury, bone density begins to diminish below the level of injury. The loss can be as great of 40% a year or two after injury. Research at ACDS is investigating the underlying mechanisms to determine whether in addition to inactivity, changes in blood flow to the bone associated with spinal cord injury, influences the rate of bone density loss. In an initiative led by the past ASPIRE Chair, Professor Ferguson-Pell, ACDS in collaboration with UCL and RNOH has created a unique facility for studying bone density using a combination of DXA and pQCT scanners. ACDS research physiotherapist, Zillah Bloomer, is currently studying the effects of vibration and intermittent pneumatic compression to determine if they modify bone blood flow and the rate of loss of bone density in newly injury people with spinal cord injury.
Over-use injuries associated with wheelchair propulsion
ACDS has created a unique in UK facility for the measurement and assessment of wheelchair users and their carers. There is extensive evidence that shows that prolonged over-exertion during wheelchair propulsion can result in chronic damage to the shoulder joint and other structures. The research team, which includes clinical researchers Lynne Hills (OT) and Lone Rose (PT), have developed new ways to assess whether individual wheelchair users are excessively stressing their upper limbs. They are investigating measures to reduce the risks of injury associated with long term wheelchair use. Studies are also underway, led by research PT Helena Palmer, to investigate whether children with spinal injuries are generating even higher stresses in their shoulder that adults, due to their lower strength and, in relative terms, the greater proportion of the weight they have to propel associated with their wheelchair.
PhD student Catherine Holloway, working with Professor Nick Tyler (Head of Civil Engineering at UCL), is studying how to improve the safety of carers and wheelchair occupants where the carer is propelling the wheelchair. There are significant risks for accidents in the built environment when wheelchair is pushed by a carer. These studies are identifying the risks and how to reduce them by improving the design of the built environment and also the design of carer-propelled wheelchairs. Central to this work is a simulated pedestrian research lab called PAMELA, that has been established by UCLs Civil Engineering Department.
Measuring muscle activity and composition
Measurement of muscle activity at complex structures such as the shoulders presents particularly challenging problems because the muscles are small, interwoven and deep within the joint structures. Traditional EMG is very limited for measuring muscle activity in these situations as the surface electrodes are too big to detect each muscle uniquely. Wire electrodes are invasive and may not give clear information about the functioning of the whole muscle, only perhaps muscle tissue in the immediate vicinity of the fine wire. Research student Liping Qi is studying a new technique for measuring muscle activity call acoustic myography. Minute microphones are used to "listen" to the stretching of the muscles, The sounds they make when analysed using a sophisticated technique called wavelet analysis may provide much better spatial discrimination of individual muscles and also give an insight into the mix of different muscle fibres that influence the power and endurance of the muscle.
Technologies for living independently
The developed world faces rapid growth over the next 30 years in the number of elderly people and a decrease in the number of younger people to care for them. There is intense interest in the development of Assistive Technologies that can enable frail elderly people to live independently and safely at home. Professor Ferguson-Pell has worked closely with NHS Innovations London to fund a new centre in East London (AT Care) that will be a national centre for the design and development of assistive technologies. AT Care has attracted substantial interest from companies like BT, IBM, Intel and O2 all of which have an interest in the backbone infrastructure to support assistive technologies including Smart Homes, Tele-rehabilitation, Tele-care and Tele-medicine. Substantial funding is being provided by the London Development Agency to support the development of AT Care and ACDS is providing a leading role in its development.
Motion Analysis Laboratory
ACDS in conjunction with the RNOH supports the operation of a state of the art motion analysis laboratory that specialises in the measurement of movement for clinical purposes. A central role of the Motion Lab is the measurement of walking in children with cerebral palsy. The measurements obtained are used to plan surgeries that can significantly improve walking and movement development in these young children. Recently RNOH Spinal Injury Unit consultant Dr Angela Gall has undertaken studies to determine whether Motion Analysis techniques can be helpful in the planning of Botox injections improving walking patterns in some incomplete injury spinal cord injured patients.
Page last modified on 20 jan 14 10:56