Reviewed on 3/4/2020 (unchanged since 26/3/20)

Dear Stakeholder,

We are all acutely aware of the fast-moving situation developing with the COVID-19 pandemic and the restrictions it places on our daily lives.

As a healthcare service provider, we at Pace Rehabilitation take our patient care; staff well-being; and social responsibility very seriously. We continue to monitor and follow the guidance from Public Health England (PHE).

Importantly, both our sites remain operational but with limited capacity. Based on PHE guidance, we have developed and implemented protocols for social distancing, infection control and pre-appointment screening of patients.  Clinical, technical and administration resources remain in place to support patients deemed to have a medical need to attend and that pass our pre-attendance screening process.  Remote consultations and assessments are used where appropriate to maintain patient support.

Our regular activities are of course extensively disrupted but we remain as keen as ever to work with our stakeholders in the best way possible.  To that end, we encourage patients, case managers, solicitors, insurers and anyone else who works with us to keep in touch by phone and e-mail in order to maintain some momentum and plan a return to normal activities as soon as possible.

For further information regarding Pace’s current operational status and the protective measures that are in place, please do not hesitate to get in touch with me via our regular switchboard numbers or e-mail my colleague Scott Richardson on srichardson@pacerehab.com.

With our very best wishes,

Toby Carlsson

Managing Director

Phantom limb pain is a debilitating condition that commonly affects individuals after amputation.

At Pace we are excited to announce we are now offering Neuromotus treatment.

What is Neuromotus?

Neuromotus is a treatment technique used to reduce the symptoms of phantom limb pain. Phantom limb pain (PLP) is a debilitating condition that affects 50-80% of amputees ^[1,2]. Its presentation is unique to the individual with varying intensity, pain description, duration and frequency but it often negatively impacts on a person’s quality of life ^[2,3].

There are many treatment options for phantom limb pain, for example; pharmaceutical (pain medication), mirror therapy, acupuncture, invasive surgery and psychological approaches such as hypnotherapy ^[1]. Most of these have been proven to reduce pain however, from clinical experience, no one treatment seems to suit all.

Neuromotus is a new non-invasive treatment option which instead of relying on visual imagery to create an illusion of the absent portion of limb, (as with mirror therapy) it uses a concept called phantom motor execution ^[3]. Phantom motor execution is the process of moving the phantom limb by activating the appropriate motor area of the brain through muscular activation in the residuum ^[3].

Who is it for?

Neuromotus is appropriate for any level of amputation, upper or lower limb, providing you have the ability to contract muscle in the residuum.

How does Neuromotus work?

Small electrodes placed on the skin over specific muscle groups in your leg or arm detect muscle signals controlled by the motor area of your brain and allow you to take control of a virtual limb on the computer screen and start to re-train the movements. It is believed that re-establishing this link between the brain and the movement of your phantom limb can have a positive effect on reducing the intensity of your PLP.

The first clinical trial showed a 47% reduction in overall PLP, 43% reduction in intrusion of PLP on day to day activities and 61% reduction of sleep disturbance after 12 treatment sessions ^[4]. These results were based on upper limb amputees but there is an ongoing research project replicating this study with the inclusion of lower limb participants.

Pace Rehabilitation Neuromotus Treatment Packages

We can offer three treatment packages, following an initial assessment and will guide you as to which suits you best.

It takes time for the treatment to influence the phantom limb pain therefore you need to ensure you can commit to a minimum of once weekly treatment prior to starting.

How to find out more

To find out if you are suitable or to book in for a telephone triage please contact us on either 0161 428 5500 (Bredbury) 01494 790 490 (Amersham) or alternatively via email at: info@pacerehab.com

A PDF version of this information can be viewed HERE.

Further information can be found at: https://integrum.se/phantom-pain/

References

1. Richardson C, Kulkarni J. A review of the management of phantom limb pain: challenges and solutions. Journal of Pain Research 2017:1861.
2. Herrador Colmenero L, Perez Marmol JM, Martí-García C, et al. Effectiveness of mirror therapy, motor imagery, and virtual feedback on phantom limb pain following amputation: A systematic review. Prosthetics and Orthotics International 2018;42(3):288-98.
3. Max O-C. The Stochastic Entanglement and Phantom Motor Execution Hypotheses: A Theoretical Framework for the Origin and Treatment of Phantom Limb Pain. Frontiers in Neurology 2018.
4. Ortiz-Catalan M, Guðmundsdóttir RA, Kristoffersen MB, et al. Phantom motor execution facilitated by machine learning and augmented reality as treatment for phantom limb pain: a single group, clinical trial in patients with chronic intractable phantom limb pain. The Lancet 2016;388(10062):2885-94.

Earlier this year Pace Rehabilitation introduced American based Naked Prosthetics (NP) functional finger prostheses to the UK, at their series of Partial Hand & Digit Symposiums.

Pace is delighted to announce that following subsequent clinical assessments of potential adopters of this exciting technology, they have just provided the first NP device to a UK patient.

Twenty-two-year-old Sam sustained traumatic amputations of parts of his left fourth and fifth fingers and was referred to Pace for clinical assessment by his solicitors at Sintons Law.

Initial prosthetic consideration was given to cosmetic devices.  However, with the recent availability of NP devices, a functional solution could also be explored.

As Pace prosthetist Toby Carlsson describes, “Sam was identified as suitable candidate for an MCP Driver for his fourth finger, which is amputated through the proximal interphalangeal joint.”  He continued, “His fifth finger is amputated further distally, through the middle phalanx.  This results in a longer finger remnant.”

Liaison between Pace’s multi-disciplinary team and NP’s Clinical Director Aislinn Wyatt, in Washington (USA), concluded that the fifth digit might be too long to also accommodate a MCP Driver.

As Toby concluded, “It was decided to start by fitting the fourth finger and possibly return to the other at a later date, once the functional benefit from the initial device have been assessed.” 

Following a cast and measures of Sam’s hand, the order was placed for the bespoke device.  Eight weeks later it was winging its way across the Atlantic.

An excited Sam attended Pace’s Bredbury clinic, following a few fine-tuning adjustments to optimise fit and function, he was quickly performing dexterous movement and activities, such as stacking cups and grasping different objects.

David Knipe, an Associate at Sintons Law acting on Sam’s behalf explained, “When suffering a life-changing amputation it is imperative that individuals have access to the most effective prosthetic aids available, to allow them to regain as much independence as possible.” Adding, “Sintons have been delighted to collaborate with both Pace Rehabilitation and Naked Prosthetics (USA) in order to make this cutting-edge technology available for our client.”

Sam will return in a few weeks’ time to further evaluate the benefits of the device.

For more information about NP devices and Pace’s clinical services, click HERE.

 

 

 

 

 

Pace’s team of specialist amputee/prosthetic rehabilitation physiotherapists have collaborated with PhysioTec to create a new and exciting online exercise module for patients.

The module is a collection of exercises appropriate for both prosthetic and non-prosthetic limb wearers, which include written instructions, pictures and even video instructions of each move.

Contact us to arrange a thorough physical assessment, to get a bespoke home exercise programme to improve your agility and balance, with access to an ongoing link and video instruction, accessible through the patient portal on our website.

If your exercise regime needs a revamp (or doesn’t exist!) why not book in for a physiotherapy review?

See our extensive Therapy services.

The November 2018 edition of our periodical electronic mailing/newsletter, eNews, is out now.

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