Partner Solutions Feb 2014
description
Transcript of Partner Solutions Feb 2014
March 2014www.ossur.com
PARTNER SOLUTIONS
RHEO KNEE® 3 user Tim “I always believed I could ride my bike again”
NEW PEDIATRIC SOLUTIONS… And a lot more Flex-Foot® background information
MIAMI LUMBAR® POSTEO – Highlight of Össur’s spinal range
Miami Lumbar® Posteo
Stabilisation, offloading and pain relief
WWW.OSSUR.COM TEL +31 (0) 499 462 840TEL +31 (0) 499 462 [email protected]
Advantages of an osteoporosis orthosis:• Alleviation of pain• Offloading• Increase in mobility• Reduction of the risk of a fall• Ease of use• Increase in quality of life
With this first edition of Partner
Solutions for this year, spring is
already in the air. And we are off
to a quick start with a number of new chal-
lenges. There are many new opportunities for
us all this year.
The first challenge was to introduce the new
Össur brand. We thought it was time for a
fresh, new look that presented the Össur brand
more clearly. You can read more about this in
this issue of Partner Solutions. The magazines
design has been given a new look, while retai-
ning the familiar Össur appeal.
4 News from the Head Office
5 Product in the spotlightFoot-Up®
6 RHEO KNEE® 3Stability and dynamicsInterview with user Tim
10Flex-Foot®
Main Flex-Foot features described
14Interview with Icelandic Flex-Foot® production specialist Magnús
16 Flex-Foot® Junior Solutions
18 Össur’s Spinal Range
19 Osteoporosis solution:Miami Lumbar® Posteo
22 Össurin action
24 Product Updates & Discontinuations
26 Agenda
In terms of content, the magazine is still cha-
racterised by a combination of interviews, pro-
duct information, scientific background infor-
mation and news about activities and events.
You can read in this edition for example an
interview with Tim, one of the first users of
RHEO KNEE 3. Besides a lot of background
information about our Flex-Foot range and the
new Junior Solutions, you will get a refresh of
Össur’s spinal range.
Yours sincerely,
Yvonne van der Rijt
Marketing Manager
PS is a production of Össur and is
published 4 times a year.
Redaction:
Yvonne van der Rijt
Design:
Marta Tripp
Contributed to this issue:
Simone Faessen
Steve Russell
Peter Slijkhuis
Froukje Aben (ZIN tekst & redactie)
Final editing:
Yvonne van der Rijt
© Copyright Össur All rights reserved.
Dear relation,
TABLE OF CONTENTS
Colophon:
3
ÖSSUR STRATEGY 2014
CHANGE IN ÖSSUR BRAND STRUCTURE
You might have read in the first Partner
Solutions about the brand restructur-
ing that Össur was going through. In
the past months we have been planning this
new brand structure within Össur.
The goal is to ensure the Össur brand structure
reflects our strategy of providing indication
based solutions to our customers. Findings are
based on research conducted with employees
and customers.
The result was a restructuring of the Össur
brand architecture along with an update to our
logo. We will no longer speak about Braces and
Supports, but about Össur OA Solutions and
Össur Injury Solutions.
IMPLEMENTATION
The implementation of it has started already.
The first changes presented to you are the new
OA & Injury Solutions product catalogue 2014
(instead of Bracing and Supports catalogue)
and the new logo you can see on on the cover
of this magazine. We will not change every-
thing overnight. Our “old“ logo will continue
to coexist with the new version for quite some
time (on products, signage and other existing
material).
In case you want to use Össur brand elements
in your marketing tools, please contact our
Marketing Manager for support: Yvonne van
der Rijt [[email protected]].
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Foot-Up®
Foot-Up is an AFO (ankle foot orthosis) prescribed in case of dropfoot. Dropfoot means
that, during the swing phase, the forefoot drops down due to muscle weakness on the
front of the lower leg. The cause of this weakness include peroneal nerve damage or paresis
due to circulatory problems in the brain. The orthosis is used to prevent the forefoot’s falling
downward, to promote heel strike, to stabilise the ankle during the support phase and to facilitate
toe clearance at the end of the support phase.
COMFORTABLE
The ankle strap is flexible and can be adjusted
to the anatomy of the lower leg and ankle. It
is made of multiple layers and is breathable.
This decreases the likelihood of sweating and
increases wearer comfort.
DYNAMIC
Foot-Up’s dynamic character is evident in the
gait. Walking with a dynamic AFO such as the
Foot-Up not only provides ankle stability, but
also provides a smooth transition during the
support phase. This improves speed and step
length while walking.
SIMPLE
Foot-Up is easy for users to don. Many users
also say it is easy to walk with Foot-Up.
DID YOU KNOW?
• Foot-Up is Össur’s 7th-best-selling product?
• A 2007 study of VU University (Faculty of
Human Movement Sciences) revealed that
walking with Foot-Up scored better in the
areas of ease-of-use and comfort than wal-
king without an AFO? And that users are
provided more comfort by Foot-Up than by
plastic AFOs?
• Foot-Up can be worn not only in lace-up
shoes, but also in sandals, loafers and boots,
thanks to the Shoeless bandage?
• Foot-Up is also available in skin-tone colour,
making it less noticeable to wear?
IN THE SPOTLIGHT
5
6
7
Interview with our RHEO KNEE® 3 user Tim
Tim Klinker is one of the faces of our
RHEO KNEE 3 campaign. He is 41 years
old and lives in Germany. He has a
degree in electronics and is currently doing a
degree in science with an internship in psycho-
therapy. Tim has many hobbies like reading,
writing, playing a lot of darts and his favourite
hobby is to ride the bicycle. Tim had his left
leg amputated two years ago. So let’s ask him
how he learned riding his bike again.
? After your amputation, did you believe you
would ever be able to ride your bike again?
Of course, I believed that I could ride my bike
again. You only have to believe in yourself and
what you can accomplish if you try.
?What did you learn during your rehabilita-
tion phase?
They taught me, how to balance my body defi-
ciencies and to carry on with all the exercises.
? Now you know what it is to be an
amputee, what can you say about the
needs of an amputee?
To have an amputation is a big step in life, but
after 40 years with a stiff leg that was begin-
ning to affect my movements, it was time to
do something about it.
? What solutions a prosthesis should give in
your opinion?
After my amputation I found how free I could
be in my movements in daily life. For example
in my hobbies. So mobility, that’s what I think
a prosthesis should give me.
? Could you ever think that you would be at
the mobility level where you are at the
moment?
Yes I thought about the mobility I could
achieve, but I was surprised how mobile I
could be again.
First I had a knee that was probably not ideal
for me but with time I got a reliable knee that
helped me to become more free and dynamic
but also gave me safety. I m now using the
RHEO KNEE 3 and it combines both without
a doubt.
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The product catalogues for OA &
Injury Solutions and Prosthetics 2014
are available on stock.
The prosthetic catalogue is updated
with all the latest changes. We added
for example Unity™ for LP Vari-
Flex® and PROPRIO FOOT® and we
implemented the SYMBIONIC® LEG
Protector.
The OA & Injury Solutions catalogue
looks a bit different due to the new
brand structure we’ve implemented
The catalogue is divided in Össur OA
Solutions and Injury Solutions.
The product catalogues are
digitally available on:
www.ossur.com/emea/b2b
and are updated every quarter.
Catalogues 2014
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FLEX-FOOT®
RHEO KNEE 3 is compatible with more Össur feet then before....
There are approximately one million
amputees worldwide. Most have had
to undergo lower limb amputations
because of poor blood circulation in the legs
and feet, brought on by either trauma or dis-
ease. All of them are individual people with
individual lifestyles, needs and aspirations.
Therefore their requirements for a prosthetic
device differ too.
Össur recognises this huge variation and takes
various factors such as personal mobility and
body weight into account in the development of
the Flex-Foot range, a collection of foot modu-
les designed with this individuality in mind. The
Flex-Foot product line consists of carbon fibre
feet, designed for optimum performance and
suitable for all ages and activity levels.
While the needs of children, active adults and
older people vary, all our customers demand
high quality products that imitate the function
of the human body as closely as possible and
that respond to their unique needs.
Van Phillips, the inventor and himself also
a user of Flex-Foot, describes his first expe-
riences with prosthetic feet that led him to
search for a better solution to satisfy his requi-
rements. “The feet were light but had no flexi-
bility. Some had a degree of ankle movement,
but no method of storing energy.” These two
attributes, flexibility with energy storage, led
Phillips to select carbon fibre as the perfect
material for a prosthetic foot. His innovation
was to revolutionise the lives of prosthesis
users around the world.
SHOCK ABSORBTION
As Perry et al. 5* indicated, prostheses for
the transtibial amputee have to provide better
ankle flexibility and have to imitate the dynamic
characteristics of a normal joint between the
foot and the leg when setting the foot down.
The prosthesis used has to provide terrain
adaptation or the initial contact in the early
stance phase. In the context of loading res-
ponse, an active heel has to absorb the shocks
and store the energy generated by the initial
contact as the amputee transfers his body
weight onto the prosthetic foot in the early
stance phase. In addition, it has to support
the initial tilting motion for inducing forward
progression in the ankle and has to control the
forward progression of the tibial portion for a
fluid roll-over of the foot in this initial phase.
The importance of this characteristic is demon-
strable in terms of the protection that this pro-
vides the vascular or diabetic amputee with
sensitive skin. Although the extent to which
this prevents skin necrosis and skin damage is
unknown, this preventive effect is likely.
RANGE OF MOTION (ROM)/FLEXIBILITY
The vertical forces that are generated upon heel
strike are stored and translated into a linear
motion described as tibial progression, from
the moment of initial contact to mid-stance,
and from forward progression to toe-off - equi-
valent to a range of motion in the joint of a
non-amputee of between 15 and 20 degrees.
This flexible, controlled motion enables the
patient not only to limit the body’s active for-
ward acceleration that has to take place in order
to proceed from early stance to mid-stance,
but also to make the stride length equal to
that of the healthy limb and to decrease energy
consumption. At the same time, the tibial pro-
gression promotes forward progression in the
opposing limb during the swing phase, which
results in more controlled placement of the
foot when completing the step and as small as
shock as possible upon putting the foot down.
This characteristic has been studied by several
researchers and, according to Hafner et al. 6*,
the Flex-Foot systematically offers the greatest
range of motion of the joint. The same study
reveals that the use of the Flex-Foot decreases
the forces exerted on the residual limb and
on the other leg, which indicates that the foot
prosthesis not only absorbs forces exerted
on the prosthetic side, but also on the side of
the healthy leg.
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FLEX-FOOT®
RHEO KNEE 3 is compatible with more Össur feet then before....
ROLL-OVER AND DISPLACEMENT OF THE
CENTRE OF GRAVITY
The full-length toe lever is the same length as
the healthy foot for a smoother, more com-
fortable and more natural gait. The range of
motion and flexibility of the joint, as indicated
above, are well-known characteristics of the
foot, but the objective of the full-length toe
lever is to enable patients to support themsel-
ves just as long on the prosthesis as they do
on their healthy leg. For persons with normal
anatomical characteristics, the unique action
of the foot’s muscles and joints ensures a natu-
ral gait and the stability required at the end of
stance. In patients with a prosthesis, the toe
lever stabilises the knee over the entire stride
length and it supports every displacement of
the body’s centre of gravity. In instances of a
short toe lever (e.g., with an SACH foot with
flexible ends), the foot’s roll-over is cut off
abruptly, shortening the stance phase of the
prosthesis and the swing phase of the healthy
leg. This has serious consequences for the
healthy side: this side becomes damaged or,
for diabetic and vascular amputees, even runs
the risk of having to be amputated as well. It
has been demonstrated that the impact on
the other leg is decreased by a combination of
sufficiently extensive range of motion of the
joint, controlled tibial progression and a full-
length toe lever. The hypothesis has also been
posed that a reduction in the forces exerted on
the healthy leg may completely prevent damage
to this leg. The efficacy of roll-over and the
displacement of the body’s centre of gravity
when using the Flex-Foot are discussed in the
study by Lehmann et al. 7*
FLEX-FOOT®
Re-Flex® Rotate
Flex-Foot Assure®
Talux®
Vari-Flex®
Vari-Flex® XC
11
ENERGY RETURN
The energy return from ESAR (Energy Storing
And Returning) feet takes place in two steps.
During the first step, after the initial contact,
the force exerted on the heel of the foot pros-
thesis results in the opening up of the J-shaped
tube (if applicable). The energy is then stored
for use during the first phase of the tibial pro-
gression. Once the J-shaped tube has ope-
ned, the returned energy initiates the forward
progression so that the patient can proceed
from the initial contact to mid-stance. This
decreases the muscle activity that the patient
has to provide. Just before the toe-off, energy
is released once again in the second step of
active forward progression up to the moment
of the toe-off. This is also influenced by the full-
length toe lever. This phase of energy return
plays a key role because it supports dynamic
swing initiation. The general energy return
is known to decrease the effort required to
walk at various levels. These effects have been
researched and proven in various studies -
e.g., Macfarlane et al. 8*, which showed that
torso motions were smoother and more regular
when using Flex-Foot, allowing transfemoral
amputees to walk more efficiently.
EVO™ – ENERGY VECTOR OPTIMIZING
Although results with Flex-Foot have been
satisfactory, we were and are still looking for
improvements, which are users would des-
cribe as beneficial and which we could quantify
using adapted analysis tools. The objective,
for the development of the EVO feature, today
present in the Vari-Flex EVO, was to mimic
the natural roll-over of the physiologic foot,
using the COP displacement during roll-over
as reference. Vector Optimization, Energy
Vector Optimization to be precise, stands for
the optimization of the movement pattern of
the COP. The feature is the result of a change in
the design of the foot cover. Foot covers have
never been considered of high functional value.
By matching the inside of the foot cover with
the arch shape of a Vari-Flex, we obtain what
we like to call EVO. Matching the outside of the
footshell to fit a shoe completes the concept by
making a solid interface between shoe/ground
and the foot module. The interface between
foot module and ground is the “make or break”
factor for function, comfort and stability. The
objective is to mimic the natural roll-over of the
physiologic foot, using the COP displacement
during roll-over as reference.
ROTATION
For the amputee, portions of this kinetic chain
are replaced with the prosthesis. Whatever
torque was applied to the biological structu-
res that were removed, are now applied to the
prosthesis and its interface with the stump.
An intact leg is free to rotate in the transverse
plane as described above, or to transmit the
transverse rotation into motion in other planes;
however, with the exception of the prosthetic
foot rotating in the shoe, few lower limb pros-
theses allow for transverse rotation.
Constrained rotation can increase stump
shear stresses and, for some amputees, may
be sufficiently uncomfortable to require an
altered gait. Given that discomfort and injury
due to shear forces between the stump and
the prosthetic socket are major complaints
of amputees, it is important to minimise the
shear forces in all planes of the socket/lining
with respect to the stump. The addition of a
torsion adapter in a prosthesis will be of impor-
tance to address secondary complaints. The
higher the level of amputation is, the higher
the necessity of rotating elements, even for
low active amputees. In case of high active
prosthetic users, rotation should be combined
with optimalisation of shock-absorption. The
installation of a torsion adapter in a lower-limb
prosthesis is therefore recommended.
1. Bob Gailey, 2008, Secondary conditions related to prosthetic users and ten steps to reduce the risk of injury, In motion, July/August, Vol 18, issue 5
2. Christiane Gauthier-Gagnon et al. Predisposing Factors Related to Prosthetic Use by People with a Transtibial and Transfemoral Amputation, JPO 1998; Vol 10, Num 4, p 99.
3. Robert Gailey, Predictive outcome measures vs functional outcome measures in the lower limb amputee, JPO 2006; Vol 18, Num 1S, p 51
4. Johannesson et al. From major amputation to prosthetic outcome: a prospective study of 190 patients in a defined population. Prosthetics and orthotics international 2004, 28, 9-21.
5. Perry J et al. Prosthetic weight acceptance mechanics in transtibial amputees wearing the Single Axis, Seattle Lite foot, and Flex-Foot. IEEE Trans Rehabil Eng. 1997;5(4):283-289.
6. Brian J. Hafner, PhD, Overview of Outcome Measures for the Assessment of Prosthetic Foot and Ankle Components, JPO 2006; Vol 18, Num 1S, p 105.
7. Lehmann JF et al. Comprehensive analysis of energy storing prosthetic feet: Flex-Foot and Seattle Foot Versus Standard SACH foot. Arch Phys Med Rehabil 1993; 74:1225–1231.
8. Pamela MacFarlane et al. Transfemoral amputee physiological requirements: Comparisons between SACH foot and Flex-Foot. Journal of prosthetics and orthotics 1997, Vol. 9, Num. 4.
9. Esquenazi et al. Rehabilitation After Amputation, Journal of American Podiatric Med. Assoc. 91(1): 13-22, 2001.
THE DATA
12
13
Earlier in this Partner Solutions we
described how the idea of Flex-Foot was
founded, what the main features of Flex-
Foot feet are and which developments this
product has gone through in the past years. In
this interview with Magnús we try to answer
questions that we get very often from CPO’s.
Magnus works as supervisor at the Flex-Foot
production department of Össur in Iceland.
All Flex-Foot feet are produced in Reykjavík,
Iceland.
? What are the main changes that have
occurred from the first versions?
The main changes are a few bolts and nuts,
finetuning of shapes and lay-up to maintain
durability, and greatly enhanced manufacturing
process, where automation plays increasingly
big part.
? Can you tell us a bit more about the
production proces?
Flex-Feet are laminated of carbon fiber/epoxy
pre-impregnated material which are combined
under extremely strict quality procedures and
with unique machinery.
Categories are controlled by the amount and
placement of carbon material(thickness). An
automated process takes care to compile that
with great precision.
? Össur is constantly searching for
innovative ideas and ways to bring those
innovations to the market. Can you explain
us a little bit more about the development of
a new product within Össur?
A product idea is taken into one end of a so-
called new product development process. If it
turns out to be viable, it results in a product.
How long it the process from the decision of
making the product till having it available for
the patient takes differs quite a bit depending
on the complexity, testing and logistics around
the new product. Anything between 10 and 30
months can be considered normal.
Besides the development of new products we
also improve existing products.
Two factors decide on an upgrade: If there is
a quality weakness which can be fixed with an
upgrade, that’s one good reason. If we see
an opportunity to make the product easier to
apply or better for the patient, that’s a very
good reason as well.
? What is the testing procedure for a
Flex-Foot?
Every carbon component is stiffness tested
before the foot is assembled to make sure that
it corresponds to an exact activity and impact
level. All products are tested in machines to
verify safety. Depending on previous experi-
ence with similar solutions, we either do or
do not conduct user tests.
? CPO’s ask us sometimes the question
‘Why does my patient feel his Flex-Foot is
stiff?’. What could be the answer according
to you?
Choosing the right category of your Flex-Foot
is crucial for optimal functionality. Weight and
impact on the foot are the main factors to take
into account when deciding on the category.
Selection-tables are presented to choose the
right category according to the weight of the
user. Please take into account the different
activities the user will execute/perform with the
prosthesis. In this case impact on the foot will
be more important than the activity itself. For
example, the impact on the foot working on a
construction-site will be different compared to
the impact on the foot of someone sitting by a
desk when working. (Other example: playing
tennis vs cycling). Choosing a category too
high will cause the foot to be too stiff. Flex-
Foot can be tested in the home-environment,
so please make sure the user is provided with
correct type of foot.
MAGNÚS ÖRN HALLDÓRSSON
“If we see an opportunity to make the product easier to apply or better for the patient, that’s a very good reason to improve an existing product.”
- Magnús Örn Halldórsson
Picture: Production of the Flex-Foot - Carbon fibre cutting
14
MAGNÚS ÖRN HALLDÓRSSON
Wrong bench-alignment of the prosthesis will
influence the lever arm of the foot. A too long
lever arm, for example aligning the socket too
far posterior (sagittal plane), will increase the
stiffness of the foot. This results into torque-
and shearforces between the skin and the
socket and can lead to damaging of the skin-
and bonestructure of the residual limb. Please
use the prescriptions of bench-alignment as
indicated in the Technical Manuals to provide
optimal functionality.
The full length toe lever of the Flex-Foot mat-
ches the length of the sound foot, giving a
smoother, more natural gait. It ensures the
amputee to spend equal time on the prosthetic
limb because of increase of stance phase, this
because of support of the prosthesis by the
rigid toes of the foot. For this reason, wrong
size selection will increase the lever arm of
the foot and increase the feeling of stiffness.
Because of the great diversity of Flex-Feet (dif-
ferent types of feet for different types of users),
the amputee can have an “almost” custom-
made design of foot, providing an excellent
option for an optimal functionality.
? Customers want to know how long a
Flex-Foot lasts. Is that a question you can
answer?
This is a difficult question to answer because
different factors are of influence when consi-
dering usage. Every prototype is tested for a
time-period of 36 months (2.000.000 cycles).
This means we know we can and will guarantee
proper functioning of the foot for this period.
(Note: Please note that there are some designs
of feet with different periods of warranty. Check
warranty specifications in your catalogue.) A
second influencing factor is the amount of
loading on the foot, which will depend on the
activity and the impact. The higher the amount
of loading, the shorter the time of the foot
will last.
? Sometimes CPO’s tell that their users
complain of noise in the Flex-Foot. What
could be causing this?
This can be dirt and debris inside the foot
cover. Also the absence of a Flex-Foot Sock is
common cause for noise.
? We also get questions on a regular base
about using prosthetis in the water. Can
users take a shower with a Flex-Foot for
example?
Flex-Foot are not designed to use in a shower-
prostheses. On the other hand, using titanium
parts which are protected against corrosion,
could give the user the benefit to use the pros-
thesis in not-salted water if the other parts of
the prosthesis are designed to use within water.
Using the prosthesis on the beach should be
no problem, as long as the user makes sure
the prosthesis is cleaned properly when leaving
the beach, so no sand can cause no problems.
15
16
KIDS ARE MORE ACTIVE THAN ADULTS
It’s no secret that kids move more than adults.
They have more energy, they play more, and,
while many adults don’t run as a part of normal
daily activity, most children do.
This is why we added not one, not two, but
three new dynamic foot options to our pediatric
product line, including a running foot for kids
with longer residual limbs and a hybrid wal-
king/running foot, the Cheetah® Xplore Junior.
Children may dream of playing with friends,
competing in sports or walking the family dog
and Össur wants to support them every step
of the way.
Cheetah® Xplore Junior
A custom-built, hybrid carbon fiber foot
designed to function as both an eve-
ryday and sports foot.
For kids that require the flexibility of an eve-
ryday walking foot and a running foot in a sin-
gle prosthesis, Cheetah Xplore Junior is the
answer. Cheetah Xplore couples the proven
performance of our Cheetah sprinting foot with
a heel for everyday walking/standing.
Vari-Flex® Junior
Vari-Flex Junior provides an exclusive
combination of comfort and dynamics.
It is specially made for children who
require the additional energy response.
Vari-Flex Junior is lightweight, easy to assemble
and has a slender profile which makes it easy to
cosmetically cover. It ensures the highest levels
of user confidence and security. Promoting a
natural gait with less fatigue and strain on the
lower back and sound side, it is the ideal foot
for any activity.
Cheetah® Junior
Custom-built, high-performance carbon
fiber foot designed primarily for sport-
ing activities.
This is the optimal run and play foot for both
transtibial and transfemoral users. It attaches
posterior to the socket, making it agile, strong
and a proven performer for children who want
to practice sports.
FULL LENGTH TOE LEVER
PROPORTIONALRESPONSE
ACTIVE TIBIAL PROGRESSION
CARBON-X®
ACTIVE HEEL
SANDAL TOE
FULL LENGTH TOE LEVER
PROPORTIONALRESPONSE
ACTIVE TIBIAL PROGRESSION
CARBON-X®
ACTIVE HEEL
PROPORTIONALRESPONSE
ACTIVE TIBIAL PROGRESSION
17
CERVICALTHORACIC
LUMBAROCCIPUT
C1
C3C5
T2T7
T9L1
L5
SACRUM
“We recognise that our customers want
access to a complete spinal range, one
that offers motion restriction, comfort
and compliance, as well as innovative features
that enhance clinical use. Össur’s focus has
been on optimising patient outcomes, using
our advanced design and materials technolo-
gies to make our products easier to use and
less stock intensive.”
When someone suffers a spinal injury, which
may carry with it the risk of permanent para-
lysis, even the most skilled clinician faces a
complex and challenging set of treatment
protocols.
Össur’s spinal range currently includes six dif-
ferent products and a number of accessories
to ensure outstanding treatment options for
every stage of the care pathway. These out-
come-focused products have been developed
in consultation with leading clinicians and their
patients and offer a number of advantages:
• Motion restriction, pain relief and the protec-
tion of injured ligaments/muscles.
• Size adjustable and modular systems that
help to reduce stock levels.
• User-friendly design and enhanced patient
comfort and compliance.
ÖSSUR’S SPINAL RANGE
MIAMI LUMBAR® TLSOA secure, comfortable orthoses allowing step-down treatment of thoracic or multi-level injuries.
MIAMI JTO®
A thoracic extension for the ambulatory needs of cervical and high-thoracic injured patients. (For use in conjunction with the Miami J.)
MIAMI LUMBAR®
The easy-to-use modular system for post-op immobilisation, pain relief and protection of injured ligaments/muscles in the lumbar region.
MIAMI J®
The popular and proven cervical collar available in a range of phenotype size options.
MIAMI J® ADVANCEDThe highly effective cervical collar offering phenotype size adjustability and a tracheotomy friendly design.
RESOLVE® HALOThe renowned MRI-safe halo for traumatic fractures/chronic disorders requiring traction.
MIAMI LUMBAR® POSTEOFunctional relief of vertebral fracture pain, with an innovative approach to ease of use and consistent donning.
18
According to the World Health
Organisation osteoporosis is amongst
the top ten most significant diseases
in the world. Osteoporosis is the condition of
reduced bone density which leads to bones
having less load-bearing capacity and increased
bone fragility. In advanced stages of the disease
someone can sustain fractures of the spine or
of the neck of the femur even on slight impact
or following light falls. According to the
International Osteoporosis Foundation, every
30 seconds someone in the European Union
has a fracture as a result of osteoporosis. Annual
direct medical costs to treat 2.3 million osteo-
porosis fractures in Europe and in the United
States of America come up to 27.000 million
USD. Every third woman and every fifth man
over 50 sustains a bone fracture which is attrib-
utable to osteoporosis.
ADVANTAGES OF AN OSTEOPOROSIS
ORTHOSIS
• Alleviation of pain
• Offloading
• Increase in mobility
• Reduction of the risk of a fall
• Ease of use
• Increase in quality of life
MIAMI LUMBAR® POSTEO
The Miami Lumbar Posteo offers functional
support for vertebral compression fractures and
provides the patient with early mobilisation. The
orthosis provides thoracic extension and lumbar
compression. This postural correction and the
active relief of the vertebra produces effective
alleviation of pain.
INDICATIONS
• Back pain caused by stable vertebral compres-
sion fractures (VCF)
• Post-operative immobilisation
OSTEOPOROSIS
19
The aim of the study was to assess if partici-
pants using the Miami Lumbar Posteo experi-
ence a significant reduction in back pain and/
or a significant improvement in function over
a 6 week period, compared with subjects not
using a brace.
A secondary goal was to evaluate if the effects
of the Miami Lumbar Posteo spinal brace dif-
fer from the effects of the Spinomed® (medi)
brace.
METHODS
A randomized controlled trial, approved by the National Bioethics Committee in Iceland. Subjects with confirmed vertebral compression fracture(s)
and chronic pain were randomized by drawing into 3 groups: Miami Lumbar Posteo brace, Spinomed brace (medi) or no brace (control group).
MIAMI LUMBAR®
POSTEO
Osteoporosis Spinal Brace Study
USERSATISFACTION
Comfort, ease of use etc. were assessed using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0)1,2.
In general, users were more satisfied on the scale of 1-5 with the Miami Lumbar Posteo brace.
N SIZ
E
WEI
GH
T
EA
SE O
F A
DJU
STM
ENT
DU
RA
BIL
ITY
EA
SE O
F U
SE
CO
MFO
RT
USE
FULN
ESS
MIAMI LUMBAR POSTEO 10 3.5 5 4.4 4.8 4.2 4 4.1
SPINOMED (MEDI) 7 3.4 4.4 3.4 4 4.1 3.4 3.7
REFERENCES
1 Demers L, Weiss-Lambrou R, Ska RB. The Quebec user evaluation of satisfaction with assistive technology (QUEST 2.0): an overview and recent progress. Technology
and Disability 2002;14:101-105.2
2 Demers L, Monette M, Lapierre Y Arnold DL, Wolfson C. Reliability, validity and applicability of the Quebec user evaluation of satisfaction with assistive technology
(QUEST 2.0) for adults with multiple sclerosis. Disability and Rehabilitation 2002;24(1-3):21-30.
THE DATA
THE DATA
Back pain was estimated by a visual analogue scale (VAS) and was sig-
nificantly reduced in subjects using either brace. A reduction of 2.0 or
more points on the VAS scale is considered a meaningful improvement.
Functional limitation, estimated by the Rolland Morris score, was sig-
nificantly reduced in subjects using either brace. A 5 point reduction
on the RM scale is considered a clinical improvement in function.
ESTIMATED MARGINAL MEANS OF PAIN
MEA
N S
CO
RE
ON
TH
E P
AIN
SC
ALE
baseline 1 week 3 weeks 6 weeks
no brace - control group spinomed (medi) miami lumbar posteo
ESTIMATED MARGINAL MEANS OF ROLAND MORRIS SCALE
MEA
N S
CO
RE
ON
TH
E FU
NC
TIO
NA
L LI
MIT
ATIO
N S
CA
LE
baseline 1 week 3 weeks 6 weeks
no brace - control group spinomed (medi) miami lumbar posteo
The exercises described below may not
be appropriate for every patient with
osteoporosis. Please consult a clinician
for a personalized training program.
CARDIOVASCULAR
• Walking and running up to 20 minutes, low to
high impact aerobic exercises.
BALANCE
• Good leg strength and balance to reduce risk
for falling. Stand on one leg for some time
without dropping the contralateral (opposite)
side of the pelvis. (Figure 1).
STEPS
• Short forward lunge. Stand on one leg while
maintaining balance, then take a short step
forward and put your weight on the front leg.
Firmly push off with the front leg to return to
starting position. Avoid changing position of
spine during the exercise. (Figure 2).
BACK MUSCLES
• Sit or stand with the spine aligned against a
wall, lift both arms over head and take deep
breaths before taking your arms down again.
Repeat 5-10 times, 2-5 times daily. (Figure 3)
• Lying prone (on stomach) with good support
of pillows under your chest and stomach, arms
in overhead position. Lift your arms from sup-
port/ floor by pulling shoulder blades together.
Try to keep the muscles in the lumbar/lower
back and abdominal wall relaxed. Repeat 5-10
times, 2-5 daily. (Figure 4)
ABDOMINAL MUSCLES
• We do not recommend any strengthening exer-
cises, only relaxation of the abdominal wall.
In a quadruped position resting forearms on
a table, relax abdominal muscles and breath
slowly. (Figure 5)
• Stretching: Stand in a corner, one foot in front
of the other with each arm on separate walls
at shoulder height. The stretch should be felt
in your chest, anterior shoulders and upper
arms. (Figure 6)
LEG MUSCLES
• Rest arms on the backrest of a stable chair.
With feet little apart and bend at the hips and
knees as far as possible without lifting your
heels from floor. (Figure 7)
2
3
7
5 6
1
4
MIAMI LUMBAR®
POSTEO
Exercises for individuals with osteoporosis
21
RICHARD BROWNE JR. JOINS TEAM ÖSSUR
Össur is pleased to announce that
World-Record holder and Paralympian
Richard Browne, Jr. is the latest elite
athlete to join Team Össur.
Richard holds World Records in both the 60m
(6.99) and 100m (10.75) races in the T-44 cate-
gory. Although relatively new to the competitive
arena, he has already distinguished himself by
competing as a member of the Gold Medal-
winning, World Record-setting U.S. 4x100
relay team at the 2013 IPC Worlds. He also
won Silver Medals in the 100m at the 2013
IPC World Championships and at the 2012
London Paralympic Games. Richard uses the
Össur Cheetah Xtreme®, which is ideally desig-
ned for short distance sprinting. He also stu-
died Physics at Morehouse College in Atlanta,
Georgia. We look forward to cheering Richard
on at his upcoming races at the IAAF Indoor
British Athletics GP in Birmingham, England;
the 5 Nations Match in Glasgow, Scotland; and
the Meeting de Mondeville in France.
AN ASPIRING JOURNEY IN MYANMAR
The 7th ASEAN Para Games were suc-
cessfully held in Myanmar at Wunna
Theikdi Stadium from the 14th to the
20th of January. This venue is the largest sta-
dium in Myanmar and was crowded with spec-
tators for this country’s milestone event. The
Para Games featured over 1000 athletes from
eleven countries in Southeast Asia (ASEAN),
competing in twelve sports, with Myanmar’s
own team being second in participation with
around 269 athletes.
Össur Asia was approached by the International
Red Cross association and the Myanmar
Paralympic Committee (MPC) to support
their athletes and with the help of the MPC,
Össur selected a total of 10 athletes (6 men
and 4 women) to assist with training, technical
support and products. One of Össur Asia’s
very own CPOs, Charles Wang spent countless
hours working with the team in the weeks lea-
ding up to the main event. It is important to
note that prior to Össur’s involvement, almost
all of the athletes in Myanmar’s team were
using very basic componentry (SACH feet,
Single-axis knees, no liners etc.) In the end,
the Myanmar team won 6 gold, 4 silver and
7 bronze medals. Truly a great achievement
and Össur Asia was proud to have been a part
of this event.
22
23
FOOT COVERS
The foot covers from Össur are known for the technology which is called EVO. EVO stands for
Energy Vector Optimization and intends to provide a more natural way of walking to the patient.
The foot covers have been specifically designed to be used in combination with the best pros-
thetic feet in the market, „Flex-Foot “ with EVO. Össur has now improved her EVO foot covers.
The new foot covers have a more anatomically correct shape and more natural looks.
MORE ANATOMICALLY CORRECT SHAPE
• Opening width reduced
• Ankle shape improved
• Lowered dorsum
• Reduced width metatarsal section
MORE NATURAL LOOKS
• Smooth surface texture
• Toe details improved
• Consistent quality and durability
NEW VALVE SETTINGS - TOTAL KNEE® 2000 & 2100
In order to clarify the valve settings of Total Knee 2000 and Total Knee 2100, we have changed
the following:
• A becomes F [flexion]
• C becomes E [extension]
• B becomes H [heel rise] it will be indicated as optional and will be covered by a sticker.
Also a yellow sticker has been added on the back link as a visual reminder that the socket should
not touch the upper half of the back link.
COLOR SWATCHES
New color swatches are available, with the 12 standard colors, showing the matt color on 1 side
and the glossy color on the other side. These swatches can be used for the CTi braces, Unloader
XT and Extreme braces, and of from early next year the Unloader One Custom brace will also
be available in custom paint options.
IMPROVED PATELLA CUP FOR CTI
CTi brace can be ordered with a patella cup, a protective cup that keeps the patella safe. User
feedback has led us to develop an improved patella cup, that fits in perfectly with the recent
improvements of the CTi brace. This new patella cup can be fitted on both new and old CTi
braces, in custom and OTS versions.
FEATURES AND BENEFITS OF THE NEW PATELLA CUP:
• Self-tracking design to stay positioned in front of the knee
• Thigh and patella shell to increase the thigh coverage
• Simple 5 point attachment system which fit both the CTi OTS and the CTi Custom
• Additional foam pad for improved cushioning
• Nylon laminate on patella cup and gear guards for increased durability and wear resistance
• Matte black finish which matches the aesthetics of the new CTi
ACCESSORY: OLD ITEM NUMBER: NEW ITEM NUMBER:
MX Kit Small B-705130072 B-711140002
MX Kit Medium B-705130073 B-711140003
MX Kit Large B-705130074 B-711140004
MX Kit X-Large did not exist before B-711140005
Gear Guards 22101 B-705000003
Patella Cup B-711130000 B-711130011
PRODUCT UPDATES
24
SURE-FLEX (JANUARY 2014)
Replacement products are Flex-Foot Assure or Balance Foot J, depending on the user profile.
Discontinued item numbers:
SFP0xyyz (BR) (xx=22-28; y=1-6, z= L or R)
SFX0xyyz (BR) (xx=22-28; y=1-6, z= L or R)
REHAB DROP LOCK (FEBRUARY 2014)
Discontinued item numbers:
B-233500000 Air Light R
B-233600000 Air Light L
B-234500000 Full Foam R
B-234600000 Full Foam L
B-236000000 Universal Air Light
B-235000000 Universal Full Foam
FROG SPLINTS (JUNE 2014)
Discontinued item numbers:
71963 Frog Splints Pad Sm 12Pk
71965 Frog Splints Pad Md 12Pk
71967 Frog Splints Pad Lg 12Pk
DISCONTINUATIONS
Note the dates of OT World 2014 in your
agenda: 13-16 May 2014!
You will have 4 days (Tuesday to Friday) at
the Trade Show, during which you will be
able to visit the Össur booth.
A sneak preview about what Össur is going
to present:
OA & INJURY SOLUTIONS
- Unloader One
- Rebound Cartilage
PROSTHETICS
- Unity
- Bionics
- Bionic Service Concept
In case you are planning to visit Leipzig for
OT World 2014, please think about arranging
your accomodation in time.
OT World 2014 – visit us in Leipzig
25
PLANNER, MULTI-TASKER AND WALKING ENCYCLOPAEDIA
Seizing all the opportunities the market
has to offer together with distributors.
If Marketing Manager B2B Yvonne van
der Rijt could sum up her ambitions in a single
sentence it would be this. Meet this versatile
professional, who not only sits at her desk
writing plans, but is also a multi-tasker, trou-
bleshooter, walking encyclopaedia and the
initiator of this magazine.
After completing her studies in communication
sciences, Yvonne started her career as a marke-
ting assistant with Somas in 2005. After a year,
she was promoted to Marketing Manager of the
Braces and Supports Division. She first became
acquainted with the international market when
she also became responsible for the Somas
International Division. After the company was
taken over by Össur, she fulfilled a similar posi-
tion, but her portfolio was expanded to include
Prosthetics as well as Braces and Supports.
Meanwhile, Össur’s business-to-business
department grew and, when a vacancy opened
up for a full-time marketing manager in 2013,
it did not take long for Yvonne to be appoin-
ted. Although her four immediate colleagues
travel all over the world, Yvonne’s main base
is still the office in Son en Breugel, where she
works on long-term plans, but is always ready
to undertake ad hoc action when necessary.
NOT DIFFICULT, BUT ENJOYABLE
The more intensive contact with customers
makes this job enjoyable for her to do. She
does not regard the cultural differences she
encounters as troublesome, but more as a huge
challenge. You cannot, for example, roll out a
marketing plan that works well in Turkey in
Poland and expect the same result. The market
requirements and the approach are vastly dif-
ferent. Yvonne has made a game out of working
out the best strategy for a country together
with the respective distributor. She uses all the
information she obtains from colleagues and
customers to release communication materi-
als in the right way, at the proper moment and
through the most appropriate channel. Despite
the occasional fortunately visible success, her
job is sometimes difficult because the results
are hard to quantify.
FROM HARDCOPY TO DIGITAL
Anyone who has been in the same line of work
for nearly ten years will notice the changes.
Yvonne has, for example, seen a clear shift away
from hardcopy to digital marketing tools. This
has been a global development that Össur has
thankfully effectively anticipated. With depart-
ments like ‘mobile solutions’ and a web team
to fall back on, Yvonne can also use on-line
tools and social media in the marketing mix
she presents to her customers.
INVESTMENTS IN KNOWLEDGE
‘Innovative’ is a word that is frequently used
and abused at the moment, but Yvonne believes
that Össur certainly deserves to be called by
this name. The sales figures for her own orga-
nisation obviously count, but the investments
that have been made in building up and trans-
ferring knowledge are also worth a great deal.
Yvonne recently organised, for example, a three-
day partner event in Volendam, during which
a vast amount of information was exchanged
by speed dating. An important outcome for the
Marketing Manager B2B is that customers want
more involvement in advance. This means they
can set translators to work and sort out all the
customs paperwork at an early stage. Yvonne
thinks it is a good thing this question came up.
It serves to emphasise what she feels every day.
Sending out the right flows of information at
the proper moment is an important criterion
in her profession for ensuring that products
are optimally placed on the market with the
correct amount of support.
Yvonne van der Rijt, Marketing Manager B2B
26
Changes, errors and typing errors are reserved
2 – 5 April 2014
WCO-IOF-ESCEO SEVILLE
2014: World Congress on
Osteoporosis, Osteoarthritis and
Musculoskeletal Diseases CME
Seville, Spain
10 – 11 April 2014
Anatomy and Surgical Exposures
in Orthopaedics Course
Oswestry, United Kingdom
11 – 12 April 2014
2nd International Congress on
Cartilage Repair of the Ankle
Prague, Czech Republic
8 – 9 May 2014
Lumbar Degenerative Disorders
Prague, Czech Republic
8 – 11 May 2014
10th Central European Orthopaedic
Congress (CEOC) & congress
of the Croatian Orthopedic and
Traumatology Association (COTA)
Split, Croatia
13 – 16 May 2014
OT World 2014
Leipzig, Germany
17 – 20 May 2014
ECTS 2014
Prague, the Czech Republic
14 – 17 May 2014
16th ESSKA Congress
Amsterdam, The Netherlands
26 – 28 May 2014
Iraq Medicare
Erbil International Fair Ground
Kurdistan Region – Iraq
4 – 6 June 2014
15th EFORT Congress
London, United Kingdom
17 – 21 September 2014
XL conference Polish society of
orthopaedics and traumatology
Wroclaw, PL
1 – 3 October 2014
EUROSPINE 2014
Lyon, France
8 – 11 October 2014
Rehacare
Düsseldorf, Germany
22 – 24 October 2014
Medikos
Serbia
2015
16 – 18 April 2015
2015 ICJR World Arthroplasty
Congress CME
Paris, France
27 – 30 May 2015
16th EFORT Congress
Prague, Czech Republic
2 – 4 September 2015
EUROSPINE 2015
Copenhagen, Denmark
* This agenda is an overview of
conferences and exhibitions Össur
wants to notify you about. It is not
intended to be complete and for
information we direct you to the
organizations of these events.
Agenda*
© ÖSSUR, 03. 2014
Össur Europe BVEkkersrijt 4106-4114PO Box 1205690 AC Son en BreugelThe Netherlands
TEL +31 (0) 499 462 840FAX +31 (0) 499 462 841 [email protected]
WWW.OSSUR.COM
27
UNITY™
Sleeveless vacuum
No sleeve required
Greater mobility and user acceptance
15-22 inHg Vacuum
Effective volume stabilization
Simple design
Quick and easy to achieve/release vacuum
Independent pump
Foot function uncompromised
Light weight
Complete system weighs only 130g
WWW.OSSUR.COM TEL +31 (0) 499 462 840TEL +31 (0) 499 462 [email protected]