BAPO Teatime Talk with Senior Orthotist Paul Charlton

05-08-21

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  • Paul Charlton

The British Association of Prosthetists and Orthotics (BAPO) has launched a series of virtual education sessions. They include a variety of less formal discussions called ‘Teatime Talks’ and more formal ‘Focus on’ sessions which are short webinars, presented by a range of industry experts on zoom.

Senior Orthotist at Peacocks Medical Group, Paul Charlton, recently took part in a number of presentations.

The first focus area was an orthotics forum, which addressed early Orthotic Management in Stroke.

Paul, has a keen interest in research and stroke rehabilitation and organised the Peacocks virtual FORTH Conference, attended by 250 delegates earlier this year. It explored the role orthotics can play in stroke treatment as well as physiotherapy, based on the Bobath approach. It also provided an opportunity to identify how physiotherapists and orthotists can work together to consider improvements in treatment.

Keen to keep the conversation going, Paul addressed a number of questions within the virtual education session.

Paul, said: “My focus talk elicited some tough questions regarding not involving newer technology in my attempts to change practice in the rehabilitation world. My argument was that this is not yet standard practice and I need a more simplistic approach to take to those currently leading the process, rather than complicating it with something more novel.

“It provided a platform to share my thought process and to engage with physiotherapists. Orthotists can have an impact in the very early stages of rehabilitation, by applying our orthotic biomechanical principles to provide important alignment changes to impact early motor learning. Also, how we can make an important contribution to complement therapy in early weight-bearing.”

Paul was then invited to discuss and share his expertise alongside Elizabeth Lee, advanced physiotherapist in Children’s Oncology at the Great North Children’s Hospital. The topic area explored Managing Children with Chemotherapy Induced Peripheral Neuropathy.

Leukaemia is the most common cancer in children under 15 with over 650 children and young adults diagnosed with leukaemia every year in the UK.

The presentation from Elizabeth explored the treatment of childhood cancer which, typically, has three phases. Remission induction, where the goal is to destroy leukaemia cells in the blood and bone marrow. Then there is consolidation, which begins when the leukaemia is in remission. The objective being to remove any leukaemia cells that may remain in the body. Then there is the third phase of treatment and this is maintenance, to get rid of any remaining leukaemia cells that may regrow and cause a relapse.

As a result of the range of treatments, young children are often left suffering with Chemotherapy- induced peripheral neuropathy (CIPN) with the peripheral nerves being affected and this can lead to a range of symptoms such as numbness, weakness discomfort or pain, cramps in the feet and less ability to feel sensations such as the cold and warmth.

Paul, said: “I was delighted to take part in this webinar and have learnt a great deal from Elizabeth and her team. This is an area that is very relevant to orthotics as, occasionally, I will receive children referred with CIPN and when assessing them and prescribing them with a treatment following chemotherapy, we find this patient group goes through cycles of neuropathy.

“It is important to engage with parents to provide them with tools to help children improve their mobility and to keep them a little fitter, so they are not just sedentary throughout this period. It is also important when they are mobile to help prevent any pain that may occur due to poor alignments, for example, in the feet.

“Many children recover well from their treatments but are left with contractures and need subsequent orthopaedic surgery. So, there are two aspects – managing mobility and managing associated pain with alignment and helping to maintain range, long term.

“It is also very hard to predict how each patient will react to the chemotherapy treatments. Ideally, it would be good for physios and orthotists to see patients at a very early stage, so as to assist with preventative methods rather than being reactive.

“It’s a traumatic time not just for the children but for their families and we can be low down on the list of priorities, so, we really want to make people aware that our services are available.

“Although there are challenges, we have had some very rewarding results with sedentary patients able to walk with orthotic support.

“I would like to thank BAPO for the opportunity to enable the discussions to continue and to raise awareness of the role orthotics continues to play.”