News: Long delays hit brain injury recovery

Children are having to wait as long as two years to be given specialist therapy to help them recover from forms of brain damage. [...] The report concludes: "Children and young people who suffer acquired brain injury have particular needs which are often poorly met by traditional services." (via BBC News)

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SAEBO Therapy

They may look like gloves Freddy Kruger and Edward Scissor hands would consider highly fashionable, but they are in fact two splints created by the American company, SAEBO. I've been aware of similar hand gym styled therapy systems, but I've never seen a glove like the SaeboFlex with the ability to lift open your fingers.

Anyone that has suffered a stroke, has celebral palsy or a spinal/head injury will probably tell you one of the biggest and hardest physical problems is the inability to open their hand. Unfortunately this leads to dependence on the stronger side and a neglect of the weaker side. Therapists will probably say this is down to the determination of the patient and that if enough energy was put into using the weaker hand, than automatically relying on the dominant, more progress could be made. This is all very well, but it's pointless to ask someone to attempt brushing their teeth with their weak hand if they cannot open it to grasp the brush. The SaeboFlex looks like it may hold some promise in this respect. The springs appear to pull open the fingers, so you would have to consciously exert a lot of force to close your fingers tight.

My initial dismay was that this was only available in America, but to my delight there is a list on their site for centres in the UK who have SAEBO devices and administer therapy courses: take a look at the list.

Driving Lessons & Adaptions: Lesson 1

When I had my stroke I was told that I would probably never walk again, and never drive a car. Well, I started walking within 6 months of my stroke and 10 years later and I've just started a course of driving lessons. And the only reason I didn't start them years ago was because I didn't have time to with my University commitments. However, I've decided it's time to get on with it now and not have to rely on friends and family all the time. The only complication to this being that I have to fit it around work now, but this isn't a massive problem, it just means I have to get up at the crack of dawn before work to squeeze it in. I will admit that I have some reservations about driving, not because I think I will be awful (time will tell on that one), but because the roads are chock-a-block with bad drivers with road rage. The weather is also less than desirable at this time of year and it's essentially pitch black when I start out, but I'm willing to persevere to get where I want to.


So, under the cover of darkness I meet my new driving instructor and we drive to a quiet neighbourhood to go through my driving adaptions and the usual things about adjusting mirror, seats, etc. Naturally it isn't possible to control a steering wheel with one hand (well, not totally impossible, there are plenty of able bodied people dangerously driving like that on a daily basis after all), which is why there is a big money making industry out there for car adaptions. You can do almost anything to change the way a car is controlled - I've even seen joysticks substituted for a steering wheel, or blowing tubes to control braking (take a look at the quick guide Motability have compiled here). However, fortunately as I am able to use my right foot and right arm perfectly well, an automatic car with an Infrared Steering Wheel Turner is mainly all I need. Hand brake adaptions may potentially be useful to make life easier, but depends on how hard the hand brake is to lift. There are several manufacturers of "secondary" or "infrared" (actually bluetooth) adaptions for cars. Elap make a 12-way adaption (left) which is programmed to interface with the car. It's all very complicated I imagine, but all you'd need to know is that when you press the left arrow button on the pad, your left indicator turns on, and you press it again to turn it off. This has to be programmed into your car so that the adaption communicates wirelessly with the electrics controlling your car. The turner ball is then attached to the steering wheel, and the pad sits to the side, so that you should (in theory) be able to steer the car with the ball and control the indicator, horn, wipers, lights etc. with your thumb. This is definitely a system that has to be practiced over and over again so that you don't have to look at which button you're pressing (this isn't really ideal when you're driving a car I've learned). For anyone planning to learn to drive with this adapation, I think it's probably a good idea if you can get some time just memorising the location of the buttons before you actually have to do it for real, but this has obvious problems as it's likely your driving instructor has the adaption installed, not you.



Another, increasingly popular adaption is the Lodgeson turner, which, as they point out on their site, is used on all adapted BSM cars, and probably in most some AA cars. which might sway your interest in buying one if you're adapting your own car. These adaptions are very much a personal choice, I'm sure there is an adaption to suit everyone if you look hard enough. The Lodgeson design (right), I think will take more time to learn than the ELAP design. The circle is possibly more ergonomic than the rectangle, but the buttons are considerably smaller and closer together, which makes it very easy to hit the wrong button. However, since I've only used it once so far, I won't judge too harshly just yet.

Ok, so which one?
If you're wondering how you find out which adaptions would suit you, there are test centres around the UK that will assess you and suggest suitable options, then let you try them out on a test track. A sort of try-before-you-buy thing really (useful since none of them are particularly cheap). Have a look at the Mobility Centres website to see where your nearest test centre is. They will normally also help you to track down a driving instructor in your area (it will be a short list). Queen Elizabeth Foundation is also a useful resource for disabled drivers, and they can provide you with a list of instructors local to you with the right adaptions.

If you haven't stumbled across Motability yet in your route to driving, they are government organisation that helps finance driving lessons, cars, wheelchair scooters and some car adaptions. They are also a good resource for information regarding disabled driving, instructors and so forth.

Anyway, after having set up my the adaptions and a run through of a little theory, there was just enough time to do a quick.. well, quite slow, 5 minute drive, and then off to work we go. Hopefully there'll be a little more driving next week - watch this space...

A Guide to Shoes

Further to my post on buying shoes, here is my guide to buying shoes if you need to accommodate an AFO leg brace:



(click to view large version)

Fashion, Feet and AFOs

Shoe shopping has been an annual headache, or rather foot ache, for many years now. I say annual, but I regularly put off shoe shopping until I absolutely have to buy a new pair of shoes, which is usually because my current well-worn pair have started to fall apart. As anyone that has slightly irregular feet will tell you, shoe shopping is no fun. In fact it's actually depressing. You walk into a shoe shop and see 4 or 5 pairs of shoes that you'd love to take home with you - but you can't, because your feet don't conform to an ideal size. And even the shoes that you think are 'ok' are still a problem. I have wide feet naturally anyway, but not freakishly wide so it isn't actually my feet causing me trouble - it's my splint. For those unaware of these contraptions - a splint is more accurately called an AFO (Ankle Foot Orthosis) or sometimes braces and calipers if you're still living in the dark ages. They're made by plaster casting your leg and then creating a thermoplastic mould of your ankle at a right angle so that when you walk with it, your foot is held in this position.

The AFO is the typical solution to someone that has drop foot, a condition which prevents the person from lifting their foot upwards. This is pretty essential if you want to walk normally, as you need to lift the front of your foot to clear the floor. If you suffer from this, as I do, your gait is exaggerated on the afflicted side - resulting in a pronounced limp because, to compensate, you have to raise your hip higher. This isn't to say the AFO actually stops you limping, it just stops you tripping over.

The Problem

Anyway, this technical talk to one side and back to the subject of shoes - most girls through their teens and young adulthood would have amassed a huge collection of shoes with a variety of heel heights to totter around on (I know many of my friends do). My collection of shoes typically extends to 1 or 2 pair at any one time, and almost all look the same. Usually in the form of a trainer, or a mary jane style shoe - I've given up on the hope of fitting into a calf boot. I've just completed another shoe shop at Clarks and left with two pairs of shoes which are pretty average looking mary jane's (or dolly shoes), that look similar to my current pair - and neither fully fit me, but I've come to realise over the years that I have to put up with a degree of discomfort with my feet. Some of my previous AFOs have caused permanent damage to my feet where the AFO has continuously rubbed under my foot as I've walked causing them to blister and scar.


The problem is that there are very few shoe makers that create stylish, comfortable shoes or even wide fit shoes. I know that AFO users are probably a very small proportion of society, but it would be nice if my options for comfortable, fitting shoes weren't restricted to orthopaedic granny slippers (case in point to the right).

The Solutions.. or close enough

There are some companies who go some way to helping out people with irregular feet, that don't desire to look like they're shuffling around in booties or slippers.

For those who hanker after knee-high boots that actually fit your legs (although I haven't tried them, so I can't honestly tell you that they do), because you weren't born with legs like a gazelle there's Duo (http://www.duoboots.com/) who will make boots (and shoes) to match the measurements of your legs - but be prepared to part with some serious cash.

Clarks are usually a safe bet, but even the most comfortable, flat-soled, mary jane styled shoe can be deceiving as my recent shopping trip showed me. To illustrate the problem, I've used the filtered search, which is very useful, out of 500+ size 6 shoes they stock, I've narrowed my options to 'wide fit' and only shoes with a bar or strap across the foot, which leaves about 10 options and several of those have heels that are too high.

Skechers, who I used to dismiss as a kids fashion trainer brand have of late been producing quite stylish shoes for women - my last pair and in honesty the pair of shoes I still rely on heavily are Skechers Biker Luxe Shoes (via Amazon):


These are pretty good because the back of the shoe is rounder and wider which helps to accommodate an AFO, they don't have a high heel (though I wouldn't mind it being an inch higher maybe) and they're wider across the foot which is helpful. They also have the all important velcro strap across the top of the foot, which helps strap in my AFO and my foot. However I did try out another Skecher shoe in their Biker range, assuming that they'd all be basically the same fit, and found that the shoe was significantly narrower than my Luxe shoe. While the Luxe is a comfy shoe, it is essentially a form of trainer, which doesn't really work well for every outfit occasion. It's a minefield to say the least, don't get me wrong I'm not expecting to be able to wear 3 inch high stiletto shoes that cripple even normal feet. I'd just like to find some nice looking, vaguely fashionable shoes, that accommodate wide feet, don't require lacing, keep my foot and AFO in place, have a reasonable depth (as the AFO adds to the height of your foot) and don't have a very high heel. Is that too much to ask? For the time being it seems so.