Aids for Daily Living
In 1974, the service set up a new internal section, the Medical Research Council Unit for Physical Aids for the Disabled, to protect the powered prosthetic limb programme from being overwhelmed by other work. It also aimed to address the obvious and growing local demand for clinical-based design and custom manufacture of devices to aid daily living.
An early example, from 1964, was a feeding aid made for a child with arthogryphosis multiplex congenita (resulting in severely limited upper limb movement). Gas power was used to raise a spoon, fork or cup and two levers were used to rotate the plate and manoeuvre the implement in the horizontal plane to the mouth.
NHS funding was subsequently secured with a remit of ‘the design and production of special aids for the handicapped, from beds and seat to wheelchair’. The requirement for special wheelchair seating grew steadily and to such an extent that it is required its own dedicated service.
Over a number of years the section evolved and changed, to become the ‘Specialised Aids for the Disabled’ with two main functions:
- the bespoke clinical provision for individual patients and
- the long term development of aids that would benefit large groups and that may eventually be manufactured commercially.
During the early 1980s it was recognised that there were no suitable mobility devices for children that could provided both postural support as well as independent mobility. Following initial development and trials in local schools for the disabled, the quadrilateral design was changed to a triangular configuration. This subsequently became know as the ‘Arrow Walker’. An adult version was developed successfully field trialled, though due to its size it was found not be suitable for use in a domestic environment. In 1993, the children’s ‘Arrow Walker’ was commercialised by Theraplay Ltd (Glasgow) and there are now several variations available on the market.
By 2000, section had become ‘The Special Needs Design Service’ – the name it still uses. At that time the service was receiving around 150 referrals annually that resulted in the provision of a device. A full-time clinical bioengineer lead the service with the support of a full-time rehabilitation engineering technician. Commercial assistive devices have since become more widely available at reasonable cost. As a result the service has reduced in size to around 50 referrals per year, but, nevertheless, remains an important source of bespoke solutions for those with complex
The nature of the section’s work has, and continues to be, extremely diverse. A few highlights include devising and manufacturing a cot rocking device, reinforced walking frames, night positioning equipment, postural supports for static seats, an adjustable hip spica plaster casting frame, customised feeding aids and a glowplug cigarette lighter. In addition the service has made adaptations to prosthetic limbs and other devices to allow participation in sports and other leisure activities. In 2012, the service manufactured an interface to allow the user on an upper limb prosthesis to carry an London Olympic torch.
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Selected Further Reading
Meadows CB, Meyerink I, Farley R, Gilmour A.
The arrow walker.
Farley RD, Roy J
Equipment review: the Edinburgh home walker – design and field trial.
British Journal of Occupational Therapy 1996;59(1): 22.
Farley R, Szadurski M, Findlay A, Douglas W, Hood M.
The arrow walker for adults: Design, evaluation and commercial development.
The Special Needs Design Service in Edinburgh.
British Journal of Therapy and Rehabilitation 2000;7(9):394-398.
Farley RD, Mitchell F, Griffiths M.
Custom skiing and trekking adaptations for a trans-tibial and trans-radial quadrilateral amputee.
Prosthetics and Orthotics International 2004;28:60-63.
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Written & compiled by Dr Michael J Dolan, SMART Centre, NHS Lothian, Edinburgh.
First published 15th March 2013. Last updated 15th March 2013. Version 1.0.