The British Association of Prosthetists and Orthotists

News

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To tune or not to tune – is that the question?

Details

In two influential studies, a number of UK orthotists have stated they do not ‘tune’ their AFO prescriptions. The definition of tuning is to ‘adjust for optimum performance’, so this finding is puzzling and suggests UK prescriptions may not be optimised. Do these findings reflect the current status of the situation in the UK? What is the evidence for tuning and optimal alignments? Do you align your AFOFCs, and tune or optimise that alignment? If not, what are your barriers to implementation. What is usual practice in the UK, what should it be? This teatime talk will be thought provoking and provocative

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Revolutionise Your Health with LimbPower’s Amputee BMI Calculator!

Say goodbye to one-size-fits-all health measurements! LimbPower has created a game-changing Amputee BMI Calculator designed specifically for amputees and individuals with limb differences. This innovative tool factors in limb absence to deliver accurate, personalised BMI results, ensuring a more relevant and meaningful health assessment.

Using it is easy. Simply enter your height, weight, and level of limb loss (left leg, right leg, left arm, or right arm). The calculator instantly adjusts the formula to reflect your unique body composition, giving you a precise BMI score tailored to you.

Why it matters? Understanding your BMI helps you manage weight, optimise prosthetic fit, and take control of your health. Plus, it’s quick and easy—no more inaccurate, generic calculations!

LimbPower has rigorously tested this tool to ensure accuracy and usability. Try it now and take the guesswork out of your health journey! https://www.limbpower.com/exercise/new-amputee-bmi-calculator

Photo Credit: Jennifer Burk
Photo Credit: Sinseeho
BMI word on wood cubes with woman measuring waist hip with a tape at the background. Copy space.

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Limb Power – Understanding Phantom Limb Pain: What It Is and How to Cope

Understanding Phantom Limb Pain: What It Is and How to Cope

Phantom limb pain (PLP) is a condition experienced by many amputees, where sensations, often painful, are felt in a limb that is no longer there. For many, this pain is not just physical but deeply psychological, affecting overall quality of life. Understanding what causes phantom limb pain and exploring effective coping mechanisms can provide significant relief and a better pathway to managing this complex condition.

What Is Phantom Limb Pain?

People with phantom limb pain experience acute sensations of pain that appear to come from the limb that has been amputated. It is estimated that between 50 and 80 percent of amputees develop phantom limb pain post-amputation.

The term ‘phantom’ does not mean that the pain is imaginary. Phantom limb pain is a very real phenomenon confirmed through brain imaging scans. Symptoms range from mild flashes of pain, similar to an electric shock, to constant, severe discomfort.

Researchers believe PLP results from a complex interaction between the brain, spinal cord, and nerves, with three main theories explaining its causes:

  • The Peripheral Theory: Nerve endings at the stump may form clusters, or neuromas, generating abnormal impulses that the brain interprets as pain.
  • The Spinal Theory: Loss of sensory input from the amputated limb causes chemical changes in the central nervous system, triggering pain symptoms.
  • The Central Theory: The brain retains a ‘memory’ of the amputated limb and its signals, leading to pain when expected feedback is absent.

Psychologist Keren Fisher explains, “When you lose a limb, the brain doesn’t just stop recognizing it. The neural pathways are still wired to that missing part of the body and continue sending signals as if it’s there.” Stress and trauma often intensify PLP, making it a multifaceted condition requiring a holistic approach.

Impact on Individuals

Phantom limb pain can profoundly affect daily life. Pain and discomfort may disrupt routines, interfere with sleep, and cause frustration or disconnection from one’s body. Social withdrawal, anxiety, and depression are common, as individuals adjust to life without a limb.

Coping Mechanisms and Effective Therapies

While there is no universal cure for phantom limb pain, several therapies and techniques have proven effective:

  1. Mirror Therapy
    Mirror therapy uses a mirror placed in front of the intact limb to simulate movements in the missing limb, tricking the brain into perceiving the limb as functional and alleviating pain.
  2. Cognitive Behavioural Therapy (CBT)
    CBT helps amputees reframe negative thought patterns. A study in the Journal of Pain Research found that patients undergoing CBT reported a 30–50% reduction in pain intensity.
  3. Mindfulness and Relaxation Techniques
    Deep breathing, meditation, and mindfulness exercises calm the nervous system and reduce stress, which exacerbates PLP.
  4. Medications and Pain Management
    Doctors may prescribe medications such as anticonvulsants (e.g., gabapentin), antidepressants (e.g., amitriptyline), or opioids (e.g., codeine, morphine). However, opioids carry risks of dependency and are generally used cautiously.
  5. Non-Invasive Techniques
    • Heat or cold applications (e.g., ice packs or creams).
    • Massage to improve circulation and muscle stimulation.
    • Acupuncture to stimulate specific points and relieve pain.
    • Transcutaneous electrical nerve stimulation (TENS) disrupts pain signals and stimulates endorphin release through small electrical impulses delivered to the stump.
  6. Mental Imagery and Mirror Visual Feedback
    Imagining movements like stretching phantom fingers or toes can reduce pain. Similarly, mirror boxes provide visual feedback to the brain, reducing discomfort by simulating the presence of the missing limb.
  7. Advancements in Prosthetics
    Prosthetics with sensory feedback mechanisms reconnect the brain to physical sensations, reducing PLP. Kiera Roche praised her microprocessor knee, saying, “It doesn’t just restore mobility; it can reduce phantom pain by giving your brain sensory feedback.”

The Power of Community Support: Stuff That Works Research Community

While individual treatments can help manage phantom limb pain, many amputees find that connecting with others who share similar experiences is equally beneficial. The Stuff That Works community is an invaluable resource for those seeking support, shared experiences, and research-backed insights into managing PLP effectively.

By joining the Stuff That Works Phantom Limb Syndrome Community, individuals can learn from real-world experiences, discover what treatments have worked for others, and contribute their own stories to collective research. The platform enables members to find practical solutions that go beyond medical literature, fostering a sense of belonging and empowerment.

To read about other lived experiences and contribute to the community, visit:
🔗 Phantom Limb Syndrome Community
🔗 Residual Limb Pain Community

The Importance of a Holistic Approach

For many amputees, managing phantom limb pain requires a combination of therapies tailored to individual needs. Kiera Roche emphasised, “Dealing with phantom limb pain isn’t just about fixing the physical sensations—it’s about treating the whole person. Healing happens when you focus on your body, mind, and spirit together.”

Phantom limb pain is a challenging condition, but with the right strategies and a strong support network, it can be managed effectively. By understanding the science behind PLP, exploring proven coping mechanisms, and engaging with supportive communities like Stuff That Works, amputees can regain a sense of control and lead fulfilling lives.

Photo Credit: Aaron Blanco

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Job Advert – Clinical Link Tutor in Enhanced Practice (Prosthetics and Orthotics)

0.4 FTE 1 year secondment opportunity!

Opportunity overview

We are looking for current NHS clinical colleagues to join our Enhanced Practice (EP) team in the Directorate of Allied and Public Health at the University of Salford. We have 4 positions with one post in each of the following professions:  Podiatry, Diagnostic Radiography, Physiotherapist, Prosthetics and Orthotics.

This role will focus on leading the Prosthetics and Orthotics professional pathway within an NHSE funded, one year project which will enable the upskilling, development, delivery and sustainability of the Enhanced Clinical Practitioner apprenticeship in England.  

The post holder will utilise their clinical expertise, experience and networks to support the development of the registered Prosthetics and Orthotics workforce.  They will have experience of supporting learning and workforce development in the practice / clinical environment.  The post holder will have the ability to develop and utilise professional networks with support from the Project Lead to drive enhanced practice within Prosthetics and Orthotics, supporting employers in developing pathways for enhanced clinical practice and career development.

 

Key responsibilities

  1. Work with the EP team to collaborate with employers, health professionals and industry partners to scope the needs for ECP development and delivery within Prosthetics and Orthotics
  2. Design and deliver a range of teaching and learning approaches for apprentices and non-apprentices including mentorship and coaching.
  3. Link with employers to develop and co-ordinate Prosthetics and Orthotics ECP pathways which facilitate recruitment, sustainability and excellent student experience.
  4. Supervise ECP student projects, including work-based learning.
  5. Extend, transform and apply own knowledge to learning, research and external activities which promote ECP readiness and delivery.
  6. Promote equality and diversity within ECP to sustain inclusive and supportive practices in accordance with university policy.

 

How to apply

To apply please submit your CV and 1 side of A4 (500 words) on how your knowledge, skills and experience meet the key responsibilities of the role.

Closing date for applications is 12 noon on Thursday 17th April. Please send applications to h.slater3@salford.ac.uk.

Interviews are scheduled to take place on Thursday 24th April.

 

A bit about our School

With over 8,000 students we are the largest School at the University, with colleagues and students from all over the world. We are a forward-thinking, dynamic school with a commitment to lifelong learning and real-world impact.

We offer programmes across a range of subject areas including counselling, nursing and midwifery, allied and public health, psychology, sociology, social work and social policy, policing and criminology, and sport.

Through our interdisciplinary research network and three research centres, we focus on improving health, social and individual outcomes. 

We are part of the global healthcare community and collaboration is at the heart of what we do, working with a wide range of industry partners locally, regionally and globally. 

We value diversity – in backgrounds and in experiences. Our difference makes us stronger, and together we share a passion for improving students’ lives.

We have a commitment to be Net Zero by 2038 and embed sustainability in all aspects of university life.

By joining us, you will become part of a wide network of professionals, sharing knowledge and expertise.  Like us, you will be passionate and committed and will be part of our ambitious journey, to shape the health professionals, community and social leaders of the future.  

Further information on Enhanced Practice  can be found here https://www.hee.nhs.uk/our-work/enhanced-clinical-practice-apprenticeships/ahp-enhanced-practice-0

Details of our  ECP apprenticeship programme  and PGCert Enhanced Practice scan be found at  PgCert Enhanced Clinical Practitioner (Enhanced Clinical Practitioner Apprenticeship) | University of Salford

Further detail can be found in the below job description and person specification:

Clinical Link Tutor (Enhanced Practice) MPF4007Download

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Advertise Your Job Vacancies with BAPO

Connect Directly with the UK’s Prosthetics and Orthotics Professionals

The British Association of Prosthetists and Orthotists (BAPO) offers a dedicated job advertisement distribution service designed to help organisations reach a highly targeted audience of prosthetic and orthotic professionals. Whether you’re looking to recruit clinical staff, technicians, support workers, or reach prospective graduates, BAPO provides an effective and respected platform to promote your vacancies.

Through our streamlined email-based system, job advertisements are circulated directly to the relevant groups within our membership—either Registered Members (Prosthetists and Orthotists) or Associate Members (Technicians, Support Workers, and Learners). This direct-to-inbox approach ensures that your job opportunity reaches individuals who are active in the profession and already engaged with the BAPO community.

Why Advertise with BAPO?

BAPO is the UK’s recognised professional body for prosthetists and orthotists, with a membership comprising the most experienced and qualified practitioners in the field. Advertising with us allows you to:

  • Reach a highly specialised audience of professionals with relevant skills and qualifications.
  • Gain credibility and visibility by advertising through a trusted professional association.
  • Streamline your recruitment efforts by targeting individuals who are actively involved in and committed to the profession.
  • Ensure timely exposure through prompt email circulation managed by the BAPO Secretariat.

    This service is ideal for NHS Trusts and Health Boards, private providers, universities, manufacturers, and third-sector organisations seeking to attract top-tier talent in prosthetics and orthotics.

Cost and Accessibility

  • Free of charge for UK-based organisations
  • £320 for organisations based outside the UK


This makes BAPO’s job advertisement service one of the most cost-effective and high-impact recruitment tools available within the sector.

How to Submit a Vacancy

To advertise a vacancy, please refer to the booking form and submission guidelines provided. Once submitted, your advert will be reviewed and distributed to the relevant membership groups by the BAPO Secretariat.

Get Your Vacancy in Front of the Right People

Whether you’re filling a permanent role, a fixed-term contract, or a specialist position, advertising through BAPO ensures that your vacancy reaches those who are most likely to apply—qualified, engaged, and ready to contribute to the future of the profession.

Job advert booking form 2025Download

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Advancing Healthcare 2025 – Shortlist

BAPO is proud to sponsor an award dedicated to celebrating impact and excellence in prosthetics and orthotics at the 2025 UK Advancing Healthcare Awards. This year’s shortlisted nominations have been announced.

Congratulations to Laura Barr who was the winner of the BAPO award for evidencing impact and excellence in prosthetics and orthotics. More will follow about the Advancing Healthcare Awards and Laura.

Many congratulations to Nikki, Laura, and Eileen for being shortlisted for the BAPO sponsored AHA award. Three fabulous role models for our profession. I am delighted the impact they have had has been recognised. I am looking forward to celebrating with them on May 23rd.

Dr Nicky Eddison,

BAPO Chair

We are very proud to sponsor this award and to shine a light on the prosthetics and orthotics profession. It’s wonderful to see the achievements of Eileen, Laura and Nikki being recognised and celebrated so huge congratulations to them all.

Sue Irving,

Chief Executive Officer

The Shortlist

Eileen Morrow

Improving the prescription of dynamic contracture bracing

I am honoured to be shortlisted for the 2025 Advancing Healthcare Award in the BAPO category for Evidencing Impact and Excellence in Prosthetics and Orthotics. I am also proud to be nominated alongside Laura Barr and Nikki Munro, whose projects are advancing our profession and delivering meaningful benefits to patients, orthotists, and the wider NHS.
Over the past four years, I have led a service evaluation at Oxford University Hospitals NHS Foundation Trust to understand which patients receive dynamic contracture bracing, and who benefits from it. I found that orthotists and referrers were uncertain when to prescribe these braces, and that orthotists were fitting the braces inconsistently. Some orthotists advised wearing them for a vague “few hours a day” or overnight, and orthotists set the brace up with different stretch settings. This variation meant patients received mixed messages, making it harder to use the braces effectively.
To address this, I worked with my team to review existing research, create a clear and consistent wear protocol, and assess its impact. We introduced a standard guideline recommending one hour of wear per day with a defined level of stretch. Our findings showed that this approach was equally as effective. We also discovered that only 20% of patients prescribed with a dynamic contracture brace saw an improvement in their contracture, but were unable to predict these patients using routinely collected clinical data. This highlights the need for further research to better understand who benefits from bracing.
This project was achieved with no additional funding, relying on strong collaboration and creative resource use. By embedding the evaluation within routine clinical practice, the entire team remained engaged in data collection over four years, even during the COVID-19 pandemic. Service users played a key role in shaping patient information and selecting outcome measures, ensuring that the project remained patient-centred and clinically relevant.

    Laura Barr

    The Orthotics Evidence Portal: enhancing evidence-based practice in the UK orthotic profession

    Bio: Laura graduated from the University of Strathclyde in 2007 and works as an Advanced Practitioner within the Orthotic and Orthopaedic services at NHS Greater Glasgow and Clyde.
     
    Project description: The Orthotics Evidence Portal, formerly known as DEBOP, is a unique resource designed to facilitate access to the evidence-base regarding the orthotic treatment of patients with musculoskeletal pathology or diabetic foot conditions. The Portal is the product of a 10 year effort by a group of orthotists in the UK who want to improve access to the orthotic evidence-base. Since 2014, it has enhanced evidence-based practice in the UK orthotic profession, by improving accessibility to clinically-relevant publications in order to assist clinical decision-making.

      Nikki Munro

      Trailblazing Leadership in Orthotics, Advancing Patient Care, Staff Development, and Service Sustainability

      Nikki Munro graduated from the University of Strathclyde in 1993 with a BSc Hons in Prosthetics and Orthotics and has worked as an Orthotist since graduation. She has worked in both the contracted and NHS sectors and has carried out a number of projects and secondments during her career. As an Advanced Specialist Orthotist she led in the specialist areas of Adult Neurology and Diabetes. She is currently Clinical Lead and Service manager for Orthotics in NHSGGC. She is also Professional lead for Orthotics within NHSGGC and lead for Quality Improvement for all AHPs in NHSGGC and holds a Scottish Improvement Lead qualification. She is Chair of the Scottish Clinical Orthotic Leads Group.

      Nikki’s summary statement for her nomination:

      Nikki has been a pioneering leader in Orthotics at NHS Greater Glasgow &Clyde (GGC) since 2016. She has developed some of
      the UK’s first Advanced Practice roles for Orthotists, revolutionised patient care through ACRT (advanced clinical referral
      triage), and championed staff development, creating lasting impact on both services and patients.