Case Studies
Proximat™
Introduction
Proximat is an easy-to-use, child-friendly, and accurate tool for measuring hip range in children with cerebral palsy, which offers several advantages for patients and NHS staff over the traditional goniometer.
Proximat was developed by Manchester PCT physiotherapists, Patsy Pott and Andrea Selley, and is now being manufactured and sold nationally.
The Problem
Around 1 in 500 children born in the UK have cerebral palsy1. Many children with this condition are at risk of hip dislocation, which is painful and can hinder their development.
Hip range is traditionally monitored through regular x-rays and, in between x-rays, using a hand-held goniometer. Regular monitoring enables preventative measures to be implemented and treatment effectiveness to be assessed.
However, the goniometer is difficult to use, and studies show it is not a reliable tool for measuring hip range, as measurements obtained using the goniometer are often not reproducible (test-retest reliability is low).2, 3, 4
The Solution
It was during a particularly awkward assessment using a goniometer that Patsy Pott had the idea for the Proximat.
Patsy was trying to measure the hip range of a two-year old child and explains: “One person was stabilising the hip, another was moving the leg and although there were two of us we couldn’t free our hands to use the goniometer, which is the usual way of checking hip movement. So I marked the treatment bed with a pen to indicate the hip range movement and measured the angle afterwards.”
The Process
Soon the idea progressed to become a large protractor drawn on to a piece of vinyl and then Andrea Selley, another physiotherapist and colleague of Patsy, set up a study into the effectiveness of the new equipment.
This study showed that the mat was reliable. When compared with existing studies of the goniometer, it was also more accurate on repeated measuring, making it more effective in identifying any problems.
Having established the effectiveness of the mat, Manchester PCT turned to TrusTECH (NHS Innovations North West), which provides advice and support to the local NHS in developing innovative approaches to improving healthcare.
TrusTECH assessed the market need for the product and helped the PCT to register the design and trademark. It then negotiated a royalty and licence agreement with JCM Seating Solutions Limited, which will manufacture and distribute Proximat to organisations across the country. The PCT will receive a share of any revenue to reinvest in patient care.
Where can I get one?
For further information, please contact JCM Seating Solutions Limited.
T: 01733 405830
www.jcmseating.co.uk
References
1. Macnair T and Hicks R. Conditions – Cerebral Palsy. BBC Health website ( accessed 11 March 2008).
2. Fosang AL, Galea MP, McCoy AT, Reddihough DS, Stofy I. (2003) Measures of muscle and joint performance in the lower limb of children with cerebral palsy. Developmental Medicine and Child Neurology; 45(10): 664–670.
3. McDowell BC, Hewitt V, Nurse A, Weston T, Baker R. (2000) The variability of goniometric measurements in ambulatory children with spastic cerebral palsy. Gait & Posture; 11(2):86–91.
4. Stuberg WA, Fuchs RH, Miedaner JA. (1988). Reliability of goniometric measurements of children with cerebral palsy. Dev Med Child Neurol; 30(5):657–666.
Figure (top right): Proximat set. The mat is supplied in a canvas bag with a pack of pens, poster, tape measure, user manual, record sheet and CD (containing electronic versions of the user manual and record sheet).
Note. TrusTECH always recommends that NHS staff speak with it about an idea before they approach a third-party/company. This helps to ensure that the idea is adequately protected through legal (intellectual property) rights, preventing others from copying the idea and helps staff to negotiate the best deal possible for their Trusts.