Proximat®

Proximat®

• 13 September 2011

Introduction

Proximat is an easy-to-use, child friendly and accurate tool for measuring hip range in children with cerebral palsy. It offers significant advantages for patients and NHS staff over the traditional goniometer.

Proximat was developed by NHS Manchester 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 born with this condition are at risk of hip dislocation, which is painful and can hinder their development.

Hip range is traditionally monitored through regular 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 have shown it is not a reliable tool for measuring hip range, as measurements obtained 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 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. 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 a piece of vinyl and then Andrea Shelley, a colleague of Patsy, set up a study into the effectiveness of the 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 problems.

Having established the effectiveness of the mat, NHS Manchester turned to TRUSTECH, who provide support to local NHS in developing innovative approaches to improving healthcare.

TRUSTECH assessed the market need for the product and helped NHS Manchester to register the design and trademark. A royalty licence agreement was then negotiated with JCM Seating Solutions Limited, who manufacture and sell Proximat. NHS Manchester receives a share of any revenue to reinvest in patient care.

Proximatis 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).

Where can I get one?

JCM Seating sell the Proximat. For more information, visit: www.jcmseating.co.uk.

NOTES:

1.  Macnair T and Hicks R. Conditions – Cerebral Palsy. BBC Health     (www.bbc.co.uk/health/conditions/cerebralpalsy1.shtml; 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 andChild Neurology; 45 (10): 664-670.
3. McDowellBC, 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. (1998) Reliability of goniometric measurements of children with cerebral palsy.  Dev Med Child Neurol; 30(5): 657-666.

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