University Hospitals Leicester have been using the BTE PrimusRS since 2006. The system is used by the therapies team primarily for upper limb rehabilitation. Over the last 12 months, the team have undertaken a project with the Breast Care and Oncology teams to assess and rehabilitate their patients. Clinical specialist Occupational Therapist, Rosie Dear has been using the Primus for the entire time it has been at UHL:
“In the time we have been using the Primus, it has become an essential part of our therapy and rehabilitation pathway, offering objective assessment and treatment of our patients. The work currently being undertaken with Occupational Therapy patients in cancer care at UHL was initiated following the reported benefits of using the BTE PrimusRS work simulator with a similar group of patients in the U.S.”.
Following a series of meetings and presentations with UHL Breast Care and Head and Neck Cancer Care teams, the Occupational Therapy out-patient team began to offer a service which, to date, has been a great success. There has been consistent, positive feedback from patients as evidenced by the testimonials provided, and improved objective outcomes which are being gathered by clinicians.
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The multidisciplinary cancer care team have identified a clear, clinical need for pre-treatment OT intervention which would include pre-operative functional assessment and ‘prehab’, in order to optimise a patient’s strength, mobility and function prior to them undergoing surgery or therapy.
The OT rehabilitation programme is appropriate for patients preparing for Cancer treatment as well as for those who have completed their treatment.
Due to their holistic, client centred and function-orientated approach to rehabilitation interventions, Occupational Therapists are ideally placed to further this service and the clinicians involved are very excited about the benefits that use of the BTE Primus RS equipment and this new service can bring to patients and the Hospital.
“We are extremely passionate to be able to develop this service as an additional benefit to patients who are going through their cancer journey, and the encouraging feedback that we are getting from our patients just serves to fuel this passion further”.
Key findings
- Pilot included 7 patients who had an average of 4.4 appointments
- 215% improvement in Disabilities of the Arm Shoulder and Hand (DASH) questionnaire
- All patients were 'better' or 'significantly better' based on Eq5D (generic health status questionnaire)data
- One significant outcome was a patient was able to start radiotherapy as Range of movement improved.
As well as the clear outcome data to demonstrate the systems benefits, it is very important to hear from the patients themselves. Here are two testimonials on how the versatile nature of the system combined with objective data has enhanced outcomes and their ability to do everyday tasks.
Maxillofacial patient following right jaw and neck surgery
“The use of the BTE Primus has tremendously improved the flexibility of my arm. I can stretch more than before, and it has helped with my recovery… The machine allows for the extra stretch and also you can keep increasing the resistance, which means a continuous workout for the arm…..
It has really helped my everyday activities such as dressing and I am working on getting back to swimming which I love to do”.
Breast care patient
“I was introduced to the BTE machine in March 19 after a referral from The Breast Care Centre at The Glenfield Hospital, one month after finishing my active treatment for Breast Cancer. As a result of having a mastectomy and lymph node clearance, I developed cording in my left arm pit. Combined with tight pectoral muscles after the surgery, I had difficulty lifting my arm above shoulder height. This made things like getting dressed, self-care and reaching into cupboards difficult. Over the past 4 months, along with massage to the area to loosen/soften the muscles and daily exercises, the BTE machine helped me to move my arm both passively and actively in a variety of ways. Gradually we have used it to increase my stamina too. I can now lift my arm above my head and reach for things without the painful tightness causing me to stop. Hooray! It was useful to take baseline assessments on the BTE machine and compare them along the way to see if improvements had been made. It’s useful for the patient to see the graphs too, a visual record of progress or areas to develop. Both Amy and Sarah were confident and very capable using the machine. They have been friendly, kind and professional and I looked forward to working with them each week. I’d recommend working with them in the future."
Due to its ability to demonstrate outcomes for both patients and clinicians, the BTE PrimusRS system also has the potential to be utilised in income generation projects; an area which is currently being explored. Combining the unique objective assessments and reporting with the high level skills of the therapy team at LRI has made it a viable proposition for use within local industry in order to support the musculoskeletal health and rehabilitation needs of the workforce.
Therapy specialty lead, Laura Meadows said:
“The primus is a highly valued piece of equipment within our Occupational Therapy Out-patients service. A variety of patients benefit from the equipment within their rehabilitation from hand and upper limb injuries as well as return to work assessments. The trial with breast care/oncology patients has been really exciting and it is great to hear the positive impact it has made on those patients. As a service we are keen to develop our use of the Primus further with the breast care team and oncology, supporting more patients with their function post-surgery. UHL therapies are also keen to look at different ways we can utilise the Primus for income generation of the trust e.g. with private companies or research.”
The Primus RS has more than proved its value for UHL patients since installation in 2006 and has now become an essential part of the UHL Occupational therapy treatment armoury; as technology is progressing machine parts are becoming obsolete therefore it is vital that the this equipment is replaced in order for the UHL Occupational Therapy team to be able to progress in its provision of services for cancer patients and the wider rehabilitation population for years to come.
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