Previous investigation of a cost-effective virtual reality arthroscopic training system, the Sheffield Knee Arthroscopy Training System (SKATS), indicated the desirability of including haptic feedback. A formal task analysis confirmed the importance of knee positioning as a core skill for trainees learning to navigate the knee arthroscopically. The system cost and existing limb interface, which permits knee positioning, would be compromised by the addition of commercial active haptic devices available currently. The validation results obtained when passive haptic feedback (resistance provided by physical structures) is provided indicate that SKATS has construct, predictive and face validity for navigation and triangulation training. When tested using SKATS, experienced surgeons (n = 11) performed significantly faster, located significantly more pathologies, and showed significantly shorter arthroscope path lengths than a less experienced surgeon cohort (n = 12). After SKATS training sessions, novices (n = 3) showed significant improvements in: task completion time, shorter arthroscope path lengths, shorter probe path lengths, and fewer arthroscope tip contacts. Main improvements occurred after the first two practice sessions, indicating rapid familiarization and a training effect. Feedback from questionnaires completed by orthopaedic surgeons indicates that the system has face validity for its remit of basic arthroscopic training.

Objective Current practice and guidelines recommend the use of neck orthoses for people with amyotrophic lateral sclerosis (ALS) to compensate for neck weakness and to provide surrogate neck control. However, available options are frequently described by patients as restrictive and unsuitable and there was a need for a new device that addressed the needs of people with ALS. MethodsThis project utilised a co-design process to develop a new neck orthosis that was more flexible yet supportive. Following development of a prototype device, an extended evaluation phase of work was undertaken. The evaluation methods included a questionnaire and interviews with patients and carers. ResultsTwenty six patients were recruited to the study, with 20 of these completing all phases of data collection. Participants described the impact of neck weakness on their life and limitations of existing supports. Evaluation of the new orthosis indicated positive views regarding the range of movement, support provided, flexibility of use, and elements such as the appearance and comfort. Feedback enabled modification of design to achieve better optimal fit. ConclusionsThe results of this evaluation highlight the value of this alternative option for people with ALS, and potentially other patient groups who require a neck orthosis.