Prosthesis and sports technology in the Paralympic community
WRITTEN BY: Tom Lloyd
Science and technology has become an increasingly important element of sporting competition. From the detailed monitoring of training programs to the ergonomic design of football boots, most sportsmen and women owe their achievements, at least in part, to the work of sports scientists and engineers.
The last decade or so has seen a rapid rate of development in the field of sports science. University laboratories have been a hive of activity, working to shave mere hundredths of a second off an athlete’s time or deliver a fraction more spin when bowling a ball. The tolerances involved are minute, and yet in the world of elite sport it could mean the difference between first and last place.
Nowhere is this synergy between man and technology more prevalent than in the Paralympic community. Since the games began in 1948 at the Stoke Mandeville Hospital in Aylesbury, engineering has been paramount to those participating in what has become an integral part of the Olympic legacy.
Improvements in Paralympic equipment have been rapid over the years, whether it is the design of a wheelchair or the materials used to reduce the weight of prosthetics, engineers have increasingly pushed the boundaries of what is acceptable. This is a trend that looks set to grow exponentially as advances in nanotechnology, 3D printing and biomedical engineering open whole new windows of opportunity.
Yet as the Paralympics embrace innovation, some quarters of the sporting community have raised concerns about the introduction of performance-enhancing systems. Coining the term ‘technology doping’, their argument is based on the principle that engineering should help to provide a level playing field in sport rather than create an unfair advantage. After all, they claim, sport is about athletic ability over and above anything else.
David James from Sheffield Hallam University bluntly disagrees with this sentiment; “no matter what you think about the Olympic ethos as encompassing this friendly event, it is about winning… In elite sport, if you’re not optimising equipment then someone else will.’
James is part of a team that has worked with numerous Paralympic athletes over the years. In 2003 they worked with Dave Holding on the optimisation of his sprint wheelchair. Using Computational Fluid Dynamics (CFD), the research enabled the team to reduce Holding’s drag coefficient quite considerably, shaving a few tenths of a second of his 100m times. This may seem insignificant to a laymen, but “it’s a lifetime; it separates the top five athletes in his field.”
Simon Choppin, another colleague at Sheffield Hallam, aired a note of caution; “whenever you have technology involved in sport, you immediately create a distance between the athlete and the event, you have to be careful that the performance of that athlete isn’t too reliant upon the equipment and cost of technology.”
The cost of performance enhancing research like that of David James and his team also comes under attack on the grounds that it puts some nations at a financial disadvantage, turning sport into a competition for those with the most money rather than the raw skill, passion and motivation. Whilst there is an element of truth in this, the relative costs must be put in perspective. James continues to explain how “it’s not just about what an athlete is wearing, or the equipment he or she has. This is a miniscule cost in the grand scheme of things… The real costs come from developing a sporting infrastructure in a country, and training schemes.”
As James maintains; “countries will still be able to invest wildly different amounts into their athletes, even if the development of technology is limited. It’s far too simplistic to just say ‘it’s not fair.’" It doesn’t really make sense to regulate an industry that is innovating at such an astonishing rate. After all, the advances made at the forefront of sports science soon filter through into the mainstream. Besides is it right for regulators to prevent Paralympians from being the best they can? Why should a sport so reliant on technology not use it to promote interest?
There is however another dimension to the Paralympic debate, one that has centred around one man, Oscar Pistorius, the South African 400m runner who at London 2012 will be the first Paralympic athlete to compete against able body opponents. His unparalleled and undeniably fantastic achievement has caused some to challenge the notion that Paralympians are at a disadvantage. With the case in point some have even suggested that Pistorius, the only athlete ever to run the second half of a 400m race faster than the first, actually has an unfair advantage, such has been the advance in prosthesis research.
The International Association of Athletics Federations (IAAF) has been forced to look closely at the link between Pistorius’s outstanding performance and his carbon-fibre prosthesis. Inspired by a cheetah’s rear leg, it has been contested that Pistorius requires less energy, has a longer stride pattern and suffers less from the effect of lactic acid build up due to his space age appendages.
Of course this notion is refuted by Pistorius, who works just as hard as any other athlete. Vicky Tolfrey, director of the Peter Harrison Centre for Disability Sport at Loughborough University, has raised concerns that allowing Pistorius to compete may not only be unfair on his opponents, but it may change the competitive nature of the Olympics. “If you start allowing an assisted device, you start opening the gates for different sports,” she said. “You could argue that wheelchair racers should be in with runners because they are still doing the same distance.”
Such a contentious point will always raise new questions. That is why it is vital for sports regulatory bodies to confront these issues now. We have opened Pandora ’s Box, with a new wave of exciting sports technology that could mean that athletes are no longer constrained by biology. In the not too distant future we will likely bee seeing a league of disabled athletes who will outperform their able-bodied competitors. It really is just a question of how far do we want to go.
How UiPath robots are helping with the NHS backlog
The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover.
However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time.
When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic?
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses.
The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020.
The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides.
What tasks do they perform?
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day.
UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work.
Is there any possibility of error with software robots, compared to humans?
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.
Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can.
Which members of staff benefit the most, and what can they do with the time saved?
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients.
In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing.
How can software robots most benefit healthcare providers both during a pandemic and beyond?
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted.
Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.
Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast.
The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues.
How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.
Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology.
Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally.
How do you see this technology evolving in the future?
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise.
By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too.
We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money.