Developed by the Baltimore Therapeutic Equipment Company, the BTE work simulator looks similar to a piece of gym equipment complete with a vertical shaft to which a series of instruments can be attached. Designed for patients recovering from muscular injuries in particular, the work simulator provides an intensive rehabilitation programme according to hospital staff. Using the simulator, the patient is able to simulate movements with a variety of tools while the therapist sets the amount of work or power required via a computer. Using special software, the tools are able to mimic hundreds of different tasks - from steering a bus to operating an intricate hand-held instrument - gently coaxing damaged tissue into action. Helen Barnes, a world class canoeist, was one of the first people in the UK to benefit from the work simulator following an operation on her shoulder. "Until I could use the machine, I was only able to use light weights which were not targeted at what I needed to do. The work simulator was able to imitate the paddle actions I need to make, gradually building up my strength week after week and giving me the confidence to go back onto the water." The machine has been at work in Nottingham since April and senior therapist, Julie Upton believes it gives therapists a fine tuned weapon against muscular injury: "The advantage of the machine is it enables us to simulate tasks we couldn't mock up in hospital. The patients love it as it allows them to see the progress they are making. It produces accurate data about how a patient is progressing so is particularly useful for assessment," she said. Consultant surgeon Lars Neumann who operated on Barnes, believes the simulator is invaluable in getting people back to work. "If a bus driver has been injured, the simulator can replicate the movements needed to drive a bus and focus in on this." He also thinks the simulator will play a role in convincing employers that particular patients have a genuine need to stay off work. "Because the computer stores data it can provide a printout of how the patient is getting on. This hard evidence is more convincing to employers as with muscular injury there are often no visible signs of the problem." This is of even greater relevance in the US where injured people must apply for medical insurance. An updated version of the machine is due for release at the beginning of next year according to BTE export sales manager, James Beaver. The new machine will run on Windows and use a touch screen. There are currently only 10 machines in use in the UK.