A Special issue on Assistive Devices in Rehabilitation

As per Census of India 2011, there are about 27 million disabled people in India of which 5.44 million are afflicted with “disability in movement” with an overall growth of 20% over the last decade. Therefore, the need for orthotics and prosthetic devices is paramount. This special issue is an attempt to summarize the key developments in Orthotics and Prosthetics (O&P) in India right from the historical perspective to latest technological developments. The field of Orthotics deals with the design, fabrication and fitting of orthotic devices to support and brace weak or ineffective joints and muscles whereas Prosthetics involves the design, fabrication and fitting of artificial limbs intended to replace a portion of the body that either has been lost through amputation or was absent at birth. Natural disasters, conflicts (i.e. war, terrorism), disease, accidents, and the like are the primary factors leading to the need for development of Orthotics and Prosthetics. Important considerations include functionality, durability, reliability, maintainability, affordability, and ease of manufacture and use. While appropriate care for the disabled is predominantly a humanitarian obligation, rehabilitation care also has to be seen in the light of the overall health needs of a country’s population. However, in view of multiple health problems and severe resource constraints, difficult choices have to be made by health planners and aid agencies endeavoring to provide at least a minimum package of essential services. Simple criteria for monitoring and evaluation must also be established to assess progress towards objectives. Clearly, in India, compromises must be made between expensive high-tech approaches available to a few, versus simpler techniques that can be useful to a larger community. Consequently, the best approach is the development of basic, low-cost devices. One component is clearly technological, but development of motivated, adaptable and well-trained professionals is equally important. The onus rests with the government: Only this guarantees a country-wide system that ensures equal access to fitting possibilities for all disabled persons while offering affordable devices that are appropriately cost-effective.

Given his unparalleled experience of over four decades in the field of rehabilitation with India’s Apex Rehab Institute AIIPMR, Dr. M. G. Mokashi, the chief mentor, PHYSIOTIMES was invited to be the guest editor for this special issue. The co-guest editor was Shri T. P. Mirajkar, who has been a pioneer in the education of Prosthetics and Orthotics in India and has shared his views on the development of the field. The issue is a balanced mix of contribution from experts representing different fields within the arena of rehabilitation that includes Physiotherapist, Occupational Therapist, Orthopedic Surgeon, MD, Orthotist and Prosthetist, Engineer, Podiatrist etc. We profusely thank all the authors for contributing their expertise. The issue also contains a list of support organizations, NGOs and associations in the P&O field in India and across the globe for your ready reference. There is a special report on the participation by PHYSIOTIMES on prestigious global platforms for PTs  and tie-ups with organizations of global repute to bring the best expertise and information to our readers in the forthcoming issue. We are sure this special issue will broaden your knowledge and understanding about the role of assistive devices in rehab and you would be able to pass on the benefits of your learnings to your patients

GUEST EDITORIAL: Assistive Devices in Rehabilitation- A historical Perspective & recent advances in India - DR. M. G. MOKASHI

I have great pleasure to part with my experiences on Assistive Devices, with many I am closely related since 1960. Till 1980s definition spelled that appliances could be worn on body like orthosis or prosthesis. Later, they became walking devices. Aids are ambulatory like wheel chair, tricycle etc.; a walker is mini movable version of parallel bars. A Seat-lift chair underlines a device in transfer activities and so a sliding board. We have used for weak/ painful hand, the forearm-resting wal... Read More

VETERAN SPEAKS: Development of Prosthetics and Orthotics field in India- An Engineer's Perspective - T.P. MIRAJKAR

It is my pleasure and privilege to part with my relished memories for posterity of the field in which I spent over 3 decades from its inception in the public sector in 1955 till my retirement in 1988. With a Diploma in Mechanical as well as Electrical engineering I was selected for the post of Prosthetic Workshop Manager, at the All India Institute of Physical Medicine and rehabilitation, just launched under Act of Parliament, then. I did not know of my fate in future.

I was lucky t... Read More

EXPERT OPINION: A Surgeon's Perspective on the use of Assistive Devices in Rehabilitation - DR. DEEPAK SHARAN

Assistive device (AD) refers to any item, piece of equipment, or product system that is used to increase, maintain, or improve the functional capabilities of persons with disabilities (PWD). AD can help improve physical or mental functioning, alleviate a disorder or impairment, prevent the worsening of a condition, and improve a person’s capacity to learn, or replace a missing limb. ADs for ambulation have been used since the Neolithic period. Currently there are over 650 million PWD wo... Read More

EXPERT SPEAKS: orthopedics Assistive Devices- Evaluation & Training - KAREN PAVRI

There are several Orthopaedic assistive devices available in the market, made from a combination of materials such as metal, plastics, synthetic fabrics etc. This article covers Physiotherapeutic evaluation and training with aids and appliances for the spine and lower limbs, as experienced over three decades.                                ... Read More

SNAPSHOT: Lower Limb injuries- A Podiatrist's Perspective on nonsurgical treatment - GREIG PRICE

The field of podiatry is relatively new in Asia.  Being based in Singapore, where podiatry has been present for less than 20 years, many medical practitioners are still unaware of what podiatry is, and how it can help treat lower limb injuries. 

Podiatry can be divided into 3 broad fields - Diabetic foot care, General care and Biomechanics.  Diabetic foot care is the management of diabetic feet for the prevention, treatment and rehabilitation of diabetic foot injuries... Read More

SPECIAL FEATURE: Rehabilitation Scenario and the use of Assistive Devices in China - DONGFENG HUANG

As the development of rehabilitation science, more and more people focus on the quality of recovery. It has been widely recognized that assistive devices can help reduce the pain and promote the function in the management of many diseases. 

According to the data of China Disabled Persons Federation, , there are about 85.02 million disabled Chinese people caused by diseases including stroke, spinal cord injury, cerebral palsy, amputation, and osteoarthritis in 2010. Stroke is th... Read More

SPECIAL ARTICLE: Novel Pneumatic Knee Brace - ANIL BHAVE

Osteoarthritis of the knee is a debilitating disease that results in decreased function and marked pain it can cost up to $5,000 per person annually for pain management1.  Currently, it is estimated that there are over 10 million people affected by this disease in the United States and will grow to 30 million by 2020. In case of India it is expected to have 60 million people affected by arthritis out of which more than half will involve severe knee joint arthritis.  Furthermore, as ... Read More

CLINICAL PEARLS: Self Help Devices in orthopaedic Impairments in Indian Population - SMITA JAYAVANT

Every person is a valuable member of society. Persons with disabilities must be recognized for their total capabilities and they must be active participants in all phases of their rehabilitation.Rehabilitation of persons with disabilities is a complex process and can be best accomplished by collaboration between the inter-disciplinary team and the person with disability and family or caregivers. Environmental conditions must be considered in the rehabilitation process as they can increase or ... Read More

FACE-TO-FACE: Technologies in Prosthetics and Orthotics: Indian Scenario - ASHOK INDALKAR

Shri. Ashok Indalkar has been working in the field of Prosthetics and Orthotics for the last 32 years. In the year 1980 I was admitted at the All India Institute of Physical Medicine and Rehabilitation, Mumbai after passing H.S.C (Science) to the Diploma in Prosthetics and Orthotics Engineering, which I completed in the year 1983. In the year 1991 I completed my Bachelor’s degree in Prosthetics and Orthotics (B.P.O) and in the year 2009 I passed the Master’s degree in Prosthetics ... Read More

STRAIGHT FROM THE GUT: Orthotic Management of Neuropathic Limb: Leprosy and Diabetes - S.K. BEHURA

If a wound or injury does not cause pain it is likely to be neglected. Neuropathy implies a defect in nerve function. It may affect motor, sensory or autonomic system. The most serious neuropathy is diminution of sensory protection. There is a lack of recognition of pressure, force or stress that a normal person would produce as an immediate response. This leads to neglect of abnormal pressure, friction & burns resulting in non-healing ulcer. Motor neuropathy leads to muscle imbalance res... Read More

A SYNOPSIS: Support Services &Organizations for Prosthetics & Orthotics - MUKESH NAYAK

In their practice, Physiotherapists recurrently come across patients with disability or those affected by limb loss. As an integral part of the rehab team, it is important for a therapist to reassure them that they can have a very fulfilling and functional lifestyle no matter what circumstances have led to their problem. With a view to help your patients in their rehabilitation journey & enhance their quality of life, we present here useful information about various organizations & as... Read More

SPECIAL REPORT: PHYSIOTIMES GOES GLOBAL-A report on our participation at various global platforms - Special Report

In our perpetual quest to bring the best of information in the field of physiotherapy to our readers, we at PHYSIOTIMES Have left no stone unturned in exploring all the Possibilities ever since inception. Taking this endeavor a step further we have collaborated with global organizations of repute in physical therapy, health and rehabilitation to promote professional interests of physical therapists on the international forum in a mutually beneficially manner. We present here a report on our r... Read More

WEB ADVISOR: Useful resources on the web for prosthetics and orthotics-WEB ADVISOR

http://www.oandp.com/   Prosthetic  and orthotic patient care and product information readily accessible for amputees, orthotists, prosthetists, and therapists.

http://enablingthefuture.org/  A Global Network of Passionate Volunteers (Called e-NABLE commu... Read More

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