Sunday, 24 July 2011

As Good as the Original - Artificial Limbs - A Boon

Published in Panorama

When walking is pure joy !!!

The feeling of being able to stand on your own two feet is indescribable! It is indeed a great joy, a dream come true for us, say Prema and Ammu, polio victims and members of RAWWD (Rehabilitation Workshop by Women with Disabilities). “Thanks to Mobility India, we can now walk, even work and fend for ourselves.” There are many others like Prema and Ammu who have begun this journey a trifle late in life, but are happy it’s happened at least now!

Mobility India’s Prefabricated Knee Ankle Foot Orthosis (PFKAFO) has given a new lease of life to hundreds of thousands of victims of polio and similar neuromuscular conditions in India, Bangla Desh, Sri Lanka and a number of African countries. While the concept of PFKAFO itself if not new, the present orthoses designed by Mobility India, is vastly different to those available elsewhere in the world and come at an extremely modest price, making them affordable even to the common man.

Says Dibyendu Ghoshal, Program Manager, Research and Development, Mobility India, “The earlier plastic Knee Ankle Foot Orthoses, though they are yet well accepted, are light weight and user friendly, take time to produce since they have to be crafted to suit individual needs. This takes days to make and individuals needing them are required to come here at least a couple of times to our unit in Bangalore to avail of them. But all that has changed with the new orthoses which can be made available to those requiring them as and when they come here.”

Mobility India, a voluntary organization empowering differently abled people to life fulfilled independent lives, worked for the last six years and spent millions of rupees to develop PFAFO technology which can fit most of the people who need such orthoses, at a record time and at a minimal cost. “We thought if you can buy a pair of readymade trousers or pair of shoes, why not a ready fit orthoses. That’s what propelled us to intensive research and we now have these prefab ones which can be worn along with any kind of footwear or no footwear at all,” enthuses Dibyendyu.

Weighing about 500 gms, PFKAFO come in 10 different sizes, categorized into adult and child sizes, priced between Rs.1000 – Rs.1200 a piece. Mobility India’s R & D unit analysed over 6000 measurements to find almost accurate dimension to the leg and foot of polio affected people. Using computer technology, they have standardized the dimension and shape for 10 sizes.

The orthoses come in a kit which is easy to assemble in about 4 hours by a trained technician. Describing the fit, Dibyendu explains, “The orthoses has two parts: upper segment above the knee and the lower portion which is below the knee. The lower part can be fitted in about 60% of the disabled people while the upper part fits over 90% of such people. This is because the deformities, most often occur in the lower part of the legs than in the upper section and if these lower segment deformities are very pronounced, we need to modify our ready fits to suit the individual needs and give them a perfect fit. In such cases we go for a custom made lower section alone”.

High Density Polyethylene (HDP) is used to make the orthoses because of its highly durable and mouldable properties. With little heat, this material can be easily remoulded to fit the contour of the leg to give optimal fit and comfort to the wearers. In addition, the plastic used in fabricating the orthoses, does not produce any reaction on the skin of the users. An inner lining of ethaflex, a polymer material which again does not produce any allergic reactions, is used to provide added comfort to the wearers. While the orthoses is washable and has holes for ventilation, the knee joints are made from stainless steel, thus obviating the need for maintenance.

While the PFKAFO are themselves durable, they may have to be changed once every three or four years due to the body’s changing physiology and musculature, agrees Dibyendu. The greatest advantage of these ready-to-wear orthoses is that anyone coming for one, can avail it on the very same day at no extra cost!

On the issue of maintenance, Dibyendu explains, “No chemical reaction can damage these orthoses. You can perhaps damage the fixture only by deliberate mechanical force, not otherwise. We do a regular follow up of the users and call them every 3 months and if the orthoses require any maintenance like oiling, we do that. But we also teach the clients to do small repairs at home itself.”

Yet again, besides the PFKAFO, Mobility India has done extensive research on the long-existing Jaipur Foot, to make it more user-friendly. To enhance the quality of the ‘foot’, Mobility India tested various kinds of rubber and has designed different die for males and females to give quality fit to the artificial limb wearers. Explaining the innovative technology perfected by Mobility India, Dibyendu reveals, “Earlier the Jaipur Foot used to be fitted with very ordinary limb which was made of Aluminium or HDP pipe. We’ve now designed it in such a way that it can be fitted with any International Modular System.”

For the first time anywhere in Asia, Mobility India’s workshop making these new Jaipur Foot, comprises of women who are themselves physically challenged. The production unit is so designed as to extract very little physical effort from these women who are trained by Mobility India in manufacturing the Jaipur Foot.

With the increasing incidence of road accidents and consequent rising number of amputees all over the world, the demand for the Jaipur Foot has increased manifold. Foot makers and Limb fitters from world over converge in India to learn the technique of manufacturing these feet.

These twin technologies, PFKAFO and Jaipur Foot, are changing the concept of using calipers to orthoses, metal bands to plastic supports, heavy boots to any footwear or even barefoot, heavyweight to light weight, expensive to economic, non-availability to easy availability, all over India and other low income countries. In furthering this R & D, Mobility India has been supported by CAPART – Government of India, Jaipur Limb Campaign UK, KaR – DF ID, UK and Christoffel Blinden Mission, Germany.

A definite effect of these innovations is the larger numbers of physically challenged individuals seeking a certain degree of independence and getting integrated into mainstream society with their newfound mobility. With children joining schools and adults becoming gainfully employed, the technology is certainly a big step towards a more inclusive society.


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