Great minds discuss assistive devices

Rolling Inspiration
By Rolling Inspiration
7 Min Read

The International Society for Prosthetics and Orthotics (ISPO) hosted its 16th World Congress in Cape Town in May, where professionals from the industry shared their knowledge on assistive devices

Professionals and manufacturers from the world of prosthetics and orthotics gathered at the Cape Town International Convention Centre to showcase the best of the industry. ISPO South Africa chairperson Mike Barkley noted that it was the first time the ISPO World Congress had been held on the African continent.

At the opening of the four-day event, Claude Tardif from the International Committee of the Red Cross emphasised the importance of improving access to mobility services and devices. He noted that “no-one is left behind” in an inclusive society, but that there were barriers to inclusivity.

“Not only the cost of the service, but also the cost of reaching the centre remains a challenge,” Tardif commented. He noted that transport is often not provided by governments, despite their assistance with funding services. His address set the tone for much of the congress, as many workshops and presentations focused on inclusive services.

The World Health Organization (WHO) announced its new standards for prosthetics and orthotics, which included the Priority Assistive Device List. The list was inspired by the Essential Medicines List published by WHO in 1977 and is updated every two years.

The Essential Medicines List has served as a guideline for many countries on pricing essential medicines to ensure they are accessible. WHO hopes the Priority Assistive Device List will have a similar function. Both the list and the standards were introduced through the Global Cooperation Assistive Technology (GATE) initiative.

One new standard, for example, states that insurance companies in all countries need to make provision for prosthetics and orthotics services. These services not only mean independence and inclusion for the patient, but also have economic benefits, as the patient is enabled to return to work or school. GATE also launched the Wheelchair Service Training of Trainers Package, which aims to educate professionals on what is considered an appropriate wheelchair.

The Centre of Rehabilitation Studies at the University of Stellenbosch is working with the WHO to ensure the Priority Assistive Devices List is introduced into South Africa’s healthcare system. Gubela Mji, its director, noted that only around 15 to 25 percent of people who require assistive devices receive the services.

She warned that old technology is often “dumped” in Africa, despite being ill-suited to the continent’s environment. Her sentiment was echoed by Elsje Scheffler, researcher at the Centre. In her research on assistive devices in Zimbabwe, Scheffler found that 90 percent of wheelchairs in the country were donated. While some of the locally manufactured wheelchairs could withstand the rural terrain, donated wheelchairs often broke or were completely inappropriate to the needs of the user.

One type of commonly donated wheelchair consists of a plastic garden chair attached to a steel frame with wheels. These chairs offer no comfort and are available in only one size. Scheffler pointed out that any wheelchair is not necessarily better than no wheelchair.

“Only with an appropriate wheelchair can you participate in society,” she said.

The Centre of Rehabilitation at the University of Stellenbosch plans to implement the Priority List into tertiary learning through providing short courses and revising undergraduate courses to include more content on assistive devices.

Other researchers also presented the findings of their projects. Ed Giesbrecht from the University of Manitoba, Canada showcased his EPIC programme, which allows wheelchair users to learn wheelchair skills through an app on their tablet. In Canada, he said, there is a lack of skills training for wheelchair users.

Krista Best, another Canadian researcher from the Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) in Québec, shared her findings on the advantage of peer-to-peer training when teaching wheelchair skills.

Emma Smith from the University of British Columbia, Canada, shared her team’s research on wheelchair cushions. They recreated the Tuball cushion developed by Evandro Guimaraes and William Mann in 2003: it’s made out of bike tyres and is said to offer similar seating to the ROHO air cushions. Smith found that with the correct material and detailed instructions, anyone can recreate the cushion. It costs US$6 (about R80) to produce one cushion.

Along with accessible prosthetists and orthotic services, 3D-printing technology was a popular topic at the congress. Canadian Computer Assisted Design (CAD) or Manufacturing (CAM) company Vorum presented their Spectra Scanner and 3D technology at a workshop. The scanner replaces traditional plaster work and takes only 30 minutes compared to plaster, which takes most of the day.

This technology was used by the University of Toronto in partnership with Canadian non-profit organisation Christian Blind Mission (CBM) to provide 3D-printing technology to three countries, including Uganda and Cambodia. Through their non-profit organisation Nia Technology, the university and CBM are attempting to provide quality prosthetics in less time by printing prosthetics.

However, in the four years since the inception of the project, they have realised that the technology is susceptible to factors such as power cuts. When a 3D-printing session is interrupted, the process cannot continue where it left off; instead it needs to start again. In addition, the printed devices were prone to breakage due to the material used in the printing. The organisation is looking at creative solutions to resolve these issues.

Other companies, such as Otto Bock, Ossür and Shonaquip, displayed their latest technology at the exhibition hall.

At the closing ceremony on May 11, various researchers received awards for their outstanding research. Details of the next ISPO World Congress were also announced – it will be held in Kobe, Japan in October 2019.

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