| PFKAFO |
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| Prefabricated Knee Ankle Foot Orthosis (PFKAFO) |
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| PFKAFO - a little adjustment helps to make it comfortable |
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| PFKAFO - Abeba (centre with her mother, regular replacemnt callipers help her to maintain her mobility and walk to school |
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| PFKAFO metal dies for KAFOs |
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| PFKAFO trials |
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| Training - Evaristo and co-trainee taking a case history on a placemen |
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Adapting a successful technology for wider dissemination
Polio eradication programmes are well underway in most developing countries, but millions of adults and children who have contracted polio continue to live with its debilitating effects. Their lives can be transformed by the physical mobility and potential for social integration that a well-fitted calliper or brace brings. For children with polio it is vital that they are able to join in, go to school and play.
Plastic callipers are lightweight and have a high acceptance rate amongst children. They are the modern alternative to traditional metal callipers worn with boots - still widely used in India, Ethiopia and other developing countries. Plastic callipers have the added advantage that they can be used with any kind of footwear and can even be modified for bare-foot walking.
However, the main problem with conventionally-produced plastic callipers is their cost and the time it takes to make them, fit them and learn to use them - up to five days with several visits to a workshop for fitting and gait training. This is not an option for poor people or people who live far away from rehabilitation facilities. For example, in India the majority of orthopaedic workshops and rehabilitation centres are in cities, whereas 80% of people who need callipers live in rural areas. Given the current technology, spread of resources and lack of trained technicians, it is difficult to see how the demand for callipers in India or elsewhere can ever be met.
DDP partnered Mobility India to research and develop the adaptation of existing conventional plastic calliper (Knee Ankle Foot Orthosis - KAFO) technology with a view to mass producing all the components that go into making the callipers. MI formed a partnership with a commercial company for their knowledge of plastics technology and production facilities. Ten standard sizes of calliper components, for left and right leg, above knee and below knee components and accessories were mass produced for easy distribution, assembly and fitting. After field tests, a programme of training and demonstration workshops was launched to introduce PFKAFO technology to key professionals, trainers in training institutes and orthotists working with rehabilitation NGOs in India.
Since 2004, PFKAFO components are being marketed by Mobility India and there is growing interest from rehabilitation professionals within India and from other countries.
Disseminating the technology
In 2005 DDP initiated a project to disseminate PFKAFO technology to Ethiopia through a trial for 100 children which is currently in its 2nd phase. We presented the technology and trial findings at the FATO conference in Kigali (2007) attended by P & O professionals from all over Africa.
Currently we are in discussion with TATCOT, Africa’s foremost orthotics training centre to include the PFKAFO technology in their orthortic course syllabus. |
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Further R & D on PFKAFO components - ankle joint
Following the feedback from the Ethiopian and first Indian PFKAFO trials and the subsequent study by the International Society of Prosthetists and Orthotists we have embarked on a collaborative R & D project to develop and incorporate an ankle joint to the Ankle Foot Orthosis that would achieve greater mobility for the user. We have been joined in this by the Swedish Institute of Assistive Technology who is facilitating the technical support to MI’s R & D team.
Visit
http://www.mobility-india.org/download/pfkafo_manual.pdf
http://www.disabilitykar.net/karreport/spring2004/disabilityissue.html |
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| Rehabilitation workshop opens in Addis Ababa |
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| Soikat, a senior technician from Mobility India doing a quality check on the calliper and fitting done for Khatijah who is affected by polio in both legs |
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| HN-ACD team putting the final touches to a pair of callipers |
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| Rakiq and Senayet-both affected by polio and now using light weight plastic callipers supplied by HN-ACD's workshop and happy with the results |
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A year ago HN-ACD’s rehabilitation workshop was a shack with corrugated zinc walls and roofs hastily set up in the compound where their new building was being constructed.
In May 2008, a ground floor room in their yet unfinished building has become a fully operational workshop. The large adjacent room has been refurbished for assessment, physiotherapy and gait training. HN-ACD’s field workers are helping hundreds of disabled children, young people and their families in different parts of Addis Ababa, in Debrezeit and in Gondar in community based rehabilitation programmes. They can now access the new workshop for mobility aids and appliances and physical therapy.
The need for the workshop grew out of our work with HN-ACD over the past 3 years. In preparation for this and in support for their community based field teams we helped to train 5 people in rehabilitation therapy and in orthotics. Mobility India was involved throughout to provide hands on technical advice in Ethiopia and training at their Bangalore based centre.
HN-ACD’s orthotics service from the workshop will provide callipers for anyone who can use callipers made from the prefabricated plastic components. The team is also providing much needed repairs and maintenance services. Children and young people who depend on callipers for their mobility and for those who are growing the workshop is meeting a life time need. It is also important to have a permanent and reliable place to go to for help when there is a sudden breakage or a change in the fitting.
The workshop has the capacity for additional machinery and facilities (such as oven, plaster modification, etc) so that callipers can also be made using conventional methods for those who cannot use the prefabricated components. The other potential is for making artificial limbs and this is a long term goal for HN-ACD and which requires a greater investment in training so that the team is equipped with these skills.
105 children and young people have already registered for the light weight plastic callipers and many more people come to the centre for rehabilitation therapy and other services as well as for advice. Many of the young people and children had been part of the 2005 PFKAFO trials project when the prefabricated component technology was introduced. |
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