Lower-limb prostheses and wheelchairs in low-income countries [An Overview]

Pearlman, Jonathan; Cooper, Rosemarie; Krizack, M.; Lindsley, Alida; Wu, Yi-Ning; Reisinger, Kim D.; Armstrong, William D.; Casanova, Hector R.; Chhabra, Harvinder Singh; Noon, Jamie H.

doi:10.1109/emb.2007.907372

Cited by 73 publications

(60 citation statements)

References 17 publications

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“…On a global scale, the World Health Organization estimated approximately 30 million amputees living in low-income countries in 2010 (25). Only 5-15% of patients have access to necessary prosthetic devices (26).…”

Section: Discussionmentioning

confidence: 99%

An Argument for Salvage in Severe Lower Extremity Trauma with Posterior Tibial Nerve Injury

Momoh

Kumaran

Lyons

et al. 2015

Plastic and Reconstructive Surgery

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BACKGROUND Absence of plantar sensation is a critical factor considered in favor of amputation for patients with lower limb-threatening injuries. This study aims to assess outcomes of limb salvage in a group of patients with severe lower extremity injuries associated with posterior tibial nerve transection. METHODS We studied eight cases of limb salvage after traumatic injuries with documented tibial nerve laceration managed at Ganga Hospital, India. Functional and health-related quality of life outcomes were assessed. Outcomes from this case series were compared to outcomes of studies from a systematic literature review on salvage of the severely injured lower extremity. RESULTS Patients in this case series reported mild pain (median score 20 on a 100 scale visual analog scale) with some return of plantar sensation in patients with tibial nerve repairs (median score 2/5). Patients demonstrated a decrease in ankle motion (27.5 degrees plantar flexion, 10 degrees extension) and muscle strength (median heel flexor score 3/5). All patients could ambulate independently. Quality of life and function measured by validated instruments revealed minimal disability. We identified 1,767 articles on lower extremity trauma and 14 articles were systematically reviewed. Relative to the case series, published articles reported similarly diminished ankle motion and muscle strength, with reports of mild pain in select studies. Patient reported outcome instruments found variations in the degree of physical disability based on time from the injury. CONCLUSIONS Though limited in number, this case series demonstrates the value of limb salvage even for patients with posterior tibial nerve injury.

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Section: Discussionmentioning

confidence: 99%

An Argument for Salvage in Severe Lower Extremity Trauma with Posterior Tibial Nerve Injury

Momoh

Kumaran

Lyons

et al. 2015

Plastic and Reconstructive Surgery

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“…Most of the WCs evaluated in this trial were the hospital-type, which are most commonly distributed in developing countries through the charitable model of delivery (Pearlman et al, 2006;Pearlman et al, 2008). This type of WC is designed for temporary indoor use only (Kim and Mulholland, 1999), is not adjustable (Howitt, 2006), and not designed to provide postural support (Borg et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Efforts should focus on the selection or re-design of the WCs to ensure they match both the user and the environmental requirements which often include high kerbs, potholed streets, gravel and mud (Kim and Mulholland, 1999;Pearlman et al, 2006;Pearlman et al, 2008). These environmental conditions apply considerably more strain on the device which it is less likely to withstand (Kim & Mulholland, 1999).…”

Section: Implications and Limitationsmentioning

confidence: 99%

“…Therefore, there is a need for improved devices that have longer durability. Usually minimum quality standards are not in place nor enforced in developing countries; thus, end users are not protected against low-quality technology (Pearlman et al, 2008). As suggested by a previous study (Pearlman et al, 2006), future work should include objective outcome measures such the ISO/ANSI/RESNA WC Standards to test WCs durability (Borg et al, 2008).…”

Section: Implications and Limitationsmentioning

confidence: 99%

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Quantitative Exploratory Evaluation of the Frequency, Causes and Consequences of Rehabilitation Wheelchair Breakdowns delivered at a Paediatric Clinic in Mexico

Toro

Garcia

Ojeda

et al. 2012

DCID

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“…31 When NGOs and aid organisations provide prosthetic and orthotic devices without charge, however, they may affect indigenous efforts to provide prosthetic and orthotic devices as local workshops cannot compete with the free high-tech devices offered. 37 This may impact the local economy and can lead to local resentment of the foreign programmes. Supporting local initiatives with training and sourcing local materials may be a more effective use of resources to ensure sustainable services and economies without dependency on NGOs.…”

Section: Types Of Service Provisionmentioning

confidence: 99%

Provision of prosthetic and orthotic services in low-income countries

Harkins

McGarry

Buis

2013

Prosthetics &Amp; Orthotics International

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Background: Disability is inextricably linked to poverty. A total of 80% of the disabled population lives in low-income countries. The demand for prosthetic and orthotic services in these countries is increasing, and a variety of methods to provide services are currently used. Objectives: To assess current models of provision to facilitate sustainable, evidence-based prosthetic and orthotic services. Study Design: Literature review. Methods: A literature search was performed through Medline (Ovid), PubMed, ISI Web of Knowledge, EMBASE and RECAL Legacy using combinations of subject heading and text word searching strategies. Full-text publications were critically appraised and ranked according to the Scottish Intercollegiate Guidelines Network guidelines. Results: Three areas were deemed pertinent to the research question. Studies were grouped into one or more of these categories based on the issues addressed: instigators, types of service provision, demographics and region-specific issues. It was found that many complex factors influence prosthetic and orthotic services in low-income countries. Demographic and regional idiosyncrasies require prosthetic and orthotic services to be tailored to address the specific needs of individual countries. Conclusions:The lack of and quality of available research made efficacy of methods used to provide services in low-income countries difficult to determine. Clinical relevanceThis review aims to highlight areas of best practice in prosthetic and orthotic services in low-income countries and to show where further research is required in order to develop evidence-based prosthetic and orthotic services.

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Lower-limb prostheses and wheelchairs in low-income countries [An Overview]

Cited by 73 publications

References 17 publications

An Argument for Salvage in Severe Lower Extremity Trauma with Posterior Tibial Nerve Injury

An Argument for Salvage in Severe Lower Extremity Trauma with Posterior Tibial Nerve Injury

Quantitative Exploratory Evaluation of the Frequency, Causes and Consequences of Rehabilitation Wheelchair Breakdowns delivered at a Paediatric Clinic in Mexico

Provision of prosthetic and orthotic services in low-income countries

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