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Health economic evaluation in orthotics and prosthetics: a systematic review protocol

CLARKE, Leigh
DILLON, Michael
SHIEL, Alan
June 2019

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The aim of this systematic review is to critically appraise the existing orthotic/prosthetic health economic evaluation literature and therefore determine evidence gaps, critical method design issues and the extent to which the literature informs orthotic/prosthetic policy and investment decisions

 

Systematic Reviews volume 8, Article number: 152 (2019)

doi:10.1186/s13643-019-1066-9

 

 

Assistive technology in Tajikistan: Situational analysis

WORLD HEALTH ORGANISATION (WHO). REGIONAL OFFICE FOR EUROPE
2019

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"This publication summarizes the current gaps, needs and opportunities for intervention in the field of assistive technology in Tajikistan. The situational analysis was conducted under the leadership of the Ministry of Health and Social Protection, Republic of Tajikistan and with technical support from the WHO Country Office, Tajikistan. It was undertaken in collaboration with different Government ministries and State agencies, development partners, United Nations agencies, nongovernmental organizations, disabled people’s organizations and users of assistive products. It adopted a realist synthesis approach, responsive to the unique social, cultural, economic and political circumstances in the country. The evaluation focuses on assistive technology policy and governance, service provision and the impact of assistive technology on the health and well-being of individual users and their families, with the aim of improving access to high-quality, affordable assistive products in Tajikistan.

 

200 persons with disabilities participated in a survey designed to collect information on self-reported need for assistive products, user experiences and barriers to access. An additional 11 focus groups made up of persons with disabilities and older adults held indepth discussions on assistive technology. The major providers of assistive technology (Government facilities, nongovernmental organizations, local producers) were also interviewed as part of the research"

Assistive technologies in developing countries

ROHWERDER, Brigitte
March 2018

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This rapid review looks at examples of existing literature on the availability of assistive technologies and efforts to make these technologies more affordable and accessible in developing countries. Needs and access to assistive technologies are overviewed. The discussion of market characteristics of assistive technologies covers availability, affordability, quality, appropriate design, and awareness and demand.  Efforts to increase the affordability and accessibility of assistive technology are discussed covering: The Global Cooperation on Assistive Technology (GATE); the WHO Priority Assistive Products List; and EYElliance and eye health initiatives. Market shaping and community based approaches are discussed in this context.

 

This is a K4D helpdesk report. This report was commissioned by the UK Department for International Development (DFID)

Pilot testing of 3D printing technology for transtibial prosthesis in complex contexts (Togo, Madagascar and Syria)

CONICAVE, Jerome
TAN, Daniele
2017

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In January-October 2016, Handicap International carried out a pilot testing of 3D printing technology for transtibial prosthesis in Togo, Madagascar and Syria. The aim of the study was to explore and test how physical rehabilitation services can be more accessible to people living in complex contexts via innovative technologies (such as 3D printing, treatment processes that use Internet technology and tools) and decentralised services by bringing them closer to the patients. This scientific summary provides the context, the objectives, the methodology, the results of the study, and perspectives for the future.

A number of technical appendices are available

RS/05

Standards for prosthetics and orthotics

WORLD HEALTH ORGANISATION (WHO)
2017

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This document provides a set of standards and a manual for implementation to support countries in developing or improving high-quality, affordable prosthetics and orthotics services. Its aim is to ensure that prosthetics and orthotics services are people-centred and responsive to every individual’s personal and environmental needs. Implementation of these standards will support Member States in fulfilling their obligations under the CRPD and in meeting the SDGs, in particular Goal 3. With these standards, any government can develop national policies, plans and programmes for prosthetics and orthotics services of the highest standard. This document has two parts: the standards and an implementation manual. Both parts cover four areas of the health system:

• policy (governance, financing and information);

• products (prostheses and orthoses);

• personnel (workforce);

• provision of services

Users’ satisfaction with prosthetic and orthotic assistive devices in the Lao People’s Democratic Republic: A cross-sectional study

DURHAM, Jo
SYCHAREUN, Vanphanom
SANTISOUK, Phonevilay
et al
December 2016

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"Abstract

 

Purpose: User satisfaction with assistive devices is a predictor of use and an important outcome measure. This study evaluated client satisfaction with prosthetic and orthotic assistive devices and services in three provinces in the Lao People’s Democratic Republic.

 

Method: A cross-sectional study was done, using the Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire. The sample was drawn from the client register of three of the five Rehabilitation Centres in the country which are under the Ministry of Health’s Centre for Medical Rehabilitation. Clients were eligible if they had received their device in the 12 months prior to the study. Based on the number of registered clients, the sample size was calculated as 274 with a 95% confidence interval, with the final sample N = 266. Qualitative semi-structured interviews were also conducted (N = 34).

 

Results: Most of the assistive devices were in use at the time of the survey and were reported to be in good condition (n = 177, 66.5%). The total mean score for satisfaction (services and device combined) was 3.80 (SD 0.55). Statistically significant differences were observed in satisfaction between gender and location of residence. Effectiveness and comfort were rated as the two most important factors when using a device; at the same time, these were the most common reasons for dissatisfaction and sub-optimal use.

 

Conclusion and Implications: Clients were quite satisfied with the assistive device and services provided, yet many reported barriers to optimal device use and difficulties in accessing follow-up services. There is a need to examine how prosthetic and orthotic devices can be improved further for better comfort and ambulation on uneven ground in low-resource contexts and to address access barriers."

Prosthetics & orthotics impact assessment : India and Bangladesh

COCHRANE, Helen
ROSARIO, Demetria
SINGH, Anil
GHOSH, Ritu
June 2015

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Mobility India is the only International Society for Prosthetics and Orthotics​ (ISPO) recognised program in India offering training for ISPO Category II single discipline. From 2002 to the time of the study Mobility India enrolled two hundred and twenty-one students. This study was conducted in association with ISPO’s USAID funded programme: ‘Rehabilitation of physically disabled people in developing countries’. Activities included: field visits to India and Bangladesh, interviewing Ministry officials, Heads of Clinical Services and Heads of Prosthetic and Orthotic Departments;  a partial audit of graduate clinical skills and competencies and determining the professional development needs of graduates in selected South-East Asian countries; and listening to service users, hearing stories of how services had directly impacted upon their lives. Services in India and Pakistan are outlined and 22 recommendations to help to further develop prosthetic and orthotic services are provided.

Prosthetic and orthotic services in developing countries

MAGNUSSON, Lina
October 2014

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This thesis aims to generate further knowledge about prosthetic and orthotic services in developing countries, with a focus on patient mobility and satisfaction with prosthetic and orthotic devices, satisfaction with service delivery, and the views of staff regarding clinical practice and education. The findings are based on patient questionnaires in Malawi and Sierra Leone, including QUEST 2.0, as well as interviews with prosthetic/orthotic technicians in Sierra Leone and Pakistan

School of Health Sciences Dissertation series No. 56, 2014; No. 66, 2014

Disability on stable developing countries and prosthetics and orthotics services

MOMPATI, Segokgo
2013

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This paper discusses Disability in stable developing countries and prosthetics and orthotics services presenting the perspectives from international non-government organisations, governments and local non-government organisations
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Haiti : reaching out to the most isolated people

HANDICAP INTERNATIONAL
July 2011

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This article highlights the experiences of a Haitian nurse who is working with Handicap International as a rehabilitation technician after the 2010 earthquake in Haiti. The article discusses her daily work, explains the procedures that are followed when amputees arrive at the centre, and describes the services provided to people with disabilities to enable their independence
Health Exchange, Issue 7

Joint position paper on the provision of mobility devices in less resourced settings : a step towards implementation of the convention on the rights of persons with disabilities (CRPD) related to personal mobility

WORLD HEALTH ORGANIZATION (WHO)
UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
2011

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"This joint position paper was developed in response to a meeting about personal mobility and mobility devices, held on 28-29 October 2009 at World Health Organization headquarters, Geneva, Switzerland. This paper aims to guide and support countries, especially those with limited resources, in the implementation of relevant articles of the CRPD associated with the provision of mobility devices"

Rehabilitation services unit annual report 2010

URSEAU, Isabelle
Ed
2011

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This 2010 annual report, produced by Handicap International’s rehabilitation services unit, illustrates the activities of the unit, the programmes and the key strategies and approaches for improving access to rehabilitation services. It would be useful to those who work with rehabilitation services in the field of disability and development

Rehabilitation technical unit annual report 2009

URSEAU, Isabelle
Ed
2010

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This report details the programmes supported by Handicap International’s rehabilitation technical unit. It also explores the strategies, project approaches and activities implemented by the unit in 2009. It is interesting to anyone interested in rehabilitation services in the field of disability and development

Physical medicine and rehabilitation clinics of North America : new advances in prosthetics and orthotics

KRAFT, George H
BOSWELL, Mark H
Eds
February 2006

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"This issue reviews the biomechanical assessment of the lower limb as well as discussing new dynamic lower limb orthoses used to compensate for weakness. Although lower limb amputations are less common than in the past, they still occur, and new developments are discussed. These include new developments in postoperative management, new socket designs and suspensions, new prostheses, and microprocessors for knee units. One of the newest concepts discussed is the use of the Lokomat robotic gait orthosis for gait retraining. The most striking of the new developments in upper limb prosthetics is the work done on myoelectric designs with myoelectric implants as a means of control. These are discussed in detail by a physician and prosthetist familiar with these topics. Other important topics are also covered. These include scoliosis treatment using spinal orthoses, orthotic management of the limb suffering from neuropathic pain, and the use of prosthetics in pediatric amputations"
Physical medicine and rehabilitation clinics of North America, Vol 17, No 1

Surgical reconstruction and rehabilitation in leprosy and other neuropathies

SCHWARZ, R. J.
BRANDSMA, J. W.
Eds
2004

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"This book is designed for those with some training in reconstructive surgery for peripheral neuropathies, but who have not been exposed to all of the procedures presently available...In this field it is absolutely essential that the surgeon works closely with a therapist able to educate the patient following reconstructive surgical procedures. As such the book is also designed for therapists, with chapters covering the principles and techniques of pre- and postoperative therapy for neuropathic limbs. The book also contains sections on orthopaedic appliances and prosthesis, but only in sufficient detail to allow the surgeon to have a reasonable understanding of how to choose an appropriate orthosis/ prosthesis and what can be expected of the same"

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