Indigenous substitutes for modern prostheses and orthoses.

In most developing countries, the physically handicapped often have rehabilitation setbacks such as unavailability of modern rehabilitative aids which may result in non-achievement of the desired goals in activities of daily living. Children with poliomyelitis, hemiplegics, amputees and paraplegics top the list of patients requiring rehabilitation at University College Hospital, Ibadan. The amputees depend on wooden peg legs or pylons made by the occupational therapy department since modular and P.T.B. prostheses are presently not available in this hospital. Physiotherapists, therefore, encounter problems in teaching correct patterns of walking and other functional activities to the above-knee amputee because knee joints are absent. Rural amputee farmers use pylons as they can wade through water and mud with them. Calipers, toe raising devices, knee cages and spinal supports are required by 75% of the 300 children with poliomyelitis and some of the paraplegics receiving physiotherapy in this hospital. Due to lack of imported parts, materials and experienced personnel, it has not been possible to meet the required demands. The occupational therapy department, as well as indigenous shoe markers and iron welders, rescue the situation as much as possible. Similarly, cervical collars are made from PVC buckets. It is therefore necessary that research on the use of local materials for prostheses and orthoses be carried out. Difficulties encountered with imported parts and materials will be removed to the advantage of patients.