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CONTINUING PHYSIOTHERAPY EDUCATION
Year : 2019  |  Volume : 1  |  Issue : 1  |  Page : 66-68

Assistive technology in locomotor disability: Physiotherapy and rehabilitation perspectives


Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India

Date of Submission27-Dec-2018
Date of Acceptance09-Apr-2019
Date of Web Publication3-Jul-2019

Correspondence Address:
Dr. Arun G Maiya
Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal - 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijptr.ijptr_23_19

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How to cite this article:
Maiya AG, Kumar A S, Anche P, Yadav H. Assistive technology in locomotor disability: Physiotherapy and rehabilitation perspectives. Indian J Phys Ther Res 2019;1:66-8

How to cite this URL:
Maiya AG, Kumar A S, Anche P, Yadav H. Assistive technology in locomotor disability: Physiotherapy and rehabilitation perspectives. Indian J Phys Ther Res [serial online] 2019 [cited 2019 Aug 21];1:66-8. Available from: http://www.ijptr.org/text.asp?2019/1/1/66/261998




  Introduction Top


A global rise in noncommunicable diseases, road traffic accidents, and improved healthcare services has led to an increase in individuals with disability or special needs. The World Health Organization states that the prevalence of individuals with special needs is over a billion, globally.[1] The 2011 Census reports from India show an increase of 22.4% in the decadal growth of individuals with various types of disabilities.[2],[3] A survey conducted in Karnataka has reported 6.3% of prevalence of disability.[4] Disability has been classified as mental retardation, leprosy-cured, blindness, low vision, hearing impairment, locomotor disability, and mental illness. The locomotor limitation is a term encompassing a condition of considerable loss of movement of limbs occurring because of disability of bones, joints, muscles, or any form of cerebral palsy.[5]

Any assistive, adaptive, or rehabilitative device used by the elderly population or people with disabilities, including the procedure of selection, location, and usage comes under the broadly defined term “assistive technology.” These devices can reduce the effects of disabilities of such people in performing activities of daily living (ADLs) and grant them superior independence in performing tasks which were previously in adequate to carry out and executed with difficulty. Owing to access to assistive technology, there has been an increase in social participation, security, and positive lifestyle among people with disabilities, along with a decrease in institutional costs without raising household expenses.


  Adaptive Technology Top


It is extremely often used interchangeably with assistive technology. However, the two words are completely different. Assistive technology is defined as “any item, piece of kit, or product system, whether or not noninheritable commercially, modified, or made-to-order, that is accustomed increase, maintain, or improve practical capabilities of people with disabilities,” whereas adaptive technology is designed specifically for persons with disabilities and would seldom be used by nondisabled persons. Especially “assistive technology is an object or system that maintains or increases the abilities of persons with disabilities,” while adaptive technology is “any object or system that is explicitly designed for increasing or maintaining the capabilities of people with disabilities.” Consequently, assistive technology is an umbrella term under which adaptive technology exists, specifically in the domains of electronic and information technology.


  Mobility Impairments Top


Wheelchairs

It is an electrically or manually propelling mobility device which includes a seating system. They are designed to allow people with impaired mobility to perform ADLs such as feeding, toileting, dressing, grooming, and bathing. They are a substitute for normal movement for such people, allowing them to perform mobility-related activities. Wheelchairs or walkers are the devices often required by people with both sitting and walking disability.

Low-cost robotic wheelchair

Semi-autonomous mobile robots have conventionally been focused at executing surveillance, delivery, or similar tasks. Mobile robots can play a very different role as part of assistive technology. Power wheelchairs are customarily used by people who are compromised with upper body strength and do not have the ability to operate manual wheelchair.

Transfer devices

These devices are mainly used by caregivers to move patients with mobility disability between beds, a bed to wheelchair or chair, transfer to commodes, toilets, shower benches, stretchers, and automobiles.

Walkers

Walking frame or rollator is a tool that provides additional support to patients for maintenance of balance or stability while standing in place or walking. It comprises a waist-high frame, approximately 12-inch deep, and must be marginally more extensive than the user. Walkers may be height adjustable and available in different sizes for varied populations such as children or heavy individuals.

Prosthesis

Prosthesis is an artificial (human-made) device to replace part. It is a device designed to substitute the function or appearance of a missing limb or body part as much as possible. In a broadest sense, prosthesis includes dentures, wigs, and plastic heart valves. However, we primarily concerned with limb prosthesis (i.e., artificial legs and arms). They are employed to replace missing body parts occurring as a result of congenital disabilities (congenital) or injury (traumatic).

Desktop video magnifier

Amplified versions of texts and pictures can be produced using this device for the benefit of individuals with poor vision. These magnifiers can be used as to read printed material, photographs, and illustrations; write checks; and complete forms. They come in various makes pertaining to size, portability, and features concerning magnification, lighting, contrasting, etc.

Wearable technology

They are smart electronic devices to be used as an accessory implant. An example of this is the technology exploring the reception of visual information by a visually impaired individual through wearable devices.


  Home Automation Top


Assistive domotics could be a style of home automation that enables the senior and disabled population to live independently. It slowly becomes a viable possibility for such people that opt to keep in their own homes instead of a healthcare center. The technology and equipment are almost like home automation for security, amusement, and energy conservation but are ready-made for elderly people. “For example, automatic prompts and prompters operate using motion sensors and prerecorded audio messages; an automatic prompt within the room might recall the resident to show off the kitchen appliance, and one by the outside door might keep in mind the resident to lock the door.”

With the advancement of medical technology, survival beyond critical illness and trauma is increasingly becoming possible. In intensive care unit patients who are with the critical illness and prolonged hospitalization, they develop muscle weakness. Maintaining the muscle strength and function becomes a secondary concern for stabilization of the patient. Complications related to prolonged bed rest are hypotension, skin breakdown, osteoporosis, contractures, and respiratory disease. The different assistive technology was used for early mobilization of the patient in the critical care unit.[6]


  Assistive Technology in Diabetic Foot Top


Diabetic foot is a syndrome characterized by a triad of conditions such as neuropathy, vascular compromise, and musculoskeletal deformities in the foot. Early detection and prevention strategies will be useful to prevent further complications such as ulcer formation and subsequent gangrene formation and amputation.

Types of assistive devices used in diabetic foot

  • Offloading footwear
  • Modified insoles
  • Plantar pressure analysis using various software such as Win track and SIMI three-dimensional (3D) motion gait analysis to prevent gait deformities raised due to diabetic foot
  • Pulseflow DF footwear which is used in diabetic foot ulcer which uses pneumatic compression technology to offload the affected area
  • A variety of foot orthoses, custom-made and prefabricated, inserted inappropriate footwear, which aims to compensate for the loss of function, to protect the feet from trauma and to redistribute high plantar pressures. Casting, foam boxes, and foot scanning are equipment's and techniques that are used to capture the shape and morphology of the feet. These impressions, manual or digital, are used in the production of custom-made foot orthoses. Based on the digital data, foot orthoses can be automatically produced by carving out the orthoses from a block or by 3D printing.[7]



  Conclusion Top


The need for long-term rehabilitative and healthcare services can increase because the proportion of elderly is high in the overall population, and therefore, the incidence of chronic disabling conditions increases. The latest high-cost, high-technology interventions are heavily relied upon as they may delay mortality while increasing the morbidity. By this, prevention or postponement of said morbidity is often cited as an essential public health goal.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Wylie K, McAllister L, Davidson B, Marshall J. Changing practice: Implications of the world report on disability for responding to communication disability in under-served populations. Int J Speech Lang Pathol 2013;15:1-3.  Back to cited text no. 1
    
2.
Murthy G, Gupta SK, John N, Vashist P. Current status of cataract blindness and vision 2020: The right to sight initiative in India. Indian J Ophthalmol 2008;56:489-94.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Ram U, Jha P, Ram F, Kumar K, Awasthi S, Shet A, et al. Neonatal, 1-59 month, and under-5 mortality in 597 Indian districts, 2001 to 2012: Estimates from national demographic and mortality surveys. Lancet Glob Health 2013;1:e219-26.  Back to cited text no. 3
    
4.
Ganesh KS, Das A, Shashi JS. Epidemiology of disability in a rural community of Karnataka. Indian J Public Health 2008;52:125-9.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Woodhams C, Corby S. Defining disability in theory and practice: A critique of the British Disability Discrimination Act 1995. J Soc Policy 2003;32:159-78.  Back to cited text no. 5
    
6.
Deitrick JE, Whedon GD, Shorr E. Effects of immobilization upon various metabolic and physiologic functions of normal men. Am J Med 1948;4:3-6.  Back to cited text no. 6
    
7.
Hellstrand Tang U. The diabetic foot-assessment and assistive devices. Institute of Clinical Sciences at Sahlgrenska Academy at the University of Gothenburg; 2017. p. 13-144.  Back to cited text no. 7
    




 

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  In this article
Introduction
Adaptive Technology
Mobility Impairments
Home Automation
Assistive Techno...
Conclusion
References

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