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Department of Physical Medicine & Rehabilitation Website

Prosthetics and Orthotics

(Artificial Limbs and Splints)

Farmer wearing a
plastic ICRC
artificial limb

gentleman farming using his artificial leg in a field full of water

Introduction

Artificial Limbs - Prostheses

Splints - Orthotics

Equipment

Academic Activities

Profile of P&O

Links

Contact us

Introduction

Prosthetic and orthotic services (formerly called the Artificial Limb Centre) make artificial limbs, splints, calipers, crutches and special shoes for people with disabilities. The main workshop is in the hospital campus underneath the Physical Medicine and Rehabilitation Outpatient Department (PMR OPD). It can be accessed by stairs or a lift. There is also a Research laboratory in the Rehabilitation Institute. People can be assessed for prosthetics and orthotics by seeing a doctor in the PMR OPD, for further details and OPD times see Medical.

Below are more details and illustrations of some of the things made in the Prosthetics & Orthotics section

Artificial Limbs (Prostheses)

The Prosthetics & Orthotics workshops make and mend several types of artificial limb. These include traditional fiberglass limbs, International Committee of the Red Cross (ICRC) plastic limbs, Endolite limbs, ALIMCO polypropylene limbs, motorised artificial hand and various other prostheses.

Some details of the work done are given below.

Amputee Clinic

The Amputee clinic continues to be held every Monday in the PMR outpatients. Dr. Bobeena Chandy, Dr Ahana Chatterjee(PMR II), Mrs. Sara Roseline, Mr. Ebenezer, (Prosthetists and Orthotists), Mr. Rajeshwari (Physiotherapist) and Mr. Paul Inbaraj (Occupational therapist). combine their skills and knowledge to run this multidisciplinary clinic. 800 (728) patients were seen in the clinic in 2008-9. During the clinic the various prosthetic options will be explained to the patients. They can then choose the prosthesis they need.

A low cost temporary artificial limb/prosthesis is now prescribed for first time amputees. The temporary limb is delivered on the second day after amputation, this helps patients to get quickly while still allowing the wound to heal. In the clinic the various artificial limb options, from Rs2000 to Rs2,50,000, are described and patients can then choose the limb that suits their needs and budget.
You can download a small leaflet that shows some of our artificial limbs here:

To get an artificial limb, please make an appointment to see one of the PMR doctors. See the hospital information pages.

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International Committee of the Red Cross Artificial Limbs

 

prosthetist, makes artificial limbs, helps fit a new leg

Fitting the limb

gentleman riding a normal bike using his artificial leg

Riding a bicycle
using a right leg
below knee ICRC
prosthesis
(artificial limb)

man standing wearing the first endolite above knee artificial limb fitted in CMC

The first above knee Endolite

the workshop with legs being made stood on the counter and a lady behind making the leg

Making a below knee limb
in the hospital workshop,
the ICRC limbs are now
made here as well

The department started working with the International Committee of the Red Cross (ICRC) in 1993. Over the years they have given us equipment, tools and prosthetic components. They have also helped with staff training and provided books and manuals. So far, 10 of our staff have gone for special training. This had been one months training on ICRC Prosthesis in Addis Ababa, Ethiopia and Hanoi Vietnam. The training in Addis Ababa helps our staff to learn new techniques in ICRC Polypropylene Prostheses. It also helps them in their overall development as a professional Prosthetist-Orthotist and as an individual.

Making the Artificial Limbs

The Physical Medicine and Rehabilitation dept has been making the ICRC limbs since 1996. The parts for the limbs are stored in the workshop in the hospital. Patients are assessed to find the right limb for them. Then measurements are taken and used to make the limb.

The parts are taken from the store cupboard. They can be made the correct size for the patient. They are then put together to make the limb. The socket is the only piece that is custom made. This means it is made specially for the patient. The socket is the closely fitting piece the stump sits in.

The next stage, and vital stage, is to learn to use the limb. New users have rehabilitation to help them learn to use it. Many new limb wearer can learn how to sit, walk, stand, go from sitting to standing, run, cycle, climb stairs etc using their new limb.

Training can take several months, especially if the skin if very fragile and keeps breaking down (developing sores) as when this happens the skin must be allowed to heal before starting the training again. Most patients start this training as inpatients but can finish it as outpatients. The training team in the Rehabilitation Institute consists of a prosthetist, physiotherapist, occupational therapist, and doctor. Together they monitor the stump and fitting of the limb to ensure it is fitting as well as possible and not damaging the skin, frequent modification of the ICRC limb is often required.

The new user of the ICRC limb is able to return to the Rehabilitation Institute for repairs and review of their progress. It is possible to do many things with these limbs and the staff at the Rehabilitation Institute continue to monitor the long term use and durability of these limbs.

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Endolite limbs

Endolite are the makers of sophisticated artificial limbs which the Prosthetics & Orthotics section of PMR are now making. The first Endolite Transfemoral (above knee) artificial limb was made in the P&O laboratory, Rehabilitation Institute in 2000. They have also made the below knee prosthesis. They are, unfortunately, very expensive BUT give choice to those who can afford them.

Motorised artificial hand

During the year motorised artificial hand has been fitted to 15 amputees. So far we have fitted the motorised hand to 46 amputees. Dr. Suresh Devasahayam, Head of the Bioengineering Department has designed new electronic component with lighter batteries and smooth noiseless motors. A motorized elbow, which can bend and extend with the help of the motor has been fitted to two above elbow amputees and the feedback has been good.

Dr. Suresh Devasahayam,has been instrumental in the concept, design and development of the motorized hand. We would like to sincerely thank the patients who have been giving us invaluable feedback and suggestions in the development of the motorised hand. We would also like to thank the Worth Trust for their continued support, in particular Mr. Anthony Samy, Managing Director, Col. Radhakrishnan, Dy. Managing Director and Ms. Jesintha, Engineer. The WORTH trust are the manufacturers of the motorised hand and Functional Electric Stimulators (FES).

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Orthotics (Splints, calipers, etc)

Orthotics are commonly called splints or calipers and include specialised shoes and crutches. Orthotics are used to support the body and help people to do things. For examples, knee-ankle-foot orthoses (KAFO's) are used by people who have been left with paralysis (weakness), for example following polio - which is sadly still very common in India. They are also used for people who are paralysed following spinal cord injuries. Many people learn to walk with these which is very different to the rehabilitation goals in say England or America. This is because the goals are culture and environment specific. In England it is easier to get around in a wheelchair as the roads are tarmacked and the footpaths are paved. However, in India the environment (roads etc) is different, so it often makes walking with calipers more suitable than trying to use a wheelchair.

To get an orthosis - splints, calipers, shoes etc please make an appointment to see one of the PMR doctors. See the hospital information pages.

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Equipment available in the P&O Workshops

The workshops have well equipped metal, leather, carpentry, plastic and prosthetic sections with wood and metal lathes, band saws, power drills, welding and brazing equipment, ovens, heat guns, moulds and press for plastic moulding, vacuum forming apparatus etc

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Academic Activities

Education: Courses offered by P&O

Name of funding agent Year
started
Students
Enrolled/year

Prosthetics & Orthotics 
Diploma course

1992

4

ICRC - CMC Vellore Diploma in
Prosthetics and Orthotics

2008

4

Mr. Anand J Samuel, B.E., Engineer is course co-ordinator of the Diploma in Prosthetics and Orthotics course. This course is recognised by the Rehabilitation Council of India and 4 students are recruited each year.

A two year Diploma in Prosthetics & Orthotics is offered by the college. For further details about this course see the page on Education in P&O.

Education and ICRC

Till now, ten of our staff have gone for a one-month advanced training on the ICRC Prosthesis in Addis Ababa, Ethiopia. The training in Addis Ababa not only helps our staff to learn new techniques in ICRC Polypropylene Prostheses, but also helps them in overall development as a professional Prosthetist-Orthotist and as an individual.

Mr. Peter Poetsma, Head of Project, ICRC Special Fund for the Disabled India-Vietnam-Bangladesh visited CMC in 2004. An ICRC sponsored diploma programme in Prosthetics and Orthotics for candidates from Bangladesh or other countries from the South was finalised during his visit. Every year, up to four International Committee of the Red Cross (ICRC) sponsored students from Southeast Asian countries will join the Diploma in Prosthetics and Orthotics course in CMC from the year 2004. These students will be registered in the ICRC CMC Vellore Diploma in Prosthetics and Orthotics course, which will be for the same duration (ie 2 years) as the regular DPO course thus giving a total of 8 students training per year, 4 on the ICRC and 4 on the regular course.

Four students from Bangladesh, sponsored by ICRC joined the ICRC - CMC Vellore Diploma in Prosthetics and Orthotics course in CMC from the academic year 2004-05. The eligibility criteria and the syllabus for the ICRC-CMC Vellore Diploma in Prosthetics and Orthotics course is identical to the eligibility criteria and the syllabus of the regular Diploma in Prosthetics and Orthotics course that is run in our institution. For the academic year 2004-05 we had eight students in the first year including the four regular students. No ICRC students joined in 2008.

a small store room with a lady and two gentlement taking stock details

First year P&O
students learn how
to take an inventory.

The P&O syllabus is shown in the PMR Education page

Mr Peter Schonenberger, ICRC Ortho-Prosthetist from Jammu visited CMC in 2005. It was decided during the visit to have an exchange programme between ICRC Jammu and CMC. As part of the programme, a Physiotherapist from Jammu visited CMC for a one-month training on amputee management during 2005.

Three delegates from the ICRC SFD (Special Fund for the Disabled) visited us in 2005. Mr. Theo Verhoeff, Director, Special Fund for the Disabled, Geneva, Mr. Peter Poetsma, Head of Project, Asia and Mr. Engelbertus Van Koll, Prosthetist/Orthotist, Vietnam spent two days in CMC. The ICRC team had a meeting with the students from Bangladesh. They also discussed future training programmes and donations from ICRC.

In 2008, Mr Leo Gasser visied cmc. Mr Gasser is a prosthetist and orthotist with the ICRC special Fund for the Disabled based in Vietnam. He assessed patients who got prostheses and orthoses from the ICRC free scheme. He also gave a seminar on managing club foot - DB splinting. The workshop settings were also discussed.

We receive items worth over Rupees Six Lakhs as donation from the ICRC most years. This allows the department to give free limbs to patients. (there is still a fee for therapy etc). About 190 patients benefit from this scheme each year.

We would like to express our sincere thanks to the International Committee of the Red Cross (ICRC) for their continued and enthusiastic support.

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Research activities past / present

CMC has been making ICRC artificial limbs since 1996 and is following up those users who live near to Vellore to details the usage of the limbs and any problems that arise. This information is then used to help improve the limbs.

An Electric Artificial Hand, with technological advancements at an affordable price for the patient, is being developed in the department. Dr. Suresh Devasahayam, Professor of Bioengineering, has been instrumental in the conceptualisation of the electric artificial hand project. During the first year of its use the hand was fitted to 30 patients from all over the country.

More details of these current projects and other research that has been undertaken in the P and O workshops can be found here Research

Name of funding agency No. of years Name of Study

International Committee of the Red Cross

1996 - present

Fabrication of polypropylene prosthesis

CMC, Vellore Fluid Fund

2003-4

Development of the Bombay-Vellore Artificial Hand

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Profile of Prosthetics & Orthotics

Staff Numbers

Prosthetists & Orthotists

 

with Degree

1

with Diploma

9

Technicians

6

Engineer

2

Others

3

Total

21

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Services provided each Year

Below are average details of the prostheses and orthoses provided each year.

Prostheses 2005-6 2008-9
Transtibial

48

118

Transfemoral

35

59

Transradial

20

20

Transhumeral

11

55

Orthoses 2005-6 2008-9
Polypropylene AFOs

800

1605

Alkathene shells

400

385

Shoes

150

328

MCR chappals

1,200

2,887

Corsets

450

682

KAFOs

300

394

Collars

340

408

Splints

1205

708

Axillary crutches

1,200

1,916

Elbow crutches

120

201

Taylor knight braces

100

143

Knee Braces

450

938

Others

1,263

4,554

Total

9582

15,401

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Milestones covered through the years.

1962 Department established
1996 Modular endoskeleton, polypropylene prostheses for transfemoral and transtibial amputees funded by the International Committee of the Red Cross

Setting up a Research/Production unit in Rehabilitation Unit.

2000 First transfemoral (above knee) Endolite limb
2003 Development of the Bombay-Vellore Artificial Hand with the gait lab
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Education

Educational Data

Student Strength

4 per year - (average 2.5/yr). Total maximum usually 8 at any time - Plus

4 students from Bangladesh. Total maximum usually 8 from Bangladesh at any time.

Student success rate

100% (2008)

Progression to higher
education rates

One CMC Diploma graduate progressed to a
Bachelor in Prosthetics & Orthotics, Mumbai

Ratio students:teachers

2.5:1

A one-day workshop on the indigenously developed motorized hand was conducted by CMC and WORTH Trust, Katpadi on 30.10.2003. The aim of the workshop was to share our experience of the motorized hand and discuss user requirements with other Prosthetists, Occupational Therapists and Doctors. 30 participants from all over the country who have had experience in the fitment of upper extremity prostheses attended the workshop.

Staff attendance at national or international seminars

Staff have attended the Annual Orthotics and Prosthetics society of India conferences at Pondicherry, Agra, Mumbai, and Hyderabad.

National and International collaboration

International Committee of the Red Cross collaboration including regular visits from Reynard who has helped to develop the workshops.

Staff in Prosthetics and Orthotics

Go to this link to see details of the staff working in the Prosthetics and Orthotics workshops in the PMR dept Prosthetics & Orthotics Staff.

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Links

External Links

Here are some links to web site of interest, outside the CMC pages.

Academic links

Patient Information

Manuals for patients, and their families: who have had an above knee or below knee amputation. Web based with advise on stump care, good pictures. Printed version can be ordered.


Manufacturers

Links within CMC's sites

Links to the rest of the PMR web pages are in the column to the left. Hover over (mouse over / move the mouse over) the titles and see more information about the page - double click on the page you want.

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Job Opportunities in PMR

Hover, move the mouse, over these words and the paragraph will show.

Vacancies arise within the PMR department at regular intervals. Medical, OT, Physio, speech therapy, orthotics and prosthetic posts and internships are all handled by the principal's Office.

Job Opportunities in PMR

Vacancies arise within the PMR department at regular intervals. Medical, OT, Physio, speech therapy, orthotics and prosthetic posts and internships are all handled by the principal's Office. Contact details below.

Links

Links to the rest of the PMR web pages are in the column to the left. Hover over (mouse over / move the mouse over) the titles and see more information about the page – double click on the page you want.

Contact Us

How to Book Appointments and Register

You can phone, post or visit the hospital to book an appointment. See PMR Contacts for full details

Appointments and Registering by Phone

You can get most telephone extensions inside the hospital without the operators,

New and returning patients may phone the Appointments Call Center any day, at the time shown below.
Please note:You need to PAY by CREDIT CARD when you book the appointment by phone. All credit cards with the VISA emblem are now accepted.

Day Time Telephone

Monday - Friday

7 am to 9.30 pm

0416 228 8000

Saturday

7 am to 7 pm

Sunday

10am to 2pm

Coming Back to CMC - Book Online

Patients coming back to CMC with a CMC hospital number can book appointments online. Payment is by credit card or the CHRIS card (CMC cash card).

Page: http://clin.cmcvellore.ac.in/index.asp#new

Job and internship enquiries

Enquiries about working as a doctor, therapist or nurse and internship enquires: please contact the principal's Office:

Email: princi@cmcvellore.ac.in

PMR Patient Enquiries

Patient care enquiries for PMR: please contact Dr. Debbie Skeil:

Email:

PMR Office Phones & Postal Addresses

The code for India is +91, the Vellore area code is (0)416. Simply dial 228 then the extension you need.
If you need operator assistance then dial 228 4000.

PMR Office

Extension

Physical Medicine and Rehabilitation
Christian Medical College, Vellore. 632004. India

2158

Eg Ringing Physical Medicine and Rehabilitation office from India:

0 416 228 2158

More detailed contact information can be found at Contact Us


We hope this information is accurate. If you have any information that may be useful or see any mistakes, please let us know.

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Last Edited Sept 2010

Department of Physical Medicine & Rehabilitation Website