Training in Prosthetics

1
Training in Prosthetics Orthotics Engineering
in INDIA

• Pritpal Singh Sidhu
• Sr .Clinical Orthotist
• Central Orthotist Ltd.
• Palmerston North

2
Personal Profile

• B.Sc Non Medical 1988 (India)
• Diploma in Prosthetics Orthotics Engineering
  1991 (India)
• PG Diploma in Lower Limbs Prosthetics
  Bio-Mechanics (1998)
• M. Sc Rehabilitation Science (Adv. Prosthetics )
  2004
• Work experience
• Prosthetist/Orthotist Office In charge in
  District
• Disability Rehabilitation Centre Patiala
  (India) Feb1992-July2007
• Clinical Orthotist Orthotics Centre
  Wellington Auckland July2007-Jan 2009

3
Professional Profile

• The following professional profile has its basis
  in the Report of the United Nations
  Inter-Regional Seminar on Standards for the
  Training of Prosthetist (UN, 1968) the so
  called Holte Report. It has moreover been
  modified to comply with Guidelines for Training
  of Personnel in Developing Countries for
  Prosthetics Orthotics Services (WHO, 1990).
• Participates as full member of the clinic team
  take part in the designing of the
  prosthetics/orthotics device, including the
  socket or body/device interface, suspension and
  selection of proper components.
• Records and reports any pertinent information
  regarding patient and patients families,
  including a determination of expectations and
  needs regarding prosthetic and orthotic aids and
  communicates appropriate information to the
  patients and their families about these.

4
National Institutes

• New Delhi
• Department of Rehabilitation, Safdarjung Hospital
• Indian Spinal Injuries Centre
• Pandit Deendayal Upadhayaya Institute for the
  Physically Handicapped
• Maharashtra
• All India Institute of Physical Medicine
  Rehabilitation,
• Gujarat
• Government Prosthetic Orthotic College Dept.
  Paraplegia Hosp. Physiotherapy Collage
• West Bengal
• National Institute for the Orthopaedically
  Handicapped,
• Orissa
• Swami Vivekanand National Institute of
  Rehabilitation Training and Research,  

5
Other Institutes Organizations

• ALMICO Artificial Limbs Manufacturing
  Corporation of India is a non-profit making
  organization, working under the aegis of Govt of
  India, Ministry of Social Justice Empowerment.
  It was incorporated in 1972 to take up
  manufacture and supply of artificial limb
  components and rehabilitation aids for the
  benefit of the physically handicapped and started
  production in 1976.
• The ALMICO is running a one year technician course

6
Taj Mahal (Agra)
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Courses for Engineers / Technicians

• Master of Science in Prosthetics Orthotics
• Bachelor in Prosthetics Orthotics
• Diploma in Prosthetics Orthotics
• Certificate Course in Prosthetics Orthotics

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M.Sc. in Prosthetics Orthotics

• Entry Requirement
• Bachelors degree in Prosthetics Orthotics from
  recognized University RCI.
• Teacher student ratio Two nos. per teacher
• The two year full time applied science curriculum
  combines clinically oriented course work in
  Rehabilitation Medicine.

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Bachelor in Prosthetics Orthotics

• Entry requirements A candidate who has passed
  102 in science or equivalent with physics,
  chemistry and mathematics/biology (with aggregate
  of 50 marks) will be eligible for admission to
  this course (equivalent to NCEA Level 3 in NZ
  with science subjects).
• DURATION OF COURSE The total duration of course
  is of 4 years with 6 months internship.
• Teaching Hours Total teaching hours in a year
  would be approximately on the basis of 6 hours
  per day 204X6 1224 hours in a year.

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Diploma in Prosthetics Orthotics

• Entry requirements
• A pass in the Higher Secondary Examination (102)
  in science subject, viz Physics, Chemistry,
  Biology and/or Mathematics. ( equivalent to NCEA
  Level 3 in NZ) OR
• A pass in the 102 in the vocational stream in
  the trade of machinist or 102 and I.T.I.
  Certificate in the trade of Fitter / Turner /
  Machinist / Tool or Die Maker.
• A pass in the final diploma examinations
  conducted by the Board of Technical Education of
  the State Govt. in Mechanical, Electrical/ or
  Electronics Engineering are also eligible.
• Duration of the course
• The course duration is Two Years followed by
  Internship of Six Months in any recognized
  Rehabilitation / Limb Fitting Centres.

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Certificate Course for Technicians

• Entry Requirement Certificate from I.T.I. in any
  of the trades of fitter/carpenter/leather. Or
  10th class pass and two years of practical
  experience in a recognised PO Centre under a PO
  Professional.
• Purpose To train category III personnel (bench
  workers) for assembly and fitting of Orthopaedic
  appliances, artificial limbs and other
  rehabilitation aids under supervision of
  Prosthetist Orthotist (Category I
  professional).
• Duration One year

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Char Minar Hydrabad
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Recognition of PO course in India

• UN (Holte Report ) 1968
• WHO 1990
• REHABILITATION COUNCIL OF INDIA 1992
• ISPO ????

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Rehabilitation Council of Indiawww.rehabcouncil.n
ic.in

• The Rehabilitation Council of India (RCI) was set
  up as a registered society in 1986. On September,
  1992 the RCI Act was enacted by Parliament and it
  became a Statutory on 22 June 1993. The Act was
  amended by Parliament in 2000 to make it more
  broad based.
• The mandate given to RCI is to regulate and
  monitor services given to persons with
  disability, to standardize syllabi and to
  maintain a Central Rehabilitation Register of all
  qualified professionals and personnel working in
  the field of Rehabilitation and Special
  Education. The Act also prescribes punitive
  action against unqualified persons delivering
  services to persons with disability.

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Objective of RCI

• The Council ensures that its recognized training
  institutions situated across the country adhere
  to the established norms and for this purpose the
  Council continuously monitors the quality of the
  training programme by adopting following
  policies-
• Inspection of the Institution
• Surprise Inspection Mid -Term Report

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CRITERIA FOR STANDARDIZATION

• One of the main functions of the Council is to
  standardize the training courses for various
  categories of Professionals/Personnel for
  ensuring quality services to the people with
  disabilities. The Council keeps on
  modifying/revising the existing syllabus and
  adopt new training programmes incorporating new
  developments.
• The Council has so for standardized 80 Long Term/
  Short Term Training Courses, which include 11
  Courses developed during the current year, with
  the help of respective Expert Committees
  constituted by the Council.

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Privilege of Persons Registered with RCI

• No person, other than the rehabilitation
  professionals/ personnel who possess a recognized
  rehabilitation qualification and is enrolled on
  the Central Rehabilitation Register
• shall hold office as rehabilitation professional
  or any such office (by whatever designation
  called) in Government or in any institution
  maintained by a local or other authority
• shall practice as rehabilitation professional
  anywhere in India
• shall be entitled to sign or authenticate any
  certificate required by any law to be signed or
  authenticated by a rehabilitation professional
• shall be entitled to give any evidence in any
  court as an expert under Section 45 of the
  Indian Evidence Act, 1872 on any matter relating
  to the handicapped
• Any person who acts in contravention of any
  provision of above shall be punished with
  imprisonment for a term which may extend to one
  year or with fine which may extend to one
  thousand rupees, or with both.

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Golden Temple (Amritsar)
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CONTINUING REHABILITATION EDUCATION PROGRAMMES

• RCI is also responsible for development and
  standardisation of training courses in the field
  of Special Education Rehabilitation and also to
  update the knowledge skills of professionals
  working in different areas of disability.
• The Council has taken a decision that attending
  two CRE's 5 days duration each is a pre-condition
  for revalidation of registration for the
  professional/personnel. The information regarding
  Continuing Rehabilitation Education (CRE) Topics
  and Programme being conducted at selected RCI
  approved Training Institutions Nationwide is
  given underneath for the Rehabilitation
  Professionals Personnel working in disability
  areas, so that they can join the nearby centre to
  upgrade their professionals skills.

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Objectives of CRE

• The Council supports relevant CRE programmes with
  the following objectives
• To upgrade the knowledge skills of in service
  practising Rehabilitation Professionals
  Personnel already registered with the RCI u/s 19
  of the RCI Act of 1992.
• To update Professional knowledge of Masters
  Trainers working in the field of Rehabilitation
  Special Education.

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Categories registered under RCI

• 1.Audiologist and Speech Therapists
• 2.Clinical Psychologists
• 3.Hearing Aid and Ear Mould Technicians
• 4.Rehabilitation Engineers and Technicians
• 5.Special Teachers for Education and Training the
  handicapped
• 6.Vocational Counsellors, Employment Officers and
  Placement Officers dealing with handicapped
• 7.Multipurpose Rehabilitation Therapists,
  Technicians
• 8.Speech Pathologists
• 9.Rehabilitation Psychologists
• 10.Rehabilitation Social Workers
• 11.Rehabilitation Practitioners in Mental
  Retardation
• 12.Orientation and Mobility Specialists
• 13.Community Based Rehabilitation Professionals
• 14.Rehabilitation Counsellors/Administrators
• 15.Prosthetists and Orthotists
• 16.Rehabilitation Workshop Managers

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Metro Rail service (DELHI)
23
INDIA GATE (DELHI)
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Other institutes in India

• About 1000 NGOs other private institution are
  working in the filed of prosthetics Orthotics.
  Some of them are also conducting various short
  courses training programmes.

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Otto Bock India

• Otto Bock India established as 100 owned
  subsidiary company in Mumbai, India in 1998 with
  the objective of making the highest quality of
  international mobility solutions available to
  India's estimated 9.0 million disabled people.

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ENDOLITE India Ltd.

• Endolite India Ltd., an ISO 90012000 Company was
  established on 07 Dec 95. It is a Rehabilitation
  Services Company focussed on Prosthetic
  Orthotic services through its Company run clinics
  and dealers. It is managed by a Board of
  Directors has its registered office a A-4,
  Naraina Industrial Area Phase-I, New Delhi

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Bharat Vikas Parishad

• Bharat Vikas Parishad is the only
  non-governmental organisation beginning with the
  establishment of its first Viklang Centre in
  Delhi in 1990 that renders service to the
  largest number of handicapped persons in the
  country year after year. The Parishad has so far 
   provided artificial limbs, calipers, tricycles,
  wheel chairs and hearing aids to about 2.65 lakhs
  handicapped persons costing over Rs. 32 crores
  free of cost (110000 NZ approx).

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Bhagwan Mahaveer Viklang Sahayata Samiti Jaipur
Foot

• Technology Jaipurfoot History Visitors Views  The
  idea of making Jaipur foot was first conceived by
  Mr. Ram Chander Sharma (Masterjee) who designed
  and developed the foot and the limb.The Jaipur
  Foot was developed in 1968.
• The BMVSS is working under the leadership
  guidance of Mr. D. R. Mehta and because of his
  Managerial background this research work could be
  organized. Indian Space Research Organization
  (ISRO) (Indian equivalent of the NASA of USA),
  the most prominent Scientific Institution of
  India, dealing with space research and products
  has signed an agreement with BMVSS for the
  development of polyurethane foot (instead of
  vulcanized rubber).  

29
Handicap International (INDIA)

• HI activities are carried out by or in
  partnership with local organizations. Handicap
  International provides capacity building support
  (technical, financial and organizational) to
  enable the partners to sustain their mission and
  carry out the activities mentioned below.
• 1. Specialised services as a condition for full
  participation orthopaedics and rehabilitation
• 2. Equal opportunities Inclusion, visibility and
  rights of disabled people
• 3. Public health and disability prevention
• 4. New project areas
• Livelihoods for  persons
• Livelihoods for  persons with disabilities in
  India
• HIV/AIDS
• Exploratory mission to disaster prone states such
  as Orissa

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Indian Red Cross Society

• Indian Red Cross Society (IRCS) was established
  in 1920 under the Indian Red Cross Society Act
  and incorporated under Parliament Act XV of 1920.
  The act was last amended in 1992 and of rules
  were formed in 1994.
• The Indian Red Cross is a voluntary humanitarian
  organization having a network of over 700
  branches throughout the country, providing relief
  in times of disasters/emergencies and promotes
  health care of the vulnerable people and
  communities.

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LOTUS Temple (DELHI)
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Qutab Minar (DELHI)
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Professional Bodies

• Orthotics Prosthetics Society of India
• Indian Association of Prosthetist Orthotist
• Indian Association of Rehabilitation professional
• ISPO (INDIA)

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Provision of Aids Appliances

• Aids/appliances are supplied to persons with
  disabilities under ADIP scheme of Ministry of
  Social Justice Empowerment, Govt. of India

35
Referral System

• PMR Specialist
• Orthopedic Specialist
• Prosthetist/Orthotist registered under RCI
• Other Specialist ( ENT, Eye, Skin Specialist)

36
Jaisal Mer (RAJASTHAN)
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Persons with disability Act 1995

• While India's economy growth rate has risen, 35
  of the population still lives below the poverty
  line and 39 of adults are illiterate. The number
  of disabled people would be around 55 million.
  Despite the introduction of legislation like the
  Persons with Disabilities Act, disabled people
  disabilities are amongst the most disempowered
  groups in India. They are constantly faced with
  discrimination and are subjected to neglect,
  prejudice, revulsion, rejection and pity.

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Criteria for ADIP assistance

• Disability certificate ( only 40 permanent
  disabled can get benefits under ADIP
• Monthly income
• Less than 6500 rupee 100 subsidy
• Between6500-10000 50 subsidy
• Over 10000 NIL

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Benchmark statement for prosthetics and
orthotics

• Subject benchmark statements provide a means of
  describing the nature and characteristics of
  programmes of study and training in health care.
  They also represent general expectations about
  standards for the award of qualifications at a
  given level and articulate the attributes and
  capabilities that those possessing such
  qualifications should be able to demonstrate.
• ( The Quality Assurance Agency for Higher
  Education 2001. Australia)

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Why Benchmark?

• Benchmark statements are used for a variety of
  purposes. Primarily, they are an important
  external source of reference when new programmes
  are being designed and developed.
• (The Quality Assurance Agency for Higher
  Education 2001. Australia)

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Legal Importance of bench marking

• Expectations of the Prosthetist Orthotist in
  providing patient/client services
• The application of practice in securing,
  maintaining or improving health and well-being
• The knowledge, understanding and skills that
  underpin the education and training of PO
  professionals.

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Planning for PO Training in NZ

• Awareness
• Willingness
• Communication
• Generation of resources
• Documentation
• Implementation

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Awareness

• To carry on the rehabilitation work in NZ the
  PO professionals has to under stand that there
  if the situation (NO TRAINING) remain same then
  after 7-10 year there wouldnt be any body to
  render services.
• More over on 100 depaendence on international
  work force is not a good idea.

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Resources we need

• Master trainers
• Volunteer for infrastructure suppliers
• Own funds ( Annual Subscription donation)
• Request for funds from Govt.
• Sponsorship from local suppliers
• Interested learners

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Implementation of International curriculum in PO
in NZ

• Phase one (Manpower Development)
• Training/work shop for local professionals by
  local master trainers for 3-4 times a year at
  least for two years. 2009-2011
• (TELE-CONFRENCING)
• Phase Two ( Trainers Development)
• Advance Training of all professional by
  international master trainers,1-2 times a year.
  2011-2012
• Phase Three (Start of Diploma course
  Certificate course in PO). 2012-2015
• Phase Four ( Start of Degree Course then Master
  Degree) 2015-----

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Phase Two ( Trainers Development)

• Advance Training of all professional by
  international master trainers,1-2 times a year.
  2011-2012

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