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Background

Polio eradication programmes are well under way in most developing countries, but millions of adults and children who have contracted polio continue to live with its debilitating effects. Their lives can be transformed by the physical mobility and potential for social integration that a well-fitted caliper or orthoses brings. For children with polio it is vital that they are able to join in, go to school and play.

Plastic Knee Ankle Foot Orthoses (KAFOs)

Knee Ankle Foot Orthoses (KAFOs) are the modern alternative to traditional metal calipers worn with boots – still widely used in many developing countries, India and Ethiopia included. Made with plastic, KAFOs are lightweight, better in appearance, user friendly and properly fitted have a high acceptance rate. A lightweight plastic caliper used early on in childhood prevents the development of secondary deformities. It improves a child’s life immeasurably by making possible everyday activities such as walking to school and playing that most children take for granted. Plastic KAFOs have the added advantage in that they can be used with any kind of footwear and with some modifications also allow for bare foot walking.

The need for Pre-fabricated Knee Ankle Foot Orthoses (PFKAFOs)

Conventionally made plastic KAFOs are excellent if government and communities have the resources to make them available to all those in need and if people who require caliper/ orthoses can afford the time and money to access these lifetime services.

Conventionally made orthoses whether plastic or metal can take up to 5 days to produce and fit and may involve several visits to the workshop by the child and accompanying family members. This is not an option for poor people of for people who live far away from rehabilitation facilities. Given current technology, uneven spread of resources and lack of trained technicians, it is difficult to see how demand for calipers in developing countries can be truly met.

PFKAFOs

Research and development (R&D) on caliper technology for polio affected people has not been a priority for many decades since polio became a thing of the past in the west. PFKAFOs are the result of the R&D project partnership between Mobility India (MI), Disability Development Partners (DDP) supported by DFID (UK) to find a new and low cost adaptation of exiting caliper technology for mass production and delivery.

The result is a set of 10 standard sizes of plastic shells or components for above knee and below knee and for both right and left legs. Accessories such as knee joints, straps etc were also specially designed for mass production so that a combination of these components and accessories can be put together as a kit for any size requirement for easy distribution.

 In India, a programme of training and demonstration workshops introduced PFKAFOs to key professionals, trainers in training institutes and orthotists working with rehabilitation of NGOs. Field test carried out in India have proven that between 60-65% of children or adults affected by polio can be fitted with PFKAFOs.