90% of wheelchairs used by people with disabilities in state inappropriate: Study

BENGALURU, INDIA: Only 10% of the wheelchairs used by 66.8 lakh people with disabilities of the state are appropriate, user-specific and manufactured as per World Health Organisation (WHO) stipulations, says a recent study by Mobility India Rehabilitation Research and Training Centre, an institute that works with WHO in training professionals across diverse rehabilitation programs for people with disabilities.

Inappropriately-built wheelchairs pose a problem for not only the specially abled but also senior citizens suffering from chronic conditions like dementia and arthritis, city experts pointed out. Lack of an appropriate wheelchair leads to postural issues and secondary deformities, several psychological and altitudinal barriers, they said. Besides, it increases pain and pressure sores and may be fatal for patients with serious spinal cord injures.

“Inappropriate wheelchairs are dangerous as they are being used by very sensitive patients already suffering from some form of deformity. Postural problems, scoliosis and reduction in sitting tolerance are some of the most common physical challenges faced by users,” said Ritu Ghosh, deputy director for training at Mobility India. “Not just that, they may be fatal for those with spinal cord injury as they have maximum negative impact on the spinal cord of users,” she added.

Besides, such wheelchairs hinder accessibility for the specially-abled who remain deprived of basic healthcare facilities, education and livelihood.

Dr Radha S Murthy, managing trustee at Nightingale’s Medical Trust that provides rehabilitation care for senior citizens, said, “More emphasis should be placed on research and development in this field to find effective solutions and create awareness among stakeholders on the importance of user-specific wheelchairs. Government should provide subsidies as customised wheelchairs are still too expensive and not affordable to most.”

WHAT INAPPROPRIATELY BUILT WHEELCHAIRS LACK

Firm support for the spine and pelvic region of the users

Adequate depth of seat to accommodate correct spinal alignment

Adjustable foot rest and arm rest with cushions

Adaptor and abductor cushions (especially for those suffering from dementia)

Functional brakes and anti-trip bar

Pelvic, back, trunket and calf straps

Source: Dr Radha S Murthy, managing trustee at Nightingale’s Medical Trust

Quote Hanger: Wheelchairs which are not user friendly lead to frustration among orthopaedic patients, accident victims

Not all patients would require the same kind of wheelchair… User-specific wheelchairs are the need of the hour which, however, are hard to find at all places. This leads to a lot of frustration and inconvenience among patients suffering from orthopaedic conditions or those who are victims of accidents

Dr Chandy Thomas, head of orthopaedics and director at HOSMAT Hospital

Mobility India all set to address the causes behind use of inappropriate wheelchairs in state

To address the issue of inappropriate wheelchairs, Mobility India has partnered with the state government’s department of empowerment of differently abled and senior citizen to train college students, wheelchair manufacturers, suppliers, doctors, nurses and other paramedical staff with a one-day orientation on Wednesday.

“Most manufacturers follow a business model to fabricate wheelchairs in bulk mode. They perceive the wheelchair as a tool for mobility rather than as an assistive device which can improve quality of life, enable people to access education, livelihood and other social opportunities,” said Ritu Ghosh, deputy director for training at Mobility India. “Also, feedback from service providers regarding the design of wheelchairs does not reach manufacturers, creating a gap. Adequate training of professionals to prescribe the right kind of wheelchair according to individual need hardly happens,” she added.

Ghosh stressed a wheelchair grievance redressal platform for all users, along with inclusion of wheelchair guidelines in the curriculum for healthcare professionals.

The orientation is for officials from District Disability Welfare, Department of Empowerment of Differently Abled and Senior Citizens, Rashtriya Bal Swasthya Karyakram, students and doctors. “This programme aims to sensitise officials on the need and benefit of appropriate wheelchair service provision and its implementation in Karnataka. We expect it to change the present scenario and bring in more user-friendly and ideal wheelchairs for users in the state,” said Ghosh.

Case studies

Manjunath B, 56, who has a physical disability after an accident 20 years ago, is an unwitting victim of an inappropriately made wheelchair. It led to reduction in the curvature of his lumbar spine, resulting in spinal deformity, tremendous lower back pain and stooping. He is bedridden now. Doctors later found that the inappropriate depth of his wheelchair seat had made him completely immobile.

Shankar, now 70, a patient of dementia, started using a wheelchair every time he went out with his wife For five years now Shankar has not been able to move on his own as he developed foot drop — a gait abnormality in which the dropping of the forefoot happens due to weakness, irritation or damage to the common fibular nerve including the sciatic nerve, or paralysis of the muscles in the anterior portion of the lower leg. Shankar’s wheelchair did not have an adaptor and abductor cushion, preventing him from sitting cross-legged for long and leading to foot drops.

Source: Times of India

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