While the most appropriate O&P intervention varies by condition, mobility level, and the individual, so too can the patient’s culture and environment play a role in the practitioner’s choice of intervention. In this issue, we explore perspectives from areas and cultures across the globe and the role those perspectives can play when delivering O&P care.
The number of individuals with limb loss in less resourced countries who lack prosthetic services is well documented, and a variety of approaches have been used to help address this problem, including donations of used prosthetic components from high-income countries. While these donations are well meaning, the prostheses often remain abandoned at the donation site as they are unsuitable for use in environments where access to electricity is unreliable, visits to clinics are difficult, and users often need to walk long distances in dusty or wet conditions the donated prostheses were not designed to withstand. “The Million-dollar Fit: Companies Develop Affordable Prostheses for Use in Less Resourced Countries” highlights several organizations that are designing affordable prostheses for market in less resourced countries while keeping the aforementioned limitations in mind. The companies have a variety of operating models, including traditional nonprofits, social entrepreneurships, for-profit companies blending profit goals with solving a social problem or hybrid models that combine a for-profit business with charitable work.
This issue’s second feature, “The Think System Makes Its Way From River City, Iowa, to Belo Horizonte, Brazil,” looks to South America for an introduction to rehabilitative Mental Practice to improve motor-skills learning in individuals with post-stroke impairment, and gait training following lower-limb amputation. During Mental Practice, participants internally practice the desired movement without physically performing it, and researchers have seen improvements in gait when it’s used in combination with physical therapy.
“The Spirit Catches You: Cultural Collisions and Cooperation in Medical Encounters” brings us back to the importance of recognizing differences between cultures to successfully navigate treatment interventions. As is often discussed in O&P literature, compliance with wear schedules, physical or occupational therapy exercises, or care of residual limbs is essential for optimal outcomes. However, this article challenges practitioners to think more broadly about issues of compliance and consider that adherence to the prescribed intervention requires the patient to agree with the approach. The author also suggests that practitioners be cognizant that cultural differences may play a significant role in the patient’s perspective and consent as clinicians work to engage him or her in the decision-making process for an appropriate O&P intervention.
I hope you enjoy this issue of The O&P EDGE as we embrace the ways in which diverse viewpoints from different places can impact and enrich the O&P care experience.