Two staff members from the University of Botswana and University of Pennsylvania recently collaborated to embark on an exercise to provide and rapidly fit a total of 17 Batswana with above-knee and below-knee prostheses. University of Botswana Senior Lecturer in the Department of Biomedical Sciences in the Faculty of Medicine, Dr Maikutlo Kebaetse, collaborated with Professor Timothy Dillingham, Chair - Physical Medicine and Rehabilitation, University of Pennsylvania in the United States of America.
Dr Dillingham was invited by the Rehabilitation and Robotics Laboratory based at Sir Ketumile Masire Teaching Hospital (Professor Michelle Johnson and Dr. Kebaetse), under the auspices of the Botswana-University of Pennsylvania Partnership. The IFIT devices were a charitable donation from Professor Dillingham, the Physical Medicine and Rehabilitation at UPenn, and the IFIT company based in Wisconsin, USA. Professor Dillingham also got assistance from his technician son, Mr Rhys Dillingham.
This, therefore, enabled Dr. Kebaetse and Professor Dillingham to provide and rapidly fit eight Batswana with above-knee and nine with below-knee prostheses. In addition, a total of eight prosthetists were trained on and participated in the fitting process. The work was carried out at Princess Marina Hospital, Bamalete Lutheran Hospital, and Maun-based Thuso Rehabilitation Centre.
For each patient, the fitting process took 1-3 hours, and most independently walked home with the device the same day, while the rest needed up to a few weeks of ambulation training before being allowed to take the devices home. Remarkably, almost all patients reported comfort during sitting and walking as a major benefit of the novel device.
Even though it is not a solution for every single patient, the IFIT technology comes with a number of benefits that support the notion that it is feasible for adoption in Botswana. Firstly, it takes a very short time to fit patients with the IFIT compared to weeks of tedious building and readjustments required for traditionally used rigid sockets.
Another benefit is that IFIT's adjustable socket is superior in that it accommodates limb-size changes due to swelling or muscle atrophy (loss of muscle bulk) besides that each complete device costs between P20 000 (US$2000) for below-knee and P30 000 (US$3000) for above knee, which is a fraction of the average cost of lower limb prostheses in Botswana.
IFIT technology thus has potential to significantly help reduce the waiting period for prosthetic fitting in Botswana. Fitting patients within a relatively short time following amputation helps decrease the likelihood that some comorbidities and impairments could worsen or be triggered, and thus the impact of disability on an individual's life.
“We will be following up patients to ascertain their acceptance of the device after 6-8 weeks of use. In future, we plan to submit a research proposal for multidisciplinary re-design of portions of the prosthesis in Botswana, with the aim to help capacitate locals in terms of skills and manufacturing,” says Dr Kebaetse.