Health, Therapy and Assistive Devices

Recognize. Remedy. Revive

APD has responded to the growing need for holistic rehabilitation of PWDs with an effective end-to-end initiative that covers:
• Health services including early intervention programmes and partnerships with leading medical institutions
• Specialized therapeutic care and
• Affordable assistive devices, mobility and hearing aids

APD’s Health, Therapy and Assistive Devices programme is directed at people with spinal injuries, communication disability, cerebral palsy, mental illness, polio and severe and multiple disabilities. The programme reaches over 6400 people every year through direct institutional intervention, collaboration with other NGOs and extensive rural and urban community outreach programmes.

Health Services

For sustainable impact, disability needs to be detected at the earliest possible time and adequately supported by expert medical intervention and training.

 

Early Intervention Programme

 

APD’s early intervention programme screens babies in rural and urban communities, covering several municipal and taluk maternity hospitals.

 

If the child has, or is at risk of developing, a disability, it is placed under follow up care and provided with early stimulation therapy intervention. Parents and caregivers are provided counselling and training and involved in the child’s nutrition and extended rehabilitation plan. To build capacity, APD trains doctors, nurses, and government health workers to perform screening and encourages them to bring the process into the public health system.

 

APD screened over 3000 babies in 2010 alone.

 

Medical Intervention

 

When a requirement for medical intervention is identified, APD directs beneficiaries to the PMR unit of St. John’s Hospital in Bengaluru. Partnership with leading medical institutions ensures that children with conditions such as fits, visual impairment, malnourishment or hydrocephalus are assessed at the weekly clinic and referred for further treatment.

 

When forces come together- Rehabilitating Gangabhavani

 

When forces come together

 

Little Gangabhavani could not go to the anganwadi with her friends. She had severe locomotor disability coupled with spine deformity and weakness of all four limbs. She couldn’t stand on her own, had trouble sitting and her chest congestion made it difficult to breathe. Moreover, she was malnourished and underweight.

 

Her parents, illiterate, daily wage agricultural labourers, made a huge effort. They took her to hospitals in their home district of Chikkabalapur and even brought her to Bengaluru. But they really had no idea how to deal with her disability.

 

Ganga was discovered in the Chintamani Taluk Hospital by an APD CBR worker. Post assessment and counselling, she was put on a rehabilitation plan and referred to APD’s partner medical institution, St John’s Hospital, for medical support.

 

At the St. John’s Hope Clinic, Ganga was treated for her orthopaedic problems and general health issues. She was put on supplements to address her malnourishment. The APD field therapist followed up on the therapy intervention recommended by the hospital to strengthen Ganga’s muscles, provide mobility training and to improve her functional activity.

 

For a year, her hopeful mother, Munilakshmi, brought her to St John’s hospital every month. As she understood her child’s condition and the progress she was making, Ganga’s mother was inspired! She enrolled in a 6 month community therapy aide course and took it upon herself to create awareness about the impact of early intervention. She became a brand ambassador for Rural APD programmes, motivating parents of other disabled children, creating a movement towards early intervention and support.

 

The medical support and counselling provided at St John’s showed results- Ganga improved her general condition and with some stability returning to her joints began moving around with the help of a rollator provided by APD. Immediately her social skills took an upturn- she could interact and play with kids her age.

Now nine years old, she is in the 5th standard in the Government school in Nayanahalli, active, friendly and ready to lend a hand to the other children. APD’s CBR programme, APD’s Health, Therapy and Assistive Devices unit, St. John’s hospital and an informed, motivated caregiver- all forces that came together to make a difference in Gangabhavani’s life!

Therapeutic Care

Therapeutic care is an essential part of the rehabilitation process that helps in regaining strength, relearning skills or finding new ways to perform day-to-day activities.

 

APD’s Therapy division focuses on an integrated therapy approach that is geared to help beneficiaries achieve independent mobility and functional ability to their fullest potential.

 

APD offers various forms of therapeutic intervention including:

 

• Physiotherapy – The mainstay of the therapeutic process that involves manual therapy, exercise and electrophysical intervention along with health promotion and rehabilitation for correction and support of most movement difficulties.

• Hydrotherapy –A fun activity for children that helps in overall development of physical fitness and health, improves movements, stretching, breathing, balance, co-ordination and control.

• Massage Therapy – For children with CP, this helps improve circulation and reduce spasticity, improves muscle tone, flexibility and general health.

• Speech Therapy – Oromotor stimulation and speech therapy improves communication

• Integration Therapy – Designed to develop the child’s creativity through activities like visual arts, painting, music, dance and storytelling. Through individualized goals, the child is stimulated across multiple dimensions to realize balance and release all interferences.

 

APD’s offers therapy services at the institution’s headquarters in Bengaluru as well as extensive rural and urban community therapy programmes. It also manages a highly specialized programme for people with Spinal Cord Injury.

 

Apart from therapeutic services, APD also offers several related training programmes, aiming to disseminate its expertise and skill across the community.

 

Institutional Intervention

Rural and Urban Community Therapy Programmes

Spinal Cord Injury Programe

Therapy Training Courses

 

•Institutional Intervention

At the APD centre in Bengaluru, experienced therapists conduct detailed assessments and prescribe home based or centre based therapy needs, assistive devices or surgical referrals. APD’s counsellors actively engage parents and caregivers in the therapy process. Periodical reassessment is conducted to determine further therapy, educational or livelihood training needs.

Nearly 2000 people were supported with various therapeutic interventions in 2010.

The centre also engages in capacity building by supporting several NGOs in Karnataka, AP and TN, conducts school awareness programmes and trains members of the APD State Disability Collective, parents, CBR workers, community teachers, animators and government health workers on rehabilitation and disability management. Therapy courses and student workshops develop skills that are often deployed in other NGOs, community programmes or APD initiatives.

 

Mahesh moves ahead

 

Mahesh is 6 years old, a student at APD’s Shraddanjali Integrated School.

 

He was diagnosed with CP- Spastic Diplegia with hip, knee and ankle contractures and flexion deformity; unable to sit, stand, roll, walk or crawl by himself.

 

He could not use his hands for basic ADLs, was totally dependent on his mother, could say just a few words and couldn’t articulate his toilet needs.His cognitive skills were not appropriate to his age and he displayed almost no social skills.

 

 

APD assessed his needs and provided intensive physiotherapy and hydrotherapy; encouraged self care activities and trained Mahesh to walk with the support of splints and rollator.

 

Mahesh’s gross motor functions improved, he gained mobility, improved the use of his hands, developed communication skills and began to interact with others around him.

 

He is even doing well at school!

 

• Rural and Urban Community Therapy Programme

 

Around a person with disability is a community that includes parents and caregivers, disability workers and aides, government health officials and NGOs, teachers and volunteers.

 

APD’s endeavour to take rehabilitation therapy to the community manifests in rigorous rural and urban community therapy programs such as weekly Taluk clinics in Magadi and Bangarapet and orientation programmes in Davangere, Bijapur and Chikkaballapur districts of Karnataka.

 

Dedicated teams work in several remote centres on capacity building, training and sensitizing the community through:

  • Identification and assessment
  • Therapy support
  • Rehabilitation planning
  • Development of community rehabilitation centres
  • Expanding services in local government hospitals and schools through community clinics
  • Training officials and health department workers to deal with disability issues
  • Integration exercises
  • Awareness programmes for children and
  • Communication of rights under the disability act.

 

Parents, caregivers and home based volunteers are sensitized and trained to support children with severe and multiple disabilities and encouraged to access APD services at Community Rehabilitation Centres. In many cases, children are supported with assistive devices or referred for corrective surgeries after which APD has provided post operative care and mobility support.

 

A step forward for Suma

 

Suma lives in Chintamani Taluk in Chikkaballapur District of Karnataka. The four year old girl had severe Cerebral Palsy at birth, and had no mobility or communication skills. Her parents did not fully understand her disability and special needs and no relief was forthcoming from the hospitals that they visited either.

 

She was identified by APD’s Community Based Rehabilitation worker in Chikkaballapur district. APD assessed her needs and drew up a rehabilitation plan with specific goals. APD commenced therapy intervention- training Suma on basic ADL skills & encouraging speech and social skills development.

 

Suma can now walk with the support of splint & rollator. She is interacting with other people and has started her journey towards independent ADLs. Her parents have been trained to support and care for her and she has been referred for education needs.

 

•SCI Program

 

The horrific trauma of Spinal Cord Injury is indescribable. Be it paraplegia (impairment of motor or sensory functions of lower extremities) or quadriplegia (partial or total loss of use of all limbs and torso), a severely shocked and depressed mind could get trapped inside a mainly dysfunctional body that will just perish painfully, without rehabilitation and support.

 

Today, APD is the only organization that has put together comprehensive, structured community based programmes for dealing with SCI. In 2010, 350 people with SCI were supported through APD programmes.

 

The complex rehabilitation process includes:

 

  • Identification of people with SCI
  • Medical and post surgical intervention through networking with hospitals and doctors
  • Providing mobility aids
  • Reviving mental stability of the patient and support groups with the help of counsellors and mental health professionals
  • Reinstating social contact and interaction through group activities, residential camps, and sports
  • Restoring a sense of self-reliance through formation of self-help groups supported by legal and alternate career counselling.

 

•Therapy Training Programmes

 

APD’s therapy unit also offers various courses at its premises.

 

The focus on community rehabilitation therapy is to help therapists go beyond physiotherapy and engage in rehabilitation of all types of disabilities, be aware of the legal provisions under the PWD Act and the UN guidelines for CBR. This gives them a much wider reach and the ability to evaluate the beneficiary and determine various treatment and legal options available to them.

 

  • Two Year Diploma in Rehabilitation Therapy (under Bangalore University)
  • One Year PG Diploma in Rehabilitation Therapy (under Bangalore University)
  • Six month Community Therapy Aide Course (three days a month)
  • One week Basic Management of Mental Retardation programme
  • 10 day Basic Management of Locomotors Disability programme
  • 10 day Neuro Developmental Therapy programme
  • Early intervention Training
Assistive Devices

APD’s Assistive Devices unit has been producing custom aids and appliances, since 1982, to meet the emerging needs of persons with disability.

 

About 3000 PWDs assessed by the internal therapy unit or identified in rural or special orthopaedic camps, are provided each year with devices that help them improve their mobility, recover from injury, perform basic ADLs, regain their independence and restore dignity to their lives.

 

The extent of the problem in India is highlighted in the NSS 58th Round report (2002). It estimates that only just over 20% of PWDs had ever been advised on aids and appliances. Less than 16% actually acquired any assistive devices.

 

Innovation

 

APD’s production unit designs light weight assistive devices like knee ankle foot orthoses, ankle foot orthoses, spinal braces, prostheses (artificial limbs), crutches, footwear, walkers, tricycles, wheelchairs, multipurpose chairs and home assistive devices.

 

Download Ortho Brochure


Download Wheelchair Brochure

 

Four new products were introduced last year - multipurpose wheelchair, toilet commode wheelchair for babies, motorized tricycle and petro model for two wheelers. The constant innovation provides better choices, addresses specific needs and reaches more people at affordable prices.

 

Extended Reach

 

Through partnerships with several European vendors like Motivation, Endolite and Otto Bock, APD is also able to bring to beneficiaries in India, high technology assistive devices including modern prostheses and specialized wheelchairs, that are mainly assembled and custom fitted at the unit in Bangalore. Hearing aids are also offered through the partnership with Siemens. This programme provides training and sustainability support to several NGOs in the southern states to build capacity and provide wider reach, especially in non-urban centres.

 

Home Accessibility

 

APD also provides aids required to create a barrier free home environment for people with severe disability.

 

Devices such as bars and rails, specialized seats, modified western commodes, mobility equipment, transfer assists etc are made available to people who face challenges in navigating around their home or performing ADLs.

 

Where required, APD has helped provide ramps at the doorway for mobility of the severely disabled and worked with local authorities to level access roads to support wheelchair movement.

 

Orthotic Units

 

Helping the community help itself

 

At Kolar, APD has helped disabled entrepreneurs establish an orthotic devices workshop. APD will provide both training and financial assistance for a period of 3 years. A second unit is due to be opened in Davangere.

 

APD also supports an NGO in Coorg to make and distribute assistive devices, having sponsored their staff for a 1 year programme in the manufacture of aids and appliances.

 

For Shobha, a stitch in time..

 

 

You can see her moving confidently about Herepalya village in her wheelchair, collecting orders from customers and making deliveries, running her little tailoring enterprise… But it wasn’t always like this.

 

Shobha was affected by polio when she was a year old and used to crawl around her house and village. Her father, a daily wage agricultural labourer and her brother, a petty shop owner took her to different hospitals. Some recommended therapy but the family did not pursue this regularly. She was stuck at home, both mobility and daily activities posing a huge physical and emotional challenge.

 

 

Shobha was identified and assessed in a routine APD camp by the Rural Wheelchair Service team, operating in Kolar District, Karnataka. The team prescribed a “Worldmade” Rough Terrain Wheelchair for her use.

 

APD also encouraged Shobha to enrol in a four month vocational training program at the Rural APD Centre where she learnt tailoring skills. Her father bought her a sewing machine that kick started her business venture. She now earns between Rs 2000 and 3000 per month.

 

Mobility and economic independence have dramatically changed Shobha’s life :