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Reaching Beyond
Our Borders

Ukraine Prosthetic Assistance Project – Report to USISPO from Jon Batzdorff

Based on conversations with the amputee veterans and prosthetists in Ukraine, it became clear that there was a need for help in the area of prosthetics and related rehabilitation. Specifically they needed assistance in fitting upper extremity and highly involved lower extremity amputees. The discussion that began in November developed into the ProsthetiKa Ukraine Prosthetic Assistance Project.

Ukrainian Canadian Congress Toronto and Canada Ukraine Foundation agreed to lead the project, and Jon Batzdorff of ProsthetiKa agreed to organize the technical aspects and assemble a team of…

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Batzdorff's Teaching
in Tanzania

Jon Batzdorff was contacted by the International Committee of the Red Cross (ICRC) / Special Fund for the Disabled to provide training in fitting above-the-knee amputees with ischial containment sockets.

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Al Ingersoll Working
in Bangladesh

Al Ingersoll, CPO, USISPO Education Chair

I was fortunate to visit Bangladesh this past year and meet with numerous people and organizations focused on the disability/rehabilitation sector. Bangladesh is well served by local organizations, (BRAC)

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Please send us your stories.


Walking in Chile

The best way to see a city is often on foot.  I arrived in Santiago, Chile in December 2009.  Santiago is a bustling city in South America with historic buildings juxtaposed with modern skyscrapers.  It was the day of their national elections, which meant that all businesses, museums, etc. were closed.  Although this made sightseeing difficult, I was able to view from the outside many famed locations that were affected by the recent earthquakes in February 2010, such as the Academia de Bellas Artes and Iglesia de Santiago. I was in good company and it was 85 degrees Fahrenheit, a stark contrast to the wintry weather in Minnesota.  During this walk, I enjoyed the weather and sights without consideration of the biomechanics that allowed me to efficiently traverse the narrow, crowded city streets.  However, that was not the case for the remainder of the week.

An opportunity to teach a five-day course at Teletón Institute for Children brought me to Santiago.  This course focused on the biomechanics of thermoplastic ankle-foot orthosis (AFO) designs.  Teletón is similar to the Shriner’s Hospital or Gillette Childrens Specialty Healthcare in the United States.  It is a childrens’ rehabilitation hospital that is funded entirely by donations received during the month of February.  They use a team approach to provide comprehensive care to their patients with child-onset disabilities such as Cerebral Palsy and Spina Bifida.  They have facilities throughout the country with combined orthotics, prosthetics, and seating departments at each.

This trip was sponsored by Becker Orthopedic and Tamarack Habilitation.  I was joined by Marty Carlson, CPO, FAAOP of Tamarack Habilitation and Rosie Jovane of Becker Orthopedic.  Together we spent five days teaching orthotists, physical therapists, and physiatrists the biomechanical principles that support our clinical decisions for thermoplastic AFO design.  This course consisted of one and a half days of didactic lectures on topics such as normal barefoot gait, the effects of footwear and orthoses on gait, pediatric AFO principals, etc.  The remainder of the course was spent with participants evaluating, molding, fabricating and fitting pediatric patient models with various styles of AFOs.  Each group made two AFOs per patient, one was made in their usual or customary design and the other using the new principles from the course, such as the Carlson modification for the sustentaculum tali, trimming the footplate proximal to the metatarsal heads, and/or using Tamarack joints.  Due to a shortage of patient models, a few groups molded each other and made AFOs for themselves using the aforementioned principles.  These groups discovered first-hand the effects of vacuum on thermoplastic splay, the support that may be achieved with the Carlson modification, and how a small amount of ShearBan may be successfully reduce skin irritation or the sensation of excessive “pressure”.  This was a week of experimentation for the participants.  They had the opportunity to apply new principals, to use biomechanics to understand when and why they worked, and to gain the confidence to try them in the future with other patients.

There are no schools for orthotists in Chile, which means that continuing education is not required nor offered by most companies in this country.  This course provided an opportunity for the orthotists to learn and to apply new knowledge, as well as to find out about other opportunities for continuing education.  On the last day of the course, the administration at Teleton pledged to provide further continuing education opportunities because they realized that education for their orthotists is not only important, but necessary for the advancement of orthotic treatment of their patients.

Since my return to Gillette Childrens Specialty Healthcare in St. Paul, Minnesota, I have remained in contact with a few of the participants.  It has been exciting to receive feedback from these clinicians who have incorporated principals from this course into their daily practice.  This experience caused me to more closely examine my own practice and to more consistently implement these techniques, with excellent results and positive feedback from my patients.  The simplicity of returning to basic biomechanics, which we learn in orthotics schools in the United States, to achieve better gait mechanics surprised me.  It further exemplifies to me the necessity of daily continued education, experimentation, and collaboration. 

I remember that by mid-week of the course I was hot, exhausted and wondering if the course would ever end and then it was finished in what seemed like an instant.  My brain was thinking more clearly in Spanish than in English at that point.  Marty and I spent one additional day relaxing and walking the streets in Valparaiso and Viña del Mar, two famed cities approximately a one-hour drive west of Santiago, along the coast of Chile.  My whirlwind trip that started on foot in the streets of Santiago ended much the same way—on foot relaxing and climbing the streets of coastal towns after a week teaching and practicing the biomechanical principals of gait and orthotic intervention.

It is with warm memories and deepest gratitude that I will always remember this experience.

Michelle Hall, CPO, FAAOP
Certified Prosthetist-Orthotis
Gillette Childrens Specialty Healthcare
St. Paul, Minnesota

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