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Welcome Message from Chairman of the Organising Committee

National Institute for Locomotor Disabilities (Divyangjan),Kolkata is an apex organization in the area of locomotor disability which came into the service since 1978 as an autonomous body under the Department of Empowerment of Persons with Disabilities(Divyangjan), Ministry of Social Justice and Empowerment, Government of India. It is located in the city Kolkata and expanding its services whole country wide. It’s objectives is to develop Human Resource (manpower) for providing services to the persons with locomotor disabilities and to conduct/sponsor, co-ordinate or subsidize research in all aspects of the education and rehabilitation of the Orthopedically Handicapped which expression shall also include the neurologically handicapped with problems of coordination or mobility. To undertake, sponsor, co-ordinate or subsidize research in biomedical engineering leading the effective evaluation of aids or suitable surgical or medical procedures or the development of new aids. To undertake or sponsor the training of trainees and teachers, employment officers, psychologists, vocational counsellors and such other personnel as may be deemed necessary by the institute for promoting education, training or rehabilitation of the orthopedically handicapped. To distribute, promote or subsidize the manufacture and distribution of any or all aids designed to promote any aspects of the education, rehabilitation or therapy of the orthopedically handicapped.

It is an attempt to bring together stake holder working in the area of Technology for the Divyangjan including Scientists, Researchers, Engineers, Doctors, Rehabilitation Professionals (Physiotherapists, Occupational therapists, Prosthetic & Orthotic Professionals, Hearing & Speech therapists, Mobility Instructors, Social Scientists, Psychologists, Vocational Counsellors, Rehabilitation Nurses and Special Educators), GOs, NGOs, Civil Rights Advocates & give them the opportunity to share latest findings in the field of Technology for Divyangjan. This program has been organized in the flow of our dedication towards contribution in the field of assistive technology as we are already introducing the courses and academic program in Assistive Technology in our institution.

A comprehensive program has been planned to cover Technology for all types of Disabilities under RPWD Act 2016. The organising committee is gratified to have a line-up of highly renowned speakers consists of experts who agreed to shed light on research Technology for in the field of Disability which will help Social inclusion of the Persons with Disabilities. Various programmes consisting of keynote, plenary, sponsored session have been assembled. Additionally, there will also be opportunities for students, researchers and practitioners to share their research and contribution towards the success of Social inclusion of Persons with Disabilities through appropriate Technology under free paper categories.

Dr. A. Biswas Chairman, Organising Committee & Director, NILD, Kolkata

On behalf of the organizing committee, I am delighted to welcome all the Speakers, delegates and the guests to the two days National Conference on Disability and Social Inclusion: Role of Technology on 10th and 11th January 2019 at IIT, Guwahati, Assam organized by National Institute for Locomotor Disabilities (Divyangjan), (NILD) Kolkata, under the Department of Empowerment of Persons with Disabilities (Divyangjan), Ministry of Social Justice & Empowerment, Govt. of India.

Message from Secretary, Organising Committee

It is our honour & privilege to welcome you all to National Conference on “Disability & Social Inclusion – The

Role of Technology”. On behalf of organizing committee, I am pleased to invite you all for the said National

Conference being organized in collaboration with IIT, Guhawati at Bhupen Hazarika Auditorium from 10th to

11th Jan 2019. Our Institute (NILD-Kolkata) has established a department and taken many initiatives in the field

of Assistive Technology since last couple of years and also planning to start a Master program on Assistive

Technology under the affiliation of Mizoram Central University in next academic session. The global push for

greater social inclusion of PwDs is taking place at a time of great technological advances. This conference

intended to create a network and to examine the evidence of technological development across IIT/Institute of

Importance in our Country, awareness & availability of Assistive Devices and how it can enhance the quality of

life of PwDs. The Educational tools, Mobility Aids, Visual and Low vision devices, AAC, Accessible

Technology, Universal Design, Accessible or Enabling Environment are all interlinked and are preconditions for

mainstreaming disability in development priorities. Investment/policy/strategy in implementation of technology

to make it available and affordable is definitely a practical step to establish the “Assistive Technology to

Achieve Sustainable Development for All.”

It is promising to know the great interest of faculties, research scientists from all over the country in

Assistive Technology. We have received 100 per cent success in confirmation of key note speakers, accepted

more than 50 abstracts and good participation of government officials from all over the country. Let us together

impart new passion in young and veteran scientists/research scholar/Rehab Professionals to make this field a

relevant, dynamic and useful for the betterment of Divyangjan. I would like to thank my friend Prof. Kanagraj

and Prof. S. Dwivedy, HOD, Department of Mechanical Engineering, IIT-Guwahati for their extended support

and cooperation, all key note speakers for sparing time from their busy schedule and all the participants in this

conference.

We will highly appreciate your active participation and ensure that you carry rich memories of this

event with you. Looking forward to meet you all

Dr. Prasanna Kumar Lenka,

(Organising Secretary)

stakeholders to take concrete measures for the empowerment of persons

with disability. This is possible with the application of newer, suitable, cost effective and appropriate technology.

Programme Outline 10.01.2019

08:30 AM - 09:30 AM Registration

09:00 AM - 10:15 AM Inauguration

Session - I (Social Inclusion : Dimension and Challenges)

10:15 AM - 10:30 AM Speaker - I (India Perspective)

10:30 AM - 10:45 AM Speaker - II (North East Perspective)

10:45 AM - 11:05 AM Speaker-III (Technology for Disabilities in General)

Tea Break (11:05 AM up to 11:20 AM) To proceed to Lecture Halls after Tea Break (11:20 AM to 11:30 AM)

Session-II (Hall-I) Session-III (Hall-II) Education Tools Mobility Technology

11:30 AM - 11:50 AM Speaker - IV Speaker - IX 11:50 AM - 12:10 PM Speaker - V Speaker - X 12:10 PM - 12:30 PM Speaker - VI Speaker - XI 12:30 PM - 12:50 PM Speaker - VII Speaker - XII 12:50 PM - 01:10 PM Speaker - VIII Speaker - XIII

01:10 PM - 02:00 PM LUNCH BREAK

02:00 PM - 04:00 PM Session-IV Free Papers of 15 minutes (10 MINUTES ppt + 5 Question

& Answer), 8 Papers in each hall

Lecturer Hall - I

ILecturer Hall - II

ILecturer Hall - III

ILecturer Hall - IV

Chairman Chairman Chairman Chairman Co-Chairman Co-Chairman Co-Chairman Co-Chairman

04:00 PM - 04:15 PM TEA BREAK

05:00 PM - 06:30 PM Cultural Proqram

11.01.2019

Session-V Session-VI Accessibility and Personal & ADL Care Universal Desiqn

09:00 AM - 09:20 AM Speaker XIV Speaker XIX

09:20 AM - 09:40 AM Speaker XV Speaker XX

09:40 AM - 10:00 AM Speaker XVI Speaker XX!

10:00 AM - 10:20 AM Speaker XVII Speaker XXII

10:20 AM - 10:40 AM Speaker XVIII Speaker XXII

10:40 AM - 11:00 AM TEA BREAK

Session-VII Session-VIII Augmented & Alternate Devices for Low Vision & Communication (AAC) Visual Impaired

11:00 AM - 11:20 AM Speaker XXIII Speaker XXVII

11:20 AM - 11:40 AM Speaker XXIV Speaker XXVIII

11:40 AM - 12:00 PM Speaker XXV Speaker XXIX

12:00 PM - 12:20 PM Speaker XXVI Speaker XXX

Session - IX (12:20 AM to 02:05 PM) Free Papers of 15 Minutes (10 minutes PPT + 5 Question & Answer), 7 Papers in each hall

Lecturer Hall - I

ILecturer Hall - II

ILecturer Hall - III

ILecturer Hall - IV

Chairman Chairman Chairman Chairman Co-Chairman Co-Chairman Co-Chairman Co-Chairman

Lunch Break (02:05 PM - 03:00 PM)

Valedictory, Certificate & Prize Distribution (3 PM to 4 PM)

End of Program

L

_J

Call For Free Papers

Last date of Abstract Submission: 21.12.2018

Confirmation of Acceptance of Abstract: 24.12.2018

Email Id for Abstract Submission: [email protected]

Papers Invited has been conceived and developed to assist researchers at

all levels scientists, professor, post doctoral scholars and students who are

seeking publishing opportunities for their research papers. Papers Invited

presents an exhaustive list of Calls for Papers issued by professional bodies

Journal editors and other conference organizers in all disciplines. Papers Invited has become the preferred destination where conference

organizers, journal publishers, researchers and academicians come

together to issue and receive information resources that encourage

presentation and publication of contemporary research.

TOPIC TO BE COVERED BUT NOT LIMITED TO:

• Education Tools - Mobility Technology

• Accessibility and Universal design, - Personal and ADL Care,

• AAC system, and - Technology for low vision and

Visual impaired

• Any other Assistive Technology developed for PwDs under RPWD Act

2016.

Abstract should contain : Introduction(about 75 words), Aim(30 words),

Method(120 words),Result(lSO words), Discussion and Conclusion (75words).

GUIDEUN ES FOR POSTERS:

Poster Size : Posters of Scientific work, clinical works, innovations and designs in 4 feet (height) x 3 feet (width) size.

Fonts: The poster should be visible from a distance of 2 metres. Please use

appropriate font sizes.

Posters will remain in place for the entire conference period.

Participants Profile

Who Should Participate:

Academicians, Scientists, Researchers, Rehabilitation Professionals

(Physiotherapists, Occupational therapists, Prosthetic&Orthotic

Professionals,Hearing & Speech therapists, Mobility Instructors, Social

Workers, Psychologists, Vocational Counselors, Rehabilitation Nurses,

Spl. Educators etc.), Rehabilitation Engineers, Assistive Technologists and

Students dealing with technological development for Empowerment of

Persons with Disabilities.

Organization Dealingwith the subjects mentioned below can participate

as informative Stall participant with nominal cost. For details contact :

[email protected]

Education Tools, Mobility Technology, Accessibility and Universal design,

Personal and ADL Care, AAC system, and Technology for low vision and

Visual impaired

Registration Details

• Registration Fees: Rs.500.00

• Last date of Registration: 24.12.2018

• Email for Submission of Registration Form : [email protected]

• Registration Fees may be Paid online:

Account Name: National Institute for Orthopaedically Handicapped

Account Number: 53015297593

IFS( Code : SBIN0030468

Account Type: Savings Account

Organizing Committee

Dr. A. Biswas Chairman, Organizing Committee

& Director,NILD, Kolkata

Dr.PK Lenka Organizing Secretary & HOD, Dept. P & 0

NILD,Kolkata, [email protected]

Prof. Santosha K. Dwivedy Co-Chairman, Organizing Committee

& Professor,HOD Dept. of Mech. Engg

IIT Guwahati, [email protected]

Prof. S. Kanagaraj Co-Organizing Secretary

& Professor, Dept. of Mech. Engg.

IIT Guwahati, [email protected]

Conference Secretariat :

National Institute for Locomotor Disabilities (Divyangjan)

B. T. Road, Bon-Hooghly, Kolkata-700090

Contact No.: 9432772725 Email: [email protected]

www.niohkol.nic.in

Contents Message from Hon’ble Minister, Ministry of State, Ministry of Social Justice & Empowerment

Message from Joint Secretary, Dept. of Empowerment PwDs Message From the Directors Desk Message From the Organizing Secretary Details of the Conference

Keynote Speakers Abstracts 1. Assistive Technology Empowering the Physically Challenged( Prof.

AnupamBasu, Director, NIT Durgapur)

2. Augmented and Alternate Communication (Dr. Ajish K. Abraham Professor in Electronics and Acoustics, All India Institute of Speech and Hearing)

3. Assistive Role of Patient Specific Design of Implants in Rehabilitation of Disables (Amit Roy Chowdhury)

4. Retinal Prosthesis for the Blind, Manjunatha Mahadevappa,School of Medical Science & Technology, IIT , Kharagpur

5. Customised patient-specific, digitally manufactured continuous fibre reinforced prosthetic socket (Amit Kumar Singh, F. Farukh, K. Kandan)

6. Accessing information across environments with Tactograph and TakeNote (Anil Prabhakar)

7. Gait analysis (Anup Nandy)

8. Evolution of Indian rehabilitation ecosystem: scope of assistive technology (Debapriya Dutta, Konga Gopikrishna)

9. Universal design and future of social inclusion in India (Gaurav Raheja)

10. Assistive wearable exoskeletons for daily living activities (Gurvinder Singh Virk)

11. Development of remedial orthosis for clubfoot patient through five corrective motions (Harlal Singh Mali)

12. Design and development of an affordable passive polycentric knee joint and dynamic ankle joint with different advanced features for trans-femoral amputees (S. Kanagaraj)

13. Biomedical engineering and technology (incubation) (Lalit Rao Amrutsagar)

14. Science and technology for robotic rehabilitation @ CSIR-CSIO (Neelesh Kumar)

15. Electro - Optical Sensor (EOS) based upper limb prosthetic arm (Prashant Gade)

16. Social inclusion and technology: reinventing access for persons with disabilities (Sarbari Sen)

17. Session on - educational tools (Shankar Subbiah S.) 18. Teaching/educational tools for persons with visual impairment (Sripriya R.)

19. Harnessing engineering and medical technologies to improve the comfort and durability of below-knee prosthesis for productive rehabilitation (Srinivasa Prakash Regalla)

20. Multimodal HMI based Omni wheelchair with assistive navigation (Subhasis

Bhaumik) 21. Accessibility of labs and class rooms (Sudhir Kamle)

22. Communication and augmentative and alternative communication (Suman Kumar)

23. Biophysics of functional electrical stimulation and its applications in rehabilitation (Suresh R. Devasahayam)

24.

The Rights of Persons with Disabilities – Accessibility of Government apps & Websites and its compliance matrix (Prasanna K. Lenka, IT section, National Institute for Locomotor Disabilities, Kolkata

25. Dimensions and Challenges of Social Inclusion: Northeast Perspective (Henry ZodinlianaPachuau), Department of Social Work, Mizoram (Central) University

26. An Affordable Bionic Hand for Extreme Upper Limb( Shyamanta M Hazarika), Biomimetic and Cognitive Robotics Lab, Mechanical Engineering, Indian Institute of Technology Guwahati

27. Wheel chair Accessibility and Robot Assisted Devices (Santosha Kumar Dwivedi (HOD, Dept. of Mechanical Engineering, Indian Institute of Technology Guwahati)

Free Paper Abstracts

1 Low-costs EMG sensing module for myoelectric hand prosthesis, AlokPrakas, ShiruSharma, NeerajSharma Indian Institute of Technology (BHU), Varanasi, India)

2

Improvised version of IITG passive knee prosthesis having internal-external rotation, anterior-posterior movement and link length variation options VaibhavJaiswal, SubramaniKanagaraja Department of Mechanical Engineering, Indian Institute of Technology, North Guwahati

3 Load line correction in lower limb using polycentric orthotic knee joint with passive assistance in single compartment knee osteoarthritis,Aman Singha*, aIndian Institute of Technology, Guwahati

4 Design and development of adjustable casting seat for IC socket design (Abhishek Tripathi)

5 Identifying the barriers in inclusive higher education for deaf and hard of hearing students: a comprehensive literature review (Vaibhao G. Athaley, Ila Gupta)

6 Design Reliability of a modified TLSO on gait and posture quantitative analysis in persons with AIS (Hasan Arif Raihan, Poly Ghosh, P.K. Lenka, Abhishek Biswas)

7 Modified elbow crutch for geriatric patients with pick-up mechanism: a case study (Chandni Pandey, Poly Ghosh)

8 Use of technology to monitor eco-behaviour of the teaching-learning environment (D. Revathi, P. Kamaraj)

9 Effect of pressure biofeedback assisted motor control exercises on pain and function in subjects with chronic nonspecific low back pain: a RCT (Jayanta Chakraborty, Bibhuti Sarkar, Pravin Kumar)

10 Clinical prevalence of risk factors of knee osteoarthritis among urban women

in Kolkata (Peimi Jojo)

11 An optimum clinical approach for the bilateral trans-femoral amputee with stubbies incorporating a modified mechanical resting device-a case study (Amarnath Prasad, Abhishek Tripathi)

12 Accessibility of prosthetic and mobility device technology to promote activity and social participation: a review of Mizoram (north east region of India) (K. Mishra)

13 Modular positioning system for obstetrical brachial pelxus injury (H.D. Sharma, Amit Kumar Mandal, Anurupa Senapati)

14 Satisfaction among patients with assistive technology provided by department of occupational therapy at NILD Kolkata: a cross sectional study (Pankaj Bajpai)

15 PDF accessibility for visually impaired (Sunil Kumar)

16 Barrier free environment for persons with disabilities (PwDs) and its psycho-social inclusion: a challenge in India (Ranjan Das, Meena Barai)

17 Robo-Rehab: a mobile app based robotic rehabilitation device (Ratan Das, Kajal Dofekar, Neelesh Kumar)

18 Social and economical impact of amputee rehabilitation by ADIP scheme in Odisha (Deepak Sahoo, A. K. Das Mohapatra, Rajesh Kumar Mohanty)

19 Inclusion and rehabilitation of persons with disabilities in rural areas utilizing community resources: a challenge (Abhijit Ghosh)

20 Assistive technology fuelling inclusive education (Achintya Prakash, Sant Prakash Gautam)

21 Low-cost sEMG sensing module for myoelectric hand prosthesis (Alok Prakash, Shiru Sharma, Neeraj Sharma)

22 Load line correction in lower limb using polycentric orthotic knee joint with passive assistance in single compartment knee osteoarthritis (Aman Singh)

23 An optimum clinical approach for the bilateraltrans-femoral amputee with stubbies incorporating modified mechanical resting device: a case study (Amarnath Prasad, Prasanna Kr. Lenka)

24 A narrative review of manual wheelchair users discomforts (Kurinji Chelvan S., Chinduja S.)

25 Design strategies for an accessible Indian Kitchen for elderly and the disabled (Sonal Atreya, Vaibhao G. Athaley, Sonam Agarwal)

26 Testing, design and virtual prototyping of functional rehabilitation devices (Ananda Podder, Prasanna Kumar Lenka, Abhishek Biswas, Himel Chakraborty)

27 The role of cosmetic restorative technology for PwDs in social inclusion (Poly Ghosh, Prasanna Kumar Lenka)

28 EconomicInclusiveness of People with Disabilities through Skill Development TrainingUsing Technological Support (Pramita Mullick, Abhijit Ghosh)

29

Effectiveness of a cognitive behavioral counseling program for the self esteem and positive attitude towards social inclusion of person with disability (PwD) (Priyanka Ghosh)

30 Role of smart technology in diabetes management (Mukesh Kumar Pathak, Sant Prakash Gautam)

31 Design children with special needs in inclusive education-effectiveness of educators and educational system (Suvendu Koley)

32 Technological advancement for inclusive society: a therapeutic perspective (Sugan)

33 Advance functional materials in design of structural assistive devices (Himel Chakraborty)

34 Effect of pressure biofeedback assisted motor control exercises on pain and function in subjects with chronic nonspecific low back pain: a randomized clinical trial (Jayanta Chakraborty, Pravin Kumar, Bibhuti Sarkar)

35 Patient safety issues in rehabilitation for person with locomotor disabilities: a review (Kuldeep Deka, Pranjal Gogoi)

36 Robotic technology in prosthetics (Kunmun Beher, Rajesh Kumar Mohanty)

37 Social inclusion of disable population: insights of sample study with children with locomotor disabilities in West Bengal (Nayan Roy Chaudhuri)

38 Reverse engineering and CAD CAM technology in prosthetics and orthotics (Mukesh Rohilla, Raagavi D, Rajesh Kumar Mohanty)

39 Design role of artificial intelligence in future prosthetics (Rishabh Gupta, Sant Prakash Gautam)

40 Development of a new cost effective assistive device: “adjustable postural correction chair” aimed at improving the life of persons with disabilities (Subrata Kumar Halder, Mama Kumar Sahoo, Sakti Prasad Das)

41 Improvised version of IITG passive knee prosthesis having inernal-external rotation, anterior-posterior movement and link length variation options (Vaibhav Jaiswal, Subramani Kanagaraj)

42 Application of technology in cerebral palsy for better community integration (Deepa Sundareswaran)

43 Qualitative study on effectiveness of picture based teaching on training menstrual care to adolescent girls with cerebral palsy and autism spectrum disorder (K.K. Dhanavendan)

44 Current needs of the assistive technologies in care of children with multiple disabilities: care-givers perspectives (S.K. Anandhalakshmi, S. Srigowri Rajesh)

45 Effect of tactile frame in overcoming tactile sensitivity among children with autism (S. Saradha priyadarshini, P. Kamaraj)

46 Emerging technological innovation for social inclusion of children with autism spectrum disorder (ASD) (Rajesh Ramachandran)

47 Life Time Determination of Active Upper Limb Prosthetic device (Akshay Saxena, Llewellyn Dsa, Priteem Behera, Priyanka Kumari, Anil Nair)

48 Attentiveness on technology support for visually impaired (non-ADIP) (G. Ananthi, Himangshu Das, P. Kamaraj)

49 Stance controlled knee ankle foot orthosis for patients with weak knee joints (Aneesh Karma)

50 Effect of ankle foot orthossis on energy expenditure in spastic dieplegic cerebral palsy (Dhruti Sundar Das , Hasan Arif Raihan, P.K Lenka)

51 Technology for social inclusion of a person with deaf blindness: a case study (Shobha N Odunavar, P. Kamaraj)

52 Congenital scoliosis with rib anomalies (Pratyush Kumar Sethi, Chunmun Mohanty, Sushree Sangeeta Nayak)

53 Design strategies on ADL and personal care paedriatic assistive device for lower limb (Sanjib Bhattacharjee, Prasanna Kr. Lenka)

54 Emerging technological innovation for social inclusion of children with autism spectrum disorder (ASD) (Rajesh Ramachandran)

55 Design use of low tech augmentative and alternative communication systems in children with multiple disabilities: a qualitative study (Kala Samayan)

56 Design and Development of a Three-Fingered Gripper for Therapeutic Purposes (Gaurav Jaiswal, Jyotindra Narayan, Santosha Kumar Dwivedy)

57 Locomotor gait analysis in spondylolisthesis using moulded LSO (Harsh Kumar Kanhaiya, Hasan Arif Raihan, P. K. Lenka)

58 Design and simulation techniques in advanced prosthetic foot (Mritunjay Kumar, Hasan Arif Raihan, Poly Ghosh, P.K. Lenka)

59 Design era of advanced powered ankle foot orthosis in stroke rehabilitation (Shaliny Bandyopadhyay, Hasan Md Arif Raihan, Prasanna Kumar Lenka)

60 Application of advanced robotics principles in upper extremity orthosis for SCI patients (Shubhlata, Hasan Arif Raihan, Poly Ghosh, Pranassn Kr. Lenka)

61 Application of microprocessor knees on trans-femoral prosthesis (Subhasish Paikray, Hasan Arif Raihan, Dhruti Sundar Das, P.K. Lenka)

Proceeding of National Conference on Disability and Social Inclusion-The Role of Technology

January 10 - 11, 2019 National Institute for Locomotor Disabilities (Divyangjan), Kolkata

In Collaboration with Indian Institute of Technology, Guwahati

Assistive Technology Empowering the Physically Challenged

Prof. AnupamBasu, Director NIT Durgapur

About the Speaker

Prof. AnupamBasu, Director NIT Durgapur, was a Professor, Dept. of

Computer Science & Engineering, IIT Kharagpur, is an active researcher

in the areas of Cognitive and Intelligent Systems, Embedded Systems

and Language Processing, Presently he is also the Executive Director of

the Indian Institute of Information Technology, (IIIT) at Kalyani. He

leads a number of projects for Technology Enabled Education,

especially for School Education

He is an Alexander von Humboldt Fellow and a Fellow of the Indian

National Academy of Engineering. The awards won by him include the

State Award for the Best Contribution to the Cause of Empowerment of

the Disabled (2014), Universal Design Award 2011, for contributions in

design for the disabled, by National Council for Promotion of

Employment of Disabled Persons, India, the National Award for the Best

Technology Innovation for the Physically Disabled (2007) and the Da-

Vinci Award 2004 from the Engineering Society of Detroit

.

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Augmented and Alternate Communication

Dr. Ajish K. Abraham Professor in Electronics and Acoustics

All India Institute of Speech and Hearing

About the Speaker

Ajish K. Abraham is Professor of Electronics & Acoustics at the All

India Institute of Speech & Hearing(AIISH), Mysore. He is currently

serving as the coordinator of Centre of Excellence at AIISH which

houses six research centres including Centre for Rehabilitation

engineering, by Acoustics and Bio-medical engineering (CRAB). His

current research interests are in developing automated diagnostic

systems for severity assessment of the disordered speech and for

assessment and rehabilitation of persons with articulation disorders. His

main research contributions are in Acoustics, Assistive technology,

Hearing aid technology, Processing of disordered speech and Speech

Acoustics. He is serving as a Member of Acoustical Sectional

Committee of Bureau of Indian Standards and Member of Engineering

Sciences Sectional Committee of Indian Science Congress Association.

He was conferred with “Distinguished Services Award” by the

Acoustical Society of India in 2016. He has also served as the Editor of

the Journal of Acoustic Society of India.




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Assistive Role of Patient Specific Design of Implants in Rehabilitation of

Disables Amit Roy ChowdhuryP

a* P

aPDepartment of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and

Technology, Shibpur, Howrah 711103, West Bengal, India

*e-mail: [email protected]

About the Speaker Amit Roy Chowdhuryis Professor of Department of Aerospace

Engineeringand Applied Mechanics at Indian Institute of Engineering

Science and Technology, Shibpur. His current research interests are in

Finite Element Method, Solid Mechanics, Biomechanics. He published 86

SCI journal papers and supervised 12 Ph.D. students.

Abstract

One of the greatest achievements of modern science has been the design and usage of assistive

and/or corrective devices for rehabilitation of the disabled. The rehabilitation process for people

with disabilities often requires the design of these assistive and/or corrective devices such

as Uwalking aids U, implants, bone-plates, fixation screws etc. intended to promote inclusion of

their users into the mainstream of society, and recreation. One of the prime functional areas

addressed through rehabilitation engineering is mobility. The innovations in orthopaedic

implant technology has helped to provide lasting relief from pain to millions of patients and

enabled them to return to their normal lifestyles for the past four decades. Numerous talented

researchers across the globe, have been working relentlessly to address and resolve the pertinent

issues responsible for implant failure. However, one of the major problems leading to long term

implant failure has been stress shielding, in the proximity of the implant. This problem is still

persistent and needs to be addressed to ensure successful and productive lifestyle for patients

with implants.

The readily available “off-the-shelf implants”, have some serious limitations. First and

foremost, there arises geometric mis-matches due to the variations in human bone sizes and the

readily available implants are not subject specific. Secondly, the design of the implant does not

take into consideration the bone condition of the patient, leading to alteration of loading pattern




of the bone. As the bone is not adapted to take on the added stress due to loading, loosening of

the implant and peri-prosthetic bone loss over time are high in these ‘ready-made’ implants.

To overcome the limitations of the off-the-shelf implants, there is need to explore the concept

of ‘patient-specific implant’. As the implant would be customized based on patient conditions,

most of the limitations of an off-the-shelf implant can be avoided. Also orthopaedic surgeons

would have the option of ordering modifications to an implant based on the patients’ bone

conditions and loading requirements. Also better parity in the pre and post implanted

mechanical environment, condition at the peri-prosthetic bone, would be achieved by the

patient specific implants which would, in turn, improve their overall longevity and

effectiveness. Additionally, these implants are expected to be economical than the imported

ones, as they would be better suited for typical Indian conditions.

The significant developments in medical imaging, image processing and CAD-based

manufacturing technologies, has made the concept of patient-specific implant a reality. Detailed

and accurate information about the shape, size, and condition of the subject’s bone can be easily

obtained by using advanced imaging technologies like CT, MRI etc.. Also, generation of any

complex model like an integrated porous structure (of the designed implant) can be generated

using advanced manufacturing technologies (like 3D printing, CNC etc.). So obtaining

important parametric information about the patient requirement and designing and

manufacturing the implant accordingly is a considerably smooth process now.

It has been observed that the main cause of resisting osseointegration (i.e. bone remodelling) is

caused by the variation in mechanical parameters (stress, strain etc.), between pre and post

implanted conditions at the peri-prosthetic bone, leading to implant failure in the long run. It is

possible to achieve a close resemblance of the mechanical environment at periprosthetic bone

by regulating the stiffness of the implant, based on the bone condition and subject’s body

weight. It is possible to create an optimum patient-specific implant by using various state-of-

the-art facilities like MRI, CT, micro-CT data, advanced Finite Element Analysis packages, 3D

printing, 5-axis CNC m/c like manufacturing tools, advanced computing models like Artificial

Neural Network (ANN), optimisation tools like Genetic Algorithm (GA) etc. Overcoming the

few remaining limitations and creating the ultimate patient specific implant is the principal

challenge which needs to be addressed.

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Retinal Prosthesis for the Blind

Manjunatha Mahadevappa * aDSchool of Medical Science & Technology, IIT , Kharagpur, India

About the Speaker

Manjunatha Mahadevappa is a Professor at the Indian Institute of

Technology Kharagpur. Dr. Mahadevappa is a senior member of the

IEEE-EMBS, a life member of the Biomedical Engineering Society of

India, and a Fellow of the Institution of Engineers (India). He has

published over 50 research papers, books, and chapters on medical

imaging and advances in therapeutic engineering. He is also a recipient of

an award “for best paper” from the International Society of Biorheology,

at the 10th ICB & the 3rd ICCH-1999, held in Pecs, Hungary. His

research interests include biomedical signal processing, biomedical

instrumentation, retinal and neural prosthesis, electrical retinal

stimulation, and rehabilitation engineering.

Abstract

Retinitis Pigmentosa and Age related Macular Degeneration are photoreceptor degeneration

diseases which causes visual impairment that extends up to complete blindness. Epiretinal

prostheses typically stimulates the surviving neurons of the retinal circuitry. Although, existing

implants restore vision empowering patients with execution of daily life activities, improving

the resolution of such vision is necessary. Moreover, color vision is yet to be introduced in

prosthetic vision. In this work, the electrode-tissue interface was studied under in-vitro

condition to understand the conversion of external (electrical and optical) stimulus to biological

signals in the retina. In this context, a multielectrode array (MEA) with a hexagonal

arrangement, of alternating ground and recording electrodes surrounding a stimulating

electrode, was proposed through simulation study of electrical and thermal parameters for focal

stimulation and uniform recording from retinal ganglion cells (RGC) using COMSOL

Multiphysics software [1]. Further, using photolithography technique, the MEA of gold thin

5




film disc electrodes was fabricated on flexible Polydimethylsiloxane (PDMS) surface [2]. To

illustrate the contribution towards epiretinal prosthesis research, in vitro experiments were

conducted with normal goat retina for comparison of light and electrically evoked responses

[3]. Wavelength information of a light stimulus and effects of variation of stimulus parameters

for both light and electrical stimuli were decoded from the RGC responses through firing rate,

interspike interval, latency analysis, and estimation of generalized linear model. Through

successful clustering of certain light and electrical responses, this study proposes that the

wavelength information could be encoded through specific electrical stimulus pulse parameters,

which envisage the potential of introducing color through epiretinal prosthesis.

The only FDA approved epiretinal implant so far is Argus II (Second Sight, California) which

has 60 electrodes for stimulation and is currently under clinical trial [4]. Epi-RET3, Germany

[5], with 25 electrodes and Bionic vision Australia with 99 electrodes are the other two groups

carrying out clinical trials of retinal implant using epiretinal space. The research groups

focusing on subretinal space for artificial stimulation has achieved larger number of electrodes

for stimulation which promises better visual acuity. Boston retinal implant [6] with 256

electrode array and Photovoltaic Retinal Prosthesis, California with 143 hexagonal electrode

array configuration are conducting animal trials. A trial with 5000 electrodes Artificial Silicon

Retina, Chicago [7] was unable to deliver adequate power for stimulation and thus so far the

maximum number of electrodes reached was 1500 by Alpha-IMS, Germany which is under

long term clinical trial [8].

References:

1. Biswas, S., Das, S., Mahadevappa, M. 2017. Design of electrode configuration for in

vitro experiments of epiretinal electrical stimulation of retinal ganglion cells. IET

Science, Measurement & Technology 11(4), 480-488.

2. Biswas, S., Sikdar, D., Das, D., Mahadevappa, M., Das, S. 2017 PDMS based

multielectrode arrays for superior in-vitro retinal stimulation and recording. Biomedical

Microdevises 19 (4), 75.

3. Biswas, S., Sikdar, D., Das, S., Mahadevappa, M., A Comparative Study of Light and

Electrically Evoked Response of Retinal Ganglion Cells. 39th Annual International

6




Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 017),

11th-15th July 2017, South Korea.

4. Weiland, J. D., Walston, S. T., Humayun, M. S., 2016. Electrical stimulation of the

retina to produce articial vision. Annual review of vision science 2, 273-294.

5. Klauke, S., Goertz, M., Rein, S., Hoehl, D., Thomas, U., Eckhorn, R., Bremmer, F.,

Wachtler, T., 2011. Stimulation with a wireless intraocular epiretinal implant elicits

visual percepts in blind humans. Investigative ophthalmology & visual science 52 (1),

449-455.

6. Kelly, S. K., Rizzo, J., 2017. The boston retinal implant. In: Artifcial Vision. Springer,

pp. 85-97.

7. Chow AY, Chow VY, Packo KH, et al. The Artificial Silicon Retina Chip for the

Treatment of Vision Loss. Arch Ophthalmol 2004;122:4:460-469

8. Zrenner, E., Bartz-Schmidt, K. U., Benav, H., Besch, D., Bruckmann, A., Gabel, V.P.,

Gekeler, F., Greppmaier, U., Harscher, A., Kibbel, S., et al., 2011. Subretinal electronic

chips allow blind patients to read letters and combine them to words. Proceedings of the

Royal Society of London B: Biological Sciences 278 (1711), 1489-1497.

7




Customised patient-specific, digitally manufactured continuous fibre

reinforced prosthetic socket Amit Kumar Singha*, F.Farukhb, K.Kandanb

aDepartment of Mechanical Engineering, Malaviya National Institute of Technology Jaipur, Rajasthan 302017,

India bSchool of Engineering and Sustainable Development,De Montfort University, Leicester LE1 9BH, United

Kingdom

About the Speaker

Dr. Amit kumar Singh is currently working as Assistant Professor in

Mechanical Engineering at Malaviya National Institute of Technology

Jaipur (Rajasthan, India). Prior to joining MNIT Jaipur he has served as

faculty member at BITS Pilani from 2005-2012. He is also adjunct faculty

at Material Research Centre at MNIT Jaipur and coordinator for Centre

for Advanced Design.

His Areas of Research Include Finite Element Based Design

Optimization, Prosthetics & Orthotics, Modelling of Lattice structures,

Bioengineering, Rapid tooling, Additive Manufacturing, Reverse

Engineering. He received DST Young Scientist Award in January 2013

for the project entitled “Effective Product Development Through

Integration of Reverse Engineering and Additive Manufacturing”.

Recently he was also awarded GCRF Networking grant from The

Academy Of Medical Sciences, UK for the project entitled “Accessible

Recycled Material Prosthtetics- Developing Capabilities and Partnesrship

in India”. This project is jointly carried with DeMontfort University UK.

He was also awarded Institute seed grant for project “ Customised Design

of Prosthtic Socket using Reverse Engineering and Additive

Manufacturing”.

He has organized and conducted several Training prograammes on

Optimization Methids, FEA, Prosthetics etc at MNIT Jaipur.

He has taught several courses such as Optimization Techniques, Robotics,

8




Concepts of Engineering Design, Machine Drawing and Research

Methodology & Design of Experiments. He has guided 6 PhD students

and at present 7 students are enrolled for PhD under him. He has also

guided several Master’s and B.Tech students at MNIT Jaipur and BITS

Pilani. He did his graduation at Kurukshetra University and M.Tech at

MNIT Jaipur with Honor’s degree. He obtained his Ph.D. at BITS Pilani

in 2012. He has about 50+ journal and conference publications to his

credit.

Abstract The A Digital manufacturing protocol to develop a prosthetic socket for amputees using

recycled plastic waste is explored. First, we describe 3D surface scanning of the residual limb

using a 3D scanner and challenges with image-processing required to generate a 3D CAD

geometry of an amputee's stump, as an alternative and efficient method than conventional

plaster of-Paris casting. Secondly, we present a digital manufacturing approach which is

capable of printing continuous Carbon/Glass/Kevlar fibre reinforced in a Nylon matrix, by

using a patient specific CAD geometry obtained via 3D Surface scanning. Thirdly, we compare

mechanical performance of 3D Printed fibre reinforced prosthetic sockets with that of standard

sockets made of thermo-forming the High-density polyethylene tubes. Finally, we present

sustainability of prosthetic socket with a perspective focused on cost and durability.

9




Accessing information across environments with Tactograph and TakeNote Anil Prabhakara*

aDepartment of Electrical Engineering, Indian Institute Of Technology, Chennai, Tamil Nadu 600036

About the Speaker

Dr. Anil Prabhakar received his PhD in 1997 from Carnegie

MellonUniversity and been with the faculty at the Dept. of

ElectricalEngineering, IIT-Madras since 2002. His current research

interests arein the areas of photonics, magnonics and assistive

technologies. Inaddition to his academic responsibilities, Dr.Prabhakar is

a Directorof Enability Foundation for Rehabilitation and a Founder-

Trustee ofChetana Charitable Trust. These organizations focus on

increasingawareness about issues faced by persons with disability and

empoweringindividuals through the use of technology. Dr.Prabhakar has

alsoco-founded Unilumen Photonics and QuNu Labs, companies

incubated byIIT Madras in areas of lasers and quantum key distribution.

Abstract Tactile pictures,diagrams, maps and graphs, are images that use raisedsurfaces so that a visually

impaired person can feel them. ATactograph enables schools to print their own tactile books

andworksheets at an affordable price. It is a motorized x-y stage thattraces a predefined picture

using an adhesive fluid, creating atactile image on a normal A4 sized paper. It also has the

ability toreproduce the tactile image as an outline on printed books, by usingsoftware-based

image processing to correct for any movement whileplacing the book.

Take Note is a compact, easy to handle note taker specially designedfor people with vision

impairment. The device has 9 buttons for inputand vibrates for feedback. 6 buttons correspond

to keys arranged as ona Brailler and 3 buttons to enter space and backspace. An inbuiltmemory

unit stores the notes typed in Braille. The device connects viaBluetooth to a system or an

Android device to transfer the storednotes. The Android phone can also be used for giving

audio feedback.The software can be configured to interpret all grades of Braille, anddifferent

languages.

10




Gait analysis AnupNandya*

aDepartment of Computer Science and Engineering, National Institute of Technology, Rourkela, Odisha 769008

About the Speaker

Dr. Anup Nandy is working as an Assistant Professor in Computer

Science and Engineering Department at NIT Rourkela. He earned his

Ph.D from IIIT Allahabad in 2016. His research interest includes Machine

Learning, Image Processing, Human Cognition, Robotics, Human Gait

Analysis. He received Early Careen Research Award from SERB, Govt.

Of India in 2017 for conducting research on “Human Cognitive State

Estimation through Multi-modal Gait Analysis”. He also received

research funding for Indo- Japanese joint research project, funded by

DST, Govt. Of India. He recently received NVIDIA GPU GRANT

AWARD in 2018 for his research on Human Gait Analysis for

Abnormality Detection.

Abstract General tools for gait analysis are 3-D motion capture systems, force plates, pressure mats etc.

3-D motion capture (Mocap) systems can track body joint movements with high accuracy. The

main drawback of Mocap systems are they are highly expensive and difficult to setup. Pressure

mats and force plates are inexpensive, but they can only measure foot placement-based

parameters and are unable to track other body parts’ movements or joint angles. Thus making

these devices accessible only in clinical environment, but not for personal care. The objective of

this talk is to discuss how to build an affordable efficient gait analysis system that can be used

even in daily basis. A regular check on gait pattern may help patients during rehabilitation or

identifying the cause if any abnormality is present. Recently, among vision sensors Microsoft

Kinect has emerged as a possible cost-effective gait analysis tool with some limitations. Also,

wearable sensors such as IMU (Inertial Measurement Unit), EMG (Electromyography) can be

used to measure different spatio-temporal features of a gait pattern. The multi-modal gait

analysis system has two major components: vision sensors such as Kinects and wearable

11




sensors such as IMU, EMG, and EEG (electroencephalography) sensors. Multiple Kinects are

more effective to capture the joint position data from different angles and then fused to measure

the actual joint angles i.e. hip angle, knee angle, ankle angle. High-density

electroencephalography (EEG) can provide a perception of human brain function during real-

world activities with different gait patterns. Understanding the human psychology and

estimating the mental state via gait analysis is a new area of research in the field of cognitive

science. The current research evaluates the validity of the EEG signals measured during

walking and correlate the results obtained with the state-of-the-art studies to find a relationship

between gait and cognitive mechanism. Hence, probable use of this system in medical

applications are as follows –Parkinson’s seizure detection tool, Stroke Detection tool, Cerebral

– Cortiacle related disease prediction tool, Neurorehabiltation using Machine Learning and

Artificial Intelligence.

12




Evolution of Indian rehabilitation ecosystem: scope of assistive technology

Debapriya Duttaa*, Konga Gopikrishnaa

aScience for Equity Empowerment and Development,Department of Science and Technology,New Delhi 110016

About the Speaker

Dr. Debapriya Dutta, Scientist ‘G’ , presently heading Science for Equity,

Empowerment Development (SEED) Division and asociate head NRDMS

division, Depatrment Science & Technology, New Delhi , Government of

India

Abstract At the dawn of 21st century, rehabilitation both as concept and practice are under debate as

rehabilitation was primarily focused on treatment of ailments to improve body functions. The

focus of rehabilitation has now gradually shifted to a stronger emphasis on social participation,

self-determination and equal opportunities. The Indian rehabilitation ecosystem thus comprises

of Policy, Practices, Programmes, Education and Skill Development, Technology and Market.

The paper examines the current status and opportunities to strengthen the rehabilitation

ecosystem and bridge the vital gap in policy, practices and technology.

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is an

international human rights treaty intended to protect the rights and dignity of Persons with

Disabilities (PwDs). It is the only UN human rights instrument with an explicit sustainable

development dimension. Some of the rights, specific to this convention, include the rights to

accessibility, information technology, independent living and social inclusion (Article 19),

personal mobility (article 20), habilitation and rehabilitation (Article 26) etc. The Rights of

Persons with Disabilities Act, 2016 is the disability legislation passed by the Indian Parliament

to fulfil its obligation to the UNCRPD, which India ratified in 2007. The Rehabilitation Council

of India (RCI) set up as a registered society in 1986, became Statutory Body on 22 June 1993

by an Act of Parliament and is mandated to regulate and monitor services given to Persons with

Disabilities (PwDs).

13




According to World Report on Disability 2011, the global burden of disease survey estimates

over a billion people (about 15% of the world's total population) to be living with disability. As

per Census 2011, in India, there are over 26.8 million PwDs in India, which constitutes 2.21%

of the total population. Rehabilitation of PwDs in India has long been just a support function in

hospitals. District Disability Rehabilitation Centres (DDRCs) were set up in 310 districts of the

Country for providing comprehensive services to the persons with disabilities during 1985-

2012. During 2014-2015, rehabilitation services were provided to 10,19,799 beneficiaries by 7

National Institutes which is trivial 3.80% when compared to the total PwDs. RCI has

recognized 444 institutions, with an intake capacity of 17745, to conduct 59 types of

rehabilitation courses under 16 categories. Estimates by RCI indicated that by the end of 12th

Five Year Plan, only 39839 individuals will be trained, thereby leaving a shortage of 166313

rehabilitation professionals/personnel in the country. It is also assessed that only 51329 persons

have been added to the existing human resource at the end of 2016, thereby, creating a shortage

of 104984 rehabilitation professional/personnel in India. There is huge gap between demand &

availability of rehabilitation professionals in the Country and it is evident that the existing

human resources are not sufficient to bring PwDs in the line of mainstream development of

society.

Disability, as referenced in various parts of Sustainable Development Goals (SDGs) emphasize

equity and equality to PwDs in education, growth and employment, accessibility of human

settlements etc (Goals 4,8,10,11 &17). Achieving SDG’s in respect to PwDs, need focussed

initiatives for strengthening the rehabilitation services. Technology issues, pertaining to

Research and Development (R&D) of rehabilitative and assistive systems has not received

attention at the intensity and scale that is necessary for a country of India’s magnitude. This

accentuates the urgent need for design and development of affordable State-of-Art rehabilitative

devices and assistive system within the country.

Significant efforts were also made by different Ministries/Departments, Department of

Empowerment of Persons with Disabilities (DoEPwD) in particular, to habilitate and

rehabilitate Divyangjan in terms of physical, social and economic aspects through various

schemes and programmes. The Department of Science and Technology (DST) through its

Technology Interventions for Disabled and Elderly (TIDE) Programme is making continuous

efforts to fill this gap by developing affordable and adaptable assistive technologies for 14




rehabilitation of PwDs. DST in collaboration with DoEPwD and its autonomous R&D

Institutions is in the process of developing new technologies including commercializing few

technologies developed under TIDE Programme for the benefit of Divyangjan.

The total rehabilitation market in India stood approximately at USD 3000 million in 2017, and

is expected to double in the next five years. While assistive devices are an integral part of health

care and are provided through the national health care system globally, the provision of

assistive devices for rehabilitation in India still remains trivial. There is a tremendous scope for

complementing the rehabilitation services with assistive technology in the country by involving

different sectors at different levels by developing new initiatives in a directed, time bound,

product oriented manner for rehabilitation of Divyangjan through appropriate scientific

interventions.

References:

1. Indian J Psychiatry. 2018 Feb; 60(Suppl 2): S253–S257

2. Journal of Family Medicine and Primary Care 1(1):69-73 · March 2012

3. World Report on Disability. Geneva: WHO; 2011. World Health Organization

4. Rehabilitation; Concepts, Practices and. Research. By Jan-IngeHanssen and Rafael

Lindqvist

5. https://www.who.int/disabilities/world_report/2011/chapter4.pdf

6. http://www.rehabcouncil.nic.in/

7. http://disabilityaffairs.gov.in/

8. https://www.un.org/development/desa/disabilities/about-us/sustainable-

development-goals-sdgs-and-disability.html

9. http://www.alimco.in/WriteReadData/UserFiles/file/ddabad_01032013.pdf

10. https://en.wikipedia.org/wiki/Rehabilitation_Council_of_India

15




Universal design and future of social inclusion in India GauravRahejaa*

aDepartment of Architecture and Planning, Centre for Excellence in Transportation Systems, Indian Institute of

Technology, Roorkee, Uttarakhand247667

e-mail: [email protected], grdesfap@iitr. ac.in

About the Speaker

Dr. Gaurav Raheja is an architect with social thinking outlooks and a well

known expert of accessibility and universal design from India. His

research interest include human centric approaches to design alongwith

other domains like urban social sustainability, children independent

mobility and aging. He is working as an Associate Professor of

Architecture and Barrier Free Transportation at the Indian Institute of

Technology(IIT) Roorkee with over twelve years of professional

experience. He is also appointed as Co-Cordinator of Design Innovation

Center at IIT Roorkee.

Dr. Raheja has been an expert member and plays key advisory roles to the

Department of Disabilities in Ministry of Social Justice and

Empowerment, Govt. of India for Accessible India Campaign launched in

2015, and conceptualization of National Institute of Universal

Design(NIUD). As an expert he has been on the selection committees of

national awards of Barrier Free Environment for the past several years by

the Govt. of India. He is one of the co-authors of Universal Design India

Principles, copyrighted and released in 2011. As an accessibility

consultant, he was invited to conduct access audits of some prestigious

projects including the Prime Minister’s Office and mobility hubs like New

Delhi Railway Station, IG International Airport, Vigyan Bhawan, etc.

during 2015 to 2017.

He was awarded the Mphasis Universal Design Award, 2010 for his

professional and research contributions in the field of universal design. He

received the Guest Research Fellowship at T U Berlin in 2017, DAAD IIT

16




Faculty Exchange Fellowship 2016 and DAAD Science Tour Fellowship

2016 amongst few others. He has been developing collaborations in

domains of accessibility, urban futures and urban mobility with German

universities like T U Darmstadt, T U Berlin, T U Dresden and INEAST

School of Asian Studies at University of Duisburg, Essen. Dr. Raheja was

recently appointed as the DAAD Research Ambassador from India.

With a vision of researching urban futures of social inclusion in built and

mobility environments, he has set up Laboratory of Inclusive Design at

the Department of Architecture & Planning, IIT Roorkee to advance

research endeavors from design, policy, planning to human participation.

Dr. Raheja has delivered several invited talks and conducted universal

design workshops at national and international platforms including DLR,

Berlin, WHO, New Delhi, IIM Ahmedabad, TISS Mumbai, Accenture,

Bangalore, CII, Vidhi Centre for Legal Research, among several others.

He has guided 03 PhDs and 16 Masters dissertations in varied domains of

architecture and transportation.

Abstract Social inclusion remains a complex challenge to be addressed across a nation as diverse as India

including persons with disabilities. Provision of accessibility in all walks of life remains a vital

goal and an initial step towards an inclusive future. Universal Design as an approach provides a

way forward to design interventions both in physical, sensory and the systemic zones of

applications. It however requires a foundational shift and a multi pronged approach towards

building an understanding and steering universal design as a progressive culture rather than an

intellectually elitist one. This paper intends to provide a critical insight towards building an

understanding on the state of the art concept of universal design.

It further highlights the key distinction between accessibility as compliance based approach

versus a best practice approach of implementation in various sectors like urban – rural built

infrastructures, transportation, education, health, etc. It highlights the WINIT model approach

for understanding the population ranges for design and the key principles of affordability and

cultural appropriateness focusing upon Universal design applications in Indian context. It 17




concludes with a recommendation for government and policy makers to encourage research and

development initiatives using universal design as approach for social inclusion with far

reaching benefits to all. Persons with disabilities, socially and economically disadvantaged

groups, elderly, diseased population groups and all others categorised as dependent would then

eventually become part of the mainstream and participate with equity in the spirit of progress.

18




Assistive wearable exoskeletons for daily living activities Gurvinder Singh Virka,b*

aTechnical Director, Innovative Technology and Science Limited, Cambridge, United Kingdom bTrustee, CLAWAR Association, United Kingdom

About the Speaker

Professor Gurvinder Singh Virk (PhD, DIC, BSc, CEng, FIET, FCIBSE,

CMath, FIMA, MIEEE) is Technical Director at InnotecUK Limited

with responsibility to lead R&D projects and product development for

realising inspection robots for hazardous applications such as offshore

wind energy generation systems, underwater installations and explosive

environments as well as service applications involving close human-

robot interactions. In addition, he is Adjunct Professor at London South

Bank University, UK. He holds a PhD in Control theory from Imperial

College, University of London, UK and his current interests are in

personal care and wearable exoskeleton robots for health and wellbeing,

medical robots for rehabilitation, active and assistive living applications,

climbing and walking robots, robot safety standardisation, robot

modularity and inter-operability, social robotics and robot ethics.

Abstract The current trend in robotics is to develop new markets in service and medical sectors. In this

respect, physical assistant robots are receiving significant attention in the research community

to produce new personal care robots able to contribute directly towards improvement in the

quality of life of humans in so called active assisted living applications (AAL). The global

ageing societal concerns are a major driver for these efforts and the potential for eventual

commercialisation is high but new markets have to be developed. The presentation will describe

applied research to develop commercially viable wearable robots for elderly persons in the

AAL projects EXO-LEGS, AXO-SUIT and A-PATH so that they stay independent living in

their own homes for as long as possible.

The presentation will describe the following key aspects of the research:

19




• Determining primary end users’ motion requirements for normal daily living

activities

• Formulating technical specifications of the needed wearable exoskeletons bearing in

mind technical and nontechnical

• challenges for achieving required performances while being compliant to

international safety regulations

• Developing concepts, designing and realising upper body and lower body prototype

exoskeletons and commissioningthem for tests with end users

• International ISO/IEC safety regulations being developed for these emerging markets

• Development of appropriate commercialisation plans in India and UK underway

There are medical and non-medical applications to be considered and an overview of these

issues in the urgently needed new robot products will also be described.

20




Development of remedial orthosis for clubfoot patient through five corrective

motions Harlal Singh Malia*

aDepartment of Mechanical Engineering, Malaviya National Institute of Technology, Jaipur,

Rajasthan 302017

e-mail: [email protected]

About the Speaker

Harlal Singh Mali post graduated in CIM from Panjab University,

Chandigarh, after his graduation in Mechanical Engineering; received his

doctoral in Mechanical Engineering from PEC (Deemed to be University),

Chandigarh, in 2010. Dr. Mali is presently working as Associate Professor

in Mechanical Engineering at MNIT Jaipur. His experience includes 12

years in teaching and 10 years in aviation industry. A young scientist

awardees from DST, Dr. Mali has applied seven patents and is working on

various funded projects. He set up an Advanced Manufacturing &

Mechatronics Lab and founder of CAM Society. Has supervised 05 Ph.D.

and 16 M. Tech. theses and has more than 60 peer- reviewed publications.

Abstract Over 13 million in India people suffer from various locomotor disabilities, of which many are

by-birth deformities. One such deformity is Clubfoot also referred as Congenital

TalipesEquinoVarus (CTEV). Clubfoot is a deformity that severely twists the foot downward

and inward, making walking difficult or impossible. CTEV is a 3-dimensional deformity of

the foot in which the foot is twisted in three mutually perpendicular planes from the

normal shape of the foot. To manage the problem, orthosis is gaining its popularity over the

conventional casting methods due to its superiority over casting method as casting causes skin

ulsers, skin rash, skin dehydration, ulcers etc.

The mechanism has been designed and developed to simultaneously correct the clubfoot

deformity after multiple iterations. It supports five degrees of freedom. It could lead to

development of an ankle foot orthsos (AFO) through which all type of corrective motion to the

deformed foot can be provided in each direction whether it is pitching, rolling and yawing. 21




Separate mechanism has been introduced to treat forefoot deformity. Slider links also caters to

the growth of the limb during the treatment period. The link length on which the entire

mechanism is based is verified by FEM and motion analysis of the product after a modeling of

demo model based on the concept. Once mechanism is verified, the measurements are taken on

the leg for clamping the device. Completed model is again modeled in Fusion360 software and

to do motion analysis of the mechanism. During the design of product flexibility was also kept

in to mind. The prototype of the product is built through 3D printing in ABS material then the

assembly is done with the help of pin, nut and bolts. The Velcro are then mounted on the

location provided on the product and the complete assembly is obtained.

The remedial orthosis can be manufactured using metals and polymers in combinations utilizing

different manufacturing processes. The prototype helps in verifying the product capability and

its existence. The developed mechanism can be submitted for clinical trials and enhancing its

robustness through replacement of polymer links and joints from different materials if needed.

22




23

Design and development of an affordable passive polycentric knee joint and

dynamic ankle joint with different advanced features for trans-femoral

amputees S.KanagarajP

a*

P

aPBiomedical Devices and Biomaterials Laboratory,Department of Mechanical Engineering,

Indian Institute of Technology Guwahati, India 781039


About the Speaker

Dr. S. Kanagaraj graduated from Thiagarajar college of Engineering,

Madurai, affiliated to Madurai Kamaraj University in 1997. He received

his Ph.D degree from Indian Institute of Technology Kharagpur in 2004.

He did his post-doctorate at University of Aveiro, Portugal till May 2008

and then he has been with the Department of Mechanical Engineering at

the Indian Institute of Technology Guwahati since 2008. He was

appointed as an Associate Professor and Professor in 2012 and 2017,

respectively. His research interests include biomedical devices,

biomaterials, assistive technology devices, prosthesis and orthoses, and

materials characterization. He has received many awards including

BIRAC-SRISTI GYTI Award 2016, Silver Award for Best Innovator at

7th India Innovation Initiative - i3 National Fair 2015, award under MLM

(More from Less for Many) category from Gandhian Young Technical

Innovation Award 2015, and meritorious scholar award in 2001 and 2002.

He has authored more than 80 journal and conference papers. One US

patent was granted and 5 Indian patents were applied. Four students

completed their Ph.D and 6 students are currently doing their Ph.D under

his supervision in addition to 2 post doctorate fellows and 3 Project

fellows. He has completed 8 projects as a PI worth of about Rs. 4.5 crore

and there are 4 on-going projects worth of Rs.6.6 crore and one

consultancy project worth of Rs.11.5 lakh. He completed 1 consultancy

project, 4 projects as a Co-PI. He started one startup company, M/s




Assistive Devices Technology Private Limited, Guwahati.

Abstract According to World Health Organization (WHO), there are about 30 million amputees currently

living in developing countries like Asia, Africa and South America etc. The number of disabled

population as per census India 2011 is increased from 2.1 to 2.21% of total population, where

the movement disability stood at 20.2% of total disability. The amputations through the lower

limb accounts for 85% of total amputation and 80% of amputees are not able to bear the cost of

prosthetic devices. As 75% of amputees live in rural areas, suffering of them further aggravated

due to poverty, and lack of rehabilitation services. Though a significant progress has been made

with prosthetic devices leading to achieve highly functional mobility, the devices are complex

in design, expensive, and difficult in maintenance. The commercially available prosthetic

devices are either expensive or produce many technical problems leading to mismatch of the

gait pattern of both sound and prosthetic leg. The objective of present study is to upgrade the

existing design of IITG polycentric knee joint with many improved functions. The dynamic

ankle joint is designed to provide the required kinematic motions and FRP composite foot will

be used to get flexible foot to provide near sound leg gait pattern. A socket system with suction

and suspension module is also being designed and developed. The abnormality noticed in

thegait pattern of knee and foot of different subjects is expected to be reduced by modifying

theirexistingdesign. As different components of lower limb prosthesis play an important role in

deciding human locomotion, comfort, weight and cost of artificial limb, an attempt is made to

optimize the system. Thus, a highly functional lower limb prosthesis consisting of polycentric

knee joint, dynamic foot, and socket system was developed in order to have improved quality of

life, independence and comfort level of doing daily activities of different subjects. The gait lab

will be used to confirm the improved gait pattern of different subjects.

24




Biomedical engineering and technology (incubation) LalitRaoAmrutsagara*

aDepartment of Energy Science and Engineering,Indian Institute of Technology, Bombay,

Maharashtra 400076

About the Speaker

Mr. Lalit Rao Amrutsagar is a Ph.D. research scholar at Biomedical

Engineering and Technology Incubation Center (BETiC) at IIT Bombay.

Just like all other members of BETiC ecosystem, Mr. Lalitrao has

expertise in the application of a systematic product realization approach

that focuses on collaborative efforts between health and rehabilitation

professionals and engineers to develop cost-effective health-care solutions

for Indian population. As a member of a multi-disciplinary team of

mechanical engineers, physios, O&Ps, prosthetic technologists and social

entrepreneurs, Mr. Lalitrao is currently working on functionally superior

and quality assured improvements in Jaipur prosthetic technology with a

focus on socket enhancements.

His team working with clinical prosthetists and using digital capture and

transformation has developed an alternative design and manufacturing

methods for batch production of transfemoral sockets which will have a

large outreach to remote locations with less resourced settings.

Abstract The Biomedical Engineering and Technology (incubation) Centre is a network of medical

device R&D facilities at IIT Bombay; College of Engineering, Pune; VNIT, Nagpur; and 7

allied cells at different research institutes. With its primary goal of accelerating indigenous

development and manufacture of medical devices suitable for the local population, BETiC

centers have about 50 multi-disciplinary faculty, full-time researchers and students,

collaborating with an equal number of expert clinicians from top hospitals in India to identify

unmet clinical needs and develop novel yet affordable solutions. A prospective researcher gets

trained in define, develop, deliver and deploy stages of BETiC research culture, through

25




MEDHA and MEDIC hackathons. Successful innovators are further invited to join BETiC,

where they are mentored and supported till the ‘edge of commercialization’ – leading to start-

ups or licensing. During 2015-2018, the BETiC team identified 400 needs, developed 120

prototypes, filed 40 patents, and licensed 15 products to Indian companies or hospitals. The

overall goal, of this ‘ISO 13485:2016’ certified medical device innovation eco-system, BETiC,

is to ensure that the end-users benefit from an innovative product at the earliest, while ensuring

world-class quality at affordable cost.

26




Science and technology for robotic rehabilitation @ CSIR-CSIO Neelesh Kumara*

aBiomedical Instrumentation Unit,CSIR-Central Scientific Instruments Organisation,

Chandigarh160030, India


About the Speaker

Dr. Neelesh Kumar working as Principal Scientist in Biomedical

Instrumentation Unit of CSIR-Central Scientific Instruments Organisation

Chandigarh from 2001. He was also head of Mechatronics/Electronics at

CSIO-Indo-Swiss Training Centre, Chandigarh. He has completed ME

(Instrumentation and Control) and MBA (Human Resource Management)

and PhD in Gait analysis forProsthetic development in 2005, 2006 and

2012 respectively. He worked on projects of national importance like “Jai

Vigyan”Linear Accelerator, Functional Electrical Stimulation System for

Paraplegics, Electronics Portal Imaging System and Electronic Knee Joint.

Presently he is working on development of Exoskeleton Devices for gait

rehabilitation. He is instrumental in setting up a Gait Motion Analysis

(Gait-lab in 2008) and Cognitive and Virtual Rehabilitation (CARE Lab in

2016) in CSIR-CSIO and involved in experimental biomechanics. His

areas of interest are techniques of gait assessment, sensor development,

design and development of assistive devices and methods to quantify

rehabilitation. He is versed with application of prosthetic biomechanics

for development robotic rehabilitation. He has received National award

for development of technological aids for mobility of disabled in 2012 and

IEI Young Engineers Award in Electronics & Telecommunication

Engineering Discipline for year 2009 and Raman Research Fellowship

2013-2014. He has more than 85 publicationsand 06 technologies

commercialised to his credit.

Abstract 27




The With the increase in casualties, man-made accidents and lifestyle disorders which results in

amputations of limb, stroke, and musculoskeletal impairments results in need of rehabilitation

aids to save human life. After any kind of disability to above or below limb, the individual

becomes fully dependent on the assistive device. Robotic Device for rehabilitation are emerging

to serve mankind it is our duty to provide quality aids at an affordable cost. A linkage between

Biomechanics and robotic device development is needed to strengthen to achieve the

technology for sophisticated and low-cost robotic device for assistance. The device

development cycle requires the knowledge of gait analysis at three stages a) for identifying

design requirements, b) for adaptive control and c) for performance quantification.

Various facets of kinematic, kinetic, and physiological analysis of human walk are done to

understand the science of Biomechanics/gait analysis. Use of active marker system in the

standard video environment is the hybrid approach to kinematic analysis. Development of

imaging algorithm is done to calculate spatiotemporal parameters. Kinetic analysis of ground

reaction force is done with force plate system. This experimental analysis depicts the

importance of internal and external force acting at anatomical joints during gait which affects

the gait symmetry and thus more comfort to the user. A bio-signal based control approach using

sensor place on devices and recording of dynamic bio-signal from is a human body. This

control strategy can help to provide more robust, accurate and effective control of adaptive

prosthetic devices.

Experimental gait analysis helped to narrow down the control parameter for variable gait. The

integration requires identification of sensing parameters (sensor development) and design of the

anthropometric mechanism, fabrication, Control Algorithm, testing and patient trials to record

the device efficacy. This engraves a pathway for cost-effective and intelligent Rehabilitation

Aids. Quantification of performance analysis of these robotic devices needs scalable and

quantified parameters of performance used by larger strata of society.

28




Electro - Optical Sensor (EOS) based upper limb prosthetic arm

Prashant Gadea* aFabAcademy, Center of Bits and Atoms,Massachusetts Institute of Technology, United States

About the Speaker

He completed his B-Tech in Electronics & Communication from J. T. Ma

College of engineering. Presently engaged in Innovating New Abilities

(INALI), Enable foundation, Fab Lab India

Abstract Introduction:The objective of this paper is to propose a novel and absolutely new method of

developing the prosthesis which can be controlled using Electro-Optical Sensor ( EOS ) that is

controlling an artificial limb with making any physical contact with the body surface. The other

objective is present how these EOS can be integrated with several other assistive aids and can

be used for people suffering from Acute Flaccid Myelitis, Quadriplegia or people with visual

defects.

Method:The sensors used in this prosthetic arm are EOS which is based on optical sensors that

convert the light rays into electrical signals and measures the physical quantity of light and then

translates it into a form that is readable by an instrument.

The EOS measures the change is muscles movement from one or several light beams When a

change occurs, the light sensor operates as a photoelectric trigger and therefore either increases

or decreases the electrical output.

Results:Several sets of experiments were conducted with 50 upper limb amputees to find the

advantages and limitations of EOS over the Myo-electric prosthesis and the following result

was found The EOS sensors were not affected with several body parameters such as body fat,

age, body sweat which are the major limitations in most of the Myo-electric prosthesis.

29




Conclusion:In summary, it was found EOS can not only be implemented with a myoelectric

prosthesis but can also be used for people with multiple disabilities such as Acute Flaccid (rare

polio-like syndrome), Quadriplegia a type of paralysis or for people with visual defects.

30




Social inclusion and technology: reinventing access for persons with

disabilities SarbariSena*

aRabindraBharati University, Kolkata, West Bengal, India

About the Speaker

Dr. (Mrs. Sarbari Sen) did her Master in Sociology in 1982 and PhD in 2000 from Kalyani Univeristy the field of Disability Rehabilitation. She worked as Head , Department of SER, NILD, Kolkata and presently enagaged as guest faculty in Rabindra Bharati University. She is an eminent expert and academician in the field of Socio-economical rehabilitation. She has been working as one of the senior in this area leading and being involved in different project and academic ventures with Govt. and non-Government sectors.

Abstract

Electrical Social inclusion is intimately related to the concept of social closure. Closure

functions through the twin mechanism of ‘exclusion and inclusion’ and can be found upon

individualistic or collective criteria. In order to understand the various dimensions of inclusion,

it is absolutely necessary to know the process and mechanisms of social exclusion. Social

exclusion is a form of multidimensional deprivation and for persons with disabilities this is

typified through various forms of alienation from the mainstream. Efforts to provide access, aid

and assistance have yielded partial results and individuals with significant disabilities are only

able to engage with the mainstream fleetingly, acutely aware of their dependent status. In the

absence of assistive technology, supportive structures and ‘un-conditioning’ of social stigma the

process of their social inclusion will remain incomplete and restricted, much like its current

impact.

In the light of the aforementioned framework, this paper is an attempt to unpack and understand

the role that technology can play in dismantling everyday barriers for persons with disabilities.

Few case studies will be presented that focus on some challenges confronted by the person with

disabilities and then illustrate the possibilities that can emerge from innovative technological

interventions. The paper will use the case studies to address the following concerns and

arguments:

31




- Factors that allow continued social exclusion of persons with disabilities.

- The relevance of innovation and technology in creating a climate of inclusion.

- The need for accessible and affordable scientific design and thought.

Dismantling informal social barriers of service providers, policy makers and inventors in order

to facilitate more inclusive thinking

32




Session on - educational tools

Shankar Subbiah S.a* aAssistive Technology and Accessibility Consultant, Agate Infotek Private Limited, Chennai

e-mail: [email protected], [email protected]

About the Speaker

A computer software engineer with 20 years of professional experience in

IT Industry working on software projects in various positions. Involved in

development of Braille Translator Software during the IT career. Started

working in the assistive technology and accessibility space of disability

domain to bridge the gap in implementation, training and support of the

eco system especially for children in education and adults in employment

since 2009.Working as Disability Rights Alliance (DRA) member on

advocacy projects for Accessibility in Chennai and the country along with

stakeholders and Government.

Abstract United Nations Sustainable Development by 2030 (UN SDG) has as its Goal 4 - ‘ensure

inclusive and equitable quality education and promote lifelong learning opportunities for all’

which outlines how to translate global commitments into practice at a country, regional and

global level in education including for persons with disabilities. Aligning with the goals,

Section 16 of Chapter 3 - Education in Rights of Persons with Disabilities, Act 2016 enacted in

India, makes it a duty for all Government and local authorities to endeavour that all educational

institutions funded or recognised by them provide inclusive education to children with

disabilities. The act further emphasises that children should have a barrier free environment

accessible to their inherent or developed abilities, reasonable accommodations in the

instructional and assessment procedures, accessible information for learning and

communication methods for inclusion. As specific measures to promote such inclusion in

education, adequate resource centres, materials that adhere to universal design of learning,

curriculum adaptations, research in the area of inclusive pedagogy have to be planned and

implemented.

33




Information and Communication Technology (ICT) as Assistive Technology plays a vital role

as enabler in this juncture, by providing physical accessibility to educational centres, access to

information resources, and for social inclusion through augmentative and alternative

communication (AAC). Such, assistive tools for Education include low tech that are available in

the environment, at low cost, easy to prepare and use as well as high tech, that can provide a

versatile presentation, improve the capabilities with creativity. For a child with locomotor

impairment, assistive technology is available as an adaptation for writing in the form of hand

grips, adapted writing boards to advanced speak or point to type in systems. Similarly, there are

adaptations and tools for reading in the form of braille, text magnification mechanisms, screen

readers, tactile graphics, DAISY / ePUB for those children with print disabilities getting access

to books. For enabling an inclusive classroom routine with instructions, easy to understand

interactive media tutoring tools, and for personal as well as group communications,

communication charts, point to speak AAC systems are developed and available in our country.

With advent of accessible mobile devices, Internet of Things, Assistive Technology as

educational tool have emerged with many apps, that interact with external devices providing

identification, assessment, early intervention, therapeutic, mobility, academic learning

solutions. The requirement now is awareness on all such tools for the stake holders primarily

educators, parents as well as authorities, and dissemination of knowledge to train, operate,

implement in educational settings. This will enable the participation and contributions of all

towards ensuring inclusive and equitable quality education for our children irrespective of their

abilities or demography or socio-economic conditions.

34




Teaching/educational tools for persons with visual impairment SripriyaR.a*

aDepartment of Special Education, National Institute for Empowerment of Persons with Visual

Disabilities-Regional Centre,Chennai 600 056


About the Speaker

Dr. Sripriya R., is presently working as Officer In- Charge and Head of

Department of Special Education, at National Institute for Empowerment

of Persons with Visual Disabilities, Regional Centre, Chennai

(Department of Empowerment of Persons with Disabilities, Ministry of

Social Justice and Empowerment, Govt. of India), which was formerly

known as a NIVH-RC, Chennai. She is the programme co-ordinator for

B.Ed Special Education (Visual Impairment) Course of Tamil Nadu

Open University. She has 14 years of enriched experience in the field of

Visual Impairment and exposure to deal children with multiple

disabilities. She is farmed with BSc., B.Ed. a double major degree in

Special Education and Maths, along with MA (Public Administration),

MSc(Psychology), MS(Counselling & Psychotherapy), M.Ed. Special

Education (Visual Impairment), SET & NET and completed Ph.D in

Special Education (Visual Impairment) under the guidance of

Dr.Premavathy Vijayan, present Vice Chancellor of Avinashilingam

University, Coimbatore.

Over 50 children with special needs and their parents benefitted

through her Guidance and Counselling. She has coordinated more

than 50 short–term training programmes, inclusive of CRE programmes

and has presented many papers in the national and international

conferences, published books and research articles in the peer reviewed

journals. She is the writer for the course material titled “Curriculum,

Adaptation and Strategies for Teaching Expanded Curriculum” of Tamil

Open University. She has contributed for RCI teleconferencing titled

“Inclusive Education” with special focus on Visual Impairment. She was

35




honoured with Women Achiever Award for her outstanding achievement

and excellence in the year 2010 by the first women Mayor of

Coimbatore, Smt. SuseelaUnni , on the occasion of World Women’s Day

organized by Centre for Women’s Studies, Avinashilingam University,

Coimbatore.

Abstract The Education serves as a channel to access and advocate the right for the right person,

detaching from promulgation of diversities. Persons with visual impairment are categorized as

one among the marginalized sectors craving for creation of barrier free and right based societies

with social inclusion. To address to the global requirement of persons with visual disabilities, it

is essential to understand about gradation changes prevailing in the education system, training

and adaptive sequences/strategies, application of tools and technologies. This presentation is

designed to focus upon the educational facts and contemplation of services with special

emphasis on technological inputs in the limelight of hurdles addressed by persons with low

vision and Blindness and highlighting the role of stakeholders and researchers to march towards

caring and flawless Inclusive Society.

Key words: Education System, Training strategies, Tools and Technologies, Inclusive society

36




Harnessing engineering and medical technologies to improve the comfort and

durability of below-knee prosthesis for productive rehabilitation SrinivasaPrakashRegallaa*

aDepartment of Mechanical Engineering, Birla Institute of Technology and Science, Pilani, Hyderabad Campus,

Hyderabad 500078

About the Speaker

Dr. Srinivasa PrakashRegalla is a professor and coordinator of the

product design & realization laboratory in the department of mechanical

engineering at BITS Pilani, Hyderabad Campus. He works in the research

areas of computer aided mechanical design, additive manufacturing (3D-

printing), design for sheet metal-forming, medical devices and prosthetic

design, bio-mechanical engineering and tribology. Prof. S. P. Regalla was

awarded with a BIRAC/BIG-5 grant in 2015-16 for development of novel

additive manufacturing technology of high comfort and low-cost below-

knee prosthesis, christened "Sukhfit", which is meant to enable productive

rehabilitation to patients in India and abroad. His research team, PSPR-

3D-Tech, completed the proof-of-concept of Sukhfit and gave it to 15

patients, who found it better than what they were wearing earlier. He is a

member of the research team, 'India America Artificial Heart Project

(IAAHP)' engaged in bringing out a low-cost artificial heart/vascular

assist device for Indian patients by 2020. Prof. Regalla published 45 peer-

reviewed international journal papers, 35 international conference papers,

2 books and 3 patents. Prof. S. P. Regalla holds a PhD from IIT Delhi, M.

Tech. from IIT Kanpur and B.Tech. fromKakatiya University, Warangal

in mechanical engineering. He was a post-doctoral guest researcher at the

NIST, Gaithersburg, MD, USA.

Abstract

37




The Unlike in the West, the need for collaboration between medicine and engineering to

improve healthcare standards in the country was realized only recently in India. The human

body and its active processes, as we all know, involve, besides biology and chemistry, all

applied engineering concepts of mechanical engineering, electrical science and materials

engineering. To improve quality and productivity of life, especially for those needing special

support systems such as prostheses it is essential to harness latest engineering and medical

technologies. At PSPR-3D-Tech, which is the name of my research team, we have developed

high-comfort and affordable below-knee prostheses through a novel route combining latest

technologies of reverse engineering, computer aided design and additive manufacturing

technologies. The main advantages of our methodology include the patient being kept at ease

during the process, needs to come for correction much less number of times and can get

productive rehabilitation with the same quality or better compared to the international brands of

prostheses at a much lower costs with our efforts towards indigenization. Some of the

observations we made through our journey are presented here with special emphasis on the

related technologies.

38




Multimodal HMI based omni wheelchair with assistive navigation SubhasisBhaumika*

aDepartment of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and

Technology, Shibpur, Howrah 711103

e-mail: [email protected], [email protected]

About the Speaker

Dr. SubhasisBhaumik did his B.E in Mechanical Engineering and M. E.

in Production Engineering. After post graduation he joined in TATA

STEEL – Jadavpur University joint research project for development of

a robotic system for steel plant application. He did his Ph.D in the area

of robotics. Dr. Bhaumik is currently working as Professor and Former

Head of the Dept. of Aerospace Engineering, Indian Institute of

Engineering Science & Technology Shibpur. He was also Head of

School of Mechatronics & Robotics in IIEST Shibpur. His research

interest is Bio-robotics, Bio-mechatronics, Smart Material,

CAD/CAM/Industrial Automation, Assistive Devices, Innovative

Product Development and BCI/HMI. Dr. Bhaumik is the principal

investigator of sponsored projects of Indo-US Fabrionics, BRNS-

BARC, DST, AICTE, UGC, Larsen & Toubro, IE(I), DST-FIST and

DIC - National Initiative on Design Innovation (MHRD). He has

published more than 70 research papers in SCI journals, book chapters

and International and National conferences. Two innovative products

have been filed for patent.He is a Fellow of Institution of Engineers (I),

member of Association of Machines and Mechanism, Robotics Society

of India and Expert Member - Rehabilitation Council of India. Dr.

Bhaumik is now acting as Dean (Research & Consultancy), IIEST

Shibpur.

Abstract 39




This work presents the design, development and control of an holonomic omnidirectional

wheelchair for indoor navigation. Wheelchairs have been an important locomotion device for

mobility impaired patients, geriatric population, amputee, stroke survivors, etc. While the needs

of many individuals with disabilities can be satisfied with traditional manual or powered

wheelchairs, a segment of the disabled community finds it difficult or impossible to use

wheelchairs independently. Motivated from the need and application of an intelligent

wheelchair and the challenges and short comings of the existing models, an attempt has been

taken which focuses on developing an omnidirectional wheelchair with increased indoor

manoeuvrability and multimodal control schemes to suit wide range of users. The developed

system is a four wheeled omnidirectional wheelchair with multimodal human machine interface

like joystick control, voice command control, myoelectric control and a gesture based control to

suit various application. Joystick and voice command based wheelchair control are both popular

control interfaces used conventionally. In myoelectric control mode, a pattern recognition based

classifier has been developed to map intention associated with forearm muscle activity to

motion command of the wheelchair. Six ratio metric features are calculated from four channels

RMS EMG to construct the feature vector based on which, a neural network classifier classifies

the motion command with the user's intention of the desired motion. A gesture recognition

based algorithm has also been developed to map seven different hand gestures with seven

different mobility commands of the wheelchair. Recognition and classifier algorithm first

differentiates between static and dynamic activity, autonomously detecting initiation and

termination of a valid gesture with the help of triaxial acceleration and myoelectric data. Based

on the feature vector, DSVM based classifier is used to recognize and classify the gesture.

Developed wheelchair is also controlled in assistive navigation mode, where it localizes itself

with respect to multiple Augmented Reality (AR) marker and navigate in indoor environment,

negotiating dynamic obstacles using spline based navigation algorithm. The developed system

can be used by geriatric population, mobility impaired patients or as a general intelligent indoor

mobility platform.

Research contributors: OisheeMazumder, AnandaSankarKundu, P. K. Lenka

40




Accessibility of labs and class rooms SudhirKamlea*

aDepartment of Aerospace Engineering, Indian Institute of Technology Kanpur, Uttar Pradesh 208016

About the Speaker

Sudhir Kamle is a professor in the Aerospace Engineering department at

Indian Institute of Technology, Kanpur. He did his B.Tech and M.Tech. in

Aeronautical Engineering from IIT Kanpur in 1977 and 1979. He did his

Ph.D. from Purdue University from the School of Aeronautics and

Astronautics in 1984. He joined IIT Kanpur after his Ph.D and he has

been there since. His current areas of research interest are smart structures,

flapping wings and image processing. Besides his academic duties, he has

served in other administrative capacities such as Head of Aerospace

department, GATE and JEE chairman and vice chairman. He is currently

serving as CVO, and as a member of "cell for differently abled persons" Abstract ElectricalIn today's scenario, the competition in higher education in India is intense and

everybody seems to be preoccupied with one's own growth. The differently abled people who

get selected in the higher educationalinstitutes such as IITs face a very difficult task in personal

andprofessional growth due to their inability in utilizing the rich culturaland educational

environment provided by the Institutes.IITs have always believed that there is always

something innovative thatcan be done using fundamental principles along with techniques and

designswhich is known from other fields. CDAP (cell for differently abled persons)

was created in IIT Kanpur in 2017 for addressing the concerns of thedifferently abled people.

The talk will cover both the design and implementation aspects ofproviding inclusive

environment to IIT kanpur community. We will coveraspects promoting inclusivity such as

barrier free infrastructurefacilities, accessible laboratory resources (physics, chemistry,

engineering labs), educational resources (special tutorials, accessiblemanuals, facilities during

examination) and administrative practices (accommodation form, digitization of information).

We will alsocover other aspects including accessibility in hostels, sports resources,

41




financial resources, psychological support and spreading awareness ofspecial needs of

differently abled persons to persons outside IIT Kanpur.

42




Communication and augmentative and alternative communication Suman Kumara*

aDepartment of Speech and Hearing, RC-Ali Yavar Jung National Institute of Speech and Hearing Disabilities

(Divyangjan), Kolkata 700090

About the Speaker

Presently working at Ali Yavar Jung National Institute of Speech and

Hearing Disabilities(Divyangjan), RC as Faculty & HOD, Speech

Language Pathology. He did hsGraduation in Speech & Hearing

from University of Mysore-1997, Post Graduation in Audiology &

Speech Rehabilitation from University of Mumbai-1999, MA Linguistics

from Annamalai University-2009. Ph.D.(Pursuing) from Maharashtra

University of Health Sciences, Nashik. He has published more than 40

research paper in different National and International Journals.

Abstract

Electrical Human beings are social creatures who by and large seek to connect to and make

relationships with others. In order to make connections and relationships, the role of

communication in some form plays an important role. Communication proficiency decides

social adjustments, emotional wellbeing and success in educational & vocational domains of

life. Beukelman and Mirenda (2013) estimated that approximately forty lakhs Americans are

unable to reliably communicate using natural speech to accomplish daily communication needs.

In India, 7.5% of persons with disabilities suffer from Speech disabilities (Census, 2011).

Augmentative and alternative communication (AAC) is an area which addresses the needs of

individuals with significant and complex communication disorders characterized by

impairments in speech-language production and/or comprehension, including spoken and

written modes of communication. AAC uses a variety of techniques and tools, including picture

communication boards, line drawings, speech-generating devices (SGDs), tangible objects,

manual signs, gestures, and finger spelling, to help the individual express thoughts, wants and

needs, feelings, and ideas. AAC is augmentative when used to supplement existing speech, and

alternative when used in place of speech that is absent or not functional. AAC may be

temporary, as when used by patients postoperatively in intensive care, or permanent, as when

43




used by an individual who will require the use of some form of AAC throughout his or her

lifetime. As per the Rights of the Persons with Disabilities Act 2016, AAC has been recognized

as one of the mode of communication and it is duty of the Government to promote use of AAC.

44




Biophysics of functional electrical stimulation and its applications in

rehabilitation Suresh R. Devasahayama*

aDepartment of Bioengineering, Christian Medical College,Vellore ,Tamil Nadu 632004

About the Speaker

Suresh Devasahayam has a Bachelors degree in Electronics and

Communication Engineering from the College of Engineering, Guindy,

followed by Master’s and Doctoral degrees in Bioengineering from the

University of Illinois, Chicago. He taught at the Indian Institute of

Technology, Bombay, for 12 years and then at the Christian Medical

College, Vellore, where he is currently Professor and Head of the

department of Bioengineering. His interests include physiological

measurement, instrumentation, signal processing, systems modeling and

rehabilitation engineering. His group has worked on versatile technology

for medical data acquisition and signal processing, and devices for

neuromuscular rehabilitation. In his research and teaching, equal emphasis

is placed on mathematical formalization, experimental measurement, and

electronic instrumentation and software. He is part of a unique program in

India awarding Masters and Doctoral degrees in a multi-institution

program involving IIT-Madras, SCTIMST-Tvm and CMC-Vellore.

Abstract Electrical Stimulation as a means of activating muscle is widely used in physical therapy. It is

used in strengthening skeletal muscle following injury to the nervous system. In the case of

muscles permanently paralyzed following spinal injury, head injury or stroke, electrical

stimulation can be used to restore function. Such Functional Electrical Stimulation (FES)

requires controlled stimulation of large limb muscles as well as fine control of movement. In

FES the human-machine interface (HMI) whereby the intention of the subject is conveyed to a

set of FES stimulators to achieve effective and functional movement, is an important

component.

45




The use of FES is usually limited to upper motor neuron lesions in which the peripeheral

nervous system is still intact. The stimulation threshold for nerve excitation being much smaller

than for direct muscle excitation, the loss of innervation results in the threshold being raised

about a hundred fold. Further, denervated muscles exhibit flaccid paralysis and neither reflex

activity nor spasticity is ever seen. Therefore, subjects with lower motor neuron lesions are

often poor candidates for FES and inevitably suffer muscle atrophy and other accompanying

issues like bone demineralization, etc. At CMC-Vellore we have designed stimulators for use

on denervated muscle and have successfully activated muscles before they have undergone

significant atrophy, i.e., within 18 months of denervation. There are a few studies reported in

the literature where denervated muscles have been successfully stimulated even after long term

denervation. Our studies are ongoing.

FES for large muscles as well as for fine control of multiple muscles poses a challenge in terms

of early muscle fatigue, and change in relative electrode position with movement. An

understanding of the biophysics of electrical stimulation can help to design electrodes, as well

as control protocols for such electrodes to compensate for and minimize the adverse effects of

fatigue and relative electrode position changes.

The excitation of nerves and muscles follows the basic principle of action potential generation,

for which the first formal models were developed by Hodgkin and Huxley. The excitation of

nerves with external electrodes can be understood with an extension of the Hodgkin-Huxley

model and models of the intervening tissue. Numerical simulations of such biophysical models

with graphical displays help to convey the ideas behind the models to therapists and

physiatrists.

Using the biophysics of electrical stimulation of excitable tissue and an understanding of

neuromuscular physiology, protocols to minimize muscle fatigue have been developed. This

remains a complex area with limited success in reducing farigue during artificial stimulation.

In this lecture our experience with Function Electrical Stimulation in terms of the biophysics,

instrumentation and rehabilitation studies will be presented.

Acknowledgement:Dr George Tharion (Professor of Physical Medicine and Rehabilitation),

Mr G Naveen, MrSahil Gera (Masters and Doctoral students in CMC-Vellore).

46




The Rights of Persons with Disabilities – Accessibility of Government apps & Websites and its compliance matrix

PrasannaK. Lenkaa*

aInformation Technology Section, National Institute for Locomotor Disabilities ,Kolkata 700090

About the Speaker

Prasanna Kumar Lenka is presently head of Department,

Prosthetic& Orthotic and Rehabilitation Engineering and also lead

the Information Technology section; NILD-Kolkata. He did his B-

Tech in Electronics & Communication in 1999 and M-Tech in

Information Technology in 2003 & joined in National Institute of

Locomotor Disabilities (NILD) Kolkata, Ministry of Social Justice

and Empowerment; Govt. of India in 2003, received PhD from

Jadavpur University in 2008 and completed M.Sc. Prosthetic &

Orthotic from West Bengal University of Health Science in 2015.

He has more than 15 years teaching experience in Bio-mechatronics

and Assistive Technology. He has supervised 04 PhD students,

published more than 50 International Journal paper and5 patents,

completed 10 DST/CSIR/Ministry project and has been working in

collaboration with SMST, IIT Kharagpur, school of Mechatronics,

IIEST, Calcutta University, Jadavpur University, VSSC, ISRO and

others. His current areas of research interest are Mechatronics,

Rehab Robotics and Assistive Technology.

Abstract One of the major challenges for persons with disabilities to obtain equal opportunity and

participation to any development process is the accessible website. It's a well known fact that

most of the online facilities including procurement of daily living items, payment of essential

service, study material, online application and many others are available in website. It

is essential that the website accessible to everyone in order to provide equal access and equal

47




opportunity to people with disabilities. An accessible web or electronic media can help people

with disabilities participate more actively in society and to get equal status in social network,

mobile apps and information communication services. Article 32 of the Convention on the

Rights of Persons with Disabilities highlighted the binding of inclusiveness and accessibility of

any developmental program in both nationally or internationally. Article -9, clause-1& 2

specify obligations on state parties (India is a signatory) for ensuring access to Information,

communications and other services, including electronic services and emergency services. PwD

Act 1995 &RPwD Act 2016 also provides equal importance to Right to avail non discriminated

basis facilities of activities of daily living including personal care, school, educational institute,

work place & public facilities. In this context, it is important for Persons with Disabilities,

Rehabilitation professionals, Policy makers, Government officials, care givers and all such

stake holders to have awareness on accessible website and the steps/procedure required to

covert inaccessible website to accessible one. Recent data were collected from published

literature and various other sources and analyzed. It has been reported from a published

documents that out of 7800 website in India, almost 75% are not accessible. It is also surprised

to note that many of government websites including most premier educational Institution

(IIT/IIM/NIT) are not accessible.

The paper discusses various issues and challenges related to barrier in website and electronic

media, strategy and method to adopt accessible website and concerned role of professionals or

service providers working in the field of Disability Rehabilitation.

Keywords: Accessibility, Disability, RPwD Act 2016, Website, Rehabilitation services

Dimensions and Challenges of Social Inclusion: Northeast Perspective

Henry ZodinlianaPachuaua* 48




aDepartment of Social Work, Mizoram (Central) University

About the Speaker

Henry ZodinlianaPachuau is working as Asst. Professor, Department

Social work, Mizoram University. He has more than 10 years of

research experience in Disability Studies and guided 3 PhD and 9

MPhil students. He has published 8 journal papers, 9 Book chapter

and 3 Magazine in the areas of Disability Rehabilitation

Abstract

The popular saying ‘India’s Diversity as a strength of its Unity’ may not always be true

in the field of Disability. Though policies exist for protection, and though it is hoped that such

mechanisms do actually bring about true justice, the reality is that social exclusion as a result

of Disability is still an inherent characteristics of communities, not only in Northeast, but in

India as a whole. Though various dimensions of exclusion or inclusion exist which highlights

itself as a result of diversity in biology and society, we have not yet broken ourselves from the

shackles of the collective consciousness that bars the development and promotion of social

inclusion in India.

This paper will attempt to highlight the socio-cultural realities in Northeast, taking

Mizoram as the major field of study. It will delve into the understanding of disability and the

various diversities and dimensions of social realities that exist within northeast that are

challenges to social inclusion and at the same time which can be used to promote social

inclusion in Northeast India.

An Affordable Bionic Hand for Extreme Upper Limb

Shyamanta M Hazarikaa*

49




50

P

aPBiomimetic and Cognitive Robotics Lab, Mechanical Engineering, Indian Institute of Technology

Guwahati-781039

About the Speaker

Abstract

Only a minuscule segment of the large upper extremity amputee population in India have access

to prosthetic hands. Imported variants are exorbitantly priced and out of reach of the common

man. Except for some 3D printed amateur efforts, which are grossly unsafe and unreliable, no

commercial production of an affordable prosthetic hand in India is reported. Development of an

indigenous affordable bionic hand for extreme upper limb holds promise. We introduce an

electromyogram (EMG) controlled five fingered neuro-bionic hand. Novelty is in biomimetic

design i.e., not only geometry but also functionality of the human hand is copied leading to a

tendon driven anthropomorphic hand. Elastic actuators for extension have been included while

flexion is through the tendon driven mechanism. The thumb curls as it flexes and straightens as

it extends. Provision for wrist movement is included. Novel EMG classification routines led to

a recognition rate of 97.5%. This is better than that reported in the literature in terms of a.

Shyamanta M Hazarika is a Professor of Mechanical

Engineering at the Indian Institute of Technology Guwahati. His

primary research interest is in Rehabilitation Robotics and

Knowledge Representation and Reasoning. This translates into

interest in bio-mimetic prosthetics; spatial cognition and cognitive

vision. Hazarika received a PhD in Knowledge Representation and

Reasoning from School of Computing, University of Leeds,

England. Beforejoining the Indian Institute of Technology

Guwahati he carried out teaching and research as Professor of

Computer Science and Engineering at Tezpur University, India and

asVertretungsprofessur of Neuroinformatics within the Cognitive

Systems Research Group, University of Bremen, Germany




recognition rate b. EMG channels used and c. grasp types recognized. The hand is designed to

emulate six grasp types. The control system reconstructs bionic reflex. Frugal innovative design

leads to an affordable functional prosthesis

Wheel Chair Accessibility and Robot Assisted Device

Santosha Kumar Dwivedi a*

a HOD, Dept. of Mechanical Engineering, Indian Institute of Technology Guwahati-781039

51




About the Speaker

Abstract

NCNILD000

Low-costs EMG sensing module for myoelectric hand prosthesis AlokPrakasha*, ShiruSharmaa, NeerajSharmaa

aIndian Institute of Technology (BHU), Varanasi, India


Santosha Kumar Dwivedi is a Professor & HOD of

Mechanical Engineering at the Indian Institute of Technology

Guwahati. His primary research interest is in Rehabilitation

Robotics and Robotic Assisted devices. Prof. Dwivedi received PhD

in Mechanical Engineering from IIT, Kharagpur in 2000, did M-

Tech from REC, Rourkela and B-Tech from Engineering college

Burla in 1991.




Background:Myoelectric prosthesis requires a sensitive sensor that can capture clear

electromyography (EMG) signal patterns from the residual limb of amputees for its smooth

operation. The currently available EMG devices mainly suffer from (1) less sensitivity in

detecting weaker strength signal especially from amputees (2) slower response leading to delay

in actuation of prosthetic hand (3) low noise susceptibility (4) higher cost (5) portability issues.

Aim: This paper proposes a low-cost surface EMG sensing module for prosthetic hand control

application.

Method:The module has been designed using the exclusive method of envelope detection and

noise cancellation which enables reliable detection of EMG signals regardless of subject

variability. The output performance of the sensing module has been compared with commercial

EMG sensor regarding signal-to-noise ratio (SNR), sensitivity and response time. In order to

perform this comparative analysis, EMG data with both the devices were recorded for 10

subjects (3 amputees and 7 intact).

Result:The results showed greater SNR values and higher sensitivity of the proposed sensing

device than the commercial EMG sensor. Also, the proposed module was faster than the

commercial sensor in producing the output response. Further, the EMG module was tested on

amputees for controlling the operation of the developed 3D printed prosthetic hand. The

proportional control scheme was implemented which translates the EMG signals captured with

the sensing module to control commands in real-time to drive the actuators coupled with the

prosthetic hand. The amputees using their different level of muscular contractions were able to

dexterously grasp various shaped objects with the hand.

Discussion and Conclusion:The developed sEMG sensing module consists of silver palette

electrodes, signal conditioning circuitry and power supply unit all encased in a single package.

This construction of sensor makes it compact and also minimizes for motion artifacts which

occur due to the movement of electrode cables. Integration of sensing module and the

proportional control scheme together was able to provide faster and smooth actuation of

myoelectric hand fingers with a control on its grasping force.

References:

[1] M. Tavakoli, C. Benussi, and J. L. Lourenco, “Single channel surface EMG control of

advanced prosthetic hands: A simple, low cost and efficient approach,” Expert Systems with

Applications, vol. 79, pp. 322–332, 2017. 53




[2] S. Pancholi and A. M. Joshi, “Portable EMG Data Acquisition Module for Upper Limb

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NCNILD0

Improvised version of IITG passive knee prosthesis having internal-external

rotation, anterior-posterior movement and link length variation options VaibhavJaiswala*, SubramaniKanagaraja

aDepartment of Mechanical Engineering, Indian Institute of Technology, North Guwahati 781039


Abstract: As per 2011 census of India, there are 5.4 million locomotor disabled persons. It is estimated that around 5-15% of these amputees acquire a prosthetic medical device, and up to 80% of amputees are not able to bear the cost of prosthesis. Any form of amputation is a serious health problem on the individuals, families and society. It also drives many patients towards various psychiatric disorders because of the inability to support themselves and their family. A polycentric knee joint is expected to provide the basic anatomical functions of able-bodied person to the amputees to bring back their active normal life. In India, users perform daily activity of cross-knee sitting, which itself a challenge to provide in prosthesis. In order to accommodate the same, trans-femoral rotator is being used in advanced prosthesis, which allows lower leg prosthetic device to rotate in the internal-external direction for the provision of cross-legged sitting. Till date, the provision for knee rotation is not provided in many of the commercially available affordable polycentric knee joint. In addition, it has the fixed alignment line and there is no provision for adjusting the same along anterior-posterior direction depending on the patient’s requirement. Additionally, a passive model of polycentric knee joint with variation of link length is required to satisfy the different level of amputees. Thus, there is a need to design and develop an inexpensive knee joint prosthesis with variation of link length; rotator mechanism, which can provide the medial-lateral rotation along with the locking provision, and provide an option for adjusting the trochanter knee ankle (TKA) alignment along anterior-posterior direction. An attempt is made to incorporate a transfemoral rotator assembly with locking mechanism and the provision for the TKA alignment adjuster in the previously designed IITG polycentric knee joint to enhance its functionality. By incorporating these features, the previously designed IITG knee will provide a kinematically stable gait pattern, internal-external knee rotation with locking provision, and TKA adjustment along anterior-posterior direction in order to increase its versatile nature. The knee joint pyramid adopter is positioned over the top part of the knee joint, which could be adjusted in the range of TKA ± 5 mm in the anterior-posterior direction. In order to provide 360o rotation in the lower leg along medial-lateral direction under unlocked condition, the inner cylinder arrangement is housed within the top part of the knee joint and it is connected with socket via a suitable adapter. The knee joint assembly with all additional features was tested in ANSYS as per the loading requirement provided by the ISO 10328. The maximum stress, deflection and strain developed in the knee joint were found to be within the acceptable limits. A prototype model of the knee

55




joint assembly along with transfemoral rotator mechanism is being manufactured using Acrylonitrile butadiene styrene (ABS)/Nylon-66. The TKA alignment adjusting unit and locking mechanism are fabricated from the stainless steel and it is a part of pyramid adapter of the knee joint. Additionally, the effect of variation of link length at initial stance phase, mid stance, push-off phase and minimum toe clearance was in progress. Once the assembly is fabricated, an attempt will be made for patient trial at GNRC, GMC, NEIGRIHMS to get rehabilitation feedback in order to further improve the different features of knee joint assembly.

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NCNILD000

Load line correction in lower limb using polycentric orthotic knee joint with

passive assistance in single compartment knee osteoarthritis Aman Singha*,

aIndian Institute of Technology, Guwahati, India


Background:The most common type of osteoarthritis is single compartment knee osteoarthritis

which is ultimately a conscious of lifestyle and continuous loading of knee joint which lead to

degeneration of the single knee condyles either medial or lateral. The management for OA is

ultimately is Total knee replacement in severe conditions, but for mild to moderate is by taking

NSAIDS or Gait pattern alteration. Orthotic knee braces for these conditions are very helpful to

reduce pain or support the knee joint and provide the Q-angle correction. But Orthotic

management in developing countries are not properly used and lack of functional knee braces

are developed for persons living in developing countries.so new Orthotic knee joint is designs

to achieve the utmost functionality with proper correction.

Aim:The aim is to design the orthotic knee brace for single compartment Osteoarthritis and

provide support the movement of anatomical knee joint with continuous correction force.

Method:The proposed knee brace is a device which is used to provide assistance and give

appropriate corrective force to shift the load line or GRF line to the healthy side of the knee

during activities of daily living which include the continuous loading of knee joint like walking,

stairs up stair down. The design of knee brace provides two function simultaneously which is

anatomical movement of the knee joint during activates with passive assistance and corrective

force. There are two independent mechanism explained below:

a) Polycentric hinge joint with passive assistance

b) Jackscrew mechanism to provide force for correction of Q-angle

Results: The final prototype is 3D model is generated and Static force analysis is performed to

study stress distribution. We already applied for the human ethical clearance for testing the first

prototype. This device provides the sufficient corrective force thought out the weight bearing

activates and normal activities of daily living with proper support.

57




Discussion andConclusion: The proposed Knee brace provides the shifting the load line

towards healthy knee joint condyle which prevents the loading of degenerated cartilage and

have immediate pain relief during weight bearing activities resulting to improve the

regeneration of cartilage and meniscus in due course of time. Which will lead to either delaying

the total knee replacement surgery for the significant period of time or avoiding the same if

systematic study is carried out.

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NCNILD000

Testing, design and virtual prototyping of functional rehabilitation devices AnandaPoddera*, Prasanna Kumar Lenkab, AbhishekBiswasc, HimelChakrabortya

aDepartment of Rehabilitation Engineering, National Institute for Locomotor Disabilities (Divyangjan), Kolkata

700 090, West Bengal, India bDepartment of Prosthetics and Orthotic, National Institute for Locomotor Disabilities (Divyangjan), Kolkata 700

090, West Bengal, India cDepartment of Physical Medicine and Rehabilitation, National Institute for Locomotor Disabilities (Divyangjan),

Kolkata 700 090, West Bengal, India

*e-mail: [email protected].

Abstract

The methodology for patient specific customised design of rehabilitation devices is a very

particular task to perform. This consists of passive, articulated biomechanical manipulated aids

physically coupled to the specific user.Therefore, must be customisedaccording to the specific

needs to the user. The geometric and kinematic measurements of the specific needs of user are

used to create a virtual model of the user requirements. The design of the customized

rehabilitation product is based on kinematic synthesis and finite element simulation. An

integrated complex virtual environment, with a virtual model of the user interacting with the

rehabilitation products allows the testing, iterative re-design and evaluation of the customised

rehabilitation devices. The geometric and kinematic data acquisition, mechanics of design and

FEA analysis, CAD/CAM and visualization modules aid the designer in this process.

Key words: Virtual reality; Engineering Mechanics; Simulation; Computer-aided design

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NCNILD000

Robotic technology in prosthetics KunmunBehera*, Rajesh Kumar Mohantya

aDepartment of Prosthetic and Orthotic, Swami Vivekanand National Institute of Rehabilitation Training and

Research, Cuttack, Odisha, 754010


Background:Robotic technology uses sophisticated and intelligent systems using the

knowledge of mechatronics, intelligent sensing, and control without direct human intervention.

Prosthetics transform physical disabilities and lead to improvements in the quality of life.

Aim: The aim of this paper is to review recent technology and clinical applications in the area

of robotic prosthetics and to discuss its current status.

Method:A literature review was conducted from sources like PubMed, Google scholar, Scopus

and EMBASE between 2000 to 2018 of use and application of robotic technology in prosthetic

industry. Studies that combined treatment options were excluded. Outcomes in clinical

application and technological advancement were investigated and summarized.

Result: Will get a better idea about how robotic technology use in prosthetics.

Discussion and Conclusion:Most of the studies have focused on the technological

advancement, however the clinical application and its outcome measures on amputees were less

investigated. Using the technology of brain–machine interfaces to control prosthetic limbs has

been advanced from a simple myoelectric prosthesis to advanced mind controlled robotic arm

and sensor smart prosthetics. Much of the work is still in the research stage and instead of

promise and challenges faced in the field of robotic prosthetics, it can be concluded that robotic

limbs begin to revolutionize prosthetics.

60




NCNILD000

Reverse engineering and CAD CAM technology in prosthetics and orthotics MukeshRohillaa*,Raagavi Da, Rajesh Kumar Mohantya




Background: Reverse Engineering (RE) is a field of engineering in which a model and further

a prototype can be generated by extracting information from previous design or available model

using the advanced tools of CAD/CAM. Thistechnology has been implemented in the field of

Prosthetics and Orthotics (P&O) for many years, but its success has been hampered by several

limitations.

Aim: To explore the technology, needs and implementation of connecting P&O industry with

RE in a developing country like India under the brimming concept of “Make in India”.

Method:The system includes three major steps. The scan is done through Acquisition (patient

digitisation) utilising optimization module. The CAD/CAM software allows the rectification of

3D digital forms for orthopaedic devices. A multiple axis robot offers large machining capacity

for production of P&O devices. To explore current clinical uses of this technology in P&O, we

conducted interviews to contrast patterns of use of this technology in device fabrication in

different private settings and teaching institutions.

Results:A growing number of prosthetic and orthotic devices are successfully being fabricated

and fitted with CAD/CAM technology after starting the process with simple measurements

instead of casted, scanned, or digitized exact anatomic data. The P&Oindustry has not yet taken

advantage of the possibilities in the computer-assisted manufacturing technique in India.

Discussion & Conclusion :Compared to conventional methods, the CAD/CAM technology is

cost effective in long run with feature of automation for design and fabrication. It helps in

documentation of anatomical & volumetric changes, provide reference for baseline and progress

of treatment regimen and simulate final design to optimize outcome. There is decreased time for

design and rectification process and increased time for patient care and training on the use of

Prosthetic and Orthotic devices.Limited application of RE and CAD/CAM makes an open field

to apply these advanced techniques in our country to boost “Make in India” concept.

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NCNILD000

Design role of artificial intelligence in future prosthetics RishabhGuptaa*, SantPrakash Gautama

aDr. Shakuntala Mishra National Rehabilitation University, Lucknow, Uttar Pradesh 226017


Introduction:Brain–Machine Interface is a direct communication channel between the brain

and an external device. It is a fast-growing emergent technology, in which researchers aim to

build a direct channel between the human brain and the computer. It is a collaboration in which

a brain accepts and controls a mechanical device as a natural part of its representation of the

body. The BMI can lead to many applications especially for disabled persons. This would be

beneficial in many fields including the Artificial Intelligence and Computational Intelligence.

Aim: Highlights the role of Artificial Intelligence in the development of future prosthetics and

also for the rehabilitation of persons with disabilities.

Method: Designs, Data and Methodology of several articles has been collected and reviewed

under the head of Artificial Intelligence and researches in prosthetics and rehabilitation.

Result:Several studies stated that Artificial Intelligence serve as revolutionary role in human

controlling systems through implementation in artificial human prosthetics with the utilization

of various bio-potentials in related areas of brain and limbs; also it assists and improves the

qualities of life of persons with physical disabilities in the role of rehabilitation.

Discussion and Conclusion:The development of an advanced human- brain - machine

interfaces with the help of artificial Intelligence systems is an interesting eye-catching topic in

the field of real world engineering and the biomedical signals have a key role to play. Using

these signals in control systems is a sophisticated technique concerned with the identification,

detection, processing, cataloguing, and appliance of signals to direct human-assisting robots or

rehabilitation devices.This study review serves as a platform for future prosthesis development.

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NCNILD000

Life Time Determination of Active Upper Limb Prosthetic device AkshaySaxenaa*, Llewellyn Dsaa, PriteemBeheraa, PriyankaKumaria, Anil Naira

aBionic Hope Pvt. Ltd


Introduction: Active upper limb prosthesis is being developed at Bionic Hope Private Limited.

Prior to releasing the product into the market, it is to be ensured that it runs for a defined period

of time, satisfactorily without major failures. To do that a test needs to be devised which

determines the life time of the said product. In terms of reliability engineering, one way of

doing so is with a success-run and/or test-to-failure approach. The latter would determine the

failure modes so that they could be worked upon and the former would ensure that the

improvements designed achieve the goals.

Aim: The test procedure aims to find out the failure modes of the initial design and determine

the life time of the final improved design.

Method: The gripper device can perform two motions: closing the fingers, so as to create a

cylindrical grasp, and opening the fingers. The controller is programmed to run the gripper

though these two motions in a loop without any external input. Closing and opening the gripper

once is counted as a single cycle. The controller is also tasked to count the number of cycles

and display it on a screen. At the same time, a camera is used to record the operation.

It is determined that the device needs to run for 3 lakh cycles in order to achieve a life time of 3

years. The test is run either until the device runs for the required number of cycles or a failure is

observed. If a part fails, the corresponding cycles it completed is noted down and the reason for

failure is analysed. Upon working on the problem an improvement is proposed and the test run

again.

Result:

The test-to-failure approach identified the following areas of failure:

1. Wear of the strings leading to breakage

2. Deformation of the motor bracket

3. Breakage of springs

After analysing each case of failure, improvements were suggested which are summarized

below. 63




1. Wear of the strings

The pathway between fingers and palm outlet suffers the most. Metal ferrules were suggested as

a solution. Upon implementation the device ran for required cycles.

2. Deformation of the motor bracket

Due to heat and repeated stress on the bracket holding the motor started to deform after nearly

40 thousand cycles. Changing its material to more heat resistant variant didn’t solve the

problem. Creating additional fastening points which secured the bracket with the outer frame

solved the problem.

3. Breakage of springs

The springs also failed due to repeated stress. Changing the design with regards to the number

of coils and wire diameter gave us an optimal design that ran for the required cycles.

Conclusion: The said approach of cyclic testing provides insight into the performance of a

product over a period of time. This method is easy to perform and doesn’t take much time to

complete. This also becomes crucial part of product design through iterative process. Such a

process of product design ensures all the potential problems be solved before hand and a

product a high reliability is created.

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NCNILD000

Assistive technology fuelling inclusive education AchintyaPrakasha*, SantPrakashGautama

Dr.ShakuntalaMisra National Rehabilitation University, Lucknow, Uttar Pradesh 226017, India


Introduction: Inclusive education is about ensuring access to quality education for all students

by effectively meeting their diverse needs in a way that is responsive, accepting, respectful and

supportive. Students participate in the education program in a common learning environment

which is easily accessible and hygienic that may lead to exclusion. It is all about how we

develop and design our schools, classrooms, programs and activities so that all students learn

and participate together.

Aim: To aware scholars and professionals, the game changing influence of ‘Assistive

Technology’ in inclusive education.

Method: Reviewing the publications and researches of the last ten years, specially relating

assistive technology in education and rehabilitation, reflect that the assistive tools, devices and

its various components are found to be a game changer to support inclusive education. It

improves function in children with both learning and physical disabilities. And, despite the

name, these devices are not always hi-tech. Assistive technology has been in the classroom for

decades, and sometimes even the simplest things can make a huge difference. Tablets,

Computers, and Software, when we think of the word “technology,” these devices are likely the

first thing to come to mind. They are customizable to accommodate the unique needs of each

special education student. Educational games of all types are an excellent tool for learning.

They also create an interactive world, allowing tactile learners to navigate lessons using touch,

sound, and sight.

Result: Inclusive education is building motivation for special students/children, which is also

providing confidence while competing non-special Student in similar conditions and assistive

technology is fuelling it by providing equity among students with different abilities

Discussion and Conclusion: Common learning environments are now being used for the majority of the special and non-special students’ regular instruction hours and may include classrooms, libraries, gym, performance theatres, music rooms, cafeterias, playgrounds and the

65




local community. Research shows that technology aids in enhancing content and skill acquisition by students with a wide range of learning styles.

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NCNILD018

Qualitative study on effectiveness of picture based teaching on training

menstrual care to adolescent girls with cerebral palsy and autism spectrum

disorder K.K.Dhanavendan*


Introduction:In training persons with multiple disabilities the role of parents, siblings and

grant parents is extremely important. Children with multiple disabilities learn slowly because of

their physical and motor coordination and severity of movements and cognitive deficits. Hence

intensive training is necessary to make them as independent as possible. While training the

adolescent girl with multiple disabilities the role of mother or female sibling plays an important

role in helping adolescent girl with multiple disabilities to become as independent as possible in

the area of menstrual care. The present study aim to focus on training mothers to train their girls

with multiple disabilities on picture based training to fixing napkins and wearing underpants.

Aim: To train mothers of girls with multiple disabilities on menstrual hygiene

To impart knowledge on personal health and hygiene

To provide knowledge on prevention of UTI

To improve learning on self motivated learning procedures

Outcome: The purpose of this study was to survey and interview parents/caretakers of girls

with MD about how to manage menstruation and what kind of support (education or training) or

help was needed or is currently given to females to manage menstruation. The results of the

study would intend to develop a manual that shows what the parents/caretakers need for the

girls with MD related to menstrual management issues.

Methodology:

Participants

A total 7 Mothers of girls (above 13 years) with cerebral palsy and autism spectrum disorder

who is attending services at model school were selected using purposive sampling techniques.

Materials

A need questionnaire prepared and elicits information from mothers of girls with cerebral palsy

and autism spectrum disorder on their difficulties on their management of menstrual hygiene.

67




Procedure

Mothers of girls with cerebral palsy and autism spectrum disorder interviewed with the need

analysis questionnaire to collect information on their difficulties of managing their daughter’s

menstrual hygiene, based on the difficulties expressed by the mothers, the investigator

developed a picture based instructional materials on menstruation. The investigator oriented the

mothers on how to use the pictures with suitable underpants adaptations.

Results:Mothers of both girls with cerebral palsy and autism spectrum disorders were reported

the picture sequence easy to understand by their children and they followed the sequence

correctly. They were able to match the picture with fixing the napkin on the underpants as per

sequence and they fail to wear correctly due to physical motor difficulties reported by mothers

of girls with cerebral palsy. In girls with autism spectrum disorder found difficulty in wearing

underpants and fixing the napkin as per pictorial sequence due to poor listening and attention

and difficulty in following verbal instruction, but they effectively learn to do through modeling

and backward chaining reported by their mothers.

Discussion and Conclusion:The result reveals that both girls with cerebral palsy and autism

spectrum disorders able to follow visual sequences and need individual adaptation in wearing

underpants and fixing the napkin. The investigator suggested adaptation on underpants for girls

with cerebral palsy; Velcro fitted open type hoggish model panties for easy fitting. For mothers

of girls with autism spectrum disorder were suggested to use Barbie doll for real simulation for

visual sequence, video modeling and both mothers found easy when they are the model for their

girls children they learn better. It indicates both of the girls with special needs have strong

visual learning and through this teachers can improve many learning skills.

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NCNILD000

Technology for social inclusion of aperson with deaf blindness: a case study Shobha N Odunavara*, P.Kamaraja

aDepartment of Special Education, National Institute for Empowerment of Persons with Multiple Disabilities

Chennai-603 112, India


Introduction: Deaf blindness is the concomitant dual sensory impairment. The sense of vision

and hearing plays a dynamic role in holistic development of individual. Loss of both the senses

is irretrievable concern to the development in terms of language, speech, communication, social

and emotional. Needof the individual with deaf blindness in terms of social, educational,

personal have to meet with external support such as technology. Socialization is possible with

the support of technology, which can lead to social inclusion.

Aim:

• To find out the role of technologyfor Social Inclusion of a person with Deaf blindness.

• To find out the challenges faced by the person with Deaf blindness during the inclusion at

Society.

Method:

Research Design: Qualitative method-A case Study.

Sample Technique: Purposive Sampling.

Sample: Post graduate student with Deaf blindness studying in Department of Special

Education, NIEPMD.

Data Collection Procedure: Focused interview for the duration of 10 hours with the time

interval. Since the participant is person with deaf blindness, he requires extra time to

communicate the information and also to get the responses.Hence, the interview was extended

to one week to gather the required information adequately.

Tool for Data Collection: Check list includes demographic information and role of technology

for Social Inclusion covering the topics such as assess of public places, family meetings,

meeting with friends.

Data Analysis: Qualitative description with coding and decoding method.

Results and Discussion:A detailed qualitative analysis revealed that technology has significant

role in the life of individual with Deaf blindness for productive inclusion in the society with 69




limited challenges. Technology supports as partner for certain areas such as transportation, for

exampleprobing or white cane probes for and locates obstacles in your path of travel. Braille

refresher helps to communicate with professionals.Individual with deaf blindness faces

challenges in certain areas such as accessing the theater, shopping malls where they cannot get

the support of technology. Hence, the environment restricts them to access and enjoy on par

with other public.

Conclusion: The condition of the Deaf blindness has the adverse effects onall walks of life of individual’s.Leading independent day to day life for them is difficult without any assistant or assistant technology. An individual with Deaf blindness faces lot of challenges since it is dual sensory impairment as well as vulnerable in nature. Hence, Technology is the negotiatorfor the individual with deaf blind which can help for Social Inclusion.

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NCNILD000

Attentiveness on technology support for visually impaired (non-ADIP) G.Ananthia*, HimangshuDasa,P.Kamaraja

aDepartment of Special Education, National Institute for Empowerment of Persons with Multiple Disabilities

Chennai-603 112, India


Introduction: Vision being an extremely vital sensory modality in most of the organisms

especially human. The loss of vision affects the performance of almost all activities of daily

living skills that hampering an individual’s quality of life. Therefore, recent technology has a

very relevant social impact. Moreover, with our ever-increasing ageing and visually impaired

populations, it has the potential to broadly impact our quality of life in the future. Recent,

advances in computer vision, wearable technology, multisensory research, and medical

interventions have facilitated the development of numerous assistive technology solutions for

visually impaired. The paper presents the current attentiveness on assistive technology for the

visually impaired.

Aim: The main aim of the present research study is to compute the attentiveness on assistive

technology for visually impaired population.

Methodology:Mixed methodology is followed for the conduct of the present study. Participants

of the study were chosen by Purposive sampling method under ten different categories and the

participants’ size is fifty numbers. Distribution of the participants as follow:(i)Persons with

Disability (PwDs)- 5,(ii) Children with Special Needs (CWSN)-5, (iii)teacher of Visually

Impaired-5, (iv)other disability specific teacher-5, (v)NGO managers-5, (vi)School Principal -

5,(vii) Enable Training Partners (ETP)-5,(viii) SSA programmers-5, (ix)School counselors -5

and (x) College/University-5. The independent variable in the shove is attentiveness on assistive

technology for visually impaired and the demographic variables are age(15 below, 16 – 30, 31&

above), locality (urban, rural), socio economic status(low, moderate, high), leisure time

activities (movie, club, magazine)

Result: The result reveal that, more than half of the participants didn’t have ample attentiveness

on assistive technology for visually impaired.

Discussion: Enable Training Partners (ETP) from urban has high attentiveness on assistive

technology when comparing to the Enable Training Partners (ETP) from rural because of the 71




training programmes attended by ETP from urban is higher than the ETP from rural. Newly

started (below 15 years) College/University has generous amount of attentiveness on assistive

technology for visually impaired than 16-30 old and 31 years above College/University. The

reason is, newly bloomed College/University has high access to information.

Conclusion: Due to the lack of attentiveness on assistive technology for visually impaired

population among the participants in the pilot study, Department of Special Education,

NIEPMD (Govt. of India) is proposed to conduct in-service training programmes, Short term

training programmes and refresher programmes on assistive technology for visually impaired

for PwDs, CWSN, Teachers of Visually Impaired, other disability specific teachers, NGO

managers, School Principals, ETP, SSA programmers, School counselors and

Colleges/Universities in addition to that we are planning to extended the benefits of the

programmes to parents and siblings of PwD and CWSN.

Key Terms: Assistive technology, visually impaired, awareness, non-ADIP

72




NCNILD000

Effect of tactile frame in overcoming tactile sensitivity among children with

autism S.Saradhapriyadarshinia*, P.Kamaraja

aDepartment of Special Education,National Institute for Empowerment of Persons with Multiple, Chennai -

603112,Tamil Nadu Disabilities


Introduction: Sensory issues adversely affect a child's behaviour and performance in the

classroom. Tactile symptoms are among the most commonly reported sensory symptoms as per

parents of children with autism spectrum disorder (Rogers et al., 2003). Children feel touch

sense more or less intensively than other people. Some may be hyposensitive to touch while

others may be hypertensive to touch. The present study is chosen with an objective to overcome

tactile sensitivity among children with autism.

Aim of the study: The aim of the study is to find out the effect of tactile frame in overcoming

tactile sensitivity among children with autism

Method of the study: Single subject method is chosen as the research design for the present

study. Extreme case sampling method was adopted for the study. The study comprised of two

children with autism, one being hypo-sensitive to touch and the other hyper-sensitivity to touch

were taken and case study was made. In order to know the areas of tactile sensitivity among the

samples, baseline data was collected using sensory processing disorder checklist. Later, the

intervention was given through tactile frame for a period of one month. Evaluation was made

after intervention.

Results and Discussions:The results revealed that the intervention made a significant effect in

overcoming tactile sensitivity among both the child. Also the behaviours associated with tactile

sensitivity seemed to be reduced after the intervention. Thus the present study shows that the

tactile frame imposed a significant effect on reducing tactile sensitivity among children with

autism.

Conclusion: The behaviours associated with tactile defensiveness are often problematic while the child is developing. They can often be very disruptive in the school setting as they seek out ways to obtain that type of stimulation. Therefore it is the need of an hour to find some

73




strategies to help children deal with sensory difficulties and to help them function in the classroom.

74




NCNILD000

Design children with special needs in inclusive education-effectiveness of

educators and educational system Suvendu Koleya*

aDepartment of Socio-economic Rehabilitation, National Institute for Locomotor Disabilities (Divyangjan),

Kolkata 700090, West Bengal, India


Introduction: The child with special needs having problem like personal, social, and many

times academics in the school and they feel isolated in their environment and society. The

inclusive approach gave lots of emphasis on the educational inclusion of the child without any

discrimination. A successful Inclusive education isn’t a program. A place or a classroom it is

way of understanding and living in the real world.

Aims: The main goal of this research is to bring special education to the mainstream of the

community so that they can take this opportunity-

• Education for all

• protection of rights

• Development ofsocial consciousness

• Development of brotherhood

• To improve quality of education

Method: While preparing the paper for this study, the case study case history, which has been

adopted, has been adopted by various methods.

Result and Discussion:After making these research papers, a special child has been able to

show good skills in some cases while studying with the common children in the same class and

in some cases. The next researcher stays on this problem

Conclusion:Despite the above challenges of inclusive education the progress in this direction

has been insignificant.no debate is required in this regrad, we believe that inclusive education is

the only answer for “education for all” which includes children with disabilities. the process of

inclusive education has strted,but much needs to be done to achieve the desired result.

Keywords: Inclusive Education, Special Education, National Policy On Education (NPE), Persons With Disabilities Act (PwDs Act).

75




NCNILD023

Use of technology to monitor eco-behaviour of the teaching-learning

environment D.Revathia*, P.Kamaraja

aDepartment of Special Education, National Institute for Empowerment of Persons with Multiple Disabilities,

Chennai,Tamil Nadu- 603112, India


Introduction: Children with multiple disabilities have different experiences, different way of

seeing the world and different learning styles. Teaching in such environment is challenging.

Teaching-learning environment is most crucial when providing instructional classroom. The

engagement of children in the classroom requires a teacher to do peer or self assessment for

instructional modifications to accelerate the child’s rate of growth. Technology is a boon for

assessment and evaluation of possible outcomes. The study focuses on the use of Eco-

behavioural Assessment System Software (EBASS) to examine the student behaviour in

relation to important instructional conditions. The specific behaviors observed and recorded by

an observer in an eco behavioral analysis can be interpreted in terms of the surrounding context

consisting of activities and materials for example, Teacher’s behavior. The approach seeks to

answer questions about the teachers. For example, “What teaching strategies and behaviors

most promote academic or literacy engagement in my students?” and “which seem to promote

the highest levels of off-task or challenging behavior?

Method: Case study method: single case-design, Sampling: Children (n=2) having multiple

disabilities in small group special education classroom

Data collection procedure:Children who have difficulties were observed in the first phase of

the study. EBASS software program was used as a pretest to analyze the eco-behaviour of the

children with multiple disabilities in small group instruction for about 30 mins. This helps the

teacher in planning and grouping the children for differentiated instructions in the classroom.

Posttest (30 mins) was also conducted to find the change in behavior and performance of the

children with multiple disabilities

Results: The study reports the use of technology of EBASS software program helped the

teacher to manage the instructional classroom by a minute to minute engagement of the

children. The molar analysis report using the software reveals the percentage occurrence of 76




behavior in each category of ecological, teacher and student variables such as setting, physical

arrangement, teacher focus, instructional grouping, academic responding, and teacher behavior,

on task, task management and competing response for every interval.

Conclusion: This EBASS software program can be very effective to be practiced in the

classroom to monitor the eco-behaviour of the teaching-learning environment.

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NCNILD000

Design use of low tech augmentative and alternative communication systems

in children with multiple disabilities: a qualitative study Kala Samayana*

aDepartment of Speech, Hearing and Communication, College of Audiology and Communication Sciences,

Chennai-112, Tamil Nadu


Introduction: Communication is possible with a proper evaluation and a communication

system customized to meet a given child’s needs, it is possible for most children to

communicate. In order to develop a communication in non-verbal children with multiple

disabilities an augmentative and alternative communication is needed. The development of

communication skills in children with multiple disabilities remains a challenge for families and

professionals, and there is a great need for targeted communication interventions. Augmentative

and alternative communication is one such effective communicative approach for language

acquisition. “Augmentative and Alternative Communication” (AAC) can be defined as any

device, system, or method that improves the ability of a child with a communication

impairment to communicate effectively.

Aim:The present study is to identify functional communication skills by using a low tech AAC

in children with multiple disabilities.

To increase communicative intent for children with multiple disabilities

To provide knowledge and importance of low tech AAC to parents and teachers

To motivate children’s self-learning

Method: The present study focuses on use of AAC in three children with multiple disabilities,

who were in the age range of 3 to 8 years attending special school at NIEPMD to assess their

functional communication skills. Children were diagnosed to have multiple disabilities

(combination of cerebral palsy with mental retardation). Low tech AAC systems with pictures

of choice board, communication chart, Yes/No board, Tamil Alphabetic board and

communication file were prepared to assess their functional communication skills. All the three

children were assessed with low tech AAC systems to see the accessibility, communication

intent, and independency. The responses were tabulated immediately after the assessment of

AAC systems. 78




Results and Discussion: The present study demonstrated rapid acquisition of functional

communication in children with MD. The results revealed that the children with multiple

disabilities learn easily from Yes/No board. Yes/No board may represent a viable mode of

communication for children with MD during initial introduction of AAC systems. Later the

investigator introduced two to four picture choice boards among children. Intervention for

children with complex communication needs helps develop functional communication skills,

promotes cognitive development, provides a foundation for literacy development, and improves

social communication (Drager et al., 2010).

Conclusion: Exposing children to symbols and systems prior to assessment may ensure more

accurate assessment results. This can be accomplished by providing core vocabulary supports in

the home and classroom and by introducing visually represented language using a variety of

communication display forms and sizes prior to the formal assessment process. The study

evidenced that children with multiple disabilities try to show their ability by multiple responses

like eye pointing, vocalization, head nodding, moving their legs towards the object etc. The

study concludes that the children were motivated to use AAC systems and used intentionally to

communicate.

Key words: AAC, Multiple disabilities, Communication disorder

79




NCNILD046

Advance functional materials in design of structural assistive devices Himel Chakrabortya*

aDepartmentof Rehabilitation Engineering, National Institute for Locomotor Disabilities (Divyangjan), Kolkata

700 090, West Bengal, India


Abstract:

The conception of functional nano-structured composites in design of technologies as an

interface between the organic and inorganic actuality through the symbiogenic approach

mediated by assistive technologies that aim to fulfill and amplify the functionalities of the

human. The basic development of structural assistive devices requires serious study of the

human singularities, needing an approach that integrates different areas of knowledge such as

physiology, design and materials engineering in order to satisfy the needs of people with

reduced functional capabilities. The purpose of this work is to widen the discussion about

independence and safe practice of social activities that involve work, leisure and sports, using

structural assistive devices developed with functional nano-structured composites, aiming to

offer more comfort to the user for being lighter, more resistant and more durable than the

existing products, as well as being recyclable, helping with the preservation of the environment.

Keywords: Nanocomposite; Design; Assistive Technology

80




NCNILD030

Design and simulation techniques in advanced prosthetic foot Mritunjay Kumara*, Hasan Arif Raihana, Poly Ghosha, P.K.Lenkaa

aDepartment of Prosthetic and Orthotic, National Institute for Locomotor Disabilities (Divyangjan), Kolkata

700090, West Bengal, India


Introduction: Prosthetic foot design & simulation technique requires mimicking as closely as

possible the actual physiological function and feel of the replaced body part. Anatomical foot

and ankle joint is a complex system of muscles, soft tissue, bones and ligaments, whose

functionality is challenging to replicate. Many current prosthetic feet are mechanical designs

with fixed spring and dampening characteristics, optimized for rather slow gait on a level

surface. Researches on human legs and gait have demonstrated its usefulness and help to

develop many different designs of prosthetic feet.

Aim of the Study: Aim of the study is to find out a method of simulation technique for

advanced Prosthetic foot.

Methods: Prosthetic Foot can be divided into three main categories conventional feet, energy

storing feet and motor powered feet. A conventional foot is A Solid Ankle Cushioning Heel,

which does not follow a normal gait pattern. Energy Storing Feet, such as, Vari-Flex® and Pro-

Flex® are made of a layered Carbon-Fiber Composite that extends from the amputee residual

limb and aims to provide natural progression through the stages of normal Gait. The Design &

simulation technique find out & analyze about the stiffness of the foot and its response to load,

may be controlled via the thickness profile of the foot, as well as its 3D shape. A simulation

model is constructed on Pro-E and the prosthetics characteristics as obtained by testing, used to

parameterized and validate the model. After completion of this first validation, the foot model is

modified by introducing non-linear materials, e.g. spring and damper, to a specific section of

the prosthesis to allow for an altered foot performance. The optimized models will later on be

transferred into physical prototypes and finally fit to prosthetic users. The basic foot model is

setup by investigating the isolated stiffness characteristics of the carbon fiber spring blades for

heel and toe by an internal standardized test procedure (basic stiffness). ISO 10328 a simplified

dynamic endurance test is used as a first validation. In addition, ISO 16955 is used to simulate

more realistic a complete heel to toe roll-over of the foot. 81




Result: Advanced prosthetic foots is used in prosthetic clinical practice with significant

improvement in gait parameters. A further evolution in prosthetics design is required to adapt

more closely to the users’ needs.

Discussion and Conclusion: This Paper highlights the effects of design & simulation

techniques are being approached in prosthetic clinical practice. This having impact on solving

prosthetic clinical problems. The study has shown that the standardized test procedure can be

simulated and modifications to the model show anticipated shifts in function.

References

1. Ahmadkhanlou F., Zite, J. And Washington, G., 2007, “A Magnetorheological Fluid-

Based Controllable Active Knee Brace”, Smart Structures And Materials Proc. Spie

6171 Pp. 148-56.

2. C. Li, M. Tokuda, J. Furusho, K. Koyanagi, S. Morimoto, Y. Hashi-Moto, A.

Nakagawa, And Y. Akazawa, 2006, ‘‘Research And Development Of The Intelligently

Controlled Prosthetic Ankle Joint,’’ In Proc. Ieee Int. Conf. Mechatronics And

Automation, Luoyang,China, Pp.1114-1119.

3. Deffenbaugh, B. W., Herr, H. M., Pratt, G. A. And Wittig, M. B., 2004, “Electronically

Controlled Prosthetic Knee” Us Patent Specification 6,764,520.

4. http://www.ep.liu.se/ecp/138/053/ecp17138053.pdf

82




NCNILD038

Design era of advanced powered ankle foot orthosis in stroke rehabilitation Shaliny Bandyopadhyaya*, Hasan Md Arif Raihana, Prasanna Kumar Lenkaa




Introduction: Human locomotor adaptation to powered ankle-foot orthosis with the intent of

identifying differences between two different orthosis control methods. The first orthosis

control method used a footswitch to provide bang-bang control (a kinematic control) and the

second orthosis control method used a proportional myoelectric signal from the soleus (a

physiological control). Both controllers activated an artificial pneumatic muscle providing

plantar flexion torque.

Objective: The objective of the study is to find about the advanced designs and significance of

powered ankle foot orthosis in orthotic treatment protocol.

Methods: We worked in prospective study for the effect of AFO in stroke patients with

conveniently selected according to the inclusion criteria. Demographic data of the subject will

be collected in the demographic data collection form. This includes age, sex, height, weight,

cause. Subject initially instructed to walk 30 meter Walk Test. Then pre post gait kinetics data

collection was done. Cain SM, Gordon KE et al 2007, develop a set up for Powered AFO.

Hardware-AFO consisted of a carbon fibre shank section and polypropylene foot section. A

metal hinge joining the shank and foot sections permitted free sagittal plane rotation of the

ankle. Inflating (pressurizing) the pneumatic muscle created a plantar flexor torque.

Testing protocol-Each session went as follows: 10 minutes of treadmill walking with the AFO

passive (Passive AFO), 30 minutes of treadmill walking with the AFO powered (Active AFO),

and finally 15 minutes of walking with the AFO passive (Passive AFO). The transitions from

passive to powered, and powered to passive, occurred without stopping.

Control-The pressure in the pneumatic muscle was controlled by one of two real-time control

schemes: proportional myoelectric control or foot switch control Subjects experienced either

proportional myoelectric control or foot switch control (six subjects, 3 male and 3 female, in

each control scheme).In the proportional myoelectric control scheme, the pressure in the

pneumatic muscle was proportional to the processed soleus electromyography (EMG). 83




Result: During steady state stroke subjects using proportional myoelectric control had much

lower soleus and gastrocnemius activation than the subjects using footswitch control. The

substantial decrease in triceps surae recruitment allowed the proportional myoelectric control

subjects to walk with ankle kinematics close to normal and reduce negative work performed by

the orthosis. These results grant evidence that the choice of orthosis control method can greatly

alter how humans adapt to powered orthosis assistance during walking.

Discussion and Conclusion:In case of subjects with post stroke hemiplegic patient used to gone through with a proper rehabilitation programme. As a result, the orthosis could be used in a gait laboratory or rehabilitation clinic where compressed air and electrical power is easily provided. This orthosis, it would be possible to study motor adaptation during human locomotion in a very controlled manner. Bio mechanists could quantify how fast humans can adjust muscle activation patterns in response to increased strength of the musculoskeletal system.

84




NCNILD039

Application of an advanced robotics principles in upper extremity orthosis

for SCI patients Shubhlataa*, .HasanArifRaihana, Poly Ghosha, Pranassn Kr. Lenkaa




Introduction:The robotics system technologies are used to develop machines that can

substitute for humans and replicate human actions. Robots can be used in many situations and

for lots of purposes like reduce man power. Previously many robotic designs clinical trial was

done with exoskeleton effectors & planar based .

Objective: The objective of this study is to outline the effect of robotic application in orthotic

treatment protocol for SCI locomotors.

Methods: Generally we prescribed WHO in SCI for wrist and hand control. There are two

types of WHO (1) static splint (2) Dynamic splint. Static splint does not allow hand motion.

Dynamic splint like tenodesis splint provide hand function because in this splint progressive

hinges is present to allow wrists motion as well as finger motion and it improves the angle of

pull and reduce the counterforce to prevent the base of the splint from migrate distally.

Tenodesis with robotic setup is structured with mechanical & electronic components (opening

spring,cable housing,pully with clip clutch, volt DC battery,charger,motor,micro switch

assembly,power pack case). The orthosis is activated by an unidirectional micro-switch

usually placed superior and posterior to the contra lateral shoulder This control site has been

found to be most effective in leaving the fitted extremity free to move without inadvertently

operating the orthosis. It provides a more nearly synergistic control motion.

Results: Upper limb rehabilitation robot is an external device that assists or guides movement

with intension of improving function. Also the robot systems have ability to provide intensive

repetitive training without over burdening of surrounding person. Thorkild J et al (1966) find

hand function was improved more significantly with robotic set up.

85

Proceeding of National Conference onDisability and Social Inclusion-The Role of Technology

January 10 - 11, 2019National Institute for Locomotor Disabilities (Divyangjan), Kolkata


Discussion and Conclusion: Robotics in upper extremity splinting introduces a new

treatment protocol for SCI with application for long term use. It is also effective to allow

patients to extend the fingers and thumb via a tenodesis effect at the wrist. In early trials, it has

produced excellent results for enhancing functional use of the injured extremity while nerve

regeneration occurs or until tendon transfers have been performed.

References:

1. Dorcas, D .S . , Libbey, S .W .and Scott, R . N .Myo-electric Control Systems,Research

Report 66.1, University of New Brunswick, Bio-Engineering Institute, 1966.

2. McLaurin, C .A. External Power in Upper- Extremity Prosthetics and Orthotics,

Orthopedic and ProstheticAppliance Journal 20: 145-151,1966.

86




NCNILD041

Application of microprocessor knees on trans-femoral prosthesis SubhasishPaikraya,HasanArifRaihana, DhrutiSundarDasa, P.K.Lenkaa



Introduction: In Transfemoral amputee during prosthetic management role of advance

microprocessor technology is applied to solve other clinical problems & provide less energy

efficient gait.The use of microprocessors in artificial limbs can provide an efficient gait to

above-knee amputees. It consists of microprocessor, software, sensors, a hydraulic or pneumatic

resistance system and a battery. Sensors monitor and detect changes in the environment, such as

walking on a different surface, going up or down on a slope or walking at a different speed.

Microprocessors respond to sensors located over the socket of the limb, they are able to adjust

the movement and position of amputee prosthesis in conjunction with residual limb.It can

respond to the speed of amputee walk as well as detect the characteristics of the surface

amputee travel. Microprocessor controlled feet respond to constant feedback from sensors to the

on board computer, which changes the resistance to plantar flexion (downward motion) and

dorsiflexion (upward motion) of the foot based on walking speed, incline, decline and type of

terrain. Adjustments are made in real time. Some designs communicate with Smartphone’s via

Bluetooth.

Aim of the study: The aim of the study is to find out the clinical report for using

microprocessor knee in trans-femoral prosthesis in Indian Scenario.

Methods: Microprocessor knees use the same fundamental hydraulic and pneumatic fluid

control systems that are integrated with non-microprocessor knees. Instead of manually

adjusted settings within the knee to accommodate a wide variety of activities of daily living, the

microprocessor knee uses a series of sensors to monitor the knee position and function and

performs immediate and necessary flexion and extension resistance adjustments to ensure the

knee is maintained in the optimal setting for the wearer.Amputee uses microprocessor control

knee joint and ankle provides significantly improved gait characteristics as compared to

conventional mechanical knee joint during normal daily activities. Gait with a microprocessor

knee is more natural, symmetric, and energy efficient owing to the knee continuously

monitoring and adjusting to gait speed, ground conditions, and stability requirements. The knee 87




senses changes in gait speed in real time and makes immediate and necessary adjustments to the

flexion and extension resistance to ensure optimal stability and knee movement regardless of

gait speed.The on-board computer of the microprocessor knee collects data from two separate

sensors within the prosthesis at a rate of 50 to 1000 times/s. The first set of sensors monitors the

knee angle position, by taking repetitive readings of the knee flexion angle: The computer can

determine if the knee is flexing or extending, or if the readings are constant, the computer

determines if the knee is stationary. The second set of force sensors measures the amount of

rotational stress or force applied below the knee during gait. During heel-strike, a plantar-

flexion moment is applied to the foot, which creates an anterior rotational force, and conversely,

toe-off creates a dorsiflexion moment that generates a posterior rotation force.When stance

phase is initiated, the microprocessor ensures that resistance to knee flexion is high so that the

knee does not collapse during stance phase. Security is enhanced by decreasing the risk of

falling. Also, the need for physiologically unsound compensatory movements during walking is

reduced. A microprocessor-controlled knee joint can detect movements that are not part of the

normal gait pattern. It can activate a higher resistance to flexion, helping to prevent a fall and

potential injury. In this way, the microprocessor- controlled knee joint can provide greater

security and stability for the individuals on many different types of terrain and with activities of

daily living.

Result: Amputee uses microprocessor control knee joint andankle provides significantly

improved gait characteristics as compared to conventional mechanical knee joint during normal

daily activities. Gait with a microprocessor knee is more natural, symmetric, and energy

efficient owing to the knee continuously monitoring and adjusting to gait speed, ground

conditions, and stability requirements. Gait parameters were significantly improved in

application of microprocessor knee. The knee senses changes in gait speed in real time and

makes immediate and necessary adjustments to the flexion and extension resistance to ensure

optimal stability and knee movement regardless of gait speed.

Discussion and Conclusion: The influence of microprocessor control prosthetic knee in

functional, preferential and performance outcomes in trans-femoral amputees as compared to

mechanical knee joint is more advanced. This technology provides more sophisticated method

of control over prosthesis as compared to conventional design. The more complex design helps

88




amputee to walk with a much more stable and efficient gait that more closely resembles a

natural walking pattern.

Reference:

1. Flynn D. Computerized lower limb prosthesis. VA Technology Assessment Program

Short Report (MDRC 152M), March 2000.

2. Traugh GH, Corcoran PJ, Reyes RL. Energy expenditure of ambulation in patients with

3. above-knee amputation. Arch Phys Med Rehabil 1975;56:67–71.

Michael JW. Modern prosthetic knee mechanisms. ClinOrthopRelat Res 1999;Apr(361):39-47.

89




NCNILD018

Design and development of adjustable casting seat for IC socket design AbhishekTripathia*




Introduction:Prosthetist skill becomes very crucial during the IC design Transfemoral socket

making, especially for IC socket wrap-casting. Pre-fabricated flexible or adjustable brims are

used to minimize the manual errors during casting due to different reasons. Adjustable IC-brims

are better option but have many adjustable parts and are not easily available. An effort has been

made to simplify the IC socket casting method by developing Adjustable Casting seat using

racing bicycle seat model with Adjustable Telescopic Pylon with standing base.

Aim: The aim is develop an Adjustable Racing Bicycle seat model with Adjustable Telescopic

Pylon and to evaluate its clinical feasibility.

Method: Two screw with a inner threaded pipe ( A turn-buckle) is used for gradual distraction

of the V- shaped frame of the racing bicycle seat model, while the patient is seating atop the

shell of the seat during casting. This V-shaped frame can be adjusted as per sub-pubic angle of

the patient, so that the both the ischial rami can be pressed laterally and therefore stopping

downward slipping of the ischia. The frame of the Adjustable Racing Bicycle seat model is

connected to the Adjustable Telescopic pylon, which is pre adjusted as per the height required

for letting patient full weight bear over the connected seat. This system is used during the

casting process of IC Socket casting procedure.

Results: The objective of the developed system was to minimize the manual effort during

casting. The other objective was to allow more dynamic seating condition of the patient for

casting, as the made IC socket is loaded dynamically during walking. The system developed

was used over a patient where casting was done for IC Socket design. The socket- cast made by

this method resulted in decreased error and less dependency while patient was able to take full

weight bearing over the Adjustable Racing Bicycle seat model. As a result socket made by this

method, required minimal or no modification at the perineum. A comparison has been drawn

between the fitting of the socket where castings were done by manual method and by this

90




system. A standard questionnaire was used to take patient feedback regarding the socket

comfort and function.

Discussion and conclusion: This method of casting still require manual interface. But the error

is less comparatively. The system could be used in case higher amputation such as Hip

Disarticulation.

91




NCNILD000

Design strategies for an accessible Indian Kitchen for elderly and the

disabled SonalAtreyaa*, Vaibhao G. Athaleyb, SonamAgarwalc

aDepartment of Architecture and Planning, Indian Institute of Technology, Roorkee, Uttarakhand 247667 bDepartment of Humanities and Social Sciences, Indian Institute of Technology, Roorkee, Uttarakhand 247667

cSALD, Shri Mata Vaishno Devi University, Katra, Jammu and Kashmir - 182320

*e-mail: [email protected], [email protected]

Introduction: One of the focuses of the 21st century designers, architects and engineers is to

make spaces accessible to all. Kitchen is one such important space, which apart from acting as

an area for interactions, is primarily the area for meal preparation. With changing family

dynamics, many times people with disabilities and elderly are required to prepare their own

meals, which may act as a cumbersome activity given their level of mobility. Elderly population

is about 8 % of total population in India and is increasing every year. The basic marker of old

age is “slowing of behaviour” resulting in slowness of reaction and task performance. Ageing

leads to decreased strength, vision, hearing, proprioception and reaction time.

Aim:The aim of the study is to provide strategies and interventions for an Indian Kitchen to

make it accessible to elderly and the disabled.

Methodology: Literature was studied to understand the problems pertaining to the Indian

population. The primary study involved a questionnaire survey of elderly participants where the

user response was collected on important parameters such as their anthropometric data, weight

analysis of the utensils involved in meal preparation and effort required while performing

certain activities in the kitchen. The next stage of data collection involved documenting the

meal preparation process through video and photography. A kitchen, in a building of 24

apartments was selected for the study, which was optimum for a family of 4. All the kitchens in

the apartment building were of the same dimension and fitted with the same height and

dimension of counter and storage space. The observations from the video were useful to

identify several physical barriers that the users were facing which interfered with smooth

functioning. The suggested changes were incorporated in a 3-D model of the kitchen.

Results: The results were categorized under the following headings

92




a. Accessibility of kitchen furniture

It was observed that the kitchen designed for a healthy adult was unable to cater to elderly with

limited mobility. The counter top height was a hindrance. Items placed overhead were

inaccessible.

b. Maintaining the flow of food preparation

The work triangle was found missing which increased the movement and also the meal

preparation time.

c. Provision of storage based on weight of utensil and storage items

It was found that there was a lack of thoughtful storage space required to store Indian food

items and utensils.

d. Suggested modifications

Based on the findings some modifications were suggested with the help of a 3-D model.

Discussion and conclusions: All human being long for independence in everyday life, which a space offers by providing unrestricted movement. A kitchen should be ergonomic as well as visually pleasing to provide comfort and happiness to the user. Strategies for designing kitchens for disabled and elderly in this research and analysis indicate to interventions and modifications that may help achieve this aim.

93




NCNILD027

An optimum clinical approach for the bilateral trans-femoral amputee with

stubbies incorporating a modified mechanical resting device-a case study AmarnathPrasada*, AbhishekTripathia




Introduction: The Bilateral Trans-Femoral Amputee Fitted with stubbies presents a unique

challenge to the rehabilitation team members. The more joints and muscles that are lost due to

amputation, the greater the energy cost of ambulation which brings stress and fatigue in the

joints and muscles around the body. An effort has been made to develop a Modified Mechanical

Resting Device that can help the amputee to seat, work and carry the device anywhere they

want.

Aim: The aim is to develop a device, which enables the amputee to have ability to rest and

move around easily and relieve stress and fatigue to the joints and muscles.

Method: The Stubbies is already worn up by the patient. The device consists of a reinforced

plastic pelvic band, worn over the pelvis. Two elastic perineal strap come from postero-lateral

site of pelvic band passing through the perineum and attaches at ipsilateral end of the pelvic

band anteriorly. A proximal telescopic pipe with easy push button is inserted into the slot of a

short cylindrical pipe and is locked inside (making a T-adopter), attached to the plastic pelvic

band at its posterior mid-section. For resting, patient adjusts the height of the adjustable distal

telescopic pipe over the Proximal Telescopic pipe. The amputee, then moves into reclined

position by flexing hip joint and thereby achieve resting support by posterior extended

telescopic aluminum pipe of the resting system.

Result: The patient was quite comfortable while taking rest on the device. Verbal question were

asked regarding effect of resting device to the patient. Patient was convinced about the effect of

resting device when he has to stand for too long. He found it to be simple to wear and remove

and could easily take it along with him when transporting. The device was found to be light in

weight, materials are easily available, cost effective, and increases the efficiency of work as

compared to the normal stubbies. The selection of this device is matched with the amputee’s

94




level of skill; although there are many short comings, which could be corrected in the future.

The device still requires to be made more users friendly. The posterior telescopic rod can easily

be removed by the patient while he wants to stand, if the T-adopter can be fixed and adjusted to

different angle.

Discussion and conclusion: working in standing position as well as walking for a prolonged

time may develop musculoskeletal disorder which may adversely affect the overall health in the

future. In this condition one needs to take rest periodically to ensure consistent and effective

work. The device is designed to support the amputee with bilateral Trans-femoral amputation

with stubbies during prolonged walking and standing by transferring significant portion of the

amputee load through the telescopic aluminum pipe to the ground.

Advantage: compact in size, support in ADL activity, can be adjusted depending upon the

height of supported place.

Disadvantage: Cosmetically unappealing, if patient do not remove the system while walking,

Chances of slippage on the slippery surface.

95




NCNILD000

Design strategies for an accessible Indian Kitchen for elderly and the

disabled SonalAtreyaa*, Vaibhao G. Athaleyb, SonamAgarwalc

aDepartment of Architecture and Planning, Indian Institute of Technology, Roorkee, Uttarakhand 247667 bDepartment of Humanities and Social Sciences, Indian Institute of Technology, Roorkee, Uttarakhand 247667

cSALD, Shri Mata Vaishno Devi University, Katra, Jammu and Kashmir - 182320

*e-mail: [email protected], [email protected]

Introduction: One of the focuses of the 21st century designers, architects and engineers is to

make spaces accessible to all. Kitchen is one such important space, which apart from acting as

an area for interactions, is primarily the area for meal preparation. With changing family

dynamics, many times people with disabilities and elderly are required to prepare their own

meals, which may act as a cumbersome activity given their level of mobility. Elderly population

is about 8 % of total population in India and is increasing every year. The basic marker of old

age is “slowing of behaviour” resulting in slowness of reaction and task performance. Ageing

leads to decreased strength, vision, hearing, proprioception and reaction time.

Aim:The aim of the study is to provide strategies and interventions for an Indian Kitchen to

make it accessible to elderly and the disabled.

Methodology: Literature was studied to understand the problems pertaining to the Indian

population. The primary study involved a questionnaire survey of elderly participants where the

user response was collected on important parameters such as their anthropometric data, weight

analysis of the utensils involved in meal preparation and effort required while performing

certain activities in the kitchen. The next stage of data collection involved documenting the

meal preparation process through video and photography. A kitchen, in a building of 24

apartments was selected for the study, which was optimum for a family of 4. All the kitchens in

the apartment building were of the same dimension and fitted with the same height and

dimension of counter and storage space. The observations from the video were useful to

identify several physical barriers that the users were facing which interfered with smooth

functioning. The suggested changes were incorporated in a 3-D model of the kitchen.

Results: The results were categorized under the following headings

96




a. Accessibility of kitchen furniture

It was observed that the kitchen designed for a healthy adult was unable to cater to elderly with

limited mobility. The counter top height was a hindrance. Items placed overhead were

inaccessible.

b. Maintaining the flow of food preparation

The work triangle was found missing which increased the movement and also the meal

preparation time.

c. Provision of storage based on weight of utensil and storage items

It was found that there was a lack of thoughtful storage space required to store Indian food

items and utensils.

d. Suggested modifications

Based on the findings some modifications were suggested with the help of a 3-D model.

Discussion and conclusions: All human being long for independence in everyday life, which a

space offers by providing unrestricted movement. A kitchen should be ergonomic as well as

visually pleasing to provide comfort and happiness to the user. Strategies for designing kitchens

for disabled and elderly in this research and analysis indicate to interventions and modifications

that may help achieve this aim.

97




NCNILD019

Identifying the barriers in inclusive higher education for deaf and hard of

hearing students: a comprehensive literature review Vaibhao G. Athaleya*,IlaGuptab

aDepartment of Humanities and Social Sciences, Indian Institutes of Technology, Roorkee, 247667 bDepartment of Architecture and Planning, Indian Institutes of Technology, Roorkee, 247667


Introduction: Accessibility in higher education for students with disability is a major concern,

especially for students with invisible disability such as deafness. As the hearing loss impacts

day to day communication of deaf and hard of hearing (DHH) person it leads to several barriers

in their education. Inclusive education of DHH students will be successful if their academic

experiences and social experiences are studied. The purpose of this paper is to review studies

conducted in the area of social and academic experiences of DHH students in inclusive higher

education.

Aim: The aim of this paper is to identify barriers DHH students face in higher education.

Identifying the barriers will create more awareness about DHH students’ needs in inclusion

higher education programs.

Methodology: This paper reviews 20 articles in the area of DHH students’ experiences in

higher education. The articles include national andinternational research papers, theses,Govt.

policiesetc. The articles were studied in terms of aim, objectives, methodology and findings.

These studies show different factors that act as barriers in DHH student’s education and further

these factors are categorized in three areas namely personal, social and academic.

Result: Past studies show several barriers DHH students face in higher education and are

categorized as personal, social and academic factors.

• Personal factors include: Degree of hearing loss, mode of communication, time spent on

learning, lack of self-disclosure,family relationship, lack of self-advocacy, lack of self-

knowledge, limited skills in sign language;

• Social factors include: Interaction with teachers, interaction with peers, interaction with

administrative staff, awareness about the disability, teachers’ attitude, peers’ attitude,

stigma related to disability;

98




• Academic factors include: Language learning, reading and writing skills, quality and

quantity of support services, quality of effective teaching, course content and its

delivery, high school experiences and achievements, academic preparation, involvement

in classroom conversation, availability of Assistive devices, mode of teaching, program

type.

Discussion and Conclusion: The identified factors vary in different institutions, locationsand

availability of resources. It is found that these factors negatively impact DHH student’s

education especially in inclusive educational programs. It is clear from the government policies

that the present emphasis is on inclusive education; hence for equitable inclusive education

there is a need to study these barriers to improve their educational experiences. In India, the

research on DHH students in higher education is scarce. DHH students’ experiences from

inclusive programs seem to be the most appropriate way to understand their needs and to create

awareness to strengthen their education in India.

99




NCNILD028

Accessibility of prosthetic and mobility device technology to promote activity

and social participation: a review of Mizoram (north east region of India) K.Mishraa*

aDepartment of Prosthetic and Orthotic, National Institute for Locomotor Disabilities (Divyangjan),SCERT campus

Chaltlang, Aizawl-796012


Aim andObjective: To determine the effectiveness of prosthetic & mobility device

interventions in terms of activity and social participation for person with disabilities with

mobility limitations in north east region (Mizoram) where the number of disabling barriers is

larger in scale and heighten the risk and vulnerabilities that PWDs face and they seek out

assistance, support & protection.

Design:Systematic review. Search of NILD -RC, Aizawl databases during the period 2011 to

2018.

Introduction:PwDs with mobility limitations, i.e. those having difficultywalking, or who are

unable to walk, and absence of limb can be providedwith prosthetic devices include B k

prosthesis, AK prosthesis, modified Syme’s prosthesis, BE Prosthesis &AE prosthesis

&Other.mobility devices such as canes, Crutch, rollators, wheelchairs, Tricycle and scooters so

as to facilitate mobility and thus enable activityand social participation. The prevalence of

mobility devices ishighest among the oldest age groups, with the risk of limitedwalking

capacity increasing with advancing age.The provision of mobility devices is generally

considered to be of great importance, and the United Nations (UN) as well asThe World Health

Organization (WHO) recommends assistive technology as important tools in creating equal

opportunities for people with disabilities. In the developing countries, assistive technology,

including mobility devices, is mostly provided free of charge if it is considered to have a great

impact on a citizen’s everyday life. Considerable resources are consequently, spent on the

provision of mobility devices, while an ageing population will realistically result in an

increasing need for such interventions.

For example, In India spending on mobility devices has increased from approximately 2010 to

2017. Given the scale of use and importance of mobility devices, their effectiveness needs to be

investigated and described. 100




Existing reviews in the area of mobility assistive devices have focused mainly on outcome

aspects other than activity and participation. One critical review has assessed the research

literature concerning the effectiveness of seating interventionsonly, such as wheeled mobility

devices International Classification of Functioning, Disability and Health (ICF) The review

showed very low grades of evidence in most of the research designs (Grade scoring used).

The ICF is a commonly used framework within rehabilitation, which identifies and classifies

the domain of activity/participationas one of its health-related domains. The ICF defines

activity as the execution of a task or action by an individual & participationas involvement in a

life situation. However, the ICF is not distinct in discriminating between activity and

participation, which means that each study sets its own specific definitions. In the ICF,

mobility, including walking etc., is seen as a subcategory of activities and participation;

however, mobility can also be a prerequisite for activity and participation and may be seen as a

necessity for the person’s real aims, for example to shop, work, take care of oneself, and visit

friends and family, rather than asan end in itself. In this review, when mobility is an aim in its

own right it is not included in the primary outcome dimensionstudied, that is the domain of

activity and participation, but is considered to be a secondary outcome dimension.

The effectiveness of an assistive device is the extent to which it produces a beneficial outcome

in a routine setting. An effectiveness study looks at whether an intervention works under

ordinary day-to-day circumstances. Context has an impact on a person’s activity and

participation. According to the ICF, environmental factors include the physical, social and

attitudinal environments in which people live and conduct their lives. Therefore, it can be

argued that outcomes for mobility devices geared to activity and participation should not be

evaluated without connection to real-life contexts.

This review assesses the evidence for the effectiveness of any kind of Prosthetic and mobility

device interventions in termsof activity and participation in real-life contexts for people with

mobility limitations.

Methods:Controlled studies and non-controlled follow-up studies were included if they

covered both baseline and follow-up data and focused on activity and participation. Study

participants had to be aged over 05 years with mobility limitations. Prosthetic device includes

Below Knee prosthesis, above knee prosthesis, modified Syme’s prosthesis, Below Elbow

Prosthesis &above Elbow prosthesis. Mobility device interventions encompassed Axillary 101




crutches, walking stick, Elbow crutch, walker (walking frame) Rollators, CP chair, manual

wheelchairs and powered wheelchairs (including scooter types). Reviewers independently

selected the studies, performed the data extraction, and assessed the studies’ methodological

quality.

Results:Seven studies were included: one randomized controlled trial, 2 controlled studies, and

4 follow-up studies that included before and after data. Two studies deals with prosthetic device

intervention & two studies of utilization & effects of wheelchair interventions and the other

studies with various other types of mobility device. Two studies were of high, internal and

external methodological quality. Interventions were found to be clinically effective in terms of

activity and participation in 5 studies. The results did not, however, give a unanimous verdict

on the effectiveness of mobility devices in enhancing the activity and participation of mobility

impaired people.

Conclusion:Interventions and outcome measurement methods varied between the studies;

consequently, it was not possible to draw any general conclusions about the effectiveness of

prosthetic & mobility device interventions. However, evidence was found that prosthetic and

mobility devices improve users’ activity and social participation and increase mobility. Paper

examine the evidence of how technology of prosthetic & Mobility device draws an advance in

community living and social inclusion of PWDs in his/ her society with self-respect & self-

dependent. A lack of high-quality research hampers conclusions about effectiveness. More

original, well-designed research is required.

102




NCNILD033

PDF accessibility for visually impaired Sunil Kumara*

Amity University, Sector-125, Noida - 201313


Introduction: There are approximately 300 million persons with visual impairments in

theworld. Technology like screen reader and refreshable braille display is helping to

visuallyimpaired people to access information from the documents. But at some theinstance,

these technologies are not sufficient for visually impaired people. In recentscenario, PDF is one

of the medium for sharing and accessing information around theworld. But in PDFs, various

fields are inaccessible like; math equations, diagrams andtables. Unicode is missing in PDFs for

various elements like Math symbols.

Aim:Generally, PDF does not have markup for the various elements like paragraphs,lists,

headings, header & footer and lists. In this paper is to provide markup to list (unorderedlist) &

paragraph in the PDF document and Unicode for non-Unicode math symbol. Throughthis,

screen reader easily recognizes where paragraph and hierarchal information in the PDFis.

Method: First, taking Latex generated PDF as an input and converting it into raw HTML

byusing existing parser (pdf2htmlEX). Then, utilizing python library (Beautiful Soup) to

readthat raw HTML for various processing like handling of non Unicoding and taggingof list &

paragraph. For detecting paragraph and a list, information is processed Div ofDiv tag in the

HTML and accordingly, giving P tag and UL tag to the information.Applying various

conditions for detecting paragraph like line-spacing, indentation, etc. If these conditions are

matched, then merge both Div tag and giving tag name P. Detectingparagraph is performed first

and then detecting list (Hierarchal information). Unordered Listsand paragraph detection are

done on the basis of human like perception. For thereplacement of non-Unicode to Unicode of

the Math symbol, checking the structure ofthe symbol of missing Unicode symbols and

replacing accordingly with the respectiveUnicode. For Unicode handling, code is processing

raw HTML character by character.

Result: Raw HTML contains a Div tag for each and every line in the document and accordingly

havea span tag for the style of the contents. After applying above method on the raw

HTML,weare getting processed output in which we have proper tag for informationregarding 103




paragraphs and lists. If documents contain Math symbol, then program is takingcare about the

missing Unicode of symbols. If exists any missing Unicode of Mathsymbol, then program

processing structure of symbol and replacing it with respectiveUnicode of the symbol.

Discussion and Conclusion: We know that visually impaired people are suffering from access STEM documents properly.Basically, PDF is widely accepted document for information sharing throughout theworld. Research papers, Books and Articles are published in PDF format on the internet. PDFis not accessible because it contains Math, Diagram, Tables, etc., which is not accessible byscreen reader properly. We need to work on PDF accessibility to help differently abledpeople for taking science as a career. Diagram and Math are two main areas where I want towork in the future.

104




NCNILD000

Current needs of the assistive technologies in care of children with multiple

disabilities: care-givers perspectives S.K. Anandhalakshmia*, S. SrigowriRajesha

aDepartment of Clinical Psychology, National Institute for Empowerment of Persons with Multiple Disabilities,

Chennai - 603112,Tamil Nadu


Introduction: Children with disabilities such as Cerebral Palsy, Autism Spectrum Disorder and

Intellectual Disabilities has significant difficulty in executing daily activities including personal

care, communication, socialization, education, etc. The intensity of such difficulties increases

in cases of multiple disabilities due to their unique needs and challenges. Considering the rapid

developments in technology in this century, appropriate developments will facilitate the

inclusion of children with multiple disabilities in the community. As the role of care giver is

significant in the execution of daily activities, their perspective in identifying the current needs

is inevitable.

Aim:The aim is to study the perspective of the caregivers about the current needs of the

Assistive Technologies in Enhancing the Care of Children with Multiple Disabilities.

Method:The purposive sample included 40 caregivers of children with multiple disabilities.

Data was gathered using semi-structured interview guide prepared by the researcher. Content

analysis method will be used to analyse the data.

Results and Discussion:As the analysis is in process the results and discussions will be

discussed in full paper.

105




NCNILD000

Emerging technological innovation for social inclusion of children with

autism spectrum disorder (ASD) Rajesh Ramachandrana*

aNational Institute for Empowerment of Persons with Multiple Disabilities, Chennai - 603112,Tamil Nadu


Introduction: Social inclusion is the provision of opportunity for social acceptance and

interactions between students with and without disabilities. Understanding of ‘social exclusion

‘is essential to foster social inclusion. Social exclusion is a phenomenon where particular group

of people have no recognition by or no voice or stake in the society they live in. Children with

Autism Spectrum Disorders (ASD) face significant level of social exclusion. Technological

innovations pave way for better social inclusion.

Aims and Objectives: This paper explores the causative factors and, barriers to social

exclusion. The innovative technologies that enhance social inclusion are being identified

Discussion:Children with autism spectrum disorder show deficits in social skills such as

initiating conversation, responding in social situations, social problem-solving, and others.

These deficits are targeted using social skills interventions, some of which use a technology-

based approach as a resource-efficient alternative to common forms of instruction. Computer

Assisted Technologies (CAT) enhances four domains of skills: Language, Emotional

recognition, Theory of mind and Social Skills. Computer Presented Social Stories (CPSS),

Video Modeling and Virtual Reality has shown significant improvement in social skills and

appropriate behaviors that lead to acceptable level of social inclusion.

Conclusion:Technological innovations enhance better social acceptance which in turn leads to

better social inclusion. Social inclusion helps to maintain the dignity of children with Autism

Spectrum Disorder.

Key Words: Autism Spectrum Disorder (ASD), Social Inclusion and Technological Innovation

106




NCNILD035

Barrier free environment for persons with disabilities (PwDs) and its psycho-

social inclusion: a challenge in India RanjanDasa*, MeenaBaraib

aDepartment of Prosthetics and Othotics, Swami Vivekanand National Institute of Rehabilitation Training and

Research, Cuttack, Odisha 754010 bDepartment of Psychology, Swami Vivekanand National Institute of Rehabilitation Training and Research,

Cuttack, Odisha 754010


Abstract: The role of Technology in development of Barrier free Environment Psycho-social

inclusion in addition to economic integration for Persons with disabilities is becoming a major

issue in different part of world including India. The Human resource development of persons

with disabilities is of equal importance as human resource development of abled persons. The

significance of accessibility of persons with disabilities (PWDs) is very important, due to their

inclusion in the areas of education, employment, business, goods and services and participation

in other social activities, technology for creating an creating a barrier free environment in

Institutions, Universities, Hospitals Recreation centres and Sports. The persons with disabilities

suffering from one or the other forms of disabilities, according to Census of India 2011 is

around 2 crore and 70 lakhs of total Indian population.

The Government of India has recently started campaigns called Accessibility India Campaign

for persons with disabilities with aims to create awareness among policy makers, civil societies,

law implementers including judiciary, consumers and PWDs. After enactment of Right of

Persons with Disabilities Act-2016, it has become imperative to develop not only the

technology to create a barrier free environment for PWDs to access the society on an equal

basis others which includes area of transportation, employment, health care, education and even

social and political participation.

The authors of this article emphasise their focus on various issues relating to recent

technological development in barrier free environment and challenges for its Socio-

Psychological inclusion of persons with disability through the means of accessibility for

inclusive growth and development of our country with their active participation.

107




NCNILD000

Technological advancement for inclusive society: a therapeutic perspective Sugana*

aNational Institute for Empowerment of Persons with Multiple Disabilities, Chennai - 603112,Tamil Nadu


Introduction:Although physical rehabilitation is commonly administered to children with

Autism, Vestibular and Proprioception has received some attention for many years, organised

vestibular rehabilitation therapy programs have only recently been introduced. This abstract

will describe the programmatic approach to vestibular and proprioceptive rehabilitation,

emphasizing cost effective technology in community based rehabilitation.

Aims and Objectives: We assessed and treated the efficacy of using swing for the children

with Autism, especially having Vestibular and proprioceptive issues. The Objective is to

understand the reduction in seeking behaviour of the children with Autism with control trials.

Methodology:Vestibular Rehabilitation by Physical therapy has emerged with scientific

approach using our traditional method of using the swing. This has been shown to be a highly

efficacious treatment modality for a majority of children with vestibular or proprioceptive

system disorders, or a combined aetiology.

This article will describe the programmatic approach to vestibular rehabilitation, emphasizing

selection criteria and reviewing results that may be anticipated when this treatment modality is

used in children with Autism populations. When we think of a swing you might think of child’s

play, but the benefits of swinging are truly therapeutic. A traditional swing requires quite a bit

of coordination and motor planning learning how to maneuver. Deep inside our joints are Golgi

Tendon Organs or receptors that signal our brains to let us know where our joints are in space.

A swing encourages vestibular and proprioceptive awareness as pressure is applied to the body

through movement and heavy work. A randomized pretest–posttest control group design was

utilized to measure the effects of a swing on independent work behaviours of 30 children with

Autism. Participants engaged in two 7-min intervals of independent work. Between the

intervals, participants in the treatment group received 5 min of vestibular stimulation using a

swing and children in the control group watched a video. There was a slight difference were

noticed between the treatment and control groups on engagement.

108




Discussion: Analyses revealed that there is a difference in trajectories between the treatment

and the control groups, after intervention the improvement in the vestibular and proprioceptive

fosters better acceptance in the community

Conclusion:This to suggest that this kind of traditional technology-swing was an effective

intervention for these children. A significant workout with proper protocol will help the child to

get integration with the community.

Keywords: Autism, integration, sensory, behaviour, intervention.

109




NCNILD000

Development of a new cost effective assistive device: “adjustable postural

correction chair” aimed at improving the life of persons with disabilities Subrata Kumar Haldera*, Mama Kumar Sahooa, Sakti Prasad Dasa




Introduction: Adjustable seating Devices for improving posture are often recommended for

non-ambulatory individuals with Developmental Disabilities. Children with multiple handicaps,

especially Cerebral Palsy, have difficulty maintaining head and trunk stability. Movement of

arm and hands pose a precarious balance. Abnormal upper extremity and hand movements are a

hindrance to child in play, educational, or later vocational activities. An estimated 2.5-3 per

1000 live births are cerebral palsy. Children with neuromotor disabilities spend a long time in

sitting. The adjustable seating device therefore reflects and reinforces therapeutic principles in

order to encourage the child to enhance their abilities throughout the day.Although there are

many positioning devices are available but they do not completely reflect therapeutic principles

and also is not adjustable to accommodate physical growth of the child or encourage changes in

physical activity. These are also not widely available.

Aim: Development of a new cost effective custom made product “Assistive device-adjustable

postural correction chair” has been performed:

-To improve position and increase the time spent in functional position.

-Produce positive behavioural changes in the head control, controlled sitting posture, visual

tracking, reach, and grasp.

Methods: 30 subjects with multiple handicapped were conveniently selected for this study with

the age group of 2-6 years who were suppose to receive assistive devices and whose

performance was not at criterion level in head control, sitting posture, visual tracking, reach,

and grasp. After assessment of the child, positioning devices were designed for positioning

according to the requirements; head support, trunk support, hip support, foot support, and tray.

Head support was used for the child who had no head control. Optimal positioning was based

on sitting position principle was used. They were observed systematically using observational

assessment instrument for 60 to 90 minutes. The activities observed were head control, 110




controlled sitting posture, visual tracking, reach, and grasp. Rating scale data was analysed

using wilcoxons sign rank test.

Result: The SPSS 20 was used for analysis. The data of all subjects were assessed before the

device was provided and data was collected for the same variables after 8 weeks of use. Each

assessment was followed by the reassessment by the same investigator. The pre scores with

observational rating were compared with final scores using Wilcoxon Signed Rank Test for the

significant difference in the variables. All the children showed significant improvement in

motor behaviour and postural changes after using the assistive device for a period of eight

weeks. Observation data indicates that sitting posture, Head control, Visual Tracking, Reach

and Grasp improved significantly.

Discussion: All components of sitting posture improved by using Assistive Device. The head

was maintained in the vertical plain, the trunk was upright, the hip was flexed to 90 degree, the

knees were flexed to 90 degree the ankle were in neutral position and arms positioned in mid

line. Head control was observed while the child focused visually in the interesting toys. Head

controls in anterior-posterior direction were significantly improved. Significant improvement in

Visual Tracking was done in vertical and horizontal tracking. Direct observation indicates that

complete reach and grasp improves significantly.

Conclusion: Therefore it is concluded that appropriate positioning becomes the basis for

attending behaviours and visually directed reach and grasp to improve the life of persons with

disabilities.

111




NCNILD032

Satisfaction among patients with assistive technology provided by

department of occupational therapy at NILD Kolkata: a cross sectional study PankajBajpaia*

aDepartment of Occupational Therapy, National Institute for Locomotor Disabilities (Divyangjan), Kolkata



Introduction: Technology is a common element in our everyday lives. Patient satisfaction has

been recognized as an abstract and complex concept that is influenced by a multitude of factors.

The success of treatment outcomes and patients’ satisfaction with their care are often inherently

linked to both the service experience and the use of their device(s). The attention given for

developing, collecting, and analyzing patient satisfaction stems from a desire to improve the

quality of rehabilitative care.

Aims:To determine the status of satisfaction among patients who received Assistive technology

from Department of Occupational Therapy at NILD Kolkata

Method:132 patients who were provided Assistive technology (including hand splints,

modification in devices and Assistive devices) for various purposes from Department of

Occupational Therapy during last 18 months were surveyed through telephonic interview.

Quebec User Evaluation of Satisfaction with assistive Technology 2.0, a standardized tool was

used to collect the responses. Data were analysed for their responses on satisfaction with

technology and services.

Results:76% users considered ‘comfort’ and ‘effectiveness’; 38% users for ‘repairs’; 30 %

users for ‘professional services’; 23% users for ‘easy to use’ as most important factors of

satisfaction from assistive technology.

Discussion and Conclusion:Technology has an important place in our daily life. Occupational

therapy uses technology to increase the Occupational performance and participation of their

clients. In the field of assistive technology, user satisfaction is identified as one of five main

outcomes categories, together with clinical results, functional status, quality of life and costs.

The assessment of satisfaction provides patients’ perspective and, is beneficial for both patients

and clinics if the data are used to improve the quality care.

112




NCNILD029

Modular positioning system for obstetrical brachial plexus injury H.D.Sharmaa*, Amit Kumar Mandala ,AnurupaSenapatia

aDepartment of Occupational Therapy, National Institute for Locomotor Disabilities (Divyangjan), Kolkata



Introduction:Obstetric Brachial Plexus Injury is an injury in newborn caused by traction on the

neck – shoulder angle during labour and delivery. Traction leads to lesion typically at the root

and trunk level of brachial plexus. Incidence is 1 to 2 in 1000 birth. Newborn develop flaccid

paralysis of upper extremity. Crying is the response of the baby that accentuate with stretch of

injured nerve due to awkward positioning and handling. Due to absence of sitting balance and

trunk control (6 months & below) bed positioning is an important part of conservative

occupational therapy management. An attempt has been made to develop a modular bed

positioning system to minimize the nerve stretch and maintain soft tissues in optimum length.

Aim:

1. Proper positioning of child on bed may reduce pain, prevent shoulder subluxation,

contraction of forearm and deformity at wrist and hand.

2. Facilitate faster recovery of injured nerve and maximize the function of affected

extremity.

Method: Parts of the positioning system is made of soft materials which will arrange

sequentially to help the child in proper position on baby bed.Components are head positioner,

trunk stabilizer, axillary support, arm component, forearm and hand component.Targeted age

group are 6 months and below.

Four children diagnosed of obstetrical brachial plexus injury (2 male and 2 female) with 4

months means age has been included in the pilot study. Demographic data and AMS (Active

Movement Scale) were recorded first day before intervention. Child was placed in bed

positioning system 8 hours/day for 2 weeks along with regular conservative therapy.

Results:Improvement in AMS has been shown and comfort ability of the children has been

noticed.Sample size is small and period of the study was short. There was no control group to

known the effectiveness of the device. Study may be performed with large sample size.

Key words: Brachialplexus, Paralysis, Conservative. 113




114




NCNILD000

Design and Development of a Three-Fingered Gripper for Therapeutic

Purposes GauravJaiswala*, JyotindraNarayana, Santosha Kumar Dwivedya

aDepartmentDepartment of Mechanical Engineering, Indian Institute of Technology, Guwahati, Assam, 781039,

INDIA

*e-mail: [email protected], [email protected], [email protected]

1. Introduction

As the physiotherapist used to perform repetitive task throughout the whole day for

visualisation of inflamed tendons, joints and ligaments; a robotic gripper can reduce manual

working hours of physiotherapists and relax them. According to survey done by Lee et al. [1],

the physiotherapist positively welcome the application of robotics in the treatment process of

swollen muscles and tendons. Moreover, the site of pain in human body can be visualised with

more accuracy by robotic grippers. Literature survey from the past presents numerous design of

grippers which includes the control of gross and fine motion responses of the finger [2].

Kawasaki et al. [3] presented anthropomorphic robot hand consists of one thumb with 4-DOFs

and four fingers with 3-DOFs each. In other work, an open source 3D printed gripper is

designed by Tlegenov et al. [4], an underactuated system for grasping various geometries.

However, sufficient proof of using finger based gripper system in physiotherapy is not

mentioned in past works. Therefore, there is a need of such kind of automation device which

can reduce the work load of physiotherapists.

2. Aim

This work present a design and modeling of three-fingered gripper for the automation of

manual operations, performed by physiotherapists. The design is modeled in SolidWorks- CAD

software with certain specifications, framed with available ultrasonic therapy unit of institute

hospital. Thereafter, the Arduino setup is installed with servo motors for the roll movement of

the gripper about the base. The specialised motions for analysing the behaviour of muscles and

ligaments are burned to Arduino interface by giving different mathematical formulations as

input file. The computational process is carried out in MATLAB software. The motion

responses being considered are progressive spiral, concentric circles and Lorenz model of 115




fractals. The gripper can be attached with a robotic arm for visualising more number of distinct

movements in the physiotherapy operations.

3. Methodology Adopted

3.1 Design of a three-fingered gripper

The three fingered gripper is designed which can hold the massaging knob throughout the

physiotherapy operations. When the finger starts grasping the knob, the first phalanx comes in

contact with the object. With the effect of that, the second phalanx cover a full wrapping about

a pivot point. Similar approach can be visualised for n-phalanx finger [5]. This designconfirms

the low cost gripper system which is one of the crucial fundamentals for designing any grasping

mechanism. The micro servomotors are attached for the actuation of one phalanx with respect

to other. Another servomotor is attached with the base in assembly which provide actuation to

the gear train. The worm gear train drives the set of worm wheels which are connected to each

finger, lead to the simultaneous drive of all fingers The application of worm gears potentially

confirms the non-backdriveability of actuation system. The diameter of the knob is 6 cm. The

length of the first and second phalanx is 4.5 cm and 5.5 cm, respectively. The width of the first

phalanx is 10mm at front and 15 mm at the back while the width of second phalanx is 6 mm

throughout. The worm wheels at end of second phalanx are of 11mm PCD and gears in gear

train are of 28mm PCD. The design of two links are adjusted according to the rest of

dimensions. The CAD model of one finger, gear train and the assemblies of three-fingered

gripper with a specified knob is shown in Figure 1.

Figure 1: CAD model of (a) one finger (b) worm gear set (c) gripper system (d) 3-fingered

gripper with knob.

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Proceeding of National Conference onDisability and Social Inclusion-The Role of Technology

January 10 - 11, 2019National Institute for Locomotor Disabilities (Divyangjan), Kolkata


3.2 The fabricated robotic arm

After designing the system, Arduino interface system is designed and installed with MATLAB.

After making the circuit as required, Pin 11 is connected to the one end of the LED pin through

resistor and other pin of LED is connected to the ground pin on the Arduino board. After

completing the installation, MATLAB codes for the motion responses are written in m-files and

saved. On running these files, MATLAB will burn those files to the board and LED starts

blinking. The complete set up of Arduino is thereafter augmented with actuation system of the

robotic arm. The designed gripper can be fixed to the robotic arm by mounting the worm gear

set with the arm end. The fabricated robotic arm in which gripper will be mounted, is shown in

Figure 2.

Figure 2. The fabricated robotic arm

4. Results and Discussions

Thereafter, for getting different motion responses, the following mathematical formulations are

given to the Arduino system by saving them as MATLAB file. The desired motion responses

achieved by the complete system are shown in Figure 3.

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Figure 3. Desired motion responses of (a) progressive spiral motion (b) concentric circles

motion (c) Lorenz fractal motion

5. Conclusions

By visualising different motion responses with the combined effect of arm movement and

gripper mechanism, it is noticed that use of robotic arm with designed three fingered gripper

has enough potential to reduce the workload of physiotherapists.

References

1. Lee, Moonhee, Matheson Rittenhouse, and Hussein A. Abdullah. "Design issues for

therapeutic robot systems: results from a survey of physiotherapists." Journal of

Intelligent and robotic systems 42, no. 3 (2005): 239-252.

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NCNILD025

Effect of pressure biofeedback assisted motor control exercises on pain and

function in subjects with chronic nonspecific low back pain: a RCT JayantaChakrabortya*, BibhutiSarkara,Pravin Kumara

aDepartment of Physiotherapy, National Institute for Locomotor Disabilities (Divyangjan), Kolkata 700090, West

Bengal, India


Purpose: The purpose of study was to compare the effect of pressure biofeedback assisted

motor control exercises versus global core stabilization exercises on pain and function in

subjects with chronic nonspecific low back pain.

Method: Total of 30 subjects were included as per inclusion & exclusion criteria through

randomized method and divided into two groups A & B. Group A consist of 15 subject with

mean age 31.26±7.87 (7 male & 8 female) and Group B consist of 15 subjects with mean age

31.60±7.89 (11 male & 4 female). Group A received pressure biofeedback assisted motor

control exercises and Group B received global core stabilization exercise, thrice/week for four

weeks. Outcome measurements were taken on Day 1 pre treatment and after 4 wk post

treatment for pain by NPRS and function by ODI.

Results: At the start of treatment there was no significant difference (p>0.05) between groups

related to age, gender, NPRS & ODI. There was significant (p<0.05) improvement in NPRS &

ODI in both group A & B after 4 wk of treatment but when we compared between group A &

B; Group A showed significant (p<0.05) improvement in NPRS & ODI compared to group B.

Conclusion: The results of this study suggest that pressure biofeedback assisted motor control

exercises are more effective on NPRS & ODI when compared to global core stabilization

exercises.

119




NCNILD000

Stance controlled knee ankle foot orthosis for patients with weak knee joints Aneesh Karma*


Abstract:Knee ankle foot orthoses (KAFO) are prescribed to patients whose knee joints can’t

function normally for reasons ranging from injuries to diseases.Current KAFO designs lock

knee joints in both stance and swing phase resulting in unnatural gait like circumduction

causing fatigue. Additionally, imported KAFOs are expensive and an orthosis resulting in

natural gait can be useful.We designed a Stance Controlled KAFO (SCKAFO) actuated by the

human body weight. Finite Element Analysis (FEM) of the model was performed, the model

was tested on polio patients and visual analogous scale (VAS) data was obtained and analyzed

for design validation.Our SCKAFO resulted in a gait closer to natural gait as compared to other

tested solutions.

Keywords: Stance controlled knee ankle foot orthosis. Passive actuation

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NCNILD036

Robo-Rehab: a mobile app based robotic rehabilitation device RatanDasa*,KajalDofekara, Neelesh Kumara

aCSIR-Central Scientific Instruments Organisation, Sector 30-C, Chandigarh 160030, India


Introduction:Spasticity removal is a major challenge for the physiotherapists and caregivers.

Spasticity can range from mild muscle stiffness to painful and uncontrollable muscle spasm.

The most common causes for muscle spasticity are multiple sclerosis, stroke, spinal cord injury,

Traumatic Brain Injury (TBI) and accidents. When left untreated, spasticity can give rise to

other secondary and severe problems like pain, limb contracture and even deformity. The

increased muscle tone may result in a loss of joint motion, leading to contractures.

Physiotherapy is the earliest form of rehabilitation to treat stroke and spasticity. With

advancement in technology, robotics has found application in therapeutic use such that it can

transform the rehabilitation process from labor-intensive tasks to robot-assisted tasks. Studies

have also reported robotic rehabilitation provides better and quantified physiotherapy outcome

in comparison to manual therapy. The developed ankle therapy device (Robo-Rehab) is a

mobile app controlled electromechanical active orthosis that supports ankle movement in

plantar flexion and dorsiflexion operations in prescribed biological range of motion. The device

is designed specifically for stroke and spasticity patients to overcome common balance problem

and retain their normal range of motion (ROM).

Figure 1: Robo-Rehab Functional Block

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Aim: To design and develop an active orthosis for foot spasticity removal and rehabilitation of

stroke patients. This device is envisaged to provide safe and intelligent control to stretch ankle

joint to prescribed ranges.

Figure 2: Patient report saved and recorded from a trial

Method:Robo-Rehab is assembly of mechanical structure unit with contour of human foot, a

linear DC actuator that provides dorsiflexion and planter flexion motions to ankle joint. A high

power motor driver is used to power and control the actuator. An in-house developed

electrogoniometer is used for recording the ankle angle joint. An android mobile application is

developed that acts as an interface between the physiotherapists and the device. Patient

information along with the therapy parameters (joint angle ranges, speed, time of therapy etc.)

can be entered by the operator. This information from the app is then transmitted to the device

and based on the inputs, the device starts functioning in prescribed method. At the end of each

trial, the patient performance parameters are recorded in the app and the same can also be

generated in the form of a report. Figure 1 below shows the functional block of Robo-Rehab.

122




Result:Currently, the device is under evaluation in CSIO Gait lab. The ankle joint can achieve

400 in plantar flexion and 250 during dorsiflexion. Figure 2 shows the report of performance of

a trial.

Discussion and Conclusion:Robo-Rehab is an intelligent and cost effective device that can

assist the physiotherapists and caregivers to provide better quantified treatment to patients.

Patient’s record history can help the physiotherapist track the patient performance and prescribe

patient specific customized treatment. This can also reduce the intense labour required by

physiotherapists give during therapy sessions.

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NCNILD022

Modified elbow crutch for geriatric patients with pick-up mechanism: a case

study ChandniPandeya*, Poly Ghosha




Background:Mobility aids are appliances used to help people who have difficulty in walking

and standing independently. They shift the body weight from the affected side to non- affected

side and hence enable some of the weight to be supported by the upper limbs. As we know in

old age, problems like stiffness/spasticity, weakness in legs, walking problems, loss of

coordination, multiple sclerosis, back pain occurs which forces them to use assistive devices

which transfer weight from injured segment to non injured segment of body and use of this

assistive devices make their ADL difficulties specially reaching to the floor. To ease the

reaching mechanism, a modified elbow crutch has been designed.

Aim:The new modified crutch helps them not only for self work but also to help others by

“picking up” their basic needs items by existing capacities of the patient & bring them to the

optimum level of his/her functional ability by the combined and co-ordinated use of modified

“picking up” crutch and their existing capabilities of hand.

Methodology:The methods used for the fabrication of this device have gone through the

several steps such as attachment, fittings and adjustment. And, the materials required for this

purpose are an elbow crutch, brake lever, cable system, front brake, nuts and bolts. The

actuation mechanism or working mechanism of this of this “pick up” crutch is that part of the

brake system that transmits force from the rides to that part of the system that does the actual

braking or picking. Brake system actuation mechanisms are either mechanical or hydraulic. The

primary modern mechanical actuation mechanism uses brake levers coupled to cable to move

brake arms, thus forcing pads against a braking or’’ picking’’ surfaces .Cable mechanism are

usually less expensive, but may requires some maintenance related to exposed area of the

cable.Hydraulic brake also uses brake levers to push fluid through a hose to move pistons in a

caliper, thus forcing pads against a braking or “picking’’ surface.

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Result:The original purpose of this pick up crutch is for the person who walks with the crutch

but has difficulty in stooping to pick up something from the floor. With the help of this crutch

and its picking up mechanism it is easy to remain independent and carry on with activities of

daily living. Also; on the other hand it is unable to pick up heavy objects. Care and maintenance

are necessary in regular interval. Patient should have good upper extremity power. Keeping all

the points in mind here mechanical actuation has been selected for this crutch instead of

hydraulic actuation because of the following reasons like less expensive, applicable for this

brake system(centre pull calliper brake system, hydraulic actuation identified mostly with disc

brake).Requires less specialized equipment to repair. They shift the body weight from the

affected side to non-affected side and hence, enable some of the body weight to be supported by

the upper limbs. Thus, built up the stability and indirectly the mobility of the patient. As the

condition of the patient improves he may progress through the different types of walking aids.

Discussion and Conclusion: With the normal elbow crutch the patient will feel uneasy or pain,

when he/she will try to pick the items required as per needs and even after putting several

efforts he/she may not be able to pick the item. But, with this “modified elbow crutch with pick

up mechanism” the patient can perform his/her task easily. Therefore, mobility aids are

appliances used to help people who have difficulty in walking and standing independently.

Crutches and walking sticks, from an engineering point of view, are considered as dynamic

mechanical systems which alleviate a disability. They act as supports, help the user to recover

from stumbling, or transmit from the arms, the energy required in lifting the feet from the

ground.

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NCNILD020

Design Reliability of a modified TLSO on gait and posture quantitative

analysis in persons with AIS HasanArifRaihana*, PolyGhosha,P.K.Lenkaa, AbhishekBiswasb


700090, West Bengal, India bDepartment of Physical Medicine and Rehabilitation, National Institute for Locomotor Disabilities (Divyangjan),



Background: Posture asymmetries are associated with the risk of progression in adolescent

idiopathic scoliosis [1]. The Cobb angle remains the gold standard to monitor change in

scoliosis over time, and is calculated from radiographs [2,3]. Although there are sophisticated

three dimensional (3D) posture analysis systems such as Optotrak(Northern Digital Inc.,

Waterloo, Canada), Vicon (ViconMotion Systems, Oxford, UK), Motion Analysis (Motion

Analysis Corporation, Santa Rosa, CA, USA) and surface topography systems, these systems

are not accessible form clinicians. The use of reliable and valid clinical tools to document

impaired posture is recommended in the guide to conservative treatment plans [4]. Application

of 3 D force applications& 3 D control of the spine is achieved in current standard European &

North American scoliosis braces. As per SRS, IRSSD & SOSORT advanced diagnostic & non-

operative treatment protocol has been processed in addition to evaluation of gait kinetic,

kinematic & Energetic parameters.

Objective: To develop an appropriate TLSO design & treatment protocol reliability of gait &

posture quantitative analysis among persons with idiopathic scoliosis.

Method: Prospective quasi experimental study design. Pre-post data were taken with electronic

force measuring instrument, Pressure measuring system for force data of modified TLSO&

COP data for balance were taken with .Kistler force Plate (Type 9260AA6, dimension- 600 X

500 X 50 mm, weight- 8.6 kg). The comparison of the various variables between pre-brace and

post in brace was done for statistical analysis. K4b2.The K4 b2 is the first COSMED portable

system for intrapulmonary gas exchange analysis on true breath by breath basis. Sport

Medicine, Research, Human Performance, Gait Lab, Occupational health, Cardiology, Cardiac

126




Rehabilitation, Clinical Nutrition and any application that requires the measurement of the

cardio-respiratory response either in the field or in the lab.

Both force and COP data was taken in static condition. Cobb’s angle was found out with

geometrical process through X-ray. Force sensor pad was placed in pressure pads in Brace. We

measure the O2 consumption level (ml/min/kg), Tidal volume (VT), Heart rate, Energy cost

EE/min (Kcal/min), VO2, VCO2, O2 expenditure.

Adaptability period was five minute. Data were taken at normal room-temperature while in the

different posture position & 30 meter walking test.

Results: Several parameters areanalyzed. These are force of trochanter force, lumber pad force

and thoracic pad force in various posture, COP Parameters – Range (AP &ML), Mean distance

(AP& ML), COP range, COP RMS , Romberg Ratio. The cardio-respiratory table and graph

established a significant better result in AIS with spinal orthosis. Cardio respiratory results

suggest that the patient was comfortable with TLSO-Brace.

Discussion and Conclusion: M. S. WONG et.al.(1998) et al. state that the corrective force the

curve have an effect on correctional forces. Eshaghi et.al (2012); states that the displacement of

the COP is maintains stability. Modified moulded TLSO can significantly increase patient’s

acceptance to stop curve progression without cardio-respiratory discomfort & also effective in

improvement of gait & postural balance in Adolescent idiopathic scoliosis.

References:

1. Kouwenhoven JW, Castelein RM. The pathogenesis of adolescent idiopathicscoliosis:

review of the literature. Spine 2008; 33:2898–908.

2. Kuklo TR, Potter BK, Schroeder TM, O’Brien MF. Comparison ofmanual and digital

measurements in adolescent idiopathic scoliosis.Spine 2006; 31:1240–6.

3. Weissberg P, Danielson BI, Willén J. Comparison of Cobb angles in idiopathic scoliosis

on standing radiographs and supine axially loadedMRI. Spine 2006; 31:3039–44.

4. American Physical Therapy Association. Pattern B: impaired posture. In: Guide to

physical therapist practice, 2nd ed. PhysTher 2001; 81:9-157.

127




NCNILD026

Clinical prevalence of risk factors of knee osteoarthritis among urban women

in Kolkata PeimiJojoa*

aDepartment of Nursing, National Institute for Locomotor Disabilities (Divyangjan), Kolkata 700090, West

Bengal, India


Introduction:Osteoarthritis is a slowly progressive inflammatory disease of the diarthrodial

joints. Osteoarthritis is characterized by degeneration of cartilage and its underlying bone

within a joint as well as bony over growth. The breakdown of these tissues eventually leads to

pain and joint stiffness. Osteoarthritis is more common in weight bearing joints like the hip,

knee and spine. Osteoarthritis is a common condition in older adults especially in women. It is

one of the leading causes of disability in older adults.

Aim:The aim of the study is to identify and assess the prevalence of risk factors of knee

Osteoarthritis among women and also test the association between the risk factors of knee

Osteoarthritis among women of selected demographic variables.

Methods:A descriptive prospective research design was chosen for the study. The study

participants were urban women residing at NILD, B.T Road, and Kolkata.Sample size consisted

of 200 women, used convenient sampling. Inclusion criteria were women of the selected area

aged 35 years above.

Data Collection tools and techniques:

Tool 1:-

Part 1: Demographic profile.

Part 2: Risk factors.

Part 3: Physical features of Knee Osteoarthritis.

Part 4: Physical assessment.

Part 1- Demographic profile (age, religion, number of family members, family income, marital

status, occupation, type of family educational status)

Part 2- Risk factors (history of injury, family history, surgery of knee, physical activity,

smoking, alcoholism, heavy lifting, using high heels, type of toilet, use of contraceptive) 128




Part 3- Physical features (pain, history of medical advice, treatment modalities, presence of

stiffness, crackling sound)

Part 4- Physical assessment (height, weight, BMI, Blood Pressure, presence of deformity,

redness, pain, swelling)

Results:

Demographic Variable-

Majority of women in control group belongs to 35-45 years (54%) and in case group belong to

46-55 years (37%). Majority of women both in control and case group belongs to Hindu

religion, had an educational status of secondary, were married, were from nuclear family, have

an income of Rs. 1000/- – Rs.5000/-, have a family member of 4, equal no. of women in case

and control groups were housewives.

Finding related to risk factors of Knee Osteoarthritis:

Maximum nos. of women in case groups was identified with an average risk of 72% and in

control group max nos. of women was having a high risk of 51%.

Finding related to physical features with knee Osteoarthritis:

Majority of women 42% have been suffering from knee Osteoarthritis for more than 5 years.

Majority of women 35% used drugs as a pain management for knee Osteoarthritis.

35% of women have joint stiffness sometimes,

43% of women hear crackling sound after waking up,

52% of women have moderate pain,

35% of women have visited a doctor for treatment within 1-6 months.

Discussion and Conclusion: The finding outcomes found that family history of knee

Osteoarthritis has an influence on developing knee Osteoarthritis. The study observes that

maximum women did strenuous work, squatting and heavy lifting, maximum women were from

pre obese and obese group & also find that maximum client with knee Osteoarthritis have

metabolic disease. The majority finding revealed that most women had achieved menopause

and were at higher risk of getting Knee Osteoarthritis.

129




NCNILD024

Locomotor gait analysis in spondylolisthesis using moulded LSO Harsh Kumar Kanhaiyaa*, HasanArifRaihana, P. K. Lenkaa




Introduction: Quantitative gait analysis has become a clinically accepted means for evaluating

and documenting certain pathologies that affect gait such as spondylolisthesis. Unfortunately,

limitations in our understanding about the patho-mechanics of gait spondylolisthesis and the

functions that need to be provided by LSO inhibit our ability to effectively use quantitative gait

data as a means to diagnose and treat observed gait deviations. At present, quantitative gait

analysis appears to be beneficial for documenting the rehabilitation progress of patients over

time and may be useful for evaluating some gaits, but the information may not necessarily

enable the experienced clinician to make better decisions regarding Advance Orthotic

prescription or modifications. Nonetheless, it is important that we continue to strive to

effectively integrate these quantitative measurements with the experience and skill of the

Orthotist and the subjective feedback of the user.

Aim: Aim of the study is to describe the effectiveness of Moulded LSO not only for the

reduction of pain also in improving the quality of gait with quantitative analysis using proper

gait analysing instruments.

Methods: force platforms were used to collect data. Data collection for each test condition was

performed three times in a gait laboratory. The patients stood on the force platform and were

asked to look forwards for 20 s with their eyes open and also with their eyes closed in a

randomized order.

Patient was instructed to comfortably walk on the gait analyzer (MAT), gait data were collected

for 10 seconds. Balance between the two lower limbs, step time, step length, and base of gait

were measured for gait analysis. In addition, the totals of both lower limbs for step time, step

length, and base of gait were evaluated. Measurements were made before and after the

intervention.

T-test was performed used to compare the data before and after the intervention. SPSS version

20.0 was used for statistical analysis, and the level of significance level was set at p < 0.05. 130




Results:The results of comparison by t-test between before and after application of the orthoses

revealed statistically meaningful differences in all variables of the gait, (i.e. Postural sway and

other parameter of the gait) when wearing the moulded lumbosacral orthoses. Postural sway

was decreased in AP & ML direction.

Discussion and Conclusion: As per finding results suggest that LSO is more effectively

prescribed for reducing pain & postural imbalance in spondylolisthesis. LSO application is

effective in spondylolisthesis in terms of improving gait.

Reference:

1. Norton PL, Brown T. The immobilizing efficiency of back braces: their effect on the

posture and motion of the lumbosacral spine. JBJS. 1957 Jan 1;39(1):111-220.

2. Burnfield JM, Few CD, Mohamed OS, Perry J. The influence of walking speed and

footwear on plantar pressures in older adults. Clinical Biomechanics. 2004 Jan

1;19(1):78-84.

3. Konz R, Fatone S, Gard S. Effect of restricted spinal motion on gait. Journal of

rehabilitation research and development. 2006 Mar 1;43(2):161.

131




NCNILD000

Congenital scoliosis with rib anomalies Pratyush Kumar Sethia*, Chunmun Mohantya, Sushree Sangeeta Nayaka


Research, Cuttack, Odisha754010

*e-mail: :[email protected]

Introduction: Congenital scoliosis is a sideway curvature of the spine. It is the vertebral

anomalies which results in imbalance of the longitudinal growth of the spine. The vertebrae are

not properly formed ( absent or fused). This occurs very early in developement in the 1st 6wks

of embryonic formation.

Aim:To design and develop a spinal brace which correct and stop progression of the curve of

the spine having congenital scoliosis (flexible) with a single or double curvature and also

provide maximum comfort to the patient.

Method: The brace is made up of polypropylene lined with polyethylene foam and it opens in

the back via a series of Velcro straps. The grip on the pelvis provides a firm foundation from

which corrective forces can be applied to the spine.

Results:The result of the fitment was properly noticed after 3 months that the curve was

reduced and further the patient was advised to follow up in regular basis.

Discussion and Conclusion:The spinal braces for child with scoliosis are lot. But in case of

corrections there are limitations like modification, remodeling similarly. So there is a need of

built in correction techniques in the designing of the orthosis. The objective of the new design

achieved when applied this orthosis to patient. As the result of wearing this orthosis, the

patient’s posture as well as the gait found better.

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NCNILD040

Social and economical impact of amputee rehabilitation by ADIP scheme in

Odisha Deepak Sahooa*, A. K. Das Mohapatraa ,Rajesh Kumar Mohantyb


Research, Cuttack, Odisha 754010 bSambalpur University, Burla, Sambalpur, Odisha 768019


Aim: Limb amputation is both a life-saving procedure and a life-changing event. The aims of

rehabilitation following amputation are to restore acceptable levels of functioning that allow

individuals to achieve their goals, to facilitate personal health, and to improve participation in

society and quality of life with prosthesis. Individual responses to limb loss are varied and

complex; some individuals experience functional, psychological and social dysfunction, many

others adjust and function well.

Method: The social impact of amputation can be substantial. Recovery and rehabilitation

encompasses reintegration into the family, community, and for some the work place, and may

require negotiation of evolving roles, relationships and identities. Major lower limb amputation

which significantly compromises mobility can necessitate significant adaptations to the

patient’s home or transition into residential care. Changes and restrictions in participation are

commonly reported after limb amputation and may be related to personal (e.g. functional

abilities, balance confidence, social discomfort, public self-consciousness, emotional impact of

amputation, changes in goals and priorities) and/or external constraints (e.g. lack of

accessibility, climate, transportation issues)

Result: A person’s achievement of status and behavioral confirmation depending on the kind of

occupation and amount of earning he/she was involved in before the amputation. The

amputation also brings up concerns about low standards of living and confusion about the

future. The level of education has an effect on the thoughts and feeling of respondents.

Educated people tend to express more thoughts and feelings than their less educated

counterparts. Educated people are more worried about losing their jobs as they have put in a lot

of effort to achieve their current positions and less educated people are worried about losing

their salaries as they lose their jobs. Concerns about dependence, hoping to get a disability grant 133




from government and other service providers. In response to these concerns Government of

India started Scheme of assistance to disabled persons for purchase/fitting of aids appliances

(ADIP Scheme) in 1981. The main objective of the Scheme is to assist the needy disabled

persons in procuring durable, sophisticated and scientifically manufactured, modern, standard

aids and appliances to promote physical, social, psychological rehabilitation of Persons with

Disabilities by reducing the effects of disabilities and at the same time enhance their economic

potential. Assistive devices are given to PwDs with an aim to improve their independent

functioning, and to arrest the extent of disability and occurrence of secondary disability.

Discussion and Conclusion: In this study we will focus on how ADIP scheme is transforming

the socio-economic status of Amputee in a state like Odisha where industrial working

opportunity is less and agriculture is the only one alternative. Here we will detail how

Disability grant is helping people with an amputation end up having to look for jobs that are

less physically demanding and these needs a higher level of education. The person’s ability to

return to work is determined by, age, gender, level of education, amputation level, multiple

amputations, co-morbidities, reason for amputation, persistant stump problems, the time it take

to obtain a permanent prosthesis, wearing comfort of the Prosthesis, walking distance and

restrictions in mobility, salary, higher job involvement, good support from the employer, and

good social support network.

134




NCNILD049

Inclusion and rehabilitation of persons with disabilities in rural areas

utilizing community resources: a challenge AbhijitGhosha*

aDepartment of Socio-Economic Rehabilitation, National Institute for Locomotor Disabilities (Divyangjan),



Background: In India out of the 121 Cr populations, 2.68 Cr persons are ‘disabled’ which is

2.21% of the total population. The country's disabled population has increased by 22.4%

between 2001 and 2011. The number of disabled, which was 2.19 crore in 2001, rose in 2011 to

2.68 crore - 1.5 crore males and 1.18 crore females. Proportion of disabled population is higher

in rural areas (In rural areas, the increase was from 2.21% in 2001 to 2.24% in 2011).The

population census data 2011 also points out majority (69%) of the disabled population

resided in rural areas (1.86 Cr disabled persons in rural areas and 0.81 Cr in urban areas).

Aim:In India where disability has been conventionally framed through a medical-welfare

model, the article emphasis on effectiveness of disability inclusive practice model through

community development.

Discussion:Inclusion is a belief- means respect for everyone. Inclusion sees as a person

&existence. A socially inclusive environment is one where everyone is welcome and permitted

to establish their identity and express their feelings. Social Rehabilitation explains services as

part of a programme aimed at enhancing social skills, facilitating integration into working life

and developing independent living skills. In India, a majority of the disabled resides in rural

areas where accessibility, availability and utilization of rehabilitation services and its cost-

effectiveness are the major issues to be considered. Therefore, inclusion, mainstreaming and

rehabilitation in rural setting: a challenge.

Due to inadequate trained professionals in the field of disability and barriers in rehabilitation

services in India, particularly in rural population, are neglected area which needs immediate

attention from civil societies. With increase in migration from rural to urban, qualified

professionals moving to cities leaving behind their communities, factors like changing life

style, unemployment, lack of social support, health infrastructure, health resources, existence

substantial problems for PwDs increasing in rural areas. With the introduction of RPwD Act-135




2016 where types of PwDs increased from 8 to 21 numbers, therefore, the total PwDs

population will also increase in a significance way in the country where adequate number of

rehabilitation professionals particularly in rural areas is very less or untrained. In such context,

role of community resources is instrumental in shaping rehabilitation services for lot of patients

and their caregivers who helps another person with the activities of daily living, health care,

financial matters, guidance, companionship, and social interaction. Trained resources can

provide care more than one aspects in the community. Mobilization, function and effectiveness

of community resources are inevitable towards empowerment of PwDs in rural areas where

‘inclusion the excluded’ a challenging task.

Conclusion: India being a signatory to United Nations Convention on the Rights of Persons

with Disabilities (U.N.C.R.P.D) stands at the threshold of its contribution to the Millennium

Development Goals of poverty reduction, health and access to safe water and sanitation.

Without accessing the needs of disabled people, it would however be difficult to equitably

achieve the above stated millennium goalswherePwDs in rural India still beyond such dreams to

improve quality of life within their own territory.

Key Words: Social Inclusion, Community resources, Rehabilitation, Care givers, Migration,

Mainstreaming, Rural community, Empowerment, Social skill.

136




NCNILD000

Economic Inclusiveness of People with Disabilities through Skill

Development TrainingUsing Technological Support

Pramita Mullicka*, Abhijit Ghosha aDepartment of Socio-economic Rehabilitation, National Institute for Locomotor Disabilities (Divyangjan),



Background:According to Census 2011, about 1.34 cores persons with disabilities are in the

employable age of 15 to 59 years and one third of the total disabled persons are working.

At all India level, 36% of the total disabled persons are workers. Among the male disabled

persons, 47% are working and among female disabled, only 23% are working. In rural India,

25% of the female disabled are working, while in urban India, the corresponding figure is 16%.

As per Census 2011, there are 1.7 Cr. disabled non –workers, among them 46% were males and

54% females. Among the total disabled non –workers, about 46% are in the age group 15 -59

years, 31% in the age group 0-14 years and 23% are 60+ years.

Though India enjoys the demographic advantage of having the youngest workforce with an

average age of 29 years in comparison with the advanced economies as opposed to the

developed countries, where the percentage of skilled workforce is between 60% and 90% of the

total workforce whereas India records a low 5% of workforce (20-24 years) with formal

employability skills.

Aim:Skills development systems have dual objectives of supporting economic growth, and

contributing to broader social objectives in the interests of society as a whole. These social

objectives include expanding access to skill development opportunities for marginalized groups,

such as persons with disabilities. The article attracts attention on introduction of new methods,

assessment technology, and model curriculum and advocacy efforts to promote the training of

people with disabilities at new height.

Discussion: By introducing new approaches such as competency-based training and un-biased

certification, job placement, structured apprenticeships and recognition of innovative learning

module, quality vocational training, and personality development process creates new

pathways. It is frequently assumed that persons with disabilities cannot suitable for any job

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whereas Skill Development Training making difference and defined as instrument to develop

the effectiveness and contribution of labour to the job market. Skill development can be seen as

means to empower PwDs and improve his/her economic participation.

Quality skill training with high employability &homogenous training curriculum

&methodologyenrichskills systems for persons with disabilities has gained momentum in recent

years, with the entry of skill India initiative and the UN Convention on the Rights of Persons

with Disabilities and the adoption of the Sustainable Development Goals 2015 – 2030, which

include a target on inclusive vocational training.

For 1 billion people living with some form of disability around the world, technological

advances that could enhance inclusion such as apps on smart phone & technology plays a huge

role in skill development also. Online assessment technologies help Skill Training to automate

key aspects of training, knowledge sharing and conduction. Technology in one area that is

acting as a multiplier effect in another IT has crossed the gap of possibility and desires. Now a

day’s placement and employability came at a point where people can easily make their future

established through the help of skill development and technological support. Online assessment

makes these placement procedures smooth. Biometric attendance and other aid of Digital

Avenue, it has become quite easy to find real time data that is up to date and upgraded.

Conclusion:Economic empowerment of PwDs is very crucial in raising their status. Skill

Development Training Programme is a landmark initiative for person with disabilities with

innovation and increased support for economic integration activities.

Key words:Skill Development Training, Empowerment, Economic Rehabilitation, Social

Inclusion, Promoting livelihood, Employment.

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NCNILD000

Effectiveness of acognitive behavioral counseling program for the self esteem

and positive attitude towards social inclusion of person with disability (PwD) Priyanka Ghosh*




Introduction:Locomotor disability is most prevalent type of disability affecting the popular of

all ages in India. Locomotor disability is not life threatening but greatly affect its the quality of

life led by the disabled people. Among the different type of disabilities, the prevalence of

locomotor disability is highest in the county (Mansis. P, Sheker. P. G, 2012). Since people with

disabilities have always shown a lack of self confidence or depression (SalehiM et all, 2015).

Wojtyna E (2007) state that self esteem has also been an important psychological factor for

subjects taking part in cognitive behavioral therapies all over the world, to ensure that all the

impacts on their quality of life are taken in to consideration

Aims: The aim of the present study is to examine the effectiveness of a cognitive behavior

therapy to the person with disability to enhance their self-esteem and positive attitude towards

social inclusion.

Method: In this qualitative research the sample of one case study used for the counseling

program. Case1 with the age group of 19. They were informed about study protocols, and

counseling programs, as well as the purpose of this study and its duration. The study used

cognitive behavior therapy along with family counseling. The programs consisted of 7 sessions

of 50 to 90 min. the session took a twice a week.

Discussion and Findings: People with disabilities develop a poor body image on their own,

because their impairment creates a negative feedback. This qualitative research also find that

low self esteem tend to become unproductive. This also tends to withdraw them from society as

social interaction makes them more conscious about their disability (Khayat. A.H, 2017).Thus

boosting their negativity, anxiousness, behavioral pattern, interaction and fear of exposure.

Study also found that cognitive behavioral counseling programs are effected when they allow

subjects to express their thoughts and frustration and esteem and reduce anxiety. Counseling

process helps individual to better understand their goals and achievements and develop positive 139




thought process by which they can understand the positive meaning of life as well as the

effectiveness of technology, treatment and schemas that will help them for social inclusion.

Furthermore, to minimize this factors family counseling also helps to reconstruct and to think

efficiently for disabled individual.

Conclusion:It can be concluded that the effectiveness of cognitive behavior counseling

program promises to overcome the subject’s negative feelings and behavior and can totally

boost up a person’s moral with the help of technology and treatment. Thus helping them to

rebuild their self-esteem and confidence to lead a successful life in future. The subject must

attend regular counseling to maintain positive mental health. There must be aware about the

technology.

Keywords:Locomotor Disability, Lower Limb Amputation, Cognitive Behavior Therapy,

Family Counselling, Effectiveness, Self-Esteem

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NCNILD000

Social inclusion of disable population: insights of sample study with

Children with loco motor disabilities in West Bengal Nayan Roy Chaudhuria*




Introduction:Children with disabilities occurred due to various reasons such as by born,

illness, injury or poor nutrition and diseases. Mental and physical developments of disable

children significantly depend on institutional and non-institutional social services starting from

family and local society. It has been recognized by United Nations and World Health

Organization including all countries in the world.

Aims and Objectives:The main aim of this study is to examine and highlight prevalence and

morbidity of Children with Locomotor Disabilities (CLDs) and its importance of their social

inclusion and human development.

Methods: The study is conducted on CLDs attended the National Institute for Locomotor

Disabilities (NILD), Kolkata, West Bengalfor their diagnosis, treatment and rehabilitation. All

respondents are residence of West Bengal. A set of disability assessment questionnaires and

schedules have been used as data collection. All relevant data and information was collected

from CLDs aged up to 10 years and 150 samples randomly drawn covering both male and

female child. Data has been analyzed considering two age groups (0-5 and 6-10 years) and by

rural-urban residence.

Results and Findings:The major findings of the study shows that number of reported cases for

female child is remarkably low which indicates female child are not getting much priority and

support from their families and most of them are residing in rural areas. Many CLDs are found

due to cerebral palsy. Usually family of children with locomotor disabilities belongs to poor

socio economic group and they are exposed to poor healthcare, malnutrition, lack of access to

clean water and basic sanitation, dangerous living and working conditions. CLDs are vulnerable

to violence, exploitation and abuse.A significant proportion of CLDs are denied access to basic

services including education and health care due to their poor socio-economic condition.Finally,

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the greatest barriers to inclusion of children with locomotor disabilities are stigma, prejudice,

ignorance and lack of training and capacity building.

Conclusion:The overall findings can be concluded that considerable organisational and social

initiatives at various levels are needed to reduce residential and gender disparities by targeting

types of vulnerabilities of CLDs. The health and service policies and programmes related to

CLDs should looked into strengthen their entitlement, social inclusion and human development

distributed from rural to urban areas considering social acceptability and living conditions for

inclusive growth of the country.

Key Words: Children with locomotor disabilities, Social inclusion, Society& Human

development.

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NCNILD000

A narrative review of manual wheelchair users discomforts KurinjiChelvanS.a*, ChindujaS.b

aDepartment of Occupational Therapist, CRC-K., India bDepartment of Physiotherapist, CRC-K., India


Background:Wheelchair is one of the commonest mobility devices which are prescribed by

rehabilitation professionals for enhancing client’s quality of life and active participation.

According to studies, other than being as a mobility device, it is one of the assistive devices to

provide support in sitting posture and prevent further deformities. On the other hand, though

wheelchair enhances their level of independency, it leads to some limitation, injuries and

discomfort. Hence, it is decided to identify the commonest distress of using manual wheelchair.

Objective:Identify the difficulties of manual wheelchair users in related to wheelchair

characteristics and other factors.

Study selection: Quantitative and qualitative studies were included which were written in

English. Studies were searched in Pubmed and Google scholar.

Results:The search identified the commonest problems mentioned in studies which are related

to wheelchair characteristics and technology. Shoulder pain, neck pain, low back pain, median

nerve injuries, carpal tunnel syndrome, pressure sores, participation limitations, accessibility

issues and so on.

Conclusion:This research enables to get orientation about common problems faced by manual

wheelchair users and provide clear vision where the technology is needed to find solutions for

them.

Keywords:Wheelchair, Manual wheelchair users, perspectives, injury prevention, influencing

factors

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NCNILD000

The role of cosmetic restorative technology for PwDs in social inclusion Poly Ghosha*, Prasanna Kumar Lenkaa,

aDepartment of Rehabilitation Engineering, National Institute for Locomotor Disabilities (Divyangjan), Kolkata

700 090, West Bengal, India


Background: The social inclusion of persons with disabilities is an essential requirement for

health promotion and quality of life. For that, there is a need to involve these individuals and

promote their participation in activities that integrate the human existential universe. But the

unfortunate damage of body parts of a human has a negative impact on physical and

psychological well-being of a human which isolates them from society. In order to alleviate

these problems, different technologies has evolved for persons with disabilities. Among them,

an aesthetic prosthesis or cosmetic restorative technology offers psychological, social,

functional, and rehabilitative advantages for PwDs by striking realism in prosthesis. Silicone is

found to be the most acceptable material which is used in cosmetic restorative technology.

Various cosmetic restoration prosthesis are used for PwDs like Cosmetic finger, partial hand,

partial foot, toe, maxillofacial prosthesis. This silicone cosmetic restoration prosthesis is found

the most acceptable prosthesis now days and can able to retain the little smile on the face of the

patients. The objectives of this study is found out how cosmetic restorative technology help

PwDs to be included in social function without discrimination.

Keywords: Maxillofacial Prosthesis; Social Inclusion; Acid Attack

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NCNILD000

Patient safety issues in rehabilitation for person with loco motor disabilities:

a review KuldeepDekaa*, PranjalGogoia

aDepartment of Physiotherapy, Down town hospital ltd., Sankardev Path, Dispur, Guwahati-781006 *e-mail: [email protected], [email protected]

Abstract

Since the publication of the Institute of medicine report, To Err Is Human: Building a safer

health system, notes that errors in health care are a significant cause of death and injury and the

emphasis on patient safety has steadily increased. The rehabilitation professionals engaged for

the management of patient with locomotor disabilities should incorporate elements of patient

safety into their practices and also to stimulate research associated with prevalence of analysis

of error/harm which occurs during the rehabilitation phase and also to develop and validate

certain specific measuring tools and instruments for patient safety issues.

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NCNILD000

Effect of ankle foot orthosis energy expenditure in spastic dieplegic

cerebral palsy DhrutiSundarDasa* ,HasanArifRaihana, P.K Lenkaa




Introduction: Cerebral palsy (CP) is a description, not a specific diagnosis, that covers a

number of neurological conditions resulting in abnormal development of movement and

postural control, which occurs in prenatal, natal and early postnatal periods. It depend on the

type and intensity of injury, influences life condition and leads to neuromuscular disorder,

involuntarily movements, mental retardation, abnormal muscle tone, and disturbance in thin and

large movements. AFO configurations frequently prescribed for children with spastic cerebral

palsy they are the Solid AFO (SAFO) and Posterior leaf spring (PLS AFO). However there

have been differences in design variants of Orthoses prescribed for the common problem of

Spastic Cerebral Palsy.

Objective: To measure the energy expenditure in patients with spastic dieplegic cerebral palsy

with using two different design variants ankle foot orthosis.

Study Design: Between group comparisons of 2 walking conditions. Sampling technique was

convenience sample of 10 Spastic dieplegiccp patients using ankle foot orthosis in each group.

Methods: Subjects walking with two different design varieties of ankle foot orthosis for one

monthon each occasion. Energy expenditure was measured by breath-by-breath analysis. The

energy expenditure during walking with ankle foot orthosis was calculated from data relating

to oxygen consumption and carbon dioxide production collected by using the Cosmed K4b2

(Cosmed Italy).Main outcome measures were VO2max, O2 costs, heart rate and energy

expenditure.

Results: The result shows a significant difference of O2 pulse (p<0.000), O2 Cost (p<0.005)

and Energy expenditure (p<0.000) respectively. But not significant difference in Heart rate

(p<0.442).By using SAFO and PLSAFO.

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Discussion and Conclusion: This study supports the hypothesis that Use of two different

design variants of ankle foot orthosis in patients with spastic cerebral palsy may decrease

energy cost and increase speed during gait.

Key words: spastic cerebral palsy, energy expenditure, walking, ankle foot orthosis

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NCNILD000

Congenital scoliosis with rib anomalies Pratyush Kumar Sethia*, Chunmun Mohantya, Sushree Sangeeta Nayaka


Research, Cuttack, Odisha754010

*e-mail: :[email protected]

Introduction: Congenital scoliosis is a sideway curvature of the spine. It is the vertebral

anomalies which results in imbalance of the longitudinal growth of the spine. The vertebrae are

not properly formed ( absent or fused). This occurs very early in developement in the 1st 6wks

of embryonic formation.

Aim:To design and develop a spinal brace which correct and stop progression of the curve of

the spine having congenital scoliosis (flexible) with a single or double curvature and also

provide maximum comfort to the patient.

Method: The brace is made up of polypropylene lined with polyethylene foam and it opens in

the back via a series of Velcro straps. The grip on the pelvis provides a firm foundation from

which corrective forces can be applied to the spine.

Results:The result of the fitment was properly noticed after 3 months that the curve was

reduced and further the patient was advised to follow up in regular basis.

Discussion and Conclusion:The spinal braces for child with scoliosis are lot. But in case of

corrections there are limitations like modification, remodeling similarly. So there is a need of

built in correction techniques in the designing of the orthosis. The objective of the new design

achieved when applied this orthosis to patient. As the result of wearing this orthosis, the

patient’s posture as well as the gait found better.

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NCNILD000

Role of smart technology in diabetes management Mukesh Kumar Pathaka*, SantPrakashGautama

Dr.ShakuntalaMisra National Rehabilitation University, Lucknow, Uttar Pradesh 226017, India

Introduction:Millions of people around the world live with diabetes and recent reports indicate

that 90% of Americans have cellular phones and 58% of American adults have a Smartphone.

Technology can support the daily diabetes self-management activities of blood glucose

monitoring, exercising, healthy eating, taking medication, monitoring for complications, and

problem-solving.

Aim: The type of diabetes, diabetes is not yet a curable disease but it is a very treatable disease,

and technology can be used to supplement healthcare provider diabetes care by providing both

educational and motivational support and also provide the live healthy life.

Method: Review of different studies with used the different health services apps and self

management tools for curable by different technology uses.

Results: Evidence suggests that mobile health applications may be used to deliver health

services and self-management tools and overcome barriers to provider access meta-analysis of

different studies found that mobile phone interventions led to statistically significant

improvements in Glycemic control and self-management.

Discussion and Conclusion: While technology can be effective for promoting diabetes

education, support, and self-management, patients report a need for personal contact with health

care providers in addition to technology with limited primary care resources, technology can

provide cost-effective ongoing diabetes self-management education and support.

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