Abstract
ISPO office
Since the beginning of the present triennium, 2004 – 2007, the ISPO Office has undergone some organizational restructuring which was mainly due to changes in the office leadership, such as a new Honorary Treasurer, the resignation of a key secretary and the complexity in shifting the administrative activities of the Education Committee and Prosthetics and Orthotics International from Glasgow, UK. For a considerable number of years, some of the major activities of the Society were managed with a large input from the National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK, but as some long-term serving officers of the Society from that institution had or were completing their terms of office a major review of ISPO Office procedures was necessary.
A consultant firm, Assistance Personnel Service, through its Director, Jens Peter Sørensen was appointed to analyse, advise and propose short and long-term strategies for improving the function and efficiency of the office. This has resulted in inviting the former Honorary Treasurer to serve in his former position on a short-term basis, as well as recruiting one new secretary and a part-time administrator who would also develop the organizational structure and manage the support staff and finances in consultation with both the Acting Treasurer and Chairman of the Finance Committee. The ISPO Executive Board had to embark on serious discussions about the future operation of the Society's affairs and, as a result, seek the necessary temporary as well as permanent solutions. Another meeting with Assistance Personnel Service is planned before the end of this year to re-examine the overall structure of the Society's administrative structure. At present the staff consists of Mrs Aase Larsson (Secretary), Ms Birte Nielsen (Secretary), Mrs Karen Schmidt (Secretary to the Education Committee and LWVF-USAID Projects), Mr Niels Petersen (part-time Office Manager) and Dr Steen Jensen (Acting Honorary Treasurer and Manager of LWVF-USAID Projects).
ISPO financial status
In 2004, the Executive Board made decisions to use some of the assets of the Society to support important activities and therefore bonds were sold and purchased to give the best return without risk to the funds of the Society. The income from Prosthetics and Orthotics International which had made a significant contribution to the yearly budget dropped considerably which was due to a fall in advertisements. The financial status as reflected in the 2004 and 2005 audited reports showed that the Results of Activities were DKK 812,977 and DKK 722,051 whereas the Net Deficits were DKK 303,141and DKK 159.383 respectively. The administration costs increased as a result of fees made for accounting related to both congresses, i.e., Hong Kong 2004 and Vancouver 2007, and the consultancy fees due to a change to Honorary Treasurer.
Leahy war victims fund-USAID
The LWVF-USAID has contributed extensive resources to develop many of the Society's activities in education, training and service delivery. The fund has continued to support activities in developing countries including sponsorship of Category-I and Category-II students, single discipline and wheelchair courses, external examiners, course inspections, basic educators courses, teacher training, teacher exchange, improvement in teaching materials, OrthoLetter, development of outcome measures of educational courses, graduate follow-up, management of projects, and field and mechanical testing of devices. The total sum of US$ 2,321,672 was used to meet the cost of the above activities from July 2004 to July 2006.
The grant has been extended up to October 2010 with an additional grant of US$ 1,870,000 to continue the sponsoring of students, improving the activities of external examiners and course inspectors, improving teaching materials, developing outcome measures and consensus conferences on lower limb orthotics and wheelchairs for developing countries.
Membership
The Membership has declined, partly due to the typical between-Congress fluctuations but also because some National Member Societies have recently been dissolved. However, it is to be noted that recently there had been a surge in new members. There is also a growing desire for greater communication and information with the membership. In addition it is recognized that the practical barriers faced by potential members from low-income countries must be faced.
ISPO educational activities
The ISPO Executive Board has continued to receive requests for advice and/or the evaluation of training and education programmes at different levels in the industrial and developing countries. Among others, there have been consultations with schools/programmes in Sri-Lanka (Category- II); Argentina (Category- II); Togo (Category-II); Mobility India (Single Discipline Course); Ethiopia (Single Discipline Course); Distance Learning Package from CIR in Tuzia: TATCOT (Wheelchair Programme); PIPOS (Category-II); University of Don Bosco (Category-II), UDB; CSPO in collaboration with La Trobe University (Category-I), Lycee d'Alembert (Category-I), Thailand (Category-I), University of Münster (Category – I) and University of Giessen (Category – I) who have applied for ISPO/WHO Category-II or Category-I accreditation. Many of these programmes are either part way through the process or have been advised to review the structure of their respective curricula in order to meet the basic requirements. The schools/programmes which have recently been evaluated and accorded recognition are NCOPE (Category – I) and Tumaini University (Category-I).
In the USA, an education summit of NCOPE/AAOP was organized to plan the future for prosthetics and orthotics education. Although, there are different routes to different levels of qualification it was anticipated that ISPO would be consulted in respect to Category-I specification. In addition there has been consultation on distance learning courses in prosthetics and orthotics which have become increasingly popular, e.g., University of Don Bosco, University of Hong Kong, TATCOT, Norwegian Centre of Telemedicine (NST) amongst others.
The ISPO information packages related to Category-I and II professional profiles and learning objectives have now being updated and finally accepted and are available on the ISPO website. This is an outcome of the ISPO European School Conference which was held in Dortmund, April 2004.
Teachers exchange programme
Last year, there was the initiation of a successful teachers exchange programme between schools in developing countries which enabled the collaborating schools to benefit from expertise in areas in which they had deficiencies. It is hoped to continue to pursue this activity in the future.
Inspectors/examiners course, Toronto, Canada
Due to the increasing number of training and education programmes in prosthetics and orthotics and that more external examiners and inspectors are required, a course for new Inspectors and Examiners has been planned to be held in Toronto, Canada this year. The course has been specifically designed for people who have shown to be motivated in participating in such tasks in future.
Basic educators' course
Building on the experience in small group problem-based learning research at Southern Illinois University (SIU), School of Medicine a team of SIU medical education faculty proposed a course designed for the faculties of prosthetics and orthotics schools in under-served areas. In April 2004 the first seminar on Instructional Design and Teaching Techniques was presented to 13 students in Phnom Penh, Cambodia (2 from PIPOS, 2 from VIETCOT, 2 from TATCOT and 6 from CSPO). The overall feedback was very positive with one school, CSPO, incorporating their newly learned skills into their regular school programme. The other schools expressed interest in spreading the techniques to additional members of their faculty. In addition to this a further course is planned for TATCOT as well as a follow-up visit to CSPO in 2007 to upgrade their educational skills.
ISPO seminars/courses/conferences
The Society has continued to support the traditional seminars and courses in different specialized areas, such as amputation surgery and related prosthetics, orthotics management of cerebral palsy, stroke management, and management of poliomyelitis. These courses are organized in collaboration with local partners in which the cost is shared according to the agreed policy for both industrial and developing countries. A consensus conference on Lower Limb Orthotics for Developing Countries was held in Hanoi, Vietnam, in March 2006 with the objective of reviewing the currently practiced technology in view of the consensus reached on appropriate technology in Phnom Penh, Cambodia (1995) and Moshi, Tanzania (2000). The outcome of this conference is an update of appropriate orthotics technology which will be available as the proceedings of that meeting.
Another consensus conference on Wheelchairs for Developing Countries is planned in Bangalore, India, in November 2006. The main objective of this conference is to clarify and strengthen wheelchair user issues in developing countries; to report/outcomes of the consensus conference should lead to the publication of guidelines; to establish the basic standards of production and service provision of wheelchair and improved training of personnel.
Interim meeting of International Committee representatives
A meeting of International Committee representatives was held in Glostrup, Denmark 10 – 11 March 2006 which was attended by representatives of NMSs from Turkey, India, Slovenia, USA, Czech Republic, Hong Kong, Canada, Netherlands, UK, Belgium, Australia, Sweden as well as a 2007 Congress representative and ISPO Executive Board members and task officers. Among other topics there were detailed discussions on the recruitment of members, improvement of communications, involvement of NMSs in different activities, clear presentation of finances as well as increasing the Society's revenue, and the formation of a Scientific Committee to embark more on research and publications.
Regional congresses and conferences
There are a number of successful regional congresses and conferences which were held in Serbia, Serbia, New Zealand, Turkey and Germany and others are scheduled to be held in Croatia, Russia and Spain.
Congresses
The world congress in Hong Kong was a very successful one with excellent sessions, good scientific events, and good quality of presented papers. It was also well attended and the feedback from most of the participants was very good. The Society made a profit of approximately US $169,400 which will be used to resource the Society's activities.
The next ISPO World Congress in Vancouver, Canada in 2007 is making good progress and it is expected to attract a high number of both North and South Americans companies and professionals and it is hoped that it will help resource the Society's activities for the next three years. Discussions are underway for a joint congress in 2010 with the German Guild as it will also be holding its Reha + Orthpaedie Technik World Congress in that year. A joint committee has been constituted of ISPO, ISPO (Germany) and Reha + Orthpaedie Technik which is discussing the arrangements for a joint congress.
ISPO journal
The ISPO Executive Board took a decision to commission a publishing house, Taylor & Francis, Informa Healthcare, 4 Park Square, Milton Park, Abingdon OX14 4RN, UK, to take over the printing, advertising and promotion of the journal from 2005. This new endeavour can be summarized in that it was published over-budget last year but within the scheduled time. The full rate of individual subscriptions to the Journal was down on the 2005 end of year figure but the Journal was more widely available through online packages. The online usage of the Journal is already as high for the first quarter of 2006 as for the full year of 2005 and it is becoming more varied in the types of article published and geographical provenance of authors. The publishing house has reported that, the impact factor remains fairly steady with a peak back in 2001 and that advertising sales have reached the 2006 target in the first quarter of the year.
Recently the publishing house has recommended an increase in frequency of Prosthetics and Orthotics International from 3 to 4 issues per year as from 2007. The factors which were considered as positive and necessary development for the Society and the Journal are as follows:
Due to the steady increase in submissions to POINT, there is a backlog of papers which a frequency increase will help to clear, cutting the time from submission to publication, which is important in encouraging the submission of good manuscripts for publication.
The Advertising Director predicts at least a 20% increase in advertising sales as a direct result of increasing the frequency.
Suggestions of a price of £140 for institutional subscriptions, which is in line with the contract, the price per issue for members would remain £1, so the cost would be £4 per year.
Summary of production, 2005
Prices
In addition to being made available to institutional customers as an individual title, Prosthetics and Orthotics International is also available to the market as a component of a number of company-wide sales models or consortia deals.
Institutions with current access to the Journal content (2006)
Scientific Committee for industrialized countries
A reformation of the previously ad hoc Committee for Industrial Countries has been transformed to a Scientific Committee with a much clearer and sound objectives of enhancing the exchange of knowledge with the NMSs and other groups involved in research; have a forum for consensus meetings in addressing general issues and those related to good practice, research and evidence based outcome in the field; focus on rapidly changing scientific and demographic evolution in prosthetics and orthotics related to surgery and other technologies; collaborate closely with industry; and contribute more to prosthetics and orthotics services in industrial countries. This reform is inevitable and obvious if the Society wishes to move forward with a vision towards a brighter future in prosthetics and orthotics and ensure better satisfaction of its members and supporters in the industrial world.
Ad Hoc committee for developing countries
The committee has been reconstituted and the new group had been very active with good collaboration. The chairperson of the committee is preparing an outline for an information catalogue which will include all areas of prosthetics and orthotics and a separate chapter on wheelchairs which is to be posted and reported on the ISPO website before the end of the year.
OrthoLetter
OrthoLetter has highlighted important basic information on activities, basic prosthetics and orthotics sciences, biomechanics and reports on different technologies practiced in developing countries. Unfortunately, due to technical reasons, it has not been possible to produce the last three editions. It is still the desire of the Society to overcome this situation and restart production before the end of this year.
ISPO website
We hope that most of the members have recently visited the ISPO Website (www.ispo.ws) and have noted the improvement of the site which is the result of commendable work of the web masters. The efforts being made by Eiji Tazawa to develop a promotion CD of the historical development of the Society should also be noted. Most importantly as recommended by the International Committee there are new developments in the ISPO Website in respect to:
Discussions and outcome of the ISPO Board Meetings
ISPO Educational activities
Sites in which NMSs can post their reports and suggestions
Reports, Journals and other Bulletins on topics related to Rehabilitation Medicine
Updates regarding activities of the Society
ISPO promotional CD
The efforts being made by Eiji Tazawa to develop a promotional CD of the historical development of the Society should also be noted. This will be a valuable resource for promoting ISPO and will provide a wealth of historical information reaching back more than 30 years to the early days of ISPO.
Collaboration with other organizations
The Society has continued collaboration with other international organizations. Some organizations which have not been active in the Society's activities include the International Commission of Technology and Access (ICTA), World Orthopaedic Concern (WOC), Rehabilitation International (RI), World rehabilitation Fund (WRF) and United Nations (UN). The organizations which have continued to be effective collaborators are:
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The collaboration between ISPO and USAID dates back to 1995, when a consensus conference on appropriate prosthetic technology for the developing world was organized by ISPO and financed through the Leahy War Victims Fund dedicated to the assistance of people affected by armed conflicts in the developing world. In 2000, a follow-up consensus conference on appropriate orthopaedic technology for low-income countries was organized and a more formalized collaboration established with the purpose of improving the quality of prosthetic devices and provision of services in orthopaedic technology. A comprehensive program of mechanical laboratory testing and clinical field testing of prosthetic feet and prosthetic models for the lower limb was completed and the results published in the journal, Prosthetics Orthotics International.
Further protocols for project evaluation and cost calculation were developed. In 2002 a workshop for prosthetics and Orthotics training institutes in non-industrialized countries was organized an resulted in an extension of the funding with the purpose of ensuring adequate training of personnel by awarding scholarships for ISPO recognized schools, investing in teachers training and improvement of training material, as well as taking part in examinations and school recognition with external experts. This two-tiered approach has had a great impact on increasing awareness of quality services and user compliance. Both the service providers and the schools have focus on quality issues and a more critical attitude towards the devices and the technical craftsmanship.
The third element in the process of increasing quality and quantity is development of outcome measures and graduate follow-up that make the impact visible.
In summary, the support of different programmes including education and training, evaluation, research, human resource development, and improvement of educational materials. Among others the support has accomplished the followings:
○To date, 83 out of 103 have been awarded and they will continue up to 2010/2011 academic year. The scholarship awards to different courses are as follows:
▪ Cat-I: 17 scholarships awarded to candidates enrolled into the programmes: 1-University of Strathclyde, 2-University of Don Bosco, 14-Tumaini University)
▪ Cat-II: 51 scholarships awarded to candidates enrolled into the programmes: UDB; TATCOT; PIPOS; VIETCOT and CSPO.
▪ Single Discipline: 15 scholarships awarded to candidates enrolled into the programmes: TATCOT; and VIETCOT.
Teaching materials (text-books) have been donated to ISPO recognized schools in the developing countries
Series of Clinical Field testing Studies of prosthetic technology and prosthetics feet in particular in developing countries and in tropical areas have resulted in nine publications printed for the next issues of Prosthetics and Orthotics International
Paper on Clinical Field Testing of prefabricated Knee-Ankle Foot-Orthosis on the process to be published
Paper on ISO-Standard Testing of 22 prosthetic feet in use in developing countries on the process to be published
Proceedings on Update of Consensus Conference on Lower Limb Orthotics Technology in developing countries on the process to be published
Consensus Conference on lower limb orthotics held in Hanoi, Vietnam, April 2006
Consensus Conference on wheelchair to be held in Bangalore, India, November 2006
Coordination of education, service delivery and quality of service in industrial countries
Harmonization of professions in industrial countries
Strengthen national programmes, policies and strategies for the implementation of the UN Standard Rules
Promote early invention and identification
Promote community based rehabilitation (CBR)
Ensure provision of adequate and effective medical care to people with disabilities
Promote and facilitate access to appropriate assistive device
Promoting research on assistive devices
Impact of Assistive devices on poverty alleviation: A joint multi-country study with ICRC, SINTEF-Norway, Swedish Handicap Institute amongst others
Strengthening of distant learning process for wider coverage and promotion of continued education
Facilitating transfer of technology
Advice on training and education in prosthetics and orthotics
Advice on professionals available to be recruited by ICRC, visit ICRC Website www.icrc.com
Advice on training and education in prosthetics and orthotics
Advice on professionals available to be recruited by HI
Advise on rehabilitation service facilities
Support on training and education in rehabilitation and service development
Support in developing appropriate technology
Support on training and education in rehabilitation and service development
Support in developing appropriate technology
Future activities of the ISPO Executive Board
▪Continue with ongoing and planned activities
▪Conduct a workshop on the future of the Society
▪Restructuring the ISPO Office
▪Securing other alternative sponsors for the Society's activities
▪Improving Communications with NMSs
Finally, this report is meant to update ISPO Members on the business and ongoing activities of the Society all members are all very welcome to contribute constructively or advise the President through
Harold. G. Shangahi
President, ISPO
1st August 2006