Stories about people who have lost an arm or a leg, but despite this, continue to fight, work, volunteer, and even play football have become widespread. Physical Medicine and Rehabilitation (PM&R) physicians, also known as physiatrists, and, of course, high-quality prostheses helped these people return to active life.
Ukraine needs more and more prostheses, as over two and a half years of war, more than 150,000 Ukrainians have lost their limbs. This is more than the number of people with amputations after World War I in all countries of the world.
Is the quality of the prostheses offered to amputees today high? Are these people aware of the differences, advantages and disadvantages of prostheses from different manufacturers? And, what do people who wear prostheses think about them?
Serhii Kolisnyk, associate professor of the Department of Physical and Rehabilitation Medicine at Vinnytsia National Pirogov Memorial Medical University and member of the Board of the Ukrainian Society of Physical and Rehabilitation Medicine, responds to these questions. The researcher was successful in the ‘NWO Hop-On Call for Researchers Based in Ukraine: NWO-NRFU Partnership Initiative 2023’ and joined one of the Dutch groups. He is currently implementing the project ‘Field Evaluation of Prosthetic Devices in Ukraine’.
So, what, how, and why does the researcher plan to evaluate?
“Today, a huge number of private enterprises are entering Ukraine to sell their products. Unfortunately, these products are not always of high quality”, the researcher says. ”Ukrainian manufacturers are not always honest either, and sometimes they offer low-quality prostheses at a high price”.
That’s why, before choosing a prosthesis, amputees often listen to the proposals of different companies, each of which swears that their products are the best, while their competitors’ are the worst. “Imagine that vendors from 50 pharmacies have come to the patient’s room and each one says that their medicine is the best. An ordinary person simply cannot choose an effective medicine”, the professor explained.
Doctors could help a patient make a choice, but they are not always well-versed in the prosthetics market either. By the way, that is why one of the project’s goals is to create a training course for PM&R physicians based on the research results.
According to the researcher, stereotypes also prevent amputees and doctors from making the right choice. For example, all patients want to have a bionic arm, however the least number of people use these prostheses. In particular, because these prostheses are very expensive.
The researcher plans to find out which prostheses (and which manufacturers) people use most often, whether they consider these products comfortable, functional, and reliable.
The researcher plans to learn about the opinion of amputees with the help of a questionnaire and internationally recognized methods. The questionnaire was prepared by the Dutch research team, and now it has been translated into Ukrainian.
Serhii Kolisnyk plans to interview several thousand amputees. He knows many of them personally, as his department cooperates with the Vinnytsia State Experimental Prosthetic and Orthopedic Enterprise. “We advise rehabilitation departments and help with rehabilitation”, he noted. ”A large number of doctors who work in rehabilitation centers in Ukraine are graduates of our department’s specialization courses”.
Professors of the Vinnytsia National Pirogov Memorial Medical University, together with their colleagues from the University of Toronto, helped launch the manufacturing of upper limb prostheses on a 3D printer on the basis of the prosthetic enterprise. “We set up the manufacture of these prostheses in less than a week. A person comes to us and in a day receives a prosthetic limb created according to individual parameters. The cost of such a prosthesis is $90 (excluding the work of a specialist)”, the researcher continued.
“This arm will not be able to chop wood, but it can lift 5-10 kilograms and cover most household needs. For example, to take a screwdriver, cutlery, to eat, to open a bottle of water. The prosthesis is shaped like a hand, it is inexpensive and functional.
Dozens of companies are currently manufacturing artificial limbs in Ukraine. With a few exceptions, these are private businesses that are paid by the state within certain thresholds. The researcher believes that the results of the study will help to understand which prostheses should be financed at the state level. In other words, the funds should be allocated to companies that manufacture the most popular and comfortable prostheses. Professor Kolisnyk already has experience in advocating for rehabilitation ideas (and, accordingly, the interests of patients) – a few years ago he was involved in the preparation of the Law of Ukraine ‘On Rehabilitation in the Health Care Sphere’).
We also asked how the researcher found partners from the Netherlands.
“They found us”, Serhii answered. ”The Ukrainian Society of PRM is well known in the world. My colleagues contacted me and invited to join the project. The Dutch group is really great. We meet once every two weeks, set goals, and if something goes wrong, they help (for instance, they advise on financial issues). I feel that they really want to support Ukraine. It motivates us to work as efficiently as possible”.
By the way, the researcher is convinced that the implementation of the project within the framework of the NWO and NRFU initiative opens up good prospects for the future. The team plans to present the results of the study at international forums. “I am sure that this study will lead to a large number of other grant projects in Ukraine”, he added. ”I would also like to say that there are many research topics in Ukraine that often lack funds. And every funding, even a small one, helps to move science forward. In our case, it also helps us to be useful to people. I am deeply convinced that research should be “for” – for people, for society, for the economy.”
Interviewed by Svitlana Galata
