Holistic treatment is a step in the right direction

RMIT researchers are bringing healthcare – and hope – to thousands of people affected by limb loss and other disabling conditions.

Millions of people in developing countries are in urgent need of prosthetic devices following the loss of a limb, but few can access the help they need.

A team from RMIT are aiming to change that, with a program that is creating self-sustaining healthcare for people in regions where landmines, chronic illness and injury have led to thousands losing mobility and quality of life.

With the help of a generous $1.6 million gift from an anonymous funding body, the Digital Health Hub Rehabilitation Project (DHHRP) is currently supporting communities in the eastern islands of Indonesia, Timor-Leste and Cambodia – with plans to expand to Africa and Indigenous Australian communities. 

Dr Dein Vindigni OAM, DHHRP’s Director of Relations, Partnerships and Clinical Training, says an integrated and holistic approach is needed, as those with limb loss often experience ongoing pain as well as mental health issues such as grief, post-traumatic stress disorder, depression and anxiety.

An image of two people holding prosthetic legs. Associate Professor Noel Lythgo (left) and Dr Dein Vindigni examine a PCAST prosthetic leg.
In these regions, if you're poor and sick or have a disability, there's no real access to healthcare and certainly no access to therapies such as osteopathy, chiropractic or remedial massage.

The DHHRP team have developed a ‘train-the-trainer’ program to upskill local prosthetic professionals in the production of cost-effective prosthetic legs using the pressure casting (PCAST) method.

PCAST was developed in 2014 by RMIT’s Associate Professor Noel Lythgo, Project Director for DHHRP, and Professor Peter Lee from the University of Melbourne.

“It’s very easy to do and the fitting success rate is 96 per cent. It cuts the fitting time from about 10 hours to four hours,” says Noel.

“Indonesia has very few centres for prosthetics and a major problem is that people can’t get to them, so we are also looking into developing mobile units that can go to the people.”

In addition, the team has a program to train more in-country workers to deliver counselling and biomechanical therapy, which is similar to remedial massage. Biomechanical therapy can help not only amputees, but also those who suffer pain and injury from working in repetitive manual jobs – which often includes children and elderly people.

Counselling is led by academic and clinical psychologist Dr Prasad Podugu, based at Charles Sturt University, and assisted by Dr Dawn Wong Lit Wan. Dr Jennifer Hallam assists with biomechanical therapy.

So far, the team have trained 193 trainers in biomechanical therapy, counselling, PCAST and research integrity. They’ve fitted 156 people with PCAST artificial legs and 3,128 people have benefited from biomechanical therapy and counselling. The project is on target to have about 4,500 biomechanical therapy and counselling treatments and 500 PCAST treatments by June 2024.

“We know that a combination of helping people help themselves with exercise and rehabilitation plus manual therapy is better than a one-or-the-other approach,” says Dein.

“Our goal is for people to keep flourishing on their own so we can step back while they keep stepping forward.”

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RMIT University acknowledges the people of the Woi wurrung and Boon wurrung language groups of the eastern Kulin Nation on whose unceded lands we conduct the business of the University. RMIT University respectfully acknowledges their Ancestors and Elders, past and present. RMIT also acknowledges the Traditional Custodians and their Ancestors of the lands and waters across Australia where we conduct our business - Artwork 'Sentient' by Hollie Johnson, Gunaikurnai and Monero Ngarigo.

aboriginal flag
torres strait flag

Acknowledgement of Country

RMIT University acknowledges the people of the Woi wurrung and Boon wurrung language groups of the eastern Kulin Nation on whose unceded lands we conduct the business of the University. RMIT University respectfully acknowledges their Ancestors and Elders, past and present. RMIT also acknowledges the Traditional Custodians and their Ancestors of the lands and waters across Australia where we conduct our business.