Challenges in assistive technologies, current panorama of the Lucy Montoro Rehabilitation Network and future perspectives

Abstract

The Lucy Montoro Network is a benchmark for interdisciplinary rehabilitation and assistive technology (AT) provision in São Paulo. This study analyzes the challenges of care and funding in Physical Medicine and Rehabilitation given the rise in acquired physical disabilities. It highlights the work of the capital’s units, which combine the manufacture and maintenance of orthoses and prostheses with Bioengineering for technological innovation. Data from May 2026 reveal significant pent-up demand: at IMREA-HCFMUSP alone, 1,541 patients were waiting for AT, particularly in the amputee clinic, where 388 prostheses were pending. The primary obstacle identified is public underfunding. Comparative analysis shows a critical gap between the Unified Health System (SUS) Table and market prices, reaching up to 464% for items such as foot replacement. In conclusion, the sustainability of care and the guarantee of patient autonomy and social inclusion depend on urgent strategies, including: periodic review and update of the SUS Table based on inflationary indices; incorporation of new items and technologies; inclusion of funds for maintenance and repairs; and incentive policies for the national industry. Coordination between funding, innovation, and healthcare network organization is essential to reduce waiting lists and promote equity in access to assistive technologies within the SUS.