The Orthotics and Prosthetics Profession
Definitions - Orthotist and
Prosthetist
Orthotist is the term for the practitioner
who provides care to patients with disabling
conditions of the limb and spine by designing, fabricating and fitting the patient with
an orthosis (brace or strengthening device).
In providing the orthosis, the orthotist is responsible for formulating its design, including the selection of materials; making all necessary casts, measurements, model modifications, and layouts; performing fittings, including static and dynamic alignments; evaluating the orthosis on the patient; instructing
the patient in its use; and maintaining patient
records; all in conformity with the attending
physician's prescription. At the request of,
and in consultation with the physician, the
orthotist assists in the formulation of the prescription for the orthosis, and examines and
evaluates the patient's orthotic needs.
The orthotist is expected to keep abreast
of new developments concerning orthotic
patient care. He is required to supervise the
functions of support personnel and laboratory activities related to the development of
the orthosis.
Prosthetist is the term for the practitioner
who provides care to patients with partial or
total absence of a limb by designing, fabricating, and fitting the patient with a prosthesis (artificial limb). In providing the prosthesis, the prosthetist is responsible for formulating its design, including selection of materials and components, making all necessary
casts, measurements, and model modifications, including static and dynamic alignments; evaluating the prosthesis on the patient; instructing the patient in its use; and
maintaining patient records; all in conformity with the attending physician's prescription. At the request of, and in consultation
with, the physician, the prosthetist assists in
the formulation of the prescription for the
prosthesis, and examines and evaluates the
patient's prosthetic needs.
The prosthetist is expected to keep abreast
of new developments concerning prosthetic
patient care. He is required to supervise the
functions of support personnel and laboratory activities related to the development of
the prosthesis.
The Rehabilitation Team
The orthotist and prosthetist are members
of the allied health care rehabilitation team.
Together with the physician, surgeon, physical and occupational therapist, social worker
and counselor, the orthotist/prosthetist determines the needs of the patient. In consultation with the physician, the orthotist/prosthetist designs, constructs, and fits the patient with an orthosis or prosthesis.
The responsibility of the trained orthotist
and prosthetist begins with the evaluation of
the patient. Once the medical prescription is
prepared by the physician, the orthotist or
prosthetist examines the patient and makes
careful and accurate measurements of the
patient's physical condition. Using that in-
formation, the orthotist/prosthetist designs a
device that will meet that patient's individual
needs and fabricates the device from various
materials such as plastic, leather, wood,
steel, and aluminum.
Once the patient has been fitted with the
prosthesis or orthosis, the prosthetist or orthotist provides the patient with basic instruction in its use and evaluates function,
fit, and comfort. The physical therapist then
takes over and works with the patient to help
him/her adjust to the use of the device correctly. Depending on the extent of the disability, the device may need adjustment or
replacement by the orthotist or prosthetist as
the patient's age, physical condition, or lifestyle changes.
When Orthotics and Prosthetics
Began
The years 1983-1992 have been proclaimed as the international "Decade of the
Disabled," yet care for the disabled goes
back to the 5th Egyptian Dynasty (2750-2625
B.C.), according to the archaeologists who
unearthed the oldest known splint - a primitive brace. Likewise, the earliest known reference to an artificial limb was made about
500 B.C. by Herodotus, who wrote of a prisoner who escaped from the stocks by cutting
off his foot - which he later replaced with a
wooden substitute. History tells us that man
has always had an urge to preserve himself in
the best physical form possible. This urge has
served as a constant stimulus to perfect and
improve orthotic and prosthetic devices, and
today technology and research have given us
access to much more sophisticated orthoses
and prostheses.
The Demand for Trained
Practitioners
Approximately 2,600 certified prosthetists
and orthotists are on the rolls of the American Board for Certification in Orthotics and
Prosthetics, but this is not enough to meet
the needs of the disabled population. As the
average age of the population increases, the
demand for certified practitioners is expected to increase even more. As a result, the
employment opportunities for prosthetists
and orthotists in the United States and overseas are many.
Orthotists and prosthetists work in privately owned facilities, laboratories, hospitals, and government agencies such as the
Veterans Administration. Depending on the
size and scope of the facility, the orthotist's
and prosthetist's duties will vary. In small
organizations, the orthotist or prosthetist
may measure the patient and design, fabricate, and fit the device. In larger facilities,
the orthotist or prosthetist will employ one
or more trainees or technicians to do the
actual fabrication, while they remain responsible for measuring, designing, fitting, and
adjusting the device.
Technology in Orthotics and
Prosthetics
Orthotic and prosthetic research includes
the development of better materials, designs, and methods of fitting to meet the
needs of individual patients. Essentially, the
prosthetist or orthotist conducts research for
each patient, because no two patients have
the exact same needs.
Although constructing a brace for a polio
patient is equally important as constructing
an artificial leg for an amputee, the technology involved in making artificial limbs is often more complex. As a result, a larger percentage of federal and private grants has
been approved for prosthetic research than
for orthotic research in recent years. Keep in
mind, however, that this trend can change as
all research is approved based on its relevance to the needs of the disabled population.
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