Vol.6, No.3

February 2001

Academy Prepares to Launch 'Project Quantum Leap'

Multi-Year Standards & Research Quest to be Detailed at Business Meeting

President Thomas V. DiBello, CO, FAAOP will devote most of his remarks during the Annual Business Meeting to describing the magnitude of "an enormous project that will change and validate how practitioners practice their profession." Over the next several years the Academy will conduct a series of consensus conferences on clinical topics which will develop clinical standards of practice for the O&P profession, embark on a broad-based program to empower needed research in targeted areas, and provide additional funding for O&P schools.

The program, named Project Quantum Leap, was conceived as the result of probing conversations conducted by Academy Board members and ultimately evolved into a priority initiative during the Academy's 2000 Strategic Planning Meeting. Reductions in private and government payer coverage and reimbursement, industry consolidation, competing credentialing entities, and increases in patient demand due to the aging of the population were all cited as contributing factors to the changing dynamics in O&P. With these changes occurring within O&P it has now become apparent that the industry must work towards developing standards based on research and proven treatment paths in order to validate the quality of O&P products and services being delivered by a multitude of providers.

The three-prong project has already begun. The Academy has begun planning its first Clinical Standards of Practice Consensus Conference for Fall 2001, which will produce a document on accepted treatment of idiopathic scoliosis. The invitation-only conference will involve experts from within O&P and other parts of the medical community involved in scoliosis. (See article below for details.) This conference will be used as a model for subsequent conferences.

The Academy is also contacting university-based centers to determine what O&P research is needed yet lacks funding. A consortium of leaders met by conference call in January to discuss the concept and to begin developing and prioritizing research focal points. It is anticipated some research will be done by several university-based centers.

Project Quantum Leap will also seek funding for special initiatives at O&P schools. Members of the National Association of Prosthetic and Orthotic Educators (NAPOE) recently met by conference call to discuss how their schools might participate in government grants. Currently, three schools are being funded by the Department of Education at a level of $100,000 per year (for five year terms) in support of curriculum priorities and scholarships for students.

"Project Quantum Leap is a very ambitious program and it will be expensive," said DiBello. The funding for the project has been budgeted in conjunction with the Academy's efforts to seek government grant money in order to partially fund the consensus conferences, school initiatives, and research.

Recognizing the Academy has little experience in this area, the Washington law firm of Arent Fox has been retained to garner congressional support for this project and to guide its efforts in securing grant money to fund these critical initiatives. Arent Fox has a long track record of successfully obtaining grants for these purposes. Their clients include the Christopher Reeves Paralysis Foundation, American Arthritis Foundation, Epilepsy Foundation of America, Dartmouth University, Landmine Survivor Network, and the Amputee Coalition of America among others.

Bush Has 5-Year Plan to Aid Independence of Disabled

President Bush announced a five-year, $1billion "new freedom initiative" to help the nation's disabled population. "Old barriers are falling away," he said. "We must speed up the day when the last barrier has been removed to full and independent lives for every American with or without disability." Citing artificial limbs and lighter wheelchairs as one way to make the world more accessible, Bush noted "they are often inaccessible to people who need but cannot afford them." His plan would include low-interest loans and an increase in federal funding to ensure that the technologies are made available to boost research and development into such products and to help bring them to market.

First Consensus Conference to Focus on Idiopathic Scoliosis

The Academy has chosen the topic of its first consensus conference to be held in Dallas this Fall as the Clinical Standards of Practice (CSOP) for the Orthotic Treatment of Idiopathic Scoliosis. Recent research strongly suggests that bracing the spine with a scoliosis orthosis is the only non-surgical method to prevent further progression of a curve that would otherwise worsen. According to the Scoliosis Research Society "brace treatment for idiopathic scoliosis in growing children is an established non-surgical method for reducing the risk of scoliosis progression…and reduces the incidence of surgery. Treatment choice is determined by a complex equation which includes the patient's physiologic maturity, curve magnitude and location, and potential for progression."

The conference will examine published materials on the topic, review recent research, and prepare a written protocol on the appropriate use of orthoses that will reflect the collective wisdom of recognized experts from around the U.S. A select group of 12-15 experts comprised of orthopaedic surgeons, ABC-certified orthotists, a psychologist, biomechanist, and a registered nurse will be invited to the closed conference. Points of consensus, where possible, will be determined on initial evaluation of the patient, prescription criteria, follow-up protocol and criteria for brace discontinuation, recommendations for a team approach to bracing, and identifying psychosocial issues. Invited experts will also define what constitutes a structural curve that should be braced and strategies to control curve patterns having more than one curve. The Academy expects to replicate the CSOP model created for this consensus conference to produce 3-4 conferences annually as it develops clinical standards of practice for the profession.

Phantom Limb Pain Is Best of Resident Research Paper

Tammie McElhinny's paper on Phantom Limb Pain: A Literature Review of Theories and Treatments is the latest to be added to the Best of the Resident Research Series as an exclusive member benefit on the Academy's website. As she describes in the preface, "phantom limb pain is reported in as many as 80% of amputees, adversely disrupting the progression of rehabilitation and ultimately activities of daily living. Since phantom limb pain is not caused by an external stimulus to the residual limb, several theories exist in an attempt to explain its etiology. Various treatments including physical, pharmacological, psychotherapeutic and surgical techniques are utilized in an effort to provide symptomatic relief. Success of these treatments differs between amputees with only a small percentage of patients reporting lasting relief from the pain." Both theories and treatments of phantom limb pain are presented in this literature review. McElhinny is currently preparing for the ABC certification exams while working at Green Prosthetics & Orthotics, Meadville, PA.

Members may access the paper in the Members Only area of the website via their passcode. (If you can't remember your passcode please contact lrascoe@oandp.org for assistance.) Members without Internet access may request a free copy of the paper by calling Lisa Rascoe at (703) 836-7118.

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