CNN Hero David Puckett, CPO, LPO: Mission of Love
"Mercy. blesses him who gives it and him who receives it. " -William Shakespeare
David Puckett helps a bilateral amputee stand on new prosthetic feet.
Peter Carey: Transforming Nations
Though recently retired, Peter Carey, MA, PhD, FRHistS, still carries the mien of the quintessential Oxford don - calm, with an intense gaze, immaculate intellect, and a tendency to inject his comments with wry, deft humor. The 60-year-old author and former Laithwaite Fellow in Modern History at Trinity College, University of Oxford, England, is a co-founder of the international powerhouse charity, The Cambodia Trust, a group whose trainees now fit O&P devices on more than 30,000 people every year throughout the developing world. Now, The Cambodia Trust is expanding beyond its current schools and clinics in Cambodia, East Timor, and Sri Lanka and into Indonesia, where Carey now resides.
From Mongolia to America Part 1: A Journey of Hope Begins
Amaglan Donid. Photos courtesy of Shebana Coelho.
When Amaglan Donid, a 59-year-old Mongolian woman with a transtibial amputation, arrives in New Jersey, it will mark the beginning of a journey made possible by the Barr Foundation Amputee Assistance Fund (Barr Foundation), Carey Glass, CPO, LPO, FAAOP, and caring individuals in Mongolia and the United States.
Tomorrow's O&P: A Survival Guide Part 2: The Economics of Outcomes
When, in the January issue, we began delving into what lay ahead for the O&P profession-soliciting insights from industry leaders, educators, and experts-we quickly discovered a great deal more than we expected. Prognostication is not a simple art, and the O&P profession is certainly not a simple subject upon which to practice it.
In the second part of this three-part series, we examine trends and indicators pertaining to O&P patient care: Is the current economic crisis likely to impact patient outcomes, either directly or indirectly? How can O&P practices survive while serving clients who can't afford their own care-nor the insurance to cover it?
Are Patient Outcomes at Risk?
"Patient outcomes are directly affected by the care people receive; in [O&P] practice, the economy really doesn't have a direct effect on patient outcomes," says
Jim Rogers, CPO, FAAOP
, president of the American Academy of Orthotists and Prosthetists (the Academy).
Darwin on Patient Evolution
As the O&P profession adapts to dramatically changing economic environmental pressures, are patient needs changing as well? Is natural selection at work in a scenario that promotes survival of the fittest?
In the 1980s, exercise science recognized and predicted a problem in the developed world: hypokinetics-lack of stimuli to the human system due to a marked decrease in physical movement. "As greater technology replaces the need for human physical movement, people may become less fit, their bodies weaker and perhaps even fatter as their caloric input exceeds their output," explains
Christopher Hovorka, MS, CPO, LPO, FAAOP, director of the master of science in prosthetics and orthotics program at the Georgia Institute of Technology (Georgia Tech). "We've seen this in the United States, and now other developing nations are seeing similar changes in the health of their populations.
The Canadian Compendium: Reinventing O&P Coding North of the Border
Kirsten Simonsen, BSc, CP(c)
In the summer of 2004, history was made during a Canadian Association for Prosthetics and Orthotics (CAPO) conference: At the first town hall meeting ever held to discuss the need for a unified national nomenclature for O&P, the room was overflowing with professionals who resoundingly agreed to create a document that would give a single voice to Canadian O&P.
Since 2004, Kirsten Simonsen, BSc, CP(c), who practices in Eastern Canada, has been involved in orchestrating the development of that document-the Compendium of Prosthetic and Orthotic Treatment (CPOT).
At the grassroots level, CAPO members recognized the importance of how the profession and its care of patients are represented to funding agencies.
Tina Mann: The Body Electric
"I sing the body electric, I celebrate the me yet to come. "
(Walt Whitman, 1819-1892, via the musical,
Tina Mann had no interest in getting around for the rest of her life in a wheelchair. But after a snowboarding accident in January 2001, her medical team at the Cleveland Clinic in Ohio gave her exactly that prognosis.
BCI Devices Open Doors for People with Disabilities
The power of the brain is being harnessed in astonishing ways, and the implications for people with limb loss, paralysis, an inability to speak, and other disabilities is exciting, to say the least. Brain-computer-interface (BCI) technology is opening doors to using the power of the mind to overcome the limitations of the body.
Imagine being able to make something move halfway around the globe simply by thinking about it.
DS/USA Hosts Ski Spectacular, CAF Buys New Headquarters
DS/USA Hosts The Hartford Ski Spectacular
When Army Major Bruce Gannaway lost his left foot to an explosive device in Baghdad, his lifelong love of skiing might have become a thing of the past. However, on the morning of December 7, 2008, Gannoway sat down on the slopes of the Beaver Run Resort in Breckenridge, Colorado, worked his prosthetic foot into a ski boot, and stood up on skis for the first time since his injury. With the advice of expert trainers Rina Drake and Tracy Ridelberger-Meier, he spent the next few hours puzzling through what he called "learning to ski with one foot asleep.
Realizing Life’s Plan
At 11 a. m. on a not-so-average Thursday, I was sitting in the auditorium of the St.
Billing and Collections Q&A
Running an O&P practice is complicated enough without having to deal with denials. When you have questions, count on "Got FAQs?" to help keep your claims on track. This month's column tackles your questions about addition codes, licensing requirements, K-Codes, and more.
Battling It Out in the States
Progress on Parity
Last year was exciting in the fight for parity. The Amputee Coalition of America (ACA) helped to introduce bills in 15 states and pass four new parity laws. New Jersey, Indiana, Vermont, and Louisiana joined Colorado, Maine, New Hampshire, Rhode Island, California, Massachusetts, and Oregon by enacting legislation that creates a consistent, appropriate standard for prosthetic coverage.
For Love…and for Money
I've talked with a lot of O&P practitioners over the last couple of years, and one thing that I hear frequently is that people don't enter the O&P profession for the money. Many, if not most, enter the profession to make a positive impact on people's lives. This month's issue is dedicated to those who have devoted their lives to "Humanitarian Journeys," and are helping people who otherwise could not afford prosthetic and orthotic care or who do not have access to the care and devices they need to resume productive lifestyles.
Accreditation Exemption Is Not Permanent
While the January 31, 2009, accreditation application deadline
has come and gone, confusion remains about which healthcare
professionala are exempt from the accreditation requirement and,
for those who are exempt, whether or not the exemption is permanent
or a delay. EDGE Direct asked the American Board for
Certification in Orthotics, Prosthetics & Pedorthics (ABC) to
help clarify the issue.
On September 3, 2008, the Centers for Medicare & Medicaid
Services (CMS) announced that professionals, including physicians,
physical therapists, occupational therapists, qualified speech
therapists, physician assistants, nurse practitioners, nurse
midwives, orthotists , prosthetists , podiatrists,
optometrists, and opticians are exempt from the September 30, 2009,
mandatory accreditation deadline.
Endolite Enhances Quality of Life
Endolite is committed to help those who face mobility and
quality of life challenges through continued research, innovation,
and design of prosthetics that enable amputees to get busy living.
We are dedicated to providing a valuable and positive experience to
our customers and listening to their feedback in order to
continually improve our service and products. As the worlds leader
in prosthetics, our goal is nothing less than to open up the world
to amputees so that they can get busy living.
Did you know that Becker Oregon
offers traditional thermoplastic and metal-and-leather AFOs and
What to expect from Becker Oregon:
- Highly trained technicians.
- Highest standards of workmanship and unsurpassed service.
- Competitive pricing.
- Quick turnaround times.
- Guaranteed customer satisfaction.
Consider Becker Oregon for your next custom
Becker Oregon A Becker Orthopedic
The Syncor Original TES Belt was
designed to meet the needs of clients with above-the-knee
amputations. Its user-friendly design includes a hand loop for easy
application and a replaceable Velcro® closure. The
Original TES Belt is low profile and has an
anti-roll, anti-bunch panel. Reinforced, color-matched seams extend
the life of the hand-washable belt.
The Silesian design evens out stress and eliminates the
pull-down feeling associated with girdle-style belts. A wide,
360-degree textured cuff grips with no air leaks, and a
proportional adductor panel increases suspension capabilities.
Sizes from infant to XXL. Custom orders are welcome.
Transfemoral amputees can now appreciate why
transtibial amputees are so taken with the new
Iceross® Seal-In® X5 liner, which
doesn't require troublesome donning procedures, yet results in an
airtight seal that conforms to the residual limb and the internal
socket wall. This proprietary design with five incorporated seals
ensures firm, pure suction, allowing for unprecedented function
without sacrificing stability, comfort, or skin health. The
integrated, full-length matrix supports the seals during donning to
prevent elongation of the distal tissue, while maintaining
SPS is offering a four-hour hands-on course on the
Plié MPC Knee® from Freedom
Advanced hydraulic engineering and optimization of
microprocessor programming allows the Plié
Knee to make nearly instantaneous adjustments related to
knee position and velocity. Reacting ten times faster than the
blink of an eye, Plié provides precise
response to actual gait dynamics as they occur, rather than a step
behind. The Plié Knee frees users from
concentrating on their stability, allowing them to regain enjoyment
of the world around them.
See our ad in the advertisers' section at right for more
Rotation of the shin section of the prosthesis
relative to the socket is a given with the new TFR
300, available through SPS.
The TFR 300 allows cross-legged sitting and
makes it easier to get into and out of tight spaces, such as cars
or airplanes. The smooth, one-handed, push-button operation and
secure-locking mechanism ensure confident, easy operation.
The TFR 300 provides 360 degrees of rotation in
a lightweight (6 oz.), low-profile (0.85-in. build height) package.
It is applicable for users weighing less than 300 lb. who need
greater flexibility/access in tight areas.
KiddieGAITTM is an engineered composite
frame with anterior shell, lateral strut, and an energy-reflecting
footplate with open calcaneus, all designed to allow customization
of the frame into a ground-reaction AFO or a partial-foot
prosthesis. The energy-reflecting properties of this system reduce
the amount of energy required to lift and move the foot
The anterior shell design triggers enhanced "position in space"
proprioceptive response and assists in management of proximal
deficits by helping to overcome either knee hyperextension or
crouch gait. Functional environments can be created that supplement
gait function instead of immobilizing and inhibiting function.
Euro International is proud to introduce the new
Rotation Adapter, REF# 10A10/T, by Streifeneder
ortho.production. Made of titanium, the Rotation
Adapter allows your patients to easily maneuver everyday
tasks with more comfort and ease. It has a proximal adjustment core
and a distal adjustment-core acceptance. It weighs in at just 195g
(0.429 lb.), and the press button activates the rotating mechanism
and contains an automatic locking system, which gives patients
security. The maximum weight is 125kg (275 lb.), and it has an
effective height of 34mm.
foot's unique triangular design is the key to its outstanding
performance. The design provides shock absorption during heel
strike without diminishing energy return of the toe spring. The
result is optimal flexibility, stability, and comfort.
The Pathfinder II is ideal for active amputees.
Feedback during clinical testing resulted in the foot receiving
high marks for durability and function. Patient weight limits: 300
lb. for Level 4 and 350 lb. for Level 3.
Other features include:
- Choice of five proximal adapters.
- 36-month warranty.
- A high-activity foot shell with nine-month warranty.
Ohio Willow Wood
The Accent Foot® provides a
service-free option for individuals who desire a cosmetically
appealing foot with an easy-to-adjust heel height to fit their
- 2 in. (51mm) user-adjustable heel height.
- Dynamic Pylon and Integrated Pyramid options.
- Ankle Fairing for superior finishing.
- Sandal-toe Foot Shell.
- Three firmness choices.
Accent: Adjustability to Fit Your
College Park Industries
The new Hosmer Sfx adds an
adjustable stance-flexion feature to most endoskeletal knee-shin
In addition, it provides:
- Improved stability and balance.
- Shock absorption for smoother gait.
- Adjustable stance-flexion resistance.
- A maximum of ten degrees of stance flexion.
- Three stiffness options.
- Proximal pyramid receiver and distal tube clamp for easy
addition to most prostheses.
- Rated for 275 lb./125kg
PEL Supply Company
Otto Bock redesigned the 3R80 rotary
hydraulic knee joint to deliver a higher level of
stance-phase control, which boosts your patients confidence as they
negotiate a variety of terrains. The new design makes it easier for
patients to initiate flexion of the knee for swing phase.
The 3R80 is designed for patients who meet K3
or K4 activity levels and lead an active lifestyle.
Otto Bock HealthCare
SPS stocks Touch Bionics revolutionary
i-LIMBTM Hand system through its U.S.
The i-LIMB Hands uniqueness lies in its close
assimilation to the human grip, with five fully articulating
powered digits that move independent of one another. The exclusive
thumb rotation enables numerous, previously unavailable grip
Field feedback indicates users demonstrate significant
improvement in functionality, manual dexterity with smaller
objects, and bimanual task completion. Many users report less
fatigue from compensatory body movements that are associated with
positioning the arm, shoulder, chest, and knees to facilitate
Model 1017 is a modular, lever-lock knee joint
with a locking mechanism that will automatically engage when the
joint reaches full extension. The long, angled lever is easily
operated by the patient and can be shortened or contoured to suit
individual needs. In addition, Model 1017 comes
with an optional anterior pull-cable that allows the patient to
simultaneously disengage both locks when necessary.
The Epirus Foot is a lightweight,
low-profile, energy-storing foot with multiaxial rotation that is
designed for low- to high-impact K3 amputees who may enjoy
occasional recreational sports.
Features and benefits of the Epirus Foot:
- Multiaxial rotation with tripod stability system.
- Low-profile, energy-storing-and-return design.
- Biomimetically engineered to provide more natural ankle
- Truly independent heel and toe.
SPS customers who fell in love with the
Spinomed® Brace will be pleased by the
redesigned Spinomed III, which has been approved
for L-Code L-0456.
- Ability to mold in cold condition to most patients. Additional
molding can be achieved with heat.
- Garment and rigid portions are customizable.
- Anti-migration straps and silicone beads keep brace in
- Full-width posterior panel and anterior panel are contained in
moisture-wicking material and are removable as the patients
- No restriction of shoulder and arm movement or thoracic and
Over the years, Friddles has provided the
orthotics and prosthetics industry with top-quality, innovative
products. The Mini-Vac Vacuum System is another
standard-setting product. This vacuum system offers unmatched functionality and quality
for your fabrication lab. Our low-maintenance unit is designed for
convenience and longevity, using the finest materials and
components available. This is a perfect match for our
Vac-Max vacuum press. For professional supplies
and products, always consider Friddles.
Friddles Orthopedic Appliances
The new Golf Eagle is constructed
of high-performance polyurethane and weighs six oz. It has a
flexible channel that easily snaps onto the club shaft and pulls up
into place on the club grip, adapting to a wide variety of grip
The Eagle captures energy on the backswing and
releases it at the bottom of the downswing, while contacting the
ball and following through for improved power and driving
Appropriate for right or left unilateral absence, but only for
the leading hand.
SPS has immediate availability of the
Standing Hip) orthosis. This
unique orthosis uses a complex angular structure engineered to
maintain good hip alignment, with the uprights following the
pathways of femur motion.
While standing or walking, S.W.A.S.H. provides
enough abduction to prevent scissoring and medial femoral rotation.
As the hips are flexed into the sitting position,
S.W.A.S.H. automatically abducts the hips into a
tripod base for enhanced stability.
S.W.A.S.H. benefits include improved sitting
and standing postures, stability, and for the ambulatory user,
Wound care centers trust Geritrex's tincture of
benzoin product line because it provides effective skin protection.
Available as a liquid (Benzoin Compound Tincture
U.S.P.), topical spray
(SprayzoinTM) and unit dose
these antiseptic formulas help toughen skin and increase adhesion
of bandages, without irritation. Surgeons, orthopedists,
orthotists, and prosthetists use Geritrex's benzoin product line
and say that it helps shield skin during the healing process.
You may purchase Benzoin Compound Tincture
U.S.P., Sprayzoin, and
Benz-Protect through wholesalers,
specialty distributors, or direct. Call today to order your free
Allsport WristTM products help restore
functional and structural characteristics of the wrist that have
been negatively affected by injury. All Allsport
Wrist models are designed to enable patients to return to
activities sooner, while reducing the risk of reinjury, even in
activities with a high incidence of wrist trauma. The patented
biaxial articulating hinge system limits extension and flexion, as
well as ulnar and radial deviation. The open-palm design is
comfortable and limits the obstruction of the patients grip. The
rigid dorsal frame provides stability and support. Available in
custom and off-the-shelf models.
Can't get the custom shoes to fit? Apis now
offers the solution! For a flat fee per pair (one pair of
custom-made inserts included), pick any style from the catalog.
More than 70 styles are available. Don't fit? Don't pay!
- Semi-surgical opening, surgical opening, composite toe
- Thermozote lining, padded tongue, padded collar, leather
- Rigid sole, semi-rigid sole, heavy-duty lug sole, ¾-length
- Forefoot rocker, mild rocker, heel-to-toe rocker, bevel
Apis Footwear Co.
Provel offers cost-effective, fast, easy-to-use,
and reliable O&P automation. The D2 digitizer,
C5 carver, and T6 thermoformer are appropriate for small clinics as
well as large central fabs. All are AOP-file compatible and backed
by a two-year warranty. The D2 digitizer allows automated shape
capture of prosthetic casts with unmatched accuracy. The C5 carver
is not only fast and precise, its self-contained dust-collection
system is extremely quiet. The T6 thermoformer consistently
produces high-quality thermoplastic sockets from industry-standard
Why do we call it the AFO Liner
Sock? Because its worn like a sock that can pull up over
the calf, accommodate individuals from foot to knee, and can be
rolled over the AFOs top. Comfortable, cushioning AFO Liner
Socks have knitted heel pockets for a more intimate fit
and make a superior interface between the skin and the AFO. Our
SilverMax AFO Liner Socks even help patients with
skin issues such as dermatitis and rashes. Ask about our study with
the Shriners Hospital in Shreveport, Louisiana. Call Comfort
Products today to learn more about our four different styles of
AFO Liner Socks. A superior product with a
Matthew Dobbs, MD, designed this new
dynamic clubfoot bar to allow active movement,
preserve muscle strength in the foot and ankle, and be less
restrictive to the child than traditional fixed bars. Children
using the Dobbs Bar can crawl and kick their legs
Children will sleep better because they can get comfortable in the
Dobbs Bar, and heel blisters
commonly associated with fixed bars are no longer a problem. The
Dobbs Bar is available in two sizes, small (6 to 9
in.) and regular (8 to 14 in.). The bar is adjustable through each
size range to accomodate growth. The foot plates are universal and
can be attached to shoes and AFOs. The results are better
compliance, a more active child, and happier parents.
D-Bar Enterprises LLC