Rough and Tumble: Meeting the Prosthetic Durability Challenges of Your Youngest Patients - March 2014

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Rough and Tumble: Meeting the Prosthetic Durability Challenges of Your Youngest Patients

Feature

Jameson Davis. Photograph courtesy of Advanced Arm Dynamics. Connor Karrow.

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Risk Factors for Plagiocephaly

Feature

In a previous article, I discussed the commonly expressed concerns of parents of infants with deformational plagiocephaly regarding potential functional deficits associated with the condition (" Beyond Cosmetic Concerns: Functional Deficits Associated with Deformational Plagiocephaly ," The O&P EDGE , April 2012). Another common concern is uncertainty about what might have caused or contributed to the development of the condition. Parents are often eager to know whether they inadvertently played a role or if they need to modify their parenting style to prevent it from occurring in subsequent children.

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Standing Out by Trying to Fit In

Feature

THE FIRST DAY OF SUMMER VACATION "Accept what you can't change and change what you can't accept," as the saying goes. When that change happens to a six-year-old girl, you accept it with the naivety that only comes with the innocence of childhood. My story begins on May 28, 1975, in the small town of New Ulm, Minnesota.

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Measuring the Usefulness and Importance of Outcome Measures

Feature

While physicians are tasked by the Centers for Medicare & Medicaid Services (CMS) to assign K-level functional classifications to lower-limb amputee patients, some turn to prosthetists for guidance. Compassion, and even profit margin, can drive prosthetists then to suggest to the physician that he or she assign a lower-limb amputee patient with a higher K-level based on potential rather than reality. If that occurs, the patient has to live with the consequences, be it a device that is too cumbersome or perhaps too heavy.

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HHS Delays ALJ Hearing Scheduling by Two Years: Continues to Fail to Adhere to Its Own Regulations

Feature

The provision of prostheses and orthoses to Medicare beneficiaries has come under heavy fire over the past few years with the imposition of new documentation requirements that were issued without the Centers for Medicare & Medicaid Services (CMS) following proper procedures. This created extensive auditing and shifting medical necessity criteria. The advent of the Recovery Audit Contractor (RAC) program, along with ramped up efforts by benefit integrity contractors such as Zone Program Integrity Contractors (ZPICs), have fueled auditing to reach new heights.

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Reversing Scoliosis and Brace Treatment of a Proximal Structural Curve

Academy Society Spotlight

Introduction In the conservative management of scoliosis through orthotic treatment, it is the orthotist's responsibility to provide an optimally fitting and functioning scoliosis brace and to achieve the orthotic intervention's objectives to reduce or hold the Cobb angle and improve the patient's clinical presentation at the end of skeletal growth. There are many factors that can influence curve patterns during the course of treatment, including good brace correction. For brace correction to be effective, the orthotist must identify changes in curve pattern that arise both predictably and unpredictably during the patient's growth and adjust the brace to those changes.

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C. Ralph Hooper Jr., CPO: Scoliosis Bracing Pioneer

Industry Leader

Hooper marks the trim lines for fitting the Charleston Bending Brace. Photographs courtesy of Ralph Hooper. As a young practitioner, C.

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Pedorthic Treatment of Pediatric Foot Problems

Stepping Out

Years ago, the use of children's orthopedic shoes was a well-established, medically accepted, and oft-prescribed solution to pediatric foot problems. Each year, pedorthists and orthotists measured for, fitted, and dispensed thousands of straight-last and outflare shoes with modifications like Thomas heels, wedges, and torque heels, as well as orthopedic contraptions like Denis Browne splints. It was big business.

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Getting the Most from Your Practice by Looking Within: Part 1 of A Four-Part Series

Better Business

Accounts Receivable Workflow: Is It Working for You? Analyzing your O&P business can be intimidating. The necessary time, resources, and money to examine your business from the inside out are not always available. To help you in this endeavor, The O&P EDGE is offering a series of four articles that will focus on key elements of your business and provide some tips for performing analyses and improving your processes.

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Master’s Program Profile Series: University of Hartford and St. Petersburg College

Education Outlook

The O&P EDGE continues its series of National Commission on Orthotic and Prosthetic Education (NCOPE)-accredited master's level O&P educational programs. This month we feature two programs. The first is the University of Hartford College of Education, Nursing and Health Professions (ENHP) Master of Science in Prosthetics and Orthotics (MSPO).

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Designing a Paralympian’s Device

Shop Talk

Jeff Erenstone, CPO, chief designer of Performance Orthotic Design and president and head clinician of Mountain Orthotic & Prosthetic Services , both located in Lake Placid, New York, specializes in crafting personalized adaptive sports equipment from his office at the site of the 1980 Winter Olympics. Recently, he built a cross-country sit-ski that will be used by Dan Cnossen in the 2014 Paralympic Winter Games in Sochi, Russia. The O&P EDGE  asked Erenstone to describe the process of developing Cnossen's sit-ski.

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Fernando “Nandito” Gallego: Spina Bifida Doesn’t Slow Down Five-Year-Old

Today’s Consumer

Nandito pictured here before therapy allowed him to stand independently without the aid of his walker. Photographs courtesy of Fernando Gallego. Fernando "Nandito" Gallego was born five years ago in San Diego, California, with myelomening- ocele level L4-S1-the most severe form of spina bifida, where the spinal cord and the tissues covering it protrude from an opening in the back.

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O&P: We’ve Come a Long Way

Perspective

I've loved watching sci-fi movies since I was a kid. Star Wars was the first movie that I saw in the theater. Aliens and The Terminator were my go-to movies when I stayed home sick from school, the Matrix was the first DVD I owned, and Inception was the first Blu-ray I owned.

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Erin Rice, CO, ATC

Face to Face

Erin Rice, CO, ATC, says she always wanted to work with children, so when she got the opportunity to stay on staff at Children's Care Hospital and School/Rehabilitation Medical Supply (CCHS/RMS) Sioux Falls, South Dakota, after her residency, the decision wasn't difficult. "It humbles me to think that I get to do this every day," she says. In her current position she treats pediatric patients who need cranial remolding helmets or orthoses in the CCHS Children's Care Rehabilitation Center outpatient-rehab setting facility, and follows up with pediatric patients with special needs at CCHS.

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Billing and Collections Q&A

Got FAQs?

Billing for O&P devices and care is complicated. When you have questions, count on "Got FAQs?" to help keep your claims on track. This month's column answers your questions about prosthetic devices not delivered until after the patient entered an SNF, and medical necessity for custom knee orthoses.

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Notes from US ISPO: PacRim 2014

Industry Review - Associations

Pacific Rim (PacRim) 2014, a Pacific Forum for Physical Rehabilitation, sponsored by the U. S. Member Society of the International Society for Prosthetics and Orthotics (US ISPO) in cooperation with The O&P EDGE , took place Sunday, January 26, through Wednesday, January 29, at the Marriott Waikoloa, Hawaii.

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“Secret Santa” Makes a Young Girl’s Wish Come True

Industry Review - Consumer

Most nine-year-old girls have clear ideas of what they want Santa to bring them for Christmas: an American Girl doll, a Nintendo DS, Harry Potter books, or board games. Ella Rodriguez's request this past Christmas, however, was something that couldn't be purchased at a store or made in Santa's workshop. "Dear Santa," she wrote.

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Christmas Wishes

Viewpoint

In early December, I received a message from an old friend who told me about the daughter of one of her friends. The daughter is an amputee and had written in her letter to Santa that all she wanted for Christmas was to meet other kids who were like her. The story pulled at my heartstrings, and I reached out immediately to the O&P community for help.

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New Alpha Liner Absorbs Heat and Reduces Sweat

Online Exclusive

WillowWood brings temperature control to prosthetic liners for the first time with Outlast®, the original heat management technology that was developed for NASA. Now amputees have a viable solution for a comfortable prosthetic liner that works to delay the onset of sweat with the Alpha® SmartTemp Liner.

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