O&P Research Supports Evidence-based Care
With the increased emphasis on demonstrating the effectiveness of O&P care, establishing evidence is a vital step toward providing third-party payers with clinically based justification for reimbursement decisions. Research results, however, are not only for payers; they are also used by O&P providers to deliver evidence-based care-the best solution for patients' needs, chosen from a changing multitude of options. Research is also being conducted to reach a more holistic understanding of the patients themselves, helping to
increase the value of patient-centered care.
The Rest of the Story
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Just under three years ago, the O&P profession was startled by the
publication of the first randomized controlled trial (RCT) on the efficacy of
cranial remolding orthoses. 1 It was somewhat surprising that an RCT had
been conducted at all.
Turning Knowledge Into Action: Using Research to Improve Patient Care
Images courtesy of Shutterstock Inc .
Knowledge translation (KT)
is "the use of knowledge in
healthcare decision making,"
and it is often discussed in
the context of intentionally
changing clinical decisions
and behaviors based on evidence
from formal research.
More than 90 terms have
been identified for research
use, including implementation
science, research utilization ,
An In-depth Look at BIPA Section 427: What It May Mean for the O&P Profession
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One of the last regulations proposed by the Obama
administration was published in the Federal Register on
January 12 by the Centers for Medicare & Medicaid Services
(CMS): a Notice of Proposed Rulemaking interpreting
Section 427 of the Benefits Improvement and Protection Act (BIPA)
of 2000. Comments on this proposed rule are due March 13, and it is
not yet clear whether the new president's actions will further delay the
publication of a final rule on this topic.
Academy Society Spotlight: Advancements in Adult Scoliosis Bracing Using a Custom-made Adult WCR Brace
This case study presents a description
and timeline of the results achieved by
applying Schroth therapy (Barcelona
Scoliosis Physical Therapy School) and
a modified Chêneau-type brace using
Rigo principles-a Wood-Chêneau-
Rigo (WCR) brace-for the conservative
treatment of a 68-year-old adult
female with scoliosis.
Conservative Treatment of Scoliosis in Adults
Scoliosis bracing for adults has been
limited for decades. The most common
form of treatment is an accommodative
TLSO, with variations that range
from a custom-made brace fabricated
from a mold and/or measurements of
the patient, to an off-the-shelf, prefabricated
TLSO fitted to the patient.
The Cycle of Service: Clinical Trials Through the VA
Clinical Trials (CTs) are considered the pinnacle of medical evidence, as recognized by the Oxford Centre for Evidence-based Medicine, England. A lot goes into CT operations: planning, conducting, and then analyzing the data, as well as budgeting labor, materiel, and fringe costs. A given CT could conceivably involve hundreds of study personnel and external reviewers; sometimes thousands of patients will enroll.
The Biomechanics of Running
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In the late 1870s the eccentric Eadweard Muybridge began pioneering work photographing bodies in motion. His
iconic pictures of people and animals opened a new chapter in understanding movement and the human body.
App Supports Self-management of Prosthetic Socket Fit Issues
Clinicians know that for new prosthesis users the task of donning a prosthetic limb and achieving a comfortable
fit can become a frustrating stumbling block. Due to the variable shape and volume fluctuations of the residual
limb, along with the potential to misunderstand the donning sequence, an individual can experience difficulty
obtaining a proper prosthetic socket fit without the help of a clinician. While many self-management educational
materials exist to help clients manage the fit of their devices, sometimes those aren't enough-especially for people
with complex suspension solutions or mild cognitive impairments.
Six Nifty Lamination Tips
After fitting a patient with a new
prosthesis, do people say to him or her,
"Hey, that leg is awesome. Where did you
get it?" Custom laminations are definitely the
way to get those kinds of comments. Here are a
few tips to make your laminations easier.
Best Practices: How to Assess Accounts Receivable
Your accounts receivable (AR) are the heartbeat of your practice,
and keeping a finger on the pulse is imperative to the health of your
company. A bounced check or financial pressures should not be the
triggers spurring you to look at your AR reports. Instead, your AR reports
should be reviewed, updated, and monitored continually.
Hanger Education Fair and National Meeting
With the theme "Empower Together,"
more than 1,100 employees from
Hanger, Austin, Texas, convened in Las
Vegas for the company's annual Education
Fair and National Meeting, January
30 through February 3. The conference
provided continuing education about
the latest O&P and therapeutic solutions,
as well as a platform to recognize
employees' achievements, examine
company strategy, and discuss how best
to empower patients and customers in
the changing healthcare landscape.
The opening ceremony, held January
31, highlighted nine Hanger Clinic
patients, who helped kick off the event.
What Does Research Mean to You?
It's easy to think that research and everyday clinical patient
care are separate entities that have little in common. However,
clinical practice and research are very much intertwined.
In this issue of The O&P EDGE , we explore how
practitioners can apply information from research studies
to their clinical practices, and we get a glimpse into the way
clinical challenges inspire research efforts.
Study: Amputation Level May Affect Post-op Pain
Phantom limb complex includes phantom sensation (PS), residual limb pain, and phantom limb pain (PLP). A study of the association between phantom limb complex in patients who had not received treatment for it and the level of lower-limb amputations found that the intensity and frequency of untreated PLP were higher early in the post-operative period in patients who had knee disarticulations, transfemoral amputations, or hip-level amputations. After six months, there were no significant differenc
ALPS Anterior Posterior Tapered Liner
ALPS New AP Tapered Liner is gradually tapered from the anterior to the posterior to provide superior comfort. This liner is available in a pin and locks system or suction suspension. The AP Tapered Liner features our black high performance fabric with gel to assist in reducing bunching in the popliteal region.
Coming soon to Friddle's On-The-Spot transfer images-Major League Baseball. Friddle's will soon have all 30 team logos and mascots available. Be on the lookout for these new additions. For more information, call or visit Friddle's website.
Friddle's Orthopedic Appliances
Made with aircraft-grade aluminum alloy, the Horizon® LT is the lightest carbon fiber foot on the market. Like the original Horizon HD, the Horizon LT is meticulously crafted utilizing maximum stress predictions to increase strength and
prevent failure. The rollover Enviroshell® design, combined with the specially engineered carbon composite, provides the perfect blend of comfort and ability. The Horizon LT brings an ultralow profile and a lightweight and economical choice for moderate-activity users. Order now at www.college-park.com/horizon-lt.
College Park Industries
With a unique and proprietary formulation, Encore Liners create a superior feel for increased patient comfort.
Features and benefits include:
- Infused with medical-grade mineral oil and vitamin E
- Durable nylon outer covering
- Available in three thicknesses for anterior and posterior
- Available in cushion or locking design
- Locking liner pin threads are 10mm-1.5mm
Why make the transition to BOC? Award-winning customer service, nationally recognized credentials, and a user-friendly website are just a few of the benefits of choosing BOC. As your credentialing partner, we provide accreditation for your O&P facility at a discounted rate, guide you through the accreditation process, and
support your future success.
Plus, it's easy and free! Make the transition to BOC for accreditation with no up-front cost. Visit our booth at the AOPA National Assembly or contact us at .
We're with you every step of the way. It's our promise. Every patient.
Every facility. Every day.
Board of Certification/Accreditation
Give us the opportunity to lessen the demands on your in-house fabrication team, so your clinicians can devote more time to their patients and to marketing new referral sources. Our highly trained technicians at Anatomical Concepts can provide a wide variety of custom-made lower-limb orthoses, such as thermoplastic AFOs and KAFOs, as well as functional and accommodative foot orthotics.
Due to their unique modular designs, any AFO from our pre-fabricated PRAFO® family can be implemented with any custom-made KAFO system for exceptional stability and patient comfort.
- Smarter: uses simple gestures to charge grips
- Faster: boost digit speed by up to 30%
- Smaller: new form-fitting anatomical design reduces profile in every dimension
TRS introduces a stronger, more versatile, two-piece cable-harness hanger system in standard and heavy-duty cable versions. It features a reusable hanger component and a replaceable, less expensive ball adapter cable fitting. The new Binary Hanger System is constructed of high-performance stainless steel and is significantly stronger than conventional hangers. Additionally, the system allows for double swaging the ferrule, capturing the cable and creating significant extra strength.
It's another superior-quality TRS product.
Patients experience greater fit, function, and freedom with Orthomerica's new Fuzion™ line of custom orthoses. The Fuzion's design and materials ensure greater patient compliance for a variety of
challenging clinical indications. Available for select adult and pediatric patients.
- Proprietary, heat-adjustable plastic makes patient management much easier (versus traditional orthoses)
- New treatment options for patients historically not candidates for orthotic intervention and management
- Fuzion's compression design holds the patient in a secure, comfortable position while assisting with spasticity management.
- Accommodates volume changes
The Triple Action™ Stance/Swing Control Ankle Joint is designed to provide highly adjustable control of the lower limb during both the stance and swing phases of gait. The patent-pending component excels in the treatment of complex neuromuscular disorders. Alignment, plantarflexion resist, and dorsiflexion resist are independently adjustable, which help to simplify optimization. The component delivers high resistance, permitting mobilization of the ankle through both the stance and swing phases of gait.
Introducing the RUSH ROGUE™! Everything you love about the existing RUSH™ Foot Collection, featuring even more comfort, improved performance, and +/- 8° of torsion. The ROGUE provides the most realistic and dynamic foot and ankle motion available. The vertical loading pylon provides comfortable relief from high-impact loading, allowing the user to push the foot to the limits. The roll-through characteristics of the foot provide exceptional energy return with no dead spot. What are you waiting for? Go ROGUE. Go RUSH. To learn more visit www.rushfoot.com.
The end of rigid brims
The new SwingBrim™ technology offers the same dynamic brim comfort as the full Socket-less Socket™, but can now be integrated into existing sockets as well. No more static brim shape. No more hard ischial seat. It's the difference between sitting on a hard chair versus sitting in a soft hammock.
View the free SwingBrim and Socket-less Socket training at MartinBionics.com.
Tidwell's Charcot Restraint Orthotic Walker is available in standard black with a removable Plastazote insert, a full interface lining, standard rocker sole, and DACRON back straps attached with copper rivets.
Tidwell's Orthotics is offering the CROW with a turnaround of 5-7 days at an incredible price.
Spinal Technology is a leading central fabricator of spinal orthoses and upper- and lower-limb orthoses and prostheses. Our ABC-certified staff orthotists and prosthetists collaborate with highly skilled, experienced technicians to provide the highest quality products, the fastest delivery time (including weekends and holidays), and unparalleled customer support in the industry.
Spinal Technology is the exclusive manufacturer of the Providence Scoliosis System, a nocturnal bracing system designed to prevent the progression of scoliosis, and the patented FlexFoam™ spinal orthoses. For more information, e-mail , call, or visit our website.
Spinal Technology Inc.
Our accommodative foot orthotics are specially designed for patients with foot deformities. We offer a variety of materials for foot conditions such as neuropathy, Charcot foot, edema, or amputation; or conditions resulting from health issues like obesity, diabetes, sports injuries, or heart conditions. Custom-made foot orthotics provide support and relief wherever necessary. Apis provides you with a free 3D camera to eliminate impressions or casting-now it's just a push of a button. Fulfill all of your pedorthic needs under one roof. Call our friendly customer service representatives for more information or free samples.
Apis Footwear Co.
All Pro-Flex® feet feature a unique three-blade design with a foot blade that incorporates a full-effective toe lever and a more anatomical split toe. This innovative design helps generate exceptional toe-off energy and a fluid, natural progression from heel strike to toe-off. Learn more about the Pro-Flex family at www.ossur.com/proflex.
Now all Allard 2.0 AFOs come with a Starter Interface pad and two tibia pads. Call customer service for more information. Make it an Allard 2.0 AFO today!
This unique AFO has been designed for people with Chopart amputations who wish to remain active. A traditional, full-length AFO will often be stiff and feel unnatural to such a patient. Using a hinged ankle and flexible foot plate with a segmented dynamic filler allows flexion before providing a "stop" that protects the residuum and prevents shoe vamp collapse. The PTB design and the anterior shell redistribute ground reaction forces up the lower limb. For more information, visit our website or call the lab toll-free.
Hersco Ortho Labs
Having a component inventory available in your facility does not make our product OTS. A VertAlign Spinal Support System is custom fit, requiring the clinical and biomechanical expertise of an orthotist to select the correct front and back shells from the 550 different size, shape, and lordosis- and kyphosis-possible configurations. The orthotist's professional skills are needed to select, adjust, and apply the components that meet the patient's unique anatomical spinal support needs. We provide components and product training. You provide clinical judgement and professional skills.
The SP High Density Liner features black fabric that allows for stability for active patients. The SP Liner has similar characteristics as silicone, but provides the superior comfort of gel.
The MAGLOCK eases the frustration of donning a pin lock liner for patients who have transtibial or transfemoral amputations and K1-K3 activity levels. The MAGLOCK is developed to deliver up to 90 lb. of force.
The large distal target allows the patient to be 10 degrees off center and still achieve suspension. The ultimate product for people who have dexterity issues, have pin alignment issues, or require a caregiver, and much more. No wires, no battery.
Do you treat idiopathic toe walking? For over ten years, we have been using this design in the vast majority of the cases we see. For the right patient, this design works exceptionally well to establish a normal heel-toe gait pattern. We have found that physical therapists prefer this design as it is less invasive and lower profile than hinged AFOs.
Our fabrication facility is centrally located in San Antonio, Texas. Mention this ad for 25% off your first order. Call or visit our website for more information.
Advanced Orthopedic Designs
Our vision is to restore hand functionality to people with partial digit amputations. By taking advantage of a newly matured manufacturing process, and through innovative design, Naked Prosthetics is becoming a leading provider of cutting-edge custom finger prostheses.
These one-of-a-kind devices articulate freely and progressively with the residual finger, providing an option for people who need a finger prosthesis that can improve object manipulation, grip strength, and dexterity.
The MCPDriver is a functional finger prosthesis designed for people with amputations at the proximal phalanx. The PIPDriver is for amputation levels at the middle phalanx.
Cost-effective automation for facilities of all sizes
Modify, carve, and thermoform. Newly released ProvelCAD modification software is easy to use and template based. The C7 Carver is not only fast and precise, but its self-contained dust collection system is extremely quiet. The T7 Thermoformer, with IR sensing, consistently produces high-quality thermoplastic sockets from industry-standard preforms. Compatible with AOP, OBJ, and STL files.
From your home, complete the first two quarters (6 months) and final quarter (3 months) of the NUPOC 21-month MPO. Spend four quarters (12 months) in mentored practicum at NUPOC, building P&O skills by working with people who have neuromusculoskeletal impairments. NUPOC graduates are eligible for NCOPE residencies and P&O certification examinations. The NUPOC MPO prepares you to become a proficient clinician, deliver comprehensive P&O services, integrate research into clinical practice, and contribute to the P&O profession. NUPOC accepts candidates on a rolling admissions basis.
Northwestern University Prosthetics-Orthotics Center
Feinberg School of Medicine