Prosthetics & Orthotics Scope of Practice by Alireza Vasefnia, BSc, MSc, CPO
2020
Credential Titles
Designations given to those individuals who have met a certification body's extensive education andclinical training requirements and who have passed specific examinations that are based ona comprehensive practice analysis of the orthotic, prosthetic and pedorthic professions.
Certified Orthotist (CO)
Certified Prosthetist (CP)
Certified Prosthetist/Orthotist (CPO)
Certified Pedorthist (C.Ped.)
Certified Fitter-Orthotics (CFo)
Certified Fitter-Mastectomy (CFm)
Certified Fitter-Therapeutic Shoes (CFts)
Certified Orthotic Assistant (COA)
Certified Prosthetic Assistant (CPA)
Certified Prosthetic-Orthotic Assistant (CPOA)
Certified Orthotic Technician (CTO)
Certified Prosthetic Technician (CTP)
Certified Prosthetic-Orthotic Technician (CTPO)
Orthotic care includes patient evaluation and the design, fabrication, fitting, modification, maintenance and repair of orthoses to treat a neuromusculoskeletal disorder or acquired condition.This also includes the provision of partial foot prostheses for transmetatarsal and distal amputations.
Prosthetic care includes patient evaluation and the design, fabrication, fitting, modification, maintenance and repair of prostheses to restore physiological function and/or cosmesis.
The practice of a certified orthotist and/or prosthetist
includes, but is not limited to:
Patient Assessment
Treatment Plan Formulation
Assessment of patients with impairment of human movement or musculoskeletal abnormalities that would impede their ability to participate in their social/work environment or other activities in order to determine a functional intervention. Patient assessment may include, but is not limited to, the evaluation and documentation of:
anthropometric data
cognition
circulation
skin integrity
protective sensation
pain
central and peripheral nerve integrity
endurance
biomechanics
gait analysis including temporal and spatial assessment
range of motion
muscle strength
posture, balance and safety
proprioception
orthotic and/or prosthetic requirements
myoelectric activity and potential for use of Functional Electrical Stimulation and/or Neuroprosthetics
activities of daily living
environmental barriers including social, home, and work reintegration
the need for physical and occupational therapy modalities
Formulation of a treatment plan is based upon a comprehensive assessment to design an intervention to alleviate limitations, improve function and enhance quality of life. Orthotic and prosthetic treatment includes, but is not limited to:
verification of prescription/documentation
evaluation of the prescription rationale
a recommendation incorporating patient and/or caregiver input
development of functional goals
use of evidence based practice
analysis of structural and design requirements
assessment of potential physical and occupational therapy requirements
consultation with and/or referral to other health care professionals
Treatment Plan Implementation
Implementation of the orthotic and/or prosthetic treatment plan includes, but is not limited to:
acquisition of anthropometric data
modification and/or rectification of anthropometric data
preparatory care
material selection
fabrication of orthoses and/or prostheses
prototype development including evaluative wear
structural evaluation
diagnostic fitting
assessment of intervention
functional exercise
gait training
functional training (both self care and work related)
documentation of patient education and instruction
supervision of the provision of care
documentation of patient encounters
Treatment Plan Follow-up
Utilization of a follow-up treatment plan that ensures successful orthotic and/or prosthetic outcomes, patient health and quality of life which includes, but is not limited to:
documentation of patient encounters, including functional changes and progress in meeting goals and expected outcomes
formulation of modifications to ensure successful outcomes
reassessment of patient goals
reassessment of treatment objectives
development of long term treatment plan
documentation of on-going patient education and instruction
Compliance
Compliance with practice management plans to develop and document policies and procedures to ensure patient protection which includes, but is not limited to:
adherence to applicable local, state and federal laws and regulations
following patient care guidelines and procedures
maintaining a safe and professional environment for patient care
comprehension of claims development and submission
Promotion of competency
Promotion of competency and enhancement of orthotic and/or prosthetic professionapractice to contribute to the profession’s body of knowledge includes, but is not limited to participation in:
continuing education
training of residents/students
clinical research
evidence based studies
promotion of public awareness of the orthotic and/or prosthetic profession
consumer organizations, governmental and non-governmental organizations
CODE OF PROFESSIONAL
RESPONSIBILITY
I. GENERAL RESPONSIBILITIES
Professional Conduct
Ethics, Custom and the Law
Disclosure of Other Agency Actions
II. RESPONSIBILITIES TO PHYSICIANS AND OTHER LICENSED HEALTHCARE PRESCRIBERS
Diagnosis and Prescription
Orthotic, Prosthetic and Pedorthic Evaluation
and Recommendation
Changes in Patient’s Condition
Provision of Services
Modifications
III. RESPONSIBILITIES TO THE PATIENT
Confidential Information
Care
Record
Research
Trust and Honesty
Practice Arrangements
Delay in Services
Compliance with Laws and Regulations
Reporting
Delegation of Responsibility
Advertising and Public Communication
Illegal Discrimination & Harassment
Sexual Relations with Patient Prohibited
Sexual Relations with Key Third Parties Prohibited
IV. RESPONSIBILITIES TO COLLEAGUES
AND THE PROFESSION
Dignity
Substance Abuse
Solicitation
Examination
V. APPLICATION OF THE CODE
Adherence to the Code
VI. PATIENT CARE BY OTHER
HEALTHCARE PROFESSIONALS
Concern about Care by Other Healthcare Professionals
VII. CREDENTIAL
Use of Credential
Education
Prosthetics 2020
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Orthotics 2020
Orthotics 2020 MAB serves to ensure clinical efficacy and to provide the necessary clinical knowledge to oversee research development and communicate the findings to patients, providers and payers, including CMS.
Prosthetics 2020 is a partnership open to interested companies who want to take a strong, proactive role in shaping the drivers of prosthetic patient care five years down the road.
- Improve the future reimbursement landscape for LEP.
- Define and provide the appropriate technology to the appropriate patients to reduce the current trend of providing the lowest cost technology to all patients.
- Define new patient segments that can benefit from LEP technology.
- Separate the O&P profession from Durable Medical Equipment (DME) in the mind of the payers.
Clinical Residency
Completion of a National Commission on Orthotic and Prosthetic Education (NCOPE) accredited residency program.
Education Programs
Bachelor/ ISPO Prosthetist/Orthotist (CAT I)
The 5-semester P&O educational program according to ISPO Category II standards is offered to practicing P&O technicians who lack previous formal education in this field.
Master's Degrees in Prosthetics and Orthotics
ISPO Associate Prosthetist/Orthotist (CAT II)
CAT II Schools
Afghan Diploma in Prosthetics and Orthotics (ADPO), Afghanistan
Bangladesh Health Professions Institute (BHPI), Bangladesh
Department of Prosthetics and Orthotics, Cambodia
Beijing College of Social Administration, China
SENA Design and Metrology Center, Colombia
Ottobock International O&P School, Modular Programme in Lower Limb Prosthetics, Germany
Private Hochschule Göttingen (PFH), Germany
Mobility India Rehabilitation Research and Training Centre, India
University of Medical Technology in Yangon (UMTY), Myanmar
Pakistan Institute of Prosthetic and Orthotic Sciences (PIPOS), Peshawar, Pakistan
University of Rwanda, Rwanda
Tanzania Training Center for Orthopaedic Technologists (TATCOT), Tanzania
Ecole Nationale des Auxiliaires Médicaux (ENAM), Togo
Vietnamese Training Centre for Orthopaedic Technologists (VIETCOT), Vietnam
CAT I Schools
National Centre for Prosthetics and Orthotics (NCPO), La Trobe University, Australia
Thomas More Kempen, Belgium
Orthotics Prosthetics Canada (OPC), Canada
School of Biomedical Engineering of Capital Medical University in Beijing, China
Sichuan University, China
Bundesfachschule für Orthopädie-Technik e.V. Germany
Kerschensteiner Schulzentrum, Staedtische Meisterschule fur Orthopaedietechnik Muenchen in Germany
The Hong Kong Polytechnic University, Hong Kong
Jakarta School for Prosthetics and Orthotics (JSPO), Indonesia
Kobe College of Medical Welfare, Japan
Niigata University of Health and Welfare, Japan
Fontys University of Applied Sciences, Netherlands
University of the East Ramon Magsaysay Memorial Medical Center, INC. – College of Allied Rehabilitation Sciences - Philippine School of Prosthetics and Orthotics, Philippines
Tumaini University, Tanzania
Sirindhorn School of Prosthetics and Orthotics, Thailand
National Centre for Prosthetics and Orthotics, University of Strathclyde, United Kingdom
National Commission on Orthotic and Prosthetic Education (NCOPE), USA
Category I and II Schools
Universidad Don Bosco (UDB), El Salvadol
Human Study School of Rehabilitation Sciences, Blended Distance Learning Education Program in P&O, Globa
Job Outlook (2016-2026)
7% growth (for all biomedical engineers)
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Computer-aided drafting in prosthetics and orthotics, pediatric orthotics, spinal orthotics, rehabilitation engineering and technology, lower limb orthotics
Master's Programs
Schools
Georgia Institute of Technology
Northwestern University
University of Washington
University of Texas Southwestern Medical Center
Loma Linda University
University of Hartford
Alabama State University
University of Pittsburgh
Concordia University-Saint Paul
Eastern Michigan University
Career
Technician
Duties
Choosing materials for devices
Reading prescriptions and work orders for accuracy
Creating, forming, and shaping the device
Adjusting and repairing devices as needed
Ensuring product quality and accuracy
Practitioner
Duties
Assessing patients and their needs
Measuring and designing braces, limbs, and other devices for patients
Fitting, adjusting, and repairing devices as needed
Educating patients how to use devices properly
Maintaining patient records
PhD Degrees in Prosthetics and Orthotics
Clinical Research Coordinator
Postdoctoral Research Scholar
Duties
Discuss project progress
Prepare manuscript
Mentoring
Travel to conferences and workshops to present results of research experiments
Visit collaborators to learn additional research techniques
Duties
Coordinate and contribute to the activities of Department of Defense grant on evaluating 3D printed prostheses.
Work with a local machine shop to design and fabricate a loading fixture to adapt an INSTRON machine to the desired loading conditions.
Periodically travel to local prosthetic clinics to meet with the study prosthetist to obtain 3D printed sockets on which we will perform failure and cyclic testing.
Analyze and write up results from the project to be included in quarterly and annual reports to the funding agency.
Assure quality of data collected and perform statistical analysis of data.
Performing data collections for ongoing research projects at CLEAR and preparation of manuscripts for scientific publications.