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Practice Analysis of ABC Certified Orthotic Fitters

January 2019

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Knowledge and Skills Statements

Results and Discussion Related to the Knowledge and Skills Statements

This section presents the results of the ratings related to the knowledge and skills statements delineated in the survey.

All survey respondents rated the knowledge and skills statements on two rating scales:

  • Criticality: How critical is the knowledge or skill to optimizing outcomes for patients and/ or caregivers? All knowledge and skill statements received a mean rating of at least 3.0 on the Criticality scale—that is, all statements were considered to be at least moderately critical.

  • Point of Acquisition: At what point should this knowledge or skill be acquired by a credentialed orthotic fitter?

A majority of respondents supported the premise that orthotic fitters should acquire 50 of the 54 knowledge and skills before attaining the CFo credential.

 

Table 16

Knowledge and Skills Statements
Anatomy/Physiology — Knowledge of:
General musculoskeletal anatomy, including upper limb, lower limb, spinal
Bony landmarks relating to gross musculoskeletal anatomy of upper limb, lower limb, and spine
Gross neuroanatomy (for example, major peripheral nerves of the upper and lower extremity)
The circulatory system as it relates to prefabricated orthotic care
Anatomical planes, planes of motion, and normal range of motion (ROM)
Human development and aging, including pediatric, adult, and geriatric, as they relate to prefabricated orthotic care
Medical terminology as it relates to prefabricated orthotic care
Pathologies — Knowledge of:
Pathologies including cause and progression (for example, vascular neurologic, orthopedic)
Tissue characteristics (for example, ulcers, pressure sores)
Volumetric changes (for example, edema, weight gain/loss)
Biomechanics — Knowledge of:
Normal human locomotion
Gait deviations
Biomechanics (for example, actions of lever arms, application of force systems)
Patient Assessment — Knowledge of:
Assessment techniques, including gait observation, weight bearing status, skin/tissue assessment, manual muscle testing (MMT), pain evaluation, and volumetric assessment
Measurement tools and techniques (for example, tape measurers, ML gauges, goniometers, Brannock device)
The psychology of the disabled
Orthotic forms (for example, assessment, measurement)
When to refer the patient to other healthcare providers (e.g., when patient needs are beyond fitters’ scope of practice, when patient’s health condition(s) require attention by other health care professionals)
Patient Assessment — Skill in:
Interpreting referral documents (prescriptions and authorization for service)
Interviewing patients
Communicating with referral sources
Taking patient history and performing physical assessment
Patient assessment techniques (for example, measuring range of motion (ROM), determining muscle strength, body segment alignment)
Interpretation of physical findings (for example, recognizing skin pressures, dermatological conditions, skeletal deformities)
Treatment Plan — Knowledge of:
Prefabricated orthotic design and fitting criteria of orthoses and compression garments (for example, anatomical/device relationships, device trimlines)
Care and maintenance of prefabricated orthoses and compression garments
Device warranties
Available educational and resource materials (for example, fitting instructions, manufacturer’s guidelines)
Treatment Plan — Skill in:
Managing patients relative to their diagnosis and condition as it pertains to prefabricated orthoses
Measuring for prefabricated orthoses and compression garments including upper limb, lower limb, and spinal
Fitting, modifying, and adjusting prefabricated orthoses and compression garments
Evaluating fit and function of prefabricated orthoses and compression garments
Determining outcomes as they relate to the treatment goal (for example, reduction of pain, immobilization, improved gait, improved function)
Documentation (for example, patient records, billing documentation, incident reports)
Materials/Equipment/Tools — Knowledge of:
Safety procedures and standards (for example, OSHA, MSDS)
Hand and power tools
Product design, composition, and materials
Materials/Equipment/Tools — Skill in:
Selection of and/or use of materials and components as it relates to prefabricated orthotic  treatment
Use of safety equipment (for example, personal protective equipment)
Safe use of hand and power tools (for example, bending irons, heat gun, drill, grinder)
Follow-Up Plan — Knowledge of:
When to refer the patient to other healthcare providers
When to modify the device based on reassessment of fit and function
Follow-Up Plan — Skill in:
Restoring the optimal fit and function of prefabricated and orthoses compression garments
Maintenance and repair of prefabricated orthoses and compression garments
Solving patient’s problems related to Activities of Daily Living (ADLs) (for example, dressing, driving)
Practice Management — Knowledge of:
Referral documents
Appropriate documentation procedures
Policies and procedures regarding privileged information (for example, HIPPA)
Roles and responsibilities associated with other healthcare professions
Reimbursement protocols (for example, DMERC, HCFA)
Universal precautions including sterile techniques and infection control
Scope of Practice of the orthotic fitter
Scope of Practice of other orthotic credentials
Federal and state rules, regulations, and guidelines (for example, FDA, ADA, licensure)