Practice Analysis of Certified Practitioners in the Disciplines of Orthotics and Prosthetics

Participants who indicated that they had provided direct patient care in the last 12 months were presented with a section covering either orthotic or prosthetic practice areas, as well as additional discipline-specific questions. Participants were directed to the orthotics or prosthetics section based on the discipline track they were assigned for the survey depending on their credential (CO or CP), or their preference for dually credentialed (CPO) practitioners. The results of these ratings provide guidance with regard to the development and/or refinement of ABC’s certification examinations.  The results also provide guidance to the National Commission on Orthotic and Prosthetic Education (NCOPE) in the development of orthotic and prosthetic residency and education standards.

Orthotics-track respondents were asked to rate the percentage of time they spend in various orthotic practice areas. Figure 1 shows the average overall allocation of orthotic practitioners’ time in the practice areas. As can be seen, practitioners spend more than half of their time in the lower extremity practice area. There was a decrease in the percentage of time spent in lower extremity from the 2015 study (from 59% to 54%). The cranial practice area increased by 5% from the previous study and the scoliosis area also saw a small increase. These changes are consistent with the notable increase in the percentage of patients in the pediatric age range seen by orthotists.

Figure 1 – Percentage of Time in Orthotic Practice Areas

Participants were then asked to indicate the percentage of time they spend on each of the orthotic device types that were delineated within each of the five practice areas, as shown in Table 25.

Table 25

In the orthotics-specific section, participants answered a series of additional questions about the orthoses they provided within the last 12 months. Results are shown below in Tables 26–34. 

Table 26

The percentage of stance control KAFOs provided by orthotists decreased from 9% in the 2015 study to 6%, as shown in Table 27.

Table 27

Custom fit (prefabricated) AFOs are more often provided than the previous study. This category increased from 18% to 22%.

Table 28

Table 29

There was a significant shift in the type of prefabricated AFOs provided by orthotists. Carbon fiber type orthoses increased from 72% in the 2015 study to 82%. A similar decrease in thermoplastic AFOs was seen, from 27% to 14%.

Table 30

There was a major change in the percentage of AFOs provided that utilized the AFO footwear combination, tuning or dynamic alignment method. In 2015 orthotists reported that they used one of these methods in only 18% of the AFOs they provided. That percentage grew to 44%. This may be due to the addition of dynamic alignment to the survey question in this study.

Table 31

Orthotists reported providing more prefabricated spinal orthoses than in 2015. The percentage for this category increased from 40% to 52%. Both the other categories, custom fabricated to patient model and custom fabricated to patient measurement, decreased from the 2015 study.

Table 32

Table 33

Table 34