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.

Prosthetics-track respondents were asked to rate the percentage of time they spend in various prosthetic practice areas. Figure 2 shows the average overall allocation of prosthetic practitioners’ time in the practice areas.  As can be seen, practitioners spend more than half of their time in the trans-tibial practice area and just more than a quarter of their time in the transfemoral/knee disarticulation area. The only other practice area that prosthetists spend more than 5% of their time in was partial foot at about 8%.

Figure 2 – Percentage of Time in Prosthetic Practice Areas

Participants were then asked to indicate the percentage of prostheses that incorporated the listed socket designs, suspension systems, and control systems. Table 34 lists the percentages for the socket designs, suspension systems, and control systems within each of six practice areas. 

Table 35

In the prosthetics-specific section, participants answered a series of additional questions about the prosthetic devices they provided within the last 12 months. Results are shown below in Tables 36-42.

Table 36

The biggest changes seen in the prosthetic feet category versus the 2015 study was in the percentage of feet in the hydraulic category. This category doubled from 6% to 12%, and the SACH category that decreased from 8% to four percent.

Table 37

The categories of prosthetic knee components were expanded, and additional specificity was added to the choices. This makes comparison to the previous study difficult. The microprocessor category did increase from 19% to 26%. One factor may be the inclusion of powered type of microprocessor knees, which was not listed in the 2015 survey

Table 38

The biggest change in the type of terminal device provided to upper extremity prosthetic patients was in the multi-articulated hand (e.g., I-Limb, Bebionic) category. Prosthetists reported using this type of terminal device 18% of the time compared to 10% previously.

Table 39

Prosthetists reported spending 39% of their work time in clinical prosthetic patient care.  (See Table 13) Out of that time, respondents spent 6% performing pre-operative consultations and 29% performing post-operative consultations, as shown in Table 40.

Table 40

In the 2015 study, prosthetists reported that they incorporated CAD/CAM in 23% of the prostheses they provided. This percentage has increased to 30%.

Table 41

Table 42 represents a new survey question asked for the first time in this study.

Table 42