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Choosing a Prosthetist or Orthotist is a very important decision and one that may affect the way you live your life. When selecting a practitioner you want to make the most informed choice of who is best qualified to meet your needs, understands your unique situation and can help guide you to a solution that is in your best interest. This decision is not easy, so you will want to ask a variety of questions to ensure that you and your potential practitioner have the same goals for your outcome. You'll also want to make sure that his or her educational background and clinical experience are such that you are confident they can truly address your needs and that he or she is certified by the American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc. (ABC) in their discipline.
By way of definition, a prosthetist is an allied health care professional who evaluates, designs and fabricates custom-made artificial limbs (prostheses). Prosthetists work with those who have had an amputation due to an accident, congenital absence or disabling disease. An orthotist is a health care professional who evaluates and treats musculoskeletal disorders by designing and fitting custom-made orthoses (braces).
The prosthetist or orthotist is an essential member of your rehabilitation team and you want to feel confident and comfortable with the practitioner working on your prosthesis or orthosis. Your prosthetist or orthotist is crucial to your recovery and plays a large role in the way in which you live day-to-day. This is why you should take the time and find the best practitioner for your needs.
Choosing a Prosthetist
How should I choose my prosthetic practitioner?
First, ask questions about his or her formal education, clinical experience and certification. Having an experienced, knowledgeable practitioner will make a critical difference in your rehabilitation success and progress. Your prosthetist will be responsible for the overall fit and function of your prosthesis. This makes your practitioner a key member of your rehabilitation team working closely with you, your surgeon, your primary care physician, therapist and others on your health-care team. You know that you have the right to choose your physician. You have the same right when choosing your prosthetist.
Why is certification important?
When considering a practitioner for your care, inquire about the individual's:
- Formal education, structured residency program and clinical experience
- Passage of a series of written and clinical examinations, and
- Ongoing continuing education programs/courses
When you are ready to make the choice, make sure your prosthetist has received a formal education in prosthetics and that you are comfortable with the amount of clinical education he or she has completed.
All American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) Certified Prosthetists must obtain a formal education (a bachelor's degree or higher) and successfully complete a one-year residency program that has been accredited by the National Commission on Orthotists and Prosthetics Education (NCOPE)prior to sitting for their board examinations. The residency program ensures that a practitioner has received the accurate amount of clinical experience necessary to be a Certified Prosthetist.
Once a candidate is eligible to sit for an examination he or she has to take three exams, two written and one clinical, before they are awarded certification. The certification process for a practitioner is a rigorous one and measures the overall competency of a candidate.
Since 1948, ABC has held the highest standards for prosthetists in the nation. ABC believes that the ability to provide superior health care services for amputees is directly tied to the individual's demonstrated level of expertise and competency consistent with nationally recognized professional standards.
How do I know if my prosthetist is ABC certified?
Practitioners meeting a set of rigorous requirements are considered a Certified Prosthetist (CP) or a Certified Prosthetist/Orthotist (CPO) by ABC. You should verify your practitioner's certification as this is an indication of their education, training as well as a benchmark of their qualifications. You can verify your prosthetist's certification by clicking here for the directory, going to the ABC website (www.abcop.org) or by calling the ABC office at 703-836-7114.
Can I find an ABC Certified Prosthetist near where I live?
Local practitioners can be found on the O&P Care website directory by clicking here or on the ABC website (www.abcop.org). You can search by zip code, state or city to help you narrow your search for a prosthetist most convenient for you.
Can I choose a place to have my prosthesis made or will the doctor have to refer me?
Your doctor will typically refer you to a facility, perhaps one that they have worked with before. In some cases your insurance company or Medicare will provide you with a list of approved practitioners/facilities. However, it is ultimately your decision where you want to receive your prosthetic care.
▲ TopPatient Care — Prosthesis
Do I need a prescription from a physician for a prosthesis?
Yes, you are required to have a physician's prescription before your prosthesis is fabricated. However, prescriptions are not usually necessary for an initial evaluation.
How long will it take to get my prosthesis?
If you are a new amputee, your first visit usually consists of an initial evaluation including information regarding your physical condition, the circumstances surrounding the reason for amputation and measurements of your residual limb. Prior proper use of compression therapy will indicate whether an impression of your residual limb is reasonable at that time.
After a model of your residual limb is obtained, you may be fitted with a "test socket". This is a clear plastic socket used as a diagnostic tool to evaluate the fit of the socket and achieve an optimal fit. During this visit you may also take a few steps while your prosthetist begins to align the prosthesis and establish an optimal functional gait pattern.
At the next visit, your prosthesis will be delivered. In some cases, it will be a preparatory or temporary prosthesis, meaning there is no cosmetic cover. You are now ready to begin, or continue physical therapy and gait training. Your prosthetist will continually monitor your progress during follow-up visits and make any necessary adjustments to your prosthesis. Once physical therapy is complete, you will use the temporary prosthesis for 3 to 6 months before your final prosthesis is fabricated.
Is wearing a prosthesis painful?
A properly fitted prosthesis should not cause pain, but there are many variables which may affect the degree of comfort: the shape of your residual limb, condition of your residual limb tissue, neuromas, skin condition, level of activity, wearing time and so on.
Do I have any say as to the type of components used in making my new prosthesis?
Yes, depending on the type of coverage provided by your health insurance plan. During the evaluation portion of your visit the prosthetist will discuss your daily activities and hobbies in order to start formulating a plan for your prosthesis and what components will best suit your needs.
How often should I see my prosthetist?
A visit to your prosthetist is usually associated with either being fitted with a new prosthesis or addressing a fitting or maintenance issue with an existing prosthesis. When you receive your first prosthesis you will be followed closely until your residual limb has "matured," you have established a daily wearing schedule and achieved an adequate gait pattern. If there are no specific problems with an existing prosthesis, it is common to have a routine follow-up visit every 6 to 9 months.
Do I need a prescription for an adjustment?
If the adjustment is to address a fitting problem with an existing prosthesis, then a new prescription is not necessary unless required by your insurance company. If the adjustment substantially alters the design of your prosthesis then a prescription is usually required.
Do I need a prescription for new liners and/or socks?
If the new liner was simply to replace a worn out liner, then a new prescription may not be necessary. Some insurance companies have limitations on how many prosthetic socks they will cover per year. Most insurance companies require a prescription if there is going to be a claim filed for reimbursement.
Can the components of my prosthesis be changed (i.e. knee, ankle, foot)? Do I need a prescription for this?
Most prostheses today are built utilizing modular components which makes interchangeability of components possible if a new component is needed to replace a worn out one. If the new component changes the design and/or function of your prosthesis then a new prescription is most likely needed. It should be noted that different insurance companies and Medicare may have different requirements for when a new prescription is required. Most insurance companies require a prescription if there is going to be a claim filed for reimbursement.
How often should my prosthesis be replaced?
The useable lifetime of a prosthesis depends on many factors.Your weight, activity level, use and care as well as the specific design of the device all contribute to the actual life of the prosthesis.The materials used to fabricate a prosthesis are generally very durable and material wear is usually not the main reason for needing a new prosthesis.Some components are replaced and maintained many times before the prosthesis requires complete replacement.The most frequent reason for the replacement of a prosthesis is an anatomical change in you, the wearer, that affects the quality of the fit.The most common reason for replacement for children is growth, but changes in alignment can also necessitate the fitting of a new prosthesis.Most prostheses have a useful life span oftwo to fiveyears.It is important to have your prosthetist re-evaluate your prosthesis every 6 to 9 months to ensure the integrity of the components and to evaluate fit/function.
What do I do if my prosthesis is not working correctly? Should I fix it myself?
First, contact your prosthetist. He or she may tell you to discontinue wearing your prosthesis immediately if you notice that any part is broken, loose, cracked, making an unusual noise, causing discomfort or causing skin breakdown.Please remember that your prosthesis is custom designed for your body shape, size, weight and activity level at the time of your initial evaluation.Follow-up appointments are necessary to identify changes in your anatomy or overall conditionbefore your prosthesis can cause a problem.You should see your prosthetist at least every6 to 9 months for follow-up care or sooner if you notice changes in your weight or experience changes in your activity level.Your prosthetist will let you know if your prosthesis requires more frequent follow-up care or specific maintenance.
▲ TopHelpful Links
Are there other resources for people that wear a prosthesis?
The Amputee Coalition of America is a resource for individuals with limb loss or limb difference and their families. You can contact the ACA at 1-888-AMP-KNOW (1-888/267-5669), or visit their website at www.amputee-coalition.org
Disabled American Veterans dedicates its mission to building better lives for America's disabled veterans and their families. You can contact the DAV at 1-877-I AM A Vet (1-877-426-2838) or visit their website at www.dav.org.
Disabled Sports USA provides leadership opportunities for individuals with disabilities to develop independence, confidence and fitness through participation in community sports, recreation and educational programs. You can contact DS/USA at .
The Wounded Warrior Project helps to raise awareness and enlist the public's aid for the needs of the severely injured service men and women. You can contact the WWP at 1-877-TEAMWWP (1-877-832-6997) or visit their website at www.woundedwarriorproject.org.
▲ TopChoosing an Orthotist
How should I choose my orthotic practitioner?
First you should ask questions about his or her formal education, clinical experience and certification. Having an experienced, knowledgeable practitioner will make the critical difference in your rehabilitation success and progress. Your orthotist will be responsible for the overall fit and function of your orthosis. This makes your practitioner a key member of your rehabilitation team working closely with you, your primary care physician, therapist and others on your health-care team. You know that you have the right to choose your physician. You have the same right when choosing your orthotist.
Why is certification important?
When considering a practitioner for your care, inquire about the individual's:
- Formal education, structured residency program and clinical experience
- Passage of a series of written and clinical examinations, and
- Ongoing continuing education programs/courses
When you are ready to make a choice, make sure your orthotist has received a formal education in orthotics and that you are comfortable with the amount of clinical education he or she has completed.
All of the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) Certified Orthotists must obtain a formal education (a bachelor's degree or higher) and successfully complete a one-year residency program that has been accredited by the National Commission on Orthotists and Prosthetics Education (NCOPE)prior to sitting for their board examinations. The residency program ensures that a practitioner has received the accurate amount of clinical experience necessary to be a Certified Orthotist.
Once a candidate is eligible to sit for an examination he or she has to take three exams, two written and one clinical, before they are awarded certification. The certification process for a practitioner is a rigorous one and measures the overall competency of a candidate.
Since 1948, ABC has held the highest standards for orthotists in the nation. ABC believes that the ability to provide superior health care for amputees is directly tied to the individual's demonstrated level of expertise and competency with nationally recognized professional standards.
How do I know if my orthotist is ABC certified?
Practitioners meeting a set of rigorous requirements are considered a Certified Orthotist (CO) or a Certified Prosthetist/Orthotist (CPO) by the ABC. You should verify your practitioner's certification for this is an indication of their education, training and a benchmark of their qualifications. You can verify your orthotist's certification by clicking here for the directory, going to the ABC website (www.abcop.org) or by calling the ABC office at 703-836-7114.
Can I find an ABC Certified Orthotist near where I live?
Local practitioners are found on the O&P Care website directory by clicking here or on the ABC website (www.abcop.org). You can search by zip code, state or city to help you narrow your search for an orthotist most convenient for you.
Can I choose a place to have my orthosis made or will the doctor have to refer me?
Your doctor will typically refer you to a facility, perhaps one that they have worked with before. In some cases, your insurance company or Medicare will provide you with a list of approved practitioners/facilities. However, it is ultimately your decision where you want to go for orthotic care.
▲ TopPatient Care — Orthosis
Do I need a prescription from a physician for an orthosis?
Yes, you are required to have a physician's prescription before your orthosis can be made. However, prescriptions are not needed for initial evaluations.
Is wearing an orthosis painful?
Not usually. However, while wearing any type of orthosis you must take good care of your skin to prevent skin breakdown. Skin breakdown can be any type of sore, red, raw or blistered area. To avoid skin breakdown you should: keep the orthosis clean with mild soap and water or a non-toxic cleaner, avoid skin creams or lotions that come in contact with the orthosis. If you experience skin breakdown, contact your orthotist immediately.
How often should my orthosis be replaced?
The useable life of an orthosis depends on many factors.Your weight and activity level, as well as the specific design of the device, all contribute to the actual wear of your orthotic.The materials used to fabricate an orthosis are generally very durable and material wear is usually not the main reason for needing a new device.Some parts, such as straps are replaced and maintained many times before the orthosis is completely replaced.The most frequent reason for replacement of an orthosis is anatomical change that affects the fit of the device.It is reasonable to expect most orthoses to be useable for one year or more and some can be worn for many years. It is important to have your orthosis re-evaluated every 6 to 12 months to ensure its integrity.
How often should I see an orthotist?
A visit to your orthotist is usually associated with either being fitted with a new orthosis or addressing a fitting or maintenance issue with an existing one. Under normal circumstances you should see your orthotist every 3 to 6 months.
Do I need a prescription for an adjustment?
Not usually; however, if the adjustment involves changing the basic type or function of the orthosis then you may need to see your physician for a prescription.
How long will my orthosis last?
This will depend largely on your age and activity level. A wearer with a higher activity level will normally put more "wear and tear" on the orthosis, meaning if you are very active you might need a replacement sooner than someone who is more inactive. Additionally, when an orthosis is fit to a child or adolescent, it will need to be replaced more often because they are still growing.
What do I do if my orthosis is not working correctly? Should I fix it myself?
First, stop wearing the orthosis if you notice that a part of it is broken, loose, cracked, making an unusual noise, causing discomfort or skin breakdown. Remember that your orthosis is custom designed for your body shape, size, weight and activity level at the time of evaluation and casting.Follow-up appointments are necessary to identify changes in your anatomy or overall condition before they cause a problem.You should see your orthotist every 3 to 6 months for follow-up care or sooner if you notice changes in your weight or experiences changes in your activity level.Your orthotist will let you know if your orthosis requires more frequent follow-up care or specific maintenance.
▲ TopPlease feel free to ask us your question directly! You may also wish to review information about what to look for in choosing an O&P Professional.