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Physical therapists play a key role in orthotics and prosthetics rehabilitation. As movement experts, PTs are vital to maximizing a person’s function and are key members of the multidisciplinary healthcare team.1 PTs work in concert with Certified Prosthetists Orthotists and Physiatrists to meet our clients’ O&P needs from evaluation/prescription to training & mastery of devices.

Falls Prevention

Physical Therapy is integral to laying a solid foundation for preparation and acquisition of a new O&P intervention. Focusing on strengthening, range of motion, balance training, endurance and O&P related education equips clients for success.2,3,4,5 Rehabilitation helps address acute and chronic impairments and has been shown to reduce overall healthcare costs with commonly associated conditions (e.g., acute low back pain; knee osteoarthritis; vascular claudication).4 One particularly important area addressed by physical therapy is falls prevention.4,5  PT training with the use of an orthosis, prosthesis and assistive device helps improve safety and execution of mobility & activities of daily living.1

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Prosthetics

Falls in adults with lower limb loss are common with self-reports ranging from 21% during initial hospital stay to 58% of individuals living in the community.6 Injuries are often incurred as a result which may impede use of a prosthesis and limit functional mobility.6  Identifying potential risk factors (e.g., lower limb weakness, impaired sensation, diabetes) and incorporating these into fall prevention strategies are important facets of rehabilitation.6,7  Physical and mental health play a key role in an individual’s function and addressing symptoms such as phantom limb pain can help improve overall quality of life and reduce risk of falls.7

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Orthotics

Risk of falls extends to individuals using orthotic interventions as well. Lower limb weakness, tonal influences and impaired balance reactions are a just a few potential risk factors experienced with orthotic users.2,8  While no one intervention alone can stop someone from falling, use of an orthosis with concomitant PT interventions has shown to help mitigate some of the underlying risks.1,2,4,5 Additionally, these O&P rehabilitation strategies can help promote key positive influences on an individual’s function such as self-efficacy, quality of life and balance confidence.8,9   

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Physical activity is vital for all stages of our lives and most effective when tailored to our individual needs.10 Reach out to a Physical Therapist to discover your specialized exercise prescription and explore your potential.11 We’re looking forward to working with you!

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References

  1. APTA. “American Physical Therapy Association Guide to Physical Therapist Practice 4.0.”2023, https://guide.apta.org/
  2. Jorge, Milagros, et al. Orthotics and Prosthetics in Rehabilitation E-Book. Saunders, 2019.
  3. Utiyama, Daniela Mitiyo Odagiri PhD; Alfieri, Fábio Marcon PhD; dos Santos, Artur César Aquino BSc; Ribeiro, Carla Paschoal Corsi BSc; Sales, Viviane Caroline BSc; Battistella, Linamara Rizzo PhD. “Effects of an Inpatient Physical Rehabilitation Program Designed for Persons with Amputations of Traumatic or Vascular Etiologies.” Journal of Prosthetics and Orthotics 34(3):p 152-158, July 2022. | DOI: 10.1097/JPO.0000000000000436
  4. APTA. “The Economic Value of Physical Therapy in the United States-a report from the American Physical Therapy Association.” September 2023, https://www.valueofpt.com/globalassets/value-of-pt/economic_value_pt_u.s._report_from_apta-report.pdf
  5. APTA. “Physical Therapy Guide to Falls.” 2023, https://www.choosept.com/guide/physical-therapy-guide-falls
  6. Hunter, Susan W et al. “Risk Factors for Falls in People With a Lower Limb Amputation: A Systematic Review.” PM & R : The Journal of Injury, Function, and Rehabilitation vol. 9,2 (2017): 170-180.e1. doi:10.1016/j.pmrj.2016.07.531
  7. Sions, J.M., Oteri, M., Beisheim, E.H., Smith, S.C., Horne, J.R., and Sarlo, F.B. “Risk Factors for Falling and Multiple Falls among Adults with Limb Loss Beyond the First Year.” Journal of Prosthetics and Orthotics, vol. 32,2S (2020): 30-34.
  8. McDald, Catriona, et al. “Systematic Review of the Evidence on Orthotic Devices for the Management of Knee Instability Related to Neuromuscular and Central Nervous System Disorders.” BMJ Open, vol. 7, no. 9, 2017, pp. e015927-e015927.
  9. Zissimopoulos, Angelika, Stefainia Fatone and Steven Gard. “The Effect of Ankle-Foot Orthoses on Self-Reported Balance Confidence in Persons with Chronic Poststroke Hemiplegia.” Prosthetics and Orthotics International, vol. 38, no. 2, 2014, pp. 148.
  10. U.S. Department of Health and Human Services. “Physical Activity Guidelines for Americans, 2nd edition.” 2018, https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
  11. APTA. “Find a PT.” 2023, https://aptaapps.apta.org//APTAPTDirectory/FindAPTDirectory.aspx

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