Fair to say this is a universal wish for ourselves and others with each new year. Hopes for prosperity and wellness resolutions abound. Exercise equipment, fitness regimens and forays into new physical activities are initiated.  There are common jokes about how New Year’s fitness resolutions are fleeting, however, the vital work towards achieving good health is a proven fact. What if it isn’t the stereotypical lofty aspirations that dissipate? What if someone doesn’t have access to achieve these essential goals? This is often the case for individuals with limb loss and limb difference (LLLD). Having the means to perform specific activities is as important as having the will. Unfortunately, not every person with LLLD has access to running, cycling, swimming, etc. for they require customized prosthetic components which are typically not covered by insurance. Activity-specific prostheses are not deemed to be “medically necessary” therefore do not meet the requirements for insurance coverage.1,2,3 How can this be when exercise is medically necessary to maintain good health?4

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So Every BODY Can Move

The O&P PT is not the only source to question this concept. Thankfully, there has been a crucial movement across our nation called So Every BODY Can Move.5 Prosthetic users, clinicians, citizens, politicians and more working together to advocate for access to specialty orthotic and prosthetic devices to allow individuals to participate in exercise, recreation and physical activity. What started as a movement to enable children access has mobilized into advocacy for all who require activity-specific orthotic and prosthetic interventions to participate in a healthy lifestyle beyond basic functional means. The collaboration has been coordinated by the American Orthotic & Prosthetic Association (AOPA), the National Association for the Advancement of Orthotics and Prosthetics (NAAOP), the Amputee Coalition, and the American Academy of Orthotists and Prosthetists (AAOP). State-by-state action has been taken with 5 states having passed legislation and more on the docket for 2024.6

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In this new year, The O&P PT will explore the @soeverybodycanmove campaign and share with you more information about how exercise is medicine, recreational prostheses and how you can get involved in supporting this indispensable movement. Let’s make this a happy, healthy new year for all!

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References

  1. CMS. “Local Coverage Determination Lower Limb Prostheses.” CMS, https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33787&ver=26. Accessed 1 January 2024.
  2. Tufts Health Plan. “Medical Necessity Guidelines: Lower Limb Prostheses.” TuftsHealthPlan, https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/lower-limb-prostheses-mng. Accessed 1 January 2024.
  3. Anthem. “Clinical UM Guideline Lower Limb Prosthesis.” Anthem, https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_a053639.html. Accessed 1 January 2024.
  4. U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. “Physical Activity Guidelines for Americans.” Health.gov, 23 June 2023, https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines
  5. So Every BODY Can Move. SEBCM, https://soeverybodycanmove.org/ Accessed 1 January 2024.
  6. Amplitude. “Insurance Coverage for Amputees: 2024 Legislation Tracker.” Amplitude, 1 January 2024,  https://livingwithamplitude.com/insurance-coverage-for-amputees-2024-legislation-tracker/
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