Association
Job outline & education
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URL: http://www.ot-forum.de/e3681/e9216/index_eng.html
Prosthestists/orthotists fabricate medical devices for handicapped people, like artificial limbs (prostheses), orthopaedic appliances for extremities and trunk (orthoses), soft orthopaedic supports and custom-made rehabilitation aids.
The manufacturing process is based on biomechanical principles and is assisted by modern fabrication techniques and the latest technological developments, therefore every item can be adapted to the individual needs of the patients. The devices are made of several materials like plastic, metal, wood, leather and fabric.
These orthopaedic appliances are manufactured in private workshops and rehabilitation establishments or laboratoratories which are annexed to hospitals. The measuring and/or casting of the affected body part is frequently performed in the hospital, immediately after the surgery like in cases of amputations.
Usually, the orthotic/prosthetic treatment is discussed confidentially with the physician in charge. The diagnosis is made by the physician after a thorough examination the orthotist/prosthetist treats the patient respecting the indication and prescription.
The post-operative treatment and the long-term care as well as the maintenance and replacement of appliances like wheel chairs, walkers, off-the-shelf supports or patient-care items of long-term use is also part of the responsibilities of the orthotists/prosthetists. The most important aspect, however, is the professional advice given to sick, disabled and elderly patients.
Orthotists/prosthetists require in addition to the technical skills, knowledge about anatomy, pathology, applied biomechanics, materials sciences, the understanding and gentleness to deal with the sick or disabled and their problems. Sensitivity towards the situation of the patient is specially required as an orthotists/prosthetists when treating psychologically affected patients like breast amputees, stoma users and quadriplegics.
Activities
Orthotists/prosthetists manufacture mechanical devices for external use to correct deficiencies of the locomotive system caused by pathological changes, congenital defects or conditions resulting after surgery (i. e. amputations). These devices are either prostheses, orthoses and rehabilitation aids which are fabricated in prosthetics and orthotics workshops or rehabilitation establishments. The measuring and the casting to obtain a workable model of the affected body part is some times performed in the hospital, immediately after the surgery as is the case after an amputation or when urgently required after sport injuries.
Important requisites for this profession are possessing manual and technical skills, machining of different types of materials, measuring, taking impressions of body parts of the affected patients, counselling and providing service to the handicapped, sick and elderly, developing individual solutions in the use of rehabilitation aids, installing, assembling and maintaining industrially manufactured components like artificial joints, wheel chairs, bathroom aids and other rehabilitation devices.
Orthotists/prosthetists are part of a rehabilitation team in which they assume the responsibility for the fabrication of technical orthopaedic devices. Two basic functions result from this position: team work and the individual creative activity. Only with the cooperation and the information of the physician, physical therapists or occupational therapists (the rehabilitation team) is it possible to logically and coherently describe the function of an orthotists/prosthetists.
The independent and specific task of the orthotists/prosthetists is a result of the above mentioned team work. The orthotists/prosthetists is in charge of the construction, manufacturing, fitting and delivery of rehabilitation devices. The objective of the rehabilitation team, after the patient is fitted with the orthopaedic device, is to optimally restore the physical and psychological condition of the patient. For many patients, the success of the rehabilitation treatment depends on the orthopaedic device. Thus, the quality and/or performance of the prostheses, orthoses, supports or wheel chairs often play a significant role during long periods of the patient’s life.
To service to the sick and handicapped is a highly qualified job which demands thorough knowledge of the field, proficiency and creativity. The orthotists/prosthetists must replace or restore the function of affected body parts based on medical and technical principles and the many possibilities of craftsmanship as well. Many technologies are available to accomplish the diverse assignments. Several materials can be used for the fabrication of orthopaedic devices. To start it is necessary to use plaster of paris (to take the moulds or casts) but other materials like metal, wood, plastic, resins, leather or fabrics are also utilised.
Furthermore, expertise in some of the modern techniques is also required i. e. myoelectric arm prostheses (controlled with the muscular impulses), hydraulic-controlled lower limb prosthesis and custom fabrication of computer-controlled prosthesis (CAD-CAM).
Additonal responsibilities include the fitting of compression stockings in cases of venous disorders, breast prostheses, stoma care and incontinence supplies. The area of rehabilitation aids includes not only wheel chairs but also custom seating shells for disabled, beds for hospital, lifting aids, oxygen devices and bathroom aids.
The work in this field can be divided into three categories:
A specialisation in one of these three categories can be considered. The orthotists/prosthetists can choose one or several of these activities according to their interests and inclination.
© 2012 Bundesinnungsverband für Orthopaedietechnik