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January 2012
Respondents were asked what percentage of their overall work time they spent performing different activities.
Respondents in general spent less than half their work time providing patient care (47% for orthotic respondents and 41% for prosthetic respondents). Prosthetic respondents spent a greater percentage of their work time than did orthotic respondents doing fabrication (43% versus 29%, respectively), while orthotic respondents spent more time than did prosthetic respondents doing administration (22% versus 14%, respectively).
Table 18
Orthotics | Prosthetics | |
---|---|---|
Patient care | 46.7% | 41.3% |
Fabrication | 29.0% | 42.6% |
Administration (e.g., billing, office management, inventory) | 22.2% | 14.0% |
Other | 2.1% | 2.0% |
The survey next asked respondents to answer a series of questions from the perspective of either an orthotic or a prosthetic assistant; they were routed to the version of the survey to complete based on their response to the screening question. Those completing the orthotic assistant version were asked the percentage of their time they spent performing activities in orthotic-related practice areas, and to provide detailed percentages for specific orthotic devices on which they spent their work time. Lower Extremity comprised the majority of total orthotic assistant work time, with an average of 57% of work time. On average, approximately 20% of work time was devoted to devices in the Spinal area, and followed by the Upper Extremity area and devices (16% of work time) and the Scoliosis area and devices (6% of time).
Table 19
Lower Extremity | 56.8% |
Spinal | 20.1% |
Scoliosis | 5.5% |
Upper Extremity | 16.0% |
Other | 1.7% |
Respondents were also asked to indicate the percentage of time they spent performing activities related to specific orthotic devices.
Table 20
% of Time | |
---|---|
Lower Extremity | 56.8% |
Shoes | 11.1% |
FO | 11.0% |
AFO | 16.7% |
KO | 8.9% |
KAFO | 4.5% |
HO | 2.2% |
HKAFO | 1.5% |
Other | 0.9% |
Spinal | 20.1% |
LSO | 8.7% |
TLSO | 7.0% |
TLO | 1.2% |
CTO | 1.1% |
CO | 1.9% |
Other | 0.2% |
Scoliosis | 5.5% |
LSO | 1.8% |
TLSO | 3.3% |
CTLSO | 0.4% |
Upper Extremity | 16.0% |
HO | 1.6% |
WHO | 6.5% |
WO | 2.0% |
EWHO | 1.1% |
EO | 2.7% |
SEWHO | 0.5% |
SO | 1.3% |
Other | 0.2% |
Respondents were asked which of six specific tasks they performed with patients with respect to the devices in each of the orthotic practice areas. Because assistants may be involved in these activities under the supervision of a practitioner, or may be acting in a supervised role, the somewhat high percentages found for some of these activities may reflect participation in, rather than independent performance of, the activities.
Table 21
Participate in initial patient evaluation | Measure/ mold/ digitize/ scan | Rectify model | Fabricate | Fit | Perform follow-up | |
---|---|---|---|---|---|---|
Lower Extremity | ||||||
Shoes | 74% | 71% | 46% | 38% | 79% | 73% |
FO | 77% | 78% | 66% | 69% | 82% | 78% |
AFO | 88% | 79% | 67% | 58% | 86% | 81% |
KO | 81% | 75% | 48% | 34% | 82% | 76% |
KAFO | 66% | 52% | 42% | 42% | 58% | 60% |
HO | 51% | 46% | 27% | 24% | 50% | 50% |
HKAFO | 37% | 35% | 30% | 26% | 33% | 38% |
Spinal | ||||||
LSO | 80% | 75% | 41% | 27% | 79% | 73% |
TLSO | 78% | 71% | 40% | 33% | 70% | 74% |
TLO | 41% | 34% | 17% | 10% | 36% | 39% |
CTO | 38% | 33% | 18% | 10% | 36% | 38% |
CO | 65% | 56% | 25% | 13% | 64% | 58% |
Scoliosis | ||||||
LSO | 55% | 51% | 25% | 20% | 51% | 49% |
TLSO | 63% | 55% | 27% | 23% | 52% | 56% |
CTLSO | 31% | 27% | 12% | 8% | 30% | 31% |
Upper Extremity | ||||||
HO | 52% | 50% | 26% | 19% | 53% | 48% |
WHO | 74% | 67% | 39% | 32% | 75% | 68% |
WO | 50% | 45% | 26% | 19% | 48% | 46% |
EWHO | 41% | 40% | 22% | 15% | 41% | 39% |
EO | 65% | 58% | 28% | 18% | 64% | 57% |
SEWHO | 27% | 25% | 12% | 11% | 26% | 26% |
SO | 51% | 47% | 17% | 15% | 53% | 50% |
Respondents answering from the perspective of prosthetic assistants were likewise asked the percentage of time they spent performing tasks associated with each prosthetic practice area. In addition, they were asked to provide detailed percentage of time distributions for the prosthetic practice areas in which they worked.
Table 22
Transtibial | 52.8% |
Transfemoral | 26.3% |
Transradial | 9.3% |
Transhumeral | 5.0% |
Symes | 6.6% |
Details of the practice areas and the time spent on various devices are presented below.
Table 23
Transtibial | 52.8% |
---|---|
Sockets | |
Patella tendon bearing | 8.3% |
Total surface bearing (no locking mechanism employed) | 7.0% |
Suspension Mechanisms | |
Roll-on liner with lock | 17.5% |
Roll-on liner with valve | 5.5% |
Sleeve | 6.0% |
Vacuum | 6.7% |
Supracondylar | 1.8% |
Transfemoral | 26.3% |
Sockets | |
Quadrilateral | 0.8% |
Ischial containment | 7.4% |
M.A.S. design | 0.9% |
Control Schemes | |
Fluid control | 0.8% |
Microprocessor | 3.4% |
Mechanical | 2.6% |
Suspension Mechanisms | |
Roll-on with locking mechanism | 4.9% |
Vacuum-assisted | 1.1% |
Traditional suction with expulsion valve | 3.8% |
Hip joint/pelvic band/waist belt | 0.6% |
Transradial | 9.3% |
Control Schemes | |
Myoelectric | 2.4% |
Body-powered | 2.7% |
Passive | 0.4% |
Suspension Mechanisms | |
Self | 0.3% |
Roll-on | 0.8% |
Suction | 0.7% |
Harness | 2.0% |
Transhumeral | 5.0% |
Control Schemes | |
Myoelectric | 1.2% |
Body-powered | 1.4% |
Hybrid | 0.2% |
Passive | 0.3% |
Suspension Mechanisms | |
Roll-on | 0.3% |
Suction | 0.3% |
Harness | 0.3% |
Symes | 6.6% |
Sockets | |
Patella tendon bearing | 1.4% |
End bearing | 1.3% |
Medial opening | 1.7% |
Posterior opening | 0.5% |
Expandable wall | 0.7% |
Suspension Mechanisms | |
Silicone liner with expulsion valve | 0.6% |
Suspension pad | 0.4% |
Prosthetic assistants were asked to indicate which of seven specific activities they perform in each practice area. Similar to the orthotic assistants, it is likely that respondents were participating in these activities under supervision, rather than performing them independently.
Table 24
Participate in initial patient evaluation | Measure/ mold | Rectify model/ delineation | Fabricate | Initial fit/ align | Delivery | Perform follow-up | |
---|---|---|---|---|---|---|---|
Transtibial | 85% | 73% | 72% | 82% | 88% | 83% | 90% |
Transfemoral | 82% | 67% | 60% | 78% | 83% | 71% | 82% |
Transradial | 39% | 37% | 33% | 55% | 57% | 45% | 44% |
Transhumeral | 35% | 32% | 24% | 48% | 44% | 29% | 40% |
Symes | 59% | 45% | 44% | 70% | 62% | 55% | 71% |