Contents
- Acknowledgements
- Practice Analysis Task Force
- Introduction
- Executive Summary
- Survey of Practice
- Results Related to Professional Background, Work Setting, and Demographic Information
- Domains, Tasks, Knowledge and Skill Statements
- Domains
- Tasks
- Knowledge and Skills Statements
- Results and Discussion Related to Practice Areas, Devices, and Activities
- Highlights of Results Related to Qualitative Responses
©2024 by the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc. All rights reserved.
No part of this document may be produced in any form without written permission of the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc.
Practice Analysis of ABC Certified Orthotic Fitters
January 2019
Results and Discussion Related to Practice Areas, Devices, and Activities
All respondents were asked to characterize the nature of their work in regard to an extensive list of orthotic devices.
Respondents spend the greatest percentage of their time working in the Lower Extremity area (44%); Spinal and Upper Extremity each accounted for approximately 20% of work time; Fracture Orthoses* takes about 10% of work time; and Other areas account for close to 6% of work time.
Table 17
| Lower Extremity | 44.2% |
| Spinal | 19.9% |
| Upper Extremity | 20.5% |
| Fracture Orthoses | 9.8% |
| Other | 5.7% |
*An ABC Certified Fitter-orthotics is competent to practice orthotics within a scope of practice that is specific to fitting certain custom fitted, prefabricated, and off-the-shelf orthoses which includes prefabricated orthoses of the upper and lower extremities, except those used in the initial and/or acute treatment of long bone fractures and dislocations. The entire Certified Fitter-orthotics Scope of Practice can be found at www.abcop.org.
A detailed breakdown of the percentage of time in each area shows the percent of time spent working with specific orthotic devices in each area.
Table 18
| Lower Extremity | 44.2% |
|---|---|
| 1.1 Orthopedic shoes | 2.9% |
| 1.2 Diabetic shoes | 7.9% |
| 1.3 Foot orthosis (FO), prefabricated | 4.1% |
| 1.4 Ankle support | 4.8% |
| 1.5 Ankle-foot orthosis (prefabricated) | 4.2% |
| 1.6 Ankle-foot orthosis (AFO-custom) | 2.8% |
| 1.7 Soft Knee orthosis (KO) | 5.5% |
| 1.8 Rigid Knee orthosis (KO), prefabricated | 6.6% |
| 1.9 Post-operative Knee orthosis (KO) | 4.2% |
| 1.10 Hip orthosis (HO) | 1.2% |
| Spinal | 19.9% |
| 2.1 Soft Lumbosacral orthosis (LSO) | 3.8% |
| 2.2 Semi-rigid Lumbosacral orthosis (LSO) | 4.7% |
| 2.3 Rigid Lumbosacral orthosis (LSO) | 2.0% |
| 2.4 Soft Thoracolumbosacral orthosis (TLSO) | 1.1% |
| 2.5 Semi-rigid Thoracolumbosacral orthosis (TLSO) | 1.8% |
| 2.6 Rigid Thoracolumbosacral orthosis (TLSO) | 1.5% |
| 2.7 Thoracolumbar orthosis (TLO-hyperextension) | 1.0% |
| 2.8 Semi-rigid Cervicothoracic orthosis (CTO) | 0.6% |
| 2.9 Soft Cervical orthosis (CO) | 1.8% |
| 2.10 Semi-rigid Cervical orthosis (CO) | 1.6% |
| Upper Extremity | 20.5% |
| 3.1 Hand orthosis (HO) | 4.2% |
| 3.2 Wrist Hand orthosis (WHO) | 11.4% |
| 3.3 Elbow orthosis (EO) | 4.9% |
| Fracture Orthoses | 9.8% |
| 4.1 Rigid sole shoe | 1.7% |
| 4.2 Walking boot | 5.6% |
| 4.3 Tibial fracture brace | 1.2% |
| 4.4 Humeral cuff | 0.9% |
| 4.5 Other | 0.4% |
| Other | 5.7% |
| 5.1 Compression garments | 1.9% |
| 5.2 Lymphedema sleeves | 0.7% |
| 5.3 Burn garments-custom | 0.3% |
| 5.4 Hernia supports | 0.4% |
| 5.5 Traction equipment | 0.2% |
| 5.6 Canes | 0.3% |
| 5.7 Crutches | 0.7% |
| 5.8 Walkers | 0.5% |
| Other | 0.7% |
Respondents were asked which of four specific activities they perform with respect to 58 specific orthotic devices organized into four categories of devices by body area (see Table 19). On average, a slightly greater percentage of respondents Measured and Assembled and Fit devices than perform the other two activities. Overall, Measure is performed most frequently, followed by Assemble and Fit. A greater percentage of respondents perform the four activities with regard to devices in the Spinal area than with regard to devices in the other three areas.
Table 19
| Perform Initial Investment | Measure | Assemble and Fit | Perform Follow-Up | |
|---|---|---|---|---|
| Lower Extremity | ||||
| L-1686 Post-op hip orthosis | 33% | 39% | 37% | 33% |
| L-1800 KO, elastic with stays | 64% | 72% | 69% | 50% |
| L-1810 Elastic hinged KO | 67% | 74% | 72% | 56% |
| L-1815 Patellar tracking KO | 62% | 71% | 67% | 52% |
| L-1820 Hinged KO with condylar pads | 68% | 74% | 71% | 58% |
| L-1825 Elastic knee sleeve | 62% | 71% | 70% | 51% |
| L-1830 Knee immobilizer | 70% | 77% | 78% | 56% |
| L-1831 KO with locking joints | 53% | 58% | 56% | 49% |
| L-1832 Post-op ROM KO | 64% | 70% | 71% | 57% |
| L-1843 KO, unloader, OA type | 59% | 64% | 61% | 56% |
| L-1845 Prefabricated functional KO | 64% | 70% | 66% | 59% |
| L-1902 Ankle Gauntlet, prefab | 65% | 71% | 71% | 51% |
| L-1906 Ankle multiligamentus orthosis | 54% | 60% | 60% | 43% |
| L-1930 Prefabricated thermoplastic AFO | 48% | 52% | 51% | 44% |
| L-1932 AFO, rigid anterior section, carbon fiber or equal | 38% | 43% | 42% | 38% |
| L-1951 AFO, spiral, plastic, or other material | 31% | 35% | 33% | 31% |
| L-1971 AFO, plastic or other material with ankle joint | 38% | 41% | 39% | 36% |
| L-4350 Ankle control orthosis, stirrup style | 53% | 59% | 57% | 42% |
| L-4360 Walking boot, pneumatic | 68% | 75% | 76% | 53% |
| L-4386 Walking boot | 73% | 79% | 79% | 58% |
| L-4396 Multi-podus splint | 52% | 58% | 56% | 47% |
| L-4396 Plantar fasciitis night splint | 70% | 78% | 78% | 58% |
| Spinal | ||||
| L-0120 Soft cervical collar | 83% | 95% | 93% | 63% |
| L-0172 Semi-rigid collar | 83% | 93% | 93% | 70% |
| L-0174 Semi-rigid collar with thoracic extension | 82% | 90% | 90% | 81% |
| L-0210 Rib belt | 86% | 92% | 91% | 66% |
| L-0450 Thoracolumbar corset | 87% | 94% | 90% | 73% |
| L-0458 TLSO, two piece rigid shells, prefabricated | 85% | 91% | 87% | 79% |
| L-0472 TLSO Ant. frame hyperextension | 85% | 89% | 89% | 79% |
| L-0625 Lumbosacral corset, short | 86% | 94% | 93% | 67% |
| L-0626 LSO warm and form | 85% | 94% | 91% | 72% |
| L-0627 Lumbar orthosis with rigid ant/ post panels | 88% | 91% | 94% | 74% |
| L-0628 Lumbosacral corset, long | 89% | 93% | 90% | 74% |
| L-0631 LSO, with rigid ant/post panels | 88% | 92% | 91% | 80% |
| L-0633 LSO, with rigid frame or panel, with rigid ant/post panels | 87% | 92% | 88% | 75% |
| Upper Extremity | ||||
| L-3651 Shoulder immobilizer elastic | 55% | 63% | 62% | 44% |
| L-3670 Accromioclavicular splint | 38% | 40% | 40% | 30% |
| L-3675 Canvas shoulder motion restraint orthosis | 38% | 42% | 41% | 30% |
| L-3960 Shoulder abduction orthosis (Gunslinger, Airplane) | 41% | 45% | 45% | 33% |
| L-3980 Humeral fracture cuff | 43% | 48% | 48% | 38% |
| L-3710 Elbow orthosis with adjustable hinges | 50% | 54% | 55% | 43% |
| L-3908 Wrist splint | 75% | 84% | 84% | 56% |
| L-3908 Wrist splint with thumb | 70% | 78% | 77% | 53% |
| A-3650 Figure of 8 shoulder splint | 49% | 53% | 53% | 37% |
| L-3999 Tennis elbow strap | 64% | 69% | 71% | 45% |
| L-3700 Elbow sleeve with stays | 43% | 48% | 48% | 34% |
| L-3701 Elbow sleeve | 52% | 60% | 59% | 37% |
| L-0210 L-3760 Elbow orthosis with adjustable locking joints | 53% | 56% | 55% | 45% |
| Other Devices | ||||
| A-6533 Above knee compression hose | 55% | 60% | 59% | 43% |
| A-6542 Custom compression hose | 40% | 43% | 43% | 34% |
| L-3260 Post-op shoe | 64% | 73% | 73% | 48% |
| L-3260 Unloader shoe (Darco wedge type) | 55% | 62% | 62% | 43% |
| L-3649 DH pressure relief shoe | 42% | 47% | 48% | 34% |
| L-3216 Ladies’ depth inlay shoe | 44% | 48% | 48% | 40% |
| L-3221 Men’s depth inlay shoe | 44% | 48% | 48% | 40% |
| A-5500 Diabetic shoe | 57% | 61% | 59% | 52% |
| A-5512 Diabetic insert | 58% | 62% | 61% | 52% |
| A-6530 Below knee compression hose | 58% | 63% | 63% | 44% |
Patient Profiles
Of the patients seen by respondents, 45% are adults (18–65 years), 41% are geriatric (66 years or older), and 14% are pediatric (up to 17 years). Slightly more than half (54%) have disease-related pathologies, 43% present with pathologies related to trauma, and 3% have other pathologies.
Table 20
| Pediatric (0–17 years) | 14.1% |
| Adult (18–65 years) | 45.0% |
| Geriatric (66 years or older) | 41.0% |
Table 21
| Disease | 53.8% |
| Trauma | 43.1% |
| Other | 3.2% |
