Chapter 1: Introduction to Prosthetics and Orthotics

OBJECTIVES

At the end of this chapter, all students are expected to:

1. Discuss the key milestones in the history of prosthetics and orthotics.

2. Discuss the rationale for learning about prosthetics and orthotics.

3. Discuss the role and function of members of a clinic team.

INTRODUCTION

People have used external devices to help them function throughout the history of humankind. Shoes and foot inserts made of animal hair were early orthoses as innkeepers recognized their client's painful feet and provided padding from animal hair gathered in the barns. There is evidence of the use of splints to support broken or injured limbs since the early dawn of civilization. A 45,000-year-old skull in the Smithsonian Institution gives evidence from teeth alignment that he may have been missing one arm. More evidence of amputations, prostheses, and bracing can be found in the records of the early Greek, Roman, and Egyptian civilizations with more emphasis on science and medicine.¹ An early recorded amputation was performed by Hegesistratus, who, in 484 BCE escaped from the stocks by cutting off one of his feet; he is reported to have carved himself a wooden foot to compensate.²

The history of developments in prosthetics and orthotics is interesting as part of the study of human civilization development. Such a study indicates the effects of both scientific and creative endeavors directed to improve human function. As one studies historical developments in health care, the influence of wars becomes evident. Wars have always created large numbers of young people with disabilities, and governments have long believed they had an obligation to those who have been injured in their cause. The study of history further illustrates the role of research and the interrelationship between increased knowledge in human anatomy and physiology and improved methods of rehabilitation and care.

PHYSICAL THERAPY

The focus of this book is the use of prostheses and orthoses to improve human function. Physical therapists (PTs) examine patients/clients, evaluate data to make clinical judgments, diagnose to determine the impact of the problems on function, and then select and implement appropriate interventions.³ Determining the need for prostheses or orthoses, working closely with prosthetists and orthotists in selecting appropriate components, and teaching patients and families the proper use and care of the devices are integral parts of these functions. Physical therapists' assistants (PTAs) work with the physical therapists in carrying out selected interventions and must also understand the fit and function of such devices. To fulfill these functions, the student must learn the different types of devices, their biomechanical principles, how they should be properly fitted, and how to teach clients the proper use and care of all devices. Today's growing technological advances have led to a great variety of currently available simple and complex devices, and continued research and development lead to new components and capabilities. To ...