Research and Quality Improvement

 

VISION STATEMENT

The American Orthotics and Prosthetics Association will serve to facilitate the expansion and development of research and quality improvement projects to support the advancement of care and innovation in the field of orthotics and prosthetics.

RESEARCH COMMITTEE:

  • Chair: Shane Wurdeman, PhD, CP, FAAOP(D)
  • Sarah Chang, PhD
  • Jason Wening, CPO
  • Goeran Fiedler, PhD
  • Kirk Ferris, CPO
  • Christopher Schumacher, CFO
  • Adam Edmonds, BSME, CPO, FAAOP, ACM
  • Matthew Wernke, PhD
  • Jeffrey Erenstone, CPO
  • Justina Appel, CO, BOCP, LPO, PhD, FAAOP
  • Taavy Miller, CPO, PhD
  • Andrea DeLuca, PhD

Assistance Needed with University of Washington Study

A University of Washington research study, funded by AOPA and the U.S. Department of Defense, that aims to develop a new self-report survey instrument to measure mobility of lower limb orthosis users is recruiting participants.

Dr. Brian Hafner and his research team are looking for volunteers for the study. Interested individuals need to complete an online or paper survey that includes questions about an individual, their health, and their orthosis use. The survey takes anywhere from 30 to 60 minutes to complete and eligible participants will receive a $50 check by mail. A person is eligible to participate if they meet the criteria below:

  • 18 years of age or older
  • Ability to read, write, and understand English
  • Ability to transfer, stand, or walk without the help of another person
  • Use of an AFO, KAFO, HKAFO, or FES device for one or both legs
  • Use of a lower limb orthosis for 6 months or longer

By producing a new assessment tool that can provide clinicians with meaningful information to guide patient care, this research has the potential to have a positive impact on the field of orthotics,  . However, the success of this project depends upon assistance from O&P professionals to identify potential participants. Pleasel consider helping in one or more of the following ways:

  • Reach out to patients (in-person, by phone, and/or by email)
  • Post informational materials (posters, flyers, and/or pamphlets) in visible areas such as waiting areas and patient rooms
  • Share information about the study through social media and/or newsletters

Feel free to invite co-workers and office staff to mention this study to people who may be interested in participating. Please direct interested patients to visit the study website to learn more about the study and take the survey. To receive free informational materials by mail, please contact a research staff member at uwcorr@uw.edu or 1-800-504-0564.

Member Research Initiative Highlight: Hanger

The American Journal of Physical Medicine and Rehabilitation recently published a study suggesting that early delivery of a prosthesis following amputation is associated with up to a 25 percent reduction in overall direct healthcare costs

In a recent webinar, a panel of experts reviewed the study’s findings while assessing their impact on patients’ day-to-day lives, and several questions arose as part of that discussion. In this webinar, study co-author and Hanger’s Director, Clinical Research Shane Wurdeman, PhD, CP, FAAOP (D) answers those questions and provides further insight into the importance of these findings to the O&P profession.

View the webinar.

RAND Value Simulation Study
As part of the Prosthetics 2020 Initiative, the RAND Corporation conducted a value simulation, the “Economic Value of Advanced Transfemoral Prosthetics” where they simulated the differential clinical outcomes and costs of microprocessor-controlled knees (MPKs) compared with non-MPKs (NMPKs), and conducted a literature review of the clinical and economic impacts of prosthetic knees, convened technical expert panel meetings, and implemented a simulation model over a ten-year time period for unilateral transfemoral Medicare amputees with Medicare Functional Classification Levels of 3 and 4.

Data Regarding Provision and Utilization of Orthotic and Prosthetic Services
AOPA, through its partnership with the research and data firm Dobson DaVanzo & Associates, LLC, has obtained a plethora of data specific to the provision and utilization of Orthotic & Prosthetic services.   This data, which is only available to current AOPA members, tells a compelling story about the type of O&P services Medicare patients are receiving as well as what provider categories (O&P, physicians, DME suppliers, pharmacies, etc.) are providing them.  It also provides valuable information regarding patients who initially receive off the shelf (OTS) items who later require custom fitted or custom fabricated items.  In addition, the compendium contains valuable information regarding the cost effectiveness of O&P services relative to their effect on overall healthcare expenditures for Medicare patients. Member login required to access.

Medicare Spending on Prosthetics from 2010-2014
Overall spending on prosthetics has decreased 15%, while spending on outdated technology has actually decreased.

February 2016 Military Medicine Supplement
Military Medicine is the official journal publication of the Association of Military Surgeons of the United States (AMSUS), and this edition contains two articles of note: 1) Suggested Guidelines for the Prescription of Orthotic Services, Device Delivery, Education, and Follow-up Care: A Multidisciplinary White Paper and 2) Economic Value of Prosthetic Services Among Medicare Beneficiaries: A Claims-Based Retrospective Cohort Study

Center for O&P Learning/ Evidence-Based Practice (COPL)

2021 COPL RFP Now Open

The American Orthotic and Prosthetic Association (AOPA), in conjunction with the Center for Orthotic and Prosthetic Learning and Outcomes/Evidence-Based Practice (COPL) and its Board of Directors, is pleased to announce its 2021 Request for Pilot Grant Proposals. Proposals are being accepted in 10 areas of orthotic and prosthetic research including an open topic.

For 2021-2022, the association is seeking proposals at two funding levels for one-time grants, $15,000 and up to two exceptional proposals for $30,000 for one year. Preference will be given to grants that address evidence-based clinical application in orthotics and prosthetics. View the RFP topics and guidelines.

The deadline for all proposals is April 30, 2021. Apply online.  

If you have any questions, please contact AOPA’s Director of Strategic Alliances Ashlie White at awhite@AOPAnet.org or 571/431-0812.

2020-2021

  • Sarah R. Chang, PhD, “Develop Evidence-Based Clinical Practice Guidelines for Vacuum-Assisted Socket Suspension Systems”
  • Jonathan D. Day, “Non-invasive method for quantifying progress of healing after transtibial amputation: a pilot study”
  • Michael Dillon, PhD, “Describe the population receiving orthotic/prosthetic services using telehealth, and their experience and satisfaction with those services”
  • Erik Hansen, MD, “The Effect of Osteoarthritis Bracing on Community Involvement, A Pilot Study”
  • Natalie Harold, CPO, “Development of a Customizable Outcome Measures Electronic Toolkit (COMET)”
  • Rebecca M. Miro, PhD, CP, MBA, CRA, “Prosthetic, functional, and clinical outcomes among female amputees: A scoping project o include a systematic review and 10-year retrospective record review of female Veterans with limb loss”

2019

  • Leigh Clarke, B.PO, MPH, “Patient and payor perspective of the benefit of prosthetic interventions and services: informing measures for future health economic evaluations.”
  • Reza Safari, PhD, “Activity, Mobility, Social Functioning, Mental Health and Quality of Life Outcomes in Limited Mobility Transfemoral and Knee Disarticulation Amputees Using Microprocessor-Controlled Knees or Non-Microprocessor Controlled Knees in the United Kingdom: A Cohort Study.”
  • Jenny A. Kent, PhD, “Vacuum Assisted Suspension: The effect of residuum-socket interface integrity on perception and control in individuals with a transtibial amputation.”
  • Christopher Hovorka, PhD, CPO, LPO, FAAOP, “Quality of life, satisfaction, gait and motion control outcomes of articulated passive dynamic, non-articulated passive dynamic and solid ankle foot orthoses in hemiparetic stroke survivors.”
  • Geoff Balkman, BA, MS, CPO “Large-scale administration and calibration of a patient-reported item bank for assessing mobility of lower limb orthosis users”

2018

  • Balkman, Geoff, BA, MS, CPO, “Development of a Mobility Outcome Measure for People who use Lower Limb Orthoses”
  • John DesJardins, PhD, “The Quantification of Containment Conditions Used for Directed Growth Within Infant Cranial Remolding Orthoses: A Pilot Study”
  • Sun Hae Jang, M.Sc., CO, FAAOP, “Normative Values, Reliability, and Validity of the Global Visual Gait Assessment for Measuring Orthotic Biomechanical Outcomes for Use in Post-Stroke Patients”
  • Shannon Mathis, Ph.D. “Gait Analysis Using Video: Defining K-Level in Lower-Limb Prosthesis Users”
  • Shane Wurdeman, PhD, MSPO, CP, FAAOP, “Prospective Falls Analysis Among Lower Limb Prosthesis Users- Understanding the Role of Prostheses in Reducing Fall Risk”
  • Eric Weber, CPO, FAAOP, “Longitudinal Tracking of Stability Events and AFO Compliance Among Stroke Survivors During Sub-Acute and Chronic Phases of Recovery”

2017

  • Sarah Anderson, La Trobe University, “Comparison of quality of life in people with partial foot or transtibial amputation”
  • Brian Kaluf, BSE, CP, Ability Prosthetics and Orthotics, Inc., “Hydraulic and Microprocessor Controlled Ankle-Foot Prostheses for Limited Community Ambulators with Unilateral Transtibial Amputation: Pilot Study”
  • Sarah Chang, PhD, Northwestern University, “A pilot study to evaluate the effects of the hydraulic ankle-foot prostheses on standing and walking in K2-level ambulators”
  • Benjamin Padilla, MD, University of California San Francisco Benoiff Children’s Hospital, “The Effects of a Custom Pectus Carintum Orthosis on Dosing Response and Quality of Life”
  • Eric Weber, CPO, FAAOP, Hanger Clinic – Department of Clinical and Scientific Affairs, “Mobility and Global Health among Users of Lower Limb Orthoses: The Establishment of a National Data Base”
  • Chris Hovorka, Ph.D., CPO, LPO, FAAOP, Georgia Institute of Technology, “Gait and Motion Control Benefits of Custom Molded Passive-Dynamic AFOs versus Custom Fit Carbon Composite AFOs in Persons with Neuromuscular Impairment”
  • Kenton Kaufman, PhD, Mayo Clinic, “Prevalence, correlates, and risk of prescription drug use and abuse in individuals with above knee amputations”

2016

2015

2015 Special Projects

Systematic Review Projects

Special Projects

  • Kenton Kaufman, PhD, PE, Mayo Clinic, “Risk factors and costs associated with accidental falls among adults with above-knee amputations: a populations-based study”
  • AOPA will commission Dobson/DaVanzo to analyze Medicare claims data from 2011-2014 and Part D prescription claims information for expanded and updated research into the cost effectiveness of timely O&P intervention and patient outcomes, continuing in the pathway of the prior cost-effectiveness report and the Mobility Saves Initiative.

Previous COPL Research Grants

2014 

2013

2013 (Research Grant Awards In Progress)

  • Vibhor Agrawal, PhD, University of Miami – “Determining Efficacy of Dynamic Response Prosthetic Feet in K-level 3″

2012 (Research Grant Awards In Progress)

  • Tamara Bushnik, PhD, FACRM, NYU Langone Medical Center, Rusk Institute of Rehabilitation Medicine — “Developing an Evidence Based  Approach to Address Functional Level Change in Persons Following Transfemoral  Amputation”
  • Jason Maikos, PhD, Department of Veterans Affairs, New York Harbor Healthcare System — “A Biomechanical and Functional Evaluation of a Microprocessor Controlled Knee Paired with a Powered Ankle-Foot Prosthesis”

2012

2011

2010

2009

Other Special Projects

Systematic Reviews (2013)

  • Marcus Besser, PhD, Thomas Jefferson University, “Orthotic Management of Stroke Patient”
  • Jason Highsmith, DPT, PhD, CP, University of South Florida, “Prosthetic Management following Transtibial Amputation”

Funded by AOPA and Participating Manufacturer Members

Funded by AOPA and Commissioned by the Amputee Coalition