In simple terms, a prosthesis is an artificial limb surgically attached to the human body. For example, a ceramic or metal total hip replacement is a prosthesis that is surgically implanted to replace the old natural hip. Similarly, an artificial lower limb will be surgically attached to the knee. On the other hand, an orthosis is an artificial aid perhaps attached to the leg such as a brace that can be removed if required. Another example of an orthosis is an insert into a shoe to correct a gait (walking) problem.
So both prosthetists and orthotists do a similar but slightly differing role. Prosthetists design, manufacture or chose for the patient an artificial limb – a good example will be a British soldier fighting in Afghanistan who has unfortunately lost a leg through an exploding mine. Importantly for the patient, a prosthetic limb should feel and look like a natural limb. Slightly differently, an orthotist will design, manufacture and apply a range of splints, braces and special footwear that can aid movement, correct deformity or relieve discomfort.
Prosthetist
Prosthetists work as a member of a clinical team, usually based in a specialised centre for the rehabilitation of amputees of all ages. Patients may require help due to loss of limb in an accident, due to a disease such as diabetes and being born without a limb. The prosthetist uses clinical skill and knowledge to design and select the most suitable prosthesis for each patient. As a prosthetist you work closely with doctors, nurses, physiotherapists and occupational therapists. The first step in making the prosthesis is assessment of the patient. A model is made of the area onto which the prosthesis is to be fitted. The prosthetist takes a plaster cast or digital image, which is then modelled to produce a safe, comfortable fit. During the fitting of the prosthesis, the prosthetist aligns the component, ensures the prosthesis is comfortable and obtains the optimum performance of the device for the individual patient.
Typical daily activities include:
- Assessing patients problems and needs, making models and taking images of the affected area
- Supervising the assembly of the prostheses
- Fitting and aligning the prostheses to ensure a comfortable fit
- Offering advice and educating the patient on making adjustments and maximising full potential
Orthotics
Orthotics is a section within the medical field concerned with the design, manufacture and application of orthoses. The orthosis may be needed to reposition the body or to provide relief from discomfort. An Orthotist is trained to understand and respond to all these conditions. The essential part of the Orthotist’s work is assessment of the patient’s problem.
A prescription is formulated in conjunction with colleagues from other disciplines. They include doctors, physiotherapists and podiatrists / chiropodists. People who require orthoses vary greatly, and they deal with people of all ages. A few examples are; older people need specially prescribed footwear and insoles to treat deformities; children with cerebral palsy require individually prescribed orthoses aiding them to walk. People who have chronic back problems may benefit from a special brace.
Typical daily activities include:
- Assessing the patients problem and formulating a prescription in conjunction with other colleagues, such as doctors and physiotherapists
- Designing the orthosis according to assessment and needs of the patient
- Taking careful and precise measurements of the patient and supervise the making
- Fitting and adjustment of the orthosis
- Educating the patient in fitting and using their orthosis independently
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