Common Assumptions in Orthotics & Prosthetics and How They can Affect Quality of Care

Evidence Based Practice (EBP) is by now widely accepted as the preferred path to optimal care provision in Orthotics & Prosthetics (O&P). Clinicians are asked to make defensible decisions based on the published evidence, which is interpreted with professional judgment and in the context of a patient’s given situation and rehabilitation goals. Yet, scarcity of published evidence in O&P is frequently cited as a challenge in implementing EBP in our field, which is consequently still rooted in many commonly held assumptions that may have been passed down through the generations and may or may not be supportable by evidence.Some such assumptions are comparably easily tested, for instance the one that, generally, more modern and expensive O&P devices are superior to traditional solutions. Others are harder to be even acknowledged, let alone investigated. It may, for instance, be assumed that patients’ use of devices as it is observed in the clinic is representative of the real-life utilization of said devices. This may further be accompanied by assumptions about the time that patients need to acclimate to a device or about the effects of unconscious bias on the evaluation of devices by their users or care providers.This presentation will discuss recent research that has shown how O&P device users are susceptible to the reactivity effect – changing their gait pattern in response to the presence of observers, how prosthesis users become acclimated to new prosthetic componentry, and how visually concealing prosthetic interventions affects patients’ judgment of these interventions. Findings may have implications both for research and clinical practice, where they may inspire re-evaluation of long-held assumptions and better approaches to improved O&P care.