Functional Outcome Levels in Prosthetics

Medicare set up functional outcome criteria to help limit abuse in the system. They really did a nice job of thinking it through for the benefit of all. It is basically what the majority of practitioners were already using in common sense practice. A very few were abusing the system by fitting very old and sick clients with very high functioning prostheses that they would not be able to use properly even if they were healthy.

Medicare has 5 levels:

Functional level:

  • 0 - non candidate

  • 1 - Sitting and transfers

  • 2 - Household ambulation

  • 3 - Community ambulater, active

  • 4 - High Activity, sports, physical demanding at work

The design considerations must be appropriate for the amputee and his/her lifestyle. The activity level, types of activities required and wanted, climate, height, weight, cosmetic needs, general health, balance, muscle strength, endurance, the condition and location of the (leg, residual limb, stump), and many other factors need to be addressed before components can be discussed. For example, a common problem with lower extremity amputations is getting in and out of cars, sports areas or theaters. Those who require extra attention in this area may require modifications to solve this problem. For others it might be the desire to ride a bicycle, play golf, or cope with the special needs of a work place.

A prosthesis should be designed to meet ones present situation and their future potential.

Children have different needs and solutions to solve than an adult. They are continually growing and usually much more active. They will cycle their prosthesis more times in a given day, meaning more steps, more arm movements, and are not as aware about protecting a prosthesis from abuse (sand, water, hitting it on objects). We also know they will be pushing the functional outcomes to the limit every day.

With new materials, products, components, and designs we are able to meet more and more of these functional needs and outcomes. As you can see many factors play into the design criteria for each patient. That is why each prosthesis is different, to solve the special needs of the individual.

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DynamicBracingSolutions™ is The National Network of Clinicians dedicated to a 21st Century approach to HOLISTIC bracing for neuromuscular disorders.

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