Abstract
Purpose: Approximately 1.5% of the world’s population (∼100 million people) need a prosthesis/orthosis. The objective of the study was to establish an overview of the literature that has examined prosthetic and orthotic interventions with a view to inform policy development.Methods: Fourteen databases were searched from 1995–2015. Studies reporting primary research on the effectiveness or cost-effectiveness of prosthetic and orthotic interventions were examined. Metadata and information on study characteristics were extracted from the included studies.Results: The searches resulted in a total of 28,958 articles, a focus on studies with the words “randomized” OR “randomized” OR “cost” OR “economic” in their citation reduced this total to 2644. Research has predominantly been conducted in Australia, Canada, Germany, Netherlands, UK and USA. A total of 346 randomized controlled trials were identified, with only four randomized controlled trials examining prosthetic interventions. The majority of research examined lower limb orthoses in the adult population and used a wide range of outcome measures.Conclusions: While various international organizations have highlighted the value of providing prosthetic and orthotic services, both to the user and society as a whole, the availability of scientific research to inform policy is limited. Future structured evaluation of prosthetic and orthotic interventions/services is warranted to inform future policy developments.Implications for rehabilitationResearch into prosthetic and orthotic interventions has grown substantially in the last 20 years, with most of this research conducted in a small number of countries and focusing on the use of lower limb orthotics in adult populations.Research to date has utilized an extensive range of outcome measures, the development of agreed standardized sets of outcomes would allow comparison and combination of results in future research.This study highlights the need for further research in this area, especially studies which examine the cost-effectiveness of prosthetic and orthotic provision.
Highlights
About 15 out of every 100 people in the world has a disability, with between 110 and 190 million adults experiencing difficulties in activities of daily living [1]
This study was part of a larger project which examined the scientific literature to date on prosthetic and orthotic interventions to inform the development of the Standards for Prosthetics and Orthotic Service Provision [9,10]
There has been a steady rise in the number of publications per year examining orthoses with a limited number of studies examining prostheses (Figure 2)
Summary
About 15 out of every 100 people in the world has a disability, with between 110 and 190 million adults experiencing difficulties in activities of daily living [1]. The use of assistive technologies such as prosthetics and orthotics, when appropriate to the user and their environment, have been shown through cohort studies to increase independence and improve participation [6,7]. With the increasing older population and prevalence of many diseases, such as diabetes, there is an increasing need for prosthetics and orthotics. A report from 2002 predicted that the number of persons with an amputation, and using a prosthesis, is expected to increase by at least 47% by the year 2020 (1,786,810 people), while the number of people requiring orthoses is expected to increase by at least 31% (7,382,876 people) [8]
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