The American Academy of Orthotists and Prosthetists
38th Annual Meeting and Scientific Symposium 2012
March 21-24, 2012 • Atlanta, GA
Experience Exceptional O&P Education

Depart hotel at 7:00 am. Shot gun start at 8:00 am

Join us to understand how the POWER KNEE uses its unique-to-the-field powered knee motion to aid with normalization of gait for amputees with high-level functional deficit, while positively affecting endurance, pain, and function for others. Discover appropriate clinical prescription for POWER KNEE and best fitting and training practice.
The SYMBIONIC LEG by Össur combines the positive attributes of both the RHEO NEE and PROPRIO FOOT within a single integrated design. Users in initial clinical fittings report improved confidence and less fear while significantly improving transfemoral amputee gait.
Discover how RHEOLOGIC Workbench software improves interface with the RHEO KNEE and also allows access to clinically-relevant data collected by the RHEO KNEE over extended periods of use. Presenter: Kurt Gruben, CPO, National Clinical Manager—Bionics, Össur Americas, Inc.

A look inside Smart MPK technology, learn how this becomes beneficial to amputees as we introduce our latest advancements in microprocessorcontrolled knees and feet. Subjective surveys from amputees often cite pain and discomfort as the leading concern, along with restriction in motion. This is caused primarily by unnecessarily high loading at the socket interface and is particularly profound when standing and walking on inclined surfaces. The visco-elastic and adaptable nature of muscle control makes it easy for the biological joint to be perfectly balanced in any number of angular positions. This workshop will discuss how the biomimetic combination of fluid damping and springs was conceived to mimic nature.

This workshop will include an overview of the selection of the type of socket and interface in relation to residual limb shape, tissue type, components, and projected vocation, along with alignment

This lecture will begin with a biomechanic overview of the function of prosthetic foot and ankle mechanisms. The attendee will gain an understanding of the basic differences in prosthetic feet when compared to physiologic function. Although the basic families of feet still exist, such as single axis, SACH, multi-axis, and dynamic response, new subsets are emerging that blur the lines between these accepted classifications. Using the design principles previously discussed, the Element and IBEX foot has been designed with a number of functions using a novel mid-tarsal flexing element. This works to 1) push support to the toes, 2) provide longer anterior rollover, 3) create more forgiving heel rollover, and 4) eliminate forefoot deadspot. The new Motion Foot and Hosmer Raize hydraulic ankles will also be presented and discussed with respect to plantarflexion control and heel height adjustment. Case studies from initial fittings and interactive demonstrations will also be presented. Speakers: Gerald Stark, MSEM, CPO/L, FAAOP; Jack Richmond, CFo; Craig Armstrong, CP; Eric Rubie; Jeremy Farley, CPO

Review and recertification for:

• The U3+ Arm
• Utah Hybrid Arm (both with lighter weight Li-Ion battery pack)
• MC Hand & Electric Terminal Device (ETD) - Brushless DC Motors for higher speed and durability
• MC Wrist Rotator - Higher speed and torque than earlier rotators.

Speakers: Harold Sears, PhD; Craig Armstrong, CP

This interactive session will provide O&P practitioners with a comprehensive review of bracing options, features, and benefits that can enhance patient outcomes and compliance. Attendees will take a virtual tour of Townsend's manufacturing facility to gain a greater understanding about capabilities and technologies incorporated in current and future brace designs. Practitioners will also receive global perspectives about manufacturers' historical and current business practices that influence market dynamics. The session will conclude with a clinically-based overview of technically challenging specialty bracing options and solutions.

Whether you've never used elevated vacuum suspension before or you're an experienced user who wants to learn about the latest developments, this fullday workshop is for you. We'll discuss the principles of elevated vacuum, share the keys for creating an airtight socket, and explain all aspects of LimbLogic® VS function. You'll leave this seminar with the knowledge you'll need for everything from patient selection to fitting and follow-up. You'll also learn about upcoming enhancements that will help you to be even more effective in providing your patient with a secure and comfortable suspension.

This workshop will engage you in fabrication techniques and teach you valuable procedures that will save you time and money while providing the best solutions for your facility and patients. Having practical fabrication materials to apply and remain cost effective maximizes the practitioner's ability to handle today's reimbursement challenges.

Spinal Technology, Inc., leader in Custom Spinal Orthoses, is presenting its popular Providence Nocturnal Scoliosis System course. Learn a new option in the nocturnal treatment of idiopathic adolescent, juvenile, congenital, and neuromuscular scoliosis. Practitioners will learn how to satisfactorily address the needs of these patients through review of scoliosis principles and use of innovative technology to improve fit and enhance comfort. Don't miss the opportunity to learn about this innovative system. Join us— space usually fills up fast for this popular course. We look forward to seeing you in Atlanta.

Learn about the operation of the i-limb ultra, biosim software, conducting patient evaluations, functional testing for control sites and other fitting concerns, use and care, therapy training protocol, reimbursement issues, as well as touch bionics' i-limb digits and livingskin prostheses.

bebionic v2 multi-articulating hands from SteeperUSA feature new motor technology allowing the hand to react very quickly under smooth, fast, proportional control. Advanced electronics provide up to 14 selectable grip patterns whilst on-board microprocessors continually monitor the motion of individual digits, ensuring grip patterns can be reliably repeated. bebalance programming software offers customized configuration for each individual user. This workshop will showcase bebionic v2 hands, providing a thorough understanding of their design, operation, and programming features, in addition to highlighting the application of latest technology solutions in the field of upper extremity prosthetics.

Compression therapy assists the legs by providing a force that helps keep the blood moving and preventing pooling in the veins of the leg. DVT, varicose veins, venous stasis ulcers, and other conditions require compression to improve blood flow and prevent the progression of the condition.

We all see many different foot types in our practices. One shoe does not fit all. Learn the importance in matching foot type to shoe type as well as accommodating foot orthoses and bulky AFOs. Dynamic computerized foot evaluation will also be demonstrated.

This is a demonstration of the new Seattle carbon composite feet and Trulife knees. The education is intended for certified prosthetists, residents, and those who are board-eligible. Attendees will gain a full understanding of the design element of all products, along with functional application, alignment, patient selection, and market indications. Biomechanics and gait cycle will be reviewed, as well as further discussion with respect to appropriate L coding and reimbursement. Speaker: Harry Bowne, BOCP

As Stance Control Orthoses (SCOs)grow into the standard of care, it is imperative to be educated on the latest technologies. You will leave this course qualified to assess, appropriately choose, and fit SCOs to benefit your patients and your practice. Lecture and hands-on training are implemented to ensure the best experience.

Devices in the past have been functionally static, preventing real-time adaptation of prosthetics to meeting patients' needs through the range of their daily activities. Advanced applied research is enabling manufacturers to introduce state-of-the-art, commercially viable products to help clinicians meet the increasing demands of their patients.

Best practices in utilizing the Pediatric WalkAide System for treatment of foot drop in children.

Gain knowledge and skills in selecting and implementing the clinical measures to quantify function and performance of persons who wear orthoses and prostheses. Basic measures that can be incorporated into your everyday clinical evaluation will be demonstrated. At a time when documentation of progress is essential for continued reimbursement, these are the tools you will need in order to easily and effectively capture this progress. Participants will observe demonstrations utilizing a spectrum of clinical measurement approaches (simple to sophisticated) that can be applied to document outcomes of clinical practice. Learn the value of clinical measures, proper clinical and laboratory methods, and interpretation of the information. Emphasis will be on the clinicians' understanding and application of these principles of patient assessment and treatment and ensuring they take home practical applied techniques to implement in their clinical practice environment. *This seminar will be conducted at Georgia Tech. There is an additional charge of $25 to cover the round-trip transportation that is provided from the hotel to the campus. Pre-registration required by March 2.

Learners will increase their knowledge of available orthotic treatment options, including the new one-size-fits-all Miami J Advanced, Miami Lumbar, TLSO, and Resolve Halo adjustable vest. A review of affected anatomy and indications will frame the rationale for orthotic treatment. Product selection guidelines will be provided based on clinical condition. A better understanding of the newest treatment options will benefit both practice and patients through enhanced outcomes.
Learning Outcomes:

1. A review of relevant anatomical structures & bracing indications.
2. A review of Össur current product offerings.
3. A review of recent advancements in orthotic design, materials, and technology.
4. Orthotic selection, hands-on fitting, and modification to optimize outcomes.

Speaker: John Parks, CO, Clinical Specialist

This comprehensive certification course will cover all the clinical needs for the next-generation microprocessor knee design. Presentation of the present design with regard to major systems of structural knee component, hydraulic cylinder, microprocessor control, and on-board electrical systems will be given. The REL-K Knee will be demonstrated by patients and adjusted by attendees for optimal function. Design challenges of the initial trials will be discussed with their solutions. Possible anticipated issues will also be discussed and simulated for clinical implementation. Suggested foot, ankle, interface, and alignment interaction will be discussed with respect to optimal performance. Contraindications will also be discussed. A short certification exam will be given afterward to certify practitioners as REL-K providers. Speakers: Gerald Stark, MSEM, CPO/L, FAAOP; Jack Richmond, CFo; Craig Armstrong, CP; Jeremy Farley, CPO

Having lower and upper extremity orthotic designs that are new, multifunctional, practical to apply, and cost effective maximizes the practitioner's efforts in today's challenging health care arena. This workshop will engage the practitioner in the review of current literature, the associated natural history, and pathophysiology to enhance the endresults for your patients. Orthotic considerations, design alternatives, current trends, and associated functional outcomes will be discussed. Stroke, TBI, MS, CP, osteoarthritis, Blounts, and general musculoskeletal injuries are the primary etiologies of the day's workshop. Participation will enlighten you on the newest unique but practical designs and associated applications in the management of the neuro rehab and orthopedic patient populations. Current L coding and medical necessity specific to these new designs will be reviewed.

ST&G will offer an interactive technical workshop covering a variety of application techniques that utilize unique materials and innovative products. Learn more about the highly anticipated magnetic suspension system and its benefits to ease the frustration of a low K2 through mid K3 patient when donning a pin lock liner for a prosthetic device. The MAGLOCK offers the security of a pin lock system—44 lbs of magnetic force and large magnetic target, which offers ease of lock location. Display and discuss newly-released and revolutionary devices for the everyday lab. Check out a new line of components that give you modular versatility to shift and rotate as needed, cosmetic covers that eliminate the need to grind and shape, as well as discussions around products to be launched in 2012-2013.

OPIE Software is the O&P industry standard for complete practice management. OPIE provides seamless workflow through the administrative, clinical, fabrication, billing, and collections processes, and then gives you extensive reporting tools to analyze the data and make improvements.

The Becker family of Stride stance control products has continued to evolve into a complete modular component group. New options and enhancements have been developed to offer the practitioner component options for almost all clinical presentations. The workshop will review current application cases for the acute and legacy patient population, as well as a set-up practicum on the PreStride. Speakers: Gary Bedard, CO, FAAOP; Pamela K. Hale, CPO

The therapeutic orthotic management portion covers clinical assessment of the pediatric and adult neuromuscular patient with spasticity and use of R1 and R2 for determining orthotic design to maintain and improve muscle length. The Adjustable Dynamic Response™ (ADR™) portion covers assessment of pediatric pathological gait and influencing knee and shank kinetics and kinematics with UltraSafeGait™ Adjustable Dynamic ResponseTM (ADRTM) knee and ankle technology. The adult portion focuses on gait rehabilitation and improving gait kinetics and kinematics with the utilization of UltraSafeStep™ Adjustable Dynamic ResponseTM (ADRTM) knee and ankle technology.

Join Freedom Innovations, a worldwide leader of lower extremity prosthetic devices, in a comprehensive educational seminar. Discover how Freedom Innovations maximizes composite technology in the largest selection of graphite foot products, from the new high-performance Renegade A•T to specialized foot products for adaptive sports. Become familiar with the nextgeneration Plié 2.0 MPC Knee and learn how it benefits the active transfemoral amputee. Discover how to achieve the best clinical outcomes with Plié 2.0 MPC Knee and gain understanding of its features, indicated use, alignment, and setup via a live demonstration.

Increase your pediatric referrals and save time and money while answering your patient needs. Pediatric gait poses several challenges for the O&P practitioner—namely, how to concurrently: • Improve dynamic posture of the locomotor system; • Minimize development of deformities and gait abnormalities; • Enhance trunk stability and reduce energy consumption during gait; • Minimize spasticity; • Overcome neuromuscular inhibitions leading to crouch gait; and • Optimize comfort. Current medical literature leads to solutions whereby the pediatric orthotist can influence the neuromuscular system, which in turn will help achieve all of the above goals. This workshop will present concepts on how to apply evidence-based data into unique orthotic interventions that benefit the child in ways that go beyond optimizing static posture. Case studies and live patient models will be presented to demonstrate the effect that these new thought processes have on a child's ability to be more stable during gait and to function at a higher level.

This course will provide the practicing orthotist with an in-depth overview of the "Gomez Orthotic Spine System" systematic approach to the comprehensive management of spinal pathologies, including idiopathic scoliosis, neuromuscular disorders, as well as degenerative spine disorders. The emphasis will be on understanding proper spine alignment and balance and the importance of conducting a detailed clinical evaluation, combined with objective assessment of tri-planar spinal flexibility to create a comprehensive biomechanical plan for successful treatment of spine deformities and instabilities. Each participant will learn the use of simple tools to measure and record clinical signs to be used in the orthosis design. The course will be taught by Jose Miguel Gomez, MD, LO, developer of the "Gomez Orthotic Systems" and founder of Laboratorio Gilete in Bogota, Colombia, SA, and Rachel Friddle- Johnson, CPO, director of Fabrication and Product Development at Friddle's Orthopedic Appliances, Inc.

Receive an overview on prosthetic foot theory and function, and learn what iST (Integrated Spring Technology) is achieving for prosthetic foot design. This course will also cover the differences between activity level and impact level during foot selection, endoskeletal noise causes and cures, as well as a special section on quantitative outcomes based measurements. Speaker: Steven Hoover, CP, LP, Technical Services Manager, College Park Industries

With a continued mission to enhance individuals' confidence, independence, and mobility, Otto Bock HealthCare presents the latest advances in microprocessor knee technology. The new technology further reduces deviations in natural gait and enables improved mobility in real-world environments such as stairs, obstacles, and uneven surfaces. This session will provide clinical and technical information comparing and contrasting our full family of microprocessor knees, including their features and benefits. Users will provide product demonstrations.

With the current challenges facing the O&P industry, businesses are finding it harder to maintain the standards of service that their patients have come to expect. Vorum, creators of Canfit CAD/ CAM solutions for O&P, believe that making the choice to automate your business can help you to continue to provide the best possible patient care and clinical outcomes. In this workshop, Canfit technology will be used to illustrate the power of CAD/ CAM and its ability to transform and improve your business. Through live patient demonstrations, participants will watch as orthotics and prosthetics are designed digitally. Using scanned data and measurements, a 3D image of each patient will be created. The 3D images will then be modified to suit the patient's needs and enable a customfitted appliance to be manufactured. Participants will see how CAD/CAM technology helps users to develop a more streamlined and efficient process, benefiting both the business and the patient. Participants will also have the opportunity to hear clinicians speak about CAD/CAM and its effect on their practices.

Systems In this workshop, learn about our new Synthex© composite fiber, which has 10 times the impact resistance of carbon. The performance characteristics of Synthex© fibers are perfectly balanced for use in prosthetic and orthotic composite applications. This workshop will demonstrate the new fiber and its unique properties and compare and contrast it to carbon, spectra, and other composite fibers commonly used in O&P. Also presented will be detailed lamination techniques, with an emphasis on reducing manufacturing costs. Speakers: Scott Wimberley, CTPO; Greg Mattson, CTPO

This course is designed for practitioners experienced in dynamic lower-extremity bracing. Participants will discuss how to customize dynamic ankle foot orthoses (DAFOs) to address complex patient presentations. Working with video case studies, participants will explore a variety of brace styles and optimizations designed to achieve the best fit and functional outcome for each case. Course participants will learn how to systematically plan a bracing project, adding specific details outside of the standard options. Active participation and lively discussion are encouraged with the goal of building knowledge and skills that will lead to the design of the best brace possible for every patient.

The Scoliosis Orthotic Management Program with Spinal Technology will provide in-depth information on idiopathic and neuromuscular scoliosis orthotic treatment using full-time scoliosis orthoses. This is a workshop designed to review clinical and technical techniques in detail, using clinical and radiographic images from multiple patient cases. An overview of spinal orthotic practice management will be illustrated throughout the program.

• Practice management of a spinal orthotic program
• Idiopathic scoliosis
• Pathomechanics of idiopathic scoliosis
• Patient clinical evaluation
• Measurement technique
• X-ray analysis at initial treatment
• Spinal orthosis design and pad placement
• Orthotic fitting and patient management
• In orthosis x-ray analysis
• Technical adjustments and modifications to maximize effectiveness
• Follow-up protocols
• Case studies
• Neuromuscular scoliosis
• Pathomechanics of neuromuscular scoliosis
• Spinal orthoses casting techniques
• Clinical care of neuromuscular scoliosis
• Postoperative scoliosis spinal management
• Severe back pain and spinal trauma management of adults with scoliosis<.li>

Speakers: Tom Colburn CO, CPed, FAAOP; James Benelli, CPO

Spend the afternoon learning about business strategies, sales tactics, and effective products that make up a successful pediatric practice. Whether you want to break into the market or grow what you already have, SureStep will help you get there. Speaker: Bernie Veldman, CO & Founder of SureStep

Prosthetic sockets are the fundamental connection between an amputee's residual limb and his prosthesis. However, prosthetic sockets are not subjected to a standard test evaluation like most other prosthetic components. The purpose of this research was to evaluate the static strength and variability of diagnostic sockets, copolymer sockets, and definitive laminated sockets as they are currently produced by the industry.

An increase or decrease in volume may change prosthetic fit, influencing comfort, stability, and activity. Though periodic doffing is suggested clinically to patients as a means to counter volume change, it is unknown if residual limbs return back to their pre-doff volumes once the prosthesis is donned and activity resumed. The purpose of this research was to evaluate the effect of a doffing period in between periods of activity on limb fluid volume.

Low back pain (LBP) is a prevalent condition among the general population. Studies have reported that persons with transfemoral amputation (TFA) are significantly more likely to suffer from LBP than persons with transtibial amputation. The purpose of this study was to investigate whether there are differences in spine kinematics during walking in persons with unilateral TFA with and without LBP.

Idiopathic toe walking (ITW) is a poorlyunderstood diagnosis of exclusion in which children typically stand with a normal upright posture but adopt an equinus pattern during walking. This study addresses ITW and potential treatments.

Join leaders in the field of prosthetics and physical therapy to discuss several complex cases of patients with lower limb amputations. Two prosthetist/ physical therapist teams, who work together frequently, will present cases and engage in some "what if" discussions with expert colleagues.

• Discuss the latest evidence to support optimal short- and long-term management.
• Consider how the experts adapt when complications, additional health issues, or lifestyle issues confound or "twist" the optimal approach.
• Discuss prosthetic and physical therapy management of patients who present with complex cases involving lower limb amputations.
• Recognize the benefits of collaboration and a team approach to optimize patient care.
• Apply current research to the management of patients with lower limb amputations.
• Consider alternative strategies to the management of prostheses and rehabilitation of patients with lower limb amputations, including the need for multiple prostheses and the consideration of employment and lifestyle preferences.

Learn practical business information, including common pitfalls in running a business, how to gain market share, and how to create an entrepreneurial niche for your practice.

This study examines the effectiveness of a new type of brace by assessing functional mobility and gait pattern. Researchers aimed to address common gait issues, like heel strike and proper push off in the terminal stance phase.

This study focuses on the application of an offloading knee ankle foot orthosis to offset associated varus thrust in patients who are deemed at risk due to obesity and other factors. Researchers also sought to determine the predictability of failure in these patients.

This study builds on previous research that showed parallel elastic structures stretching from hip to ankle could reduce the muscular effort required to walk. Researchers explored how a kinetic orthosis, a physical system with parallel elastic structures, could improve mobility in a man recovering from a stroke.

Existing research on the WalkAide and other functional electrical stimulation (FES) devices for use in cerebral palsy (CP) patients exists, but only measures forward directed movement and gait speed. This study aims to report the effects of the WalkAide on gait quality, symmetry, and quantity, as well as multidirectional stability in a child with CP.

There are few studies that quantify the effect that ankle motion resistance may have on walking. Researchers in this study tested the hypothesis that dorsiflexion resistance applied to the ankle-foot in a normal, healthy subject would decrease the range of ankle dorsiflexion compared to free ankle motion during walking.

Researchers have noted changes in calf circumference in patients who have switched from molded plastic to energy reflecting AFOs. The authors of this study tested the hypothesis that calf atrophy in neuro-deficit populations are influenced not just by medical condition, but by the style of AFO used in the management of foot drop.

There is mounting evidence that the effective use of properly-designed orthoses in the treatment of AIS can influence the natural history of curve progression in those considered to be at risk. There is also evidence, however, that a patient's willingness or ability to tolerate this treatment regimen is cause for concern. The intent of this symposium is to compare and contrast what may be considered a more conventional approach to orthotic design to alternative thermoplastic designs, such as those made possible through the use of CAD/CAM technology.

Do you really know the cost of your inventory? Is it just a series of wild guesses and random reactions to what you need at any given moment? Discuss how to organize, streamline, and control one of the greatest loss areas in your practice.

Discuss the management of the bilateral upper limb patient.

Discuss the training and conditioning involved in the treatment of the bilateral upper limb patient.

Our lives are changing at a faster pace than ever before. How do we cope with all of the changes in our lives? This program will not stop change, but it will provide tools to take control of your life. You can either let change control you, or you can harness change to your benefit.

A recently-developed method based on close-range photogrammetry that uses a single-lens reflex digital camera to reconstruct a 3D surface has proven satisfactory in theoretical calculation. This study aims to evaluate the photogrammetry-based system by comparing it to other methods and systems.

This study used a randomized cross-over trial to determine the efficacy of existing prescription guidelines for K2 level prosthetic foot (dysvascular) transtibial foot amputees (TTAs).

This descriptive qualitative study gathered data to better assess the prosthetic needs of farmers and ranchers from an engineering perspective.

This study reported the kinematics and associated asymmetry in sit-to-stand with transfemoral patients who use microprocessor knees.

This presentation evaluates the accuracy of two models' prediction of biaxial socket rotation due to external forces.

This study evaluates the indication for prescription of an electric multiarticulating digit prosthesis and the functional outcomes of its use.

Patients with upper limb amputations will experience profound functional and emotional consequences, but also phantom sensations, residual limb pain, overuse symptoms affecting neck, shoulders, and back, and elevated risk of anxiety and depression. This literature review attempts to quantify the prevalence and reported severity of these additional challenges among those with upper limb loss.

Recent studies have suggested that the mirror neuron system may be preferentially engaged by movements of a limb similar in appearance to that of the viewer. This study attempted to replicate these findings in subjects without limb loss as well as prosthesis users who imitated tool-use movements by actors with similar and dissimilar arm types.

The researchers in this preliminary study used a wearable sensor to collect acceleration data to differentiate between non-manipulative and manipulative tasks.

Open to students & educators only

Open to students & educators only

Participate in a discussion of new ideas that enhance understanding of foot and ankle biomechanics.

Persons with transfemoral amputations consume significantly more oxygen than able-bodied individuals to walk, and the same can be assumed in running. This study attempts to determine the energy cost of running with a prosthetic knee versus a straight pylon in distance runners with transfemoral amputations.

This study quantifies the change in prosthetic moments after a systematic alteration of the ML dimension of a transtibial socket.

This literature review provides a grade of recommendation for Otto Bock's C-Leg use relative to patient safety and efficiency of both gait bioenergetics and healthcare cost.

This study mechanically evaluated a direct manufacturing technology, Selective Laser Sintering (SLS), for a prosthetic socket application.

The goal of this study was to help prosthetists educate patients on prosthetic sock management so that it can be done correctly, consistently, and independently.

This study compared the gait symmetry of active patients with transfemoral amputations who used a passive mechanical knee joint or a microprocessor-controlled knee joint.

Focus on the necessary financial, organizational, and personnel controls needed to effectively manage an O&P company. Review benchmarks, budgeting, employee fraud, and many other important issues affecting your business.

The area of upper limb prosthetic rehabilitation has seen a surge of activity and research in recent years. Multi-articulating hand systems, once thought impossible, have emerged from the research lab into the everyday lives of our patients. With a desire for even higher functionality, surgeons around the world have been working on transplantation techniques for the upper limb amputee. This symposium will explore the practical realities and applications of hand transplantation and multi-articulated hands.

This interactive session will begin with an overview of outcome measures— what they mean and how to find them. Participants will rotate through three stations. At each station they will review and participate in completing measures as they would be conducted in the clinical setting. The session will close with an overall review and practical ways to utilize the information, along with Q&A.

The Lyapunov exponent (LyE), which measures the consistency of gait pattern over multiple strides, has been used to identify pathological gait in the absence of other biomechanical tools sensitive enough to detect patient perception. This study correlated the LyE values of the leg joints with patient preference in a prosthesis to determine if the measure was sensitive enough to detect clinically significant differences in performance.

This study used an end-user's questionnaire to more objectively assess the perceptions of patients who have transitioned from conventional prosthetic or microprocessor-regulated knees to the Plie 2.0.

This study aimed to better understand the ability of prosthetic feet to handle altered demands associated with load carriage.

This exploration of how amputation affects innate foot preference could have implications for therapy and the understanding of the motor control strategies of prosthesis users.

Despite the more than 105 foot designs presently available, a previous survey showed that prosthetists generally rely on four or five mainstay designs. This survey was developed to learn more about the factors that practitioners use to select products.

This study attempted to determine the effects of an adjustable "flat region" feature in a prosthesis on standing balance and mobility.

This randomized control trial aimed to further demonstrate the SpineCor system's effectiveness for treatment of early adolescent idiopathic scoliosis as compared to the disease's natural evolution.

The purpose of this study was to compare the anthropomorphic measurements using the threedimensional reconstruction of a torso surface model from CT scan to the traditional hand-molding method for fabrication of TLSO.

This prospective cohort study evaluated the effectiveness of the Dynamic SpineCor brace in the treatment of large and moderate adolescent idiopathic scoliosis, small curves, and juvenile scoliosis.

Patients who present with hyperkyphosis and pectus carinatum pose difficult challenges to orthotists. This case study addresses concerns about the flexibility of both deformities, competing corrective sagittal plane forces, thoracolumbosacral orthosis design, and how potential corrections will affect spinal balance and overall function.

It is crucial to clearly define the goals of the treatment of idiopathic scoliosis, which are governed by differing philosophies and design possibilities. The primary goal should be to prevent the progression of the scoliotic deformity for the duration of treatment.

Neuromuscular scoliosis may continue to progress despite orthotic rigid brace intervention. This case study describes orthotic management of the condition using the effects of force paneling within a dynamic elastomeric fabric suit.

Skin problems are one of the most common complaints facing orthotic and prosthetic users today. Nearly 75 percent of these patients encounter a dermatological issue due to the artificial interface contacting skin. This session will provide an overview of the most common skin problems in this population as well as specific mechanisms and related research. Skin care and treatment options to assist and prepare clinicians in the identification and management of skin problems will be discussed.

The Orthotic and Prosthetic Education and Research Foundation (OPERF) Showcase highlights research conducted with support from OPERF. Investigators, students, and residents will give an overview of their OPERF-sponsored research. The featured presenters:
Small Grant Award Recipient:
Effects of the Össur AFO Dynamic and a Custom Fabricated Polymer AFO on the Gait of Acute Hemiplegic CVA Subjects
Jason Wening, MS, CPO
Fellowship Award Recipients:
Transfemoral Amputee Gait as it Relates to Prosthetic Alignment
Sara Koehler
Effects of Ankle-Foot Orthosis on Foot Placement Post-Stroke: Balance Implications
Kiki Zissimopoulos
Resident Travel Award Recipients
Using Gait Analysis to Compare the Biomechanical Effects of AFOs Designed with a Solid Ankle versus AFOs Designed with a Compression Heel
Brock Sande, CPO
Transtibial Amputee's Ability and Knowledge of Socket Management and the Relationship to the Educational Needs of Amputees
John Frederick, CPO/LPO, BEP

Renowned podiatrist Dr. Justin Wernick will give a lecture on lower limb evaluation.

Discuss with the Academy executive director and the chair of the Academy Professional Issues Council (PIC) the current political climate as it relates to healthcare and the potential impact on the O&P profession.

Researchers investigated the pedaling technique employed by persons with transtibial amputations during a cycling task to establish a foundation for future motor control research and potential improvement of prosthetic design.

This study examines how shortening the crank arm on the residual limb can reduce asymmetries in joint kinematics and measures the effect on limb output during a cycling task.

Enhanced knowledge on how the human motor system adjusts to amputation could drive advancements in socket design to enable better integration between the revised motor system and the prosthesis. Researchers studied the relationship between control of the prosthetic interface and control of a locomotor task-in this case, cycling-toward this end.

Accurate and precise measures of balance in persons with lower limb amputations would help prosthetists evaluate the progress and effectiveness of therapeutic interventions and identify individuals at greater risk for falls, but no single standardized clinical assessment tool to quantify functional balance in this population is currently available. This study assessed the feasibility of testing, construct validity, and inter-rating reliability of the Berg Balance Scale for this purpose.

This study investigated differences in perceived difficulty and safety while subjects performed activities of daily living with two microprocessor knees.

The International Classification of Functioning, Disability, and Health (ICF) provides a common framework for defining and describing disability and health. Viewing disability as an interaction between health condition and environmental factors is the key to measuring disability and evaluating interventions to reduce it. This session describes how the ICF can enhance communication between health professionals involved in O&P care; assist in the identification and standardization of appropriate outcome measures; and provide a conceptual framework for education programs in O&P.

Gain a foundation of knowledge to understand and evaluate current treatment protocols, both published and practiced. Review fabrication techniques and materials that have been used historically and new techniques and materials currently used in facilities around the country.

Discuss the treatment plan and management of the bilateral transtibial patient.

This session will briefly address the prevalence of balance compromise in terms of falls, injuries, and activity limitations in patient populations commonly prescribed lower limb orthoses.

Review emerging ideas in the field of pedorthics.

Learn about research on foot pressure measurement and optimal placement of padding.

Review what published literature has to say about the effects of AFOs on balance based on the systematic evidence review commissioned by the Academy.

Barriers that made it extremely difficult for clinicians to earn advanced academic degrees are eroding. Our growing cadre of CPO/PhDs will accelerate development of O&P science, translation of research into improved patient care, and advancement of our profession. Experiences of some of today's clinicianresearchers will be highlighted in this session.

This research provides the detailed framework required to perform Finite Element Analysis to simulate residual limb and prosthetic socket interaction.

In individuals with a transtibial amputation, compromised proprioception and muscle control contribute to falls. Researchers examined the ML dynamic stability margin for both able-bodied and transtibial subjects to better understand lateral stability.

This study aimed to identify conceptual gaps in the understanding of how environmental factors affect mobility. The results will inform the development of an item bank for measuring self-reported mobility in prosthesis users.

The mental health needs of persons with limb loss have traditionally been considered under the purview of psychologists, social workers, and primary care physicians, but patients need comprehensive care provided by a team. Prosthetists are positioned to educate patients about the signs of psychosocial distress and to offer information on resources that help patients seek appropriate care.

This study characterized how sock ply relates to sock thickness in various sock materials and evaluated how sock thickness changed during loading conditions.

Learn how to connect various lower limb pathologies back to the foot. Understanding how controlling the foot solves problems further up the chain can be a key driver for referrals.

Review clinical considerations that may affect orthotic treatment plans, such as task consideration, the position of the center of mass, the impact and assessment of fatigue, altering the base of support, and the differences between optimizing and normalizing gait.

Review the role of proprioception in the maintenance of static and dynamic balance. Review recent research findings associated with the proprioceptive effects of AFOs on balance in patients with compromised distal sensation.

Review the symptoms and pathology of Charcot, including some case studies.

This study investigated the benefits and challenges associated with administering a patient satisfaction outcome measure in a clinical setting to demonstrate a feasible model for incorporating a standardized outcome measure into an O&P practice.

This study examines the effectiveness of transcutaneous electrical nerve stimulation as a treatment for chronic pain.

This presentation describes a quality improvement consultation project that was offered to five Midwestern O&P facilities.

Idiopathic toe walking in children can lead to various future orthopedic problems. Prevention of toe walking in the early stages of growth is essential to the development of a normal gait pattern.

Due to the dynamic nature of a stance control orthosis, there is a critical need to match the anatomical knee and ankle axial centers with the orthotic components during fabrication. This study analyzes new clinimetric tools for this purpose.

This study evaluates short-term lower limb constraint as a motor behavior shaping strategy.

This study attempted to identify trends in orthotic treatment using foot orthoses to provide focus for future research.

Patients with inclusion body myositis experiencing lower limb muscle weakness can be candidates for gait activated stance control orthoses to facilitate ambulation. This study examines this idea for a patient with the goal of being a community ambulator and prolonging bipedal ambulation to avoid use of a wheelchair.

This study aimed to measure dynamic and static balance as well as gait efficiency in patients with and without use of a sling.

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Focus on how prosthetists can use the graduated approach to prosthetic management of bilateral transfemoral amputees.

This study aimed to investigate the effect of transtibial prosthesis malalignment on socket reaction moments. Researchers used a novel instrumented prosthesis alignment component to measure sagittal and coronal socket reaction moments at the bottom of the socket.

In this study an empirical approach was used to obtain evacuation curves on human subjects by measuring change in vacuum pump pressure and therefore to gain insight into socket/liner interface volume and pressure decay.

Walk through several examples of how to design process flow that cut waste and will thrill your patients, employees, and referral sources.

Attendees will receive an overview of the dynamics of aging with an underlying neuromuscular disability and obtain an understanding of treatment for pediatric versus adult populations. Case presentations will illustrate adult orthotic management aimed at improving or maintaining function. Multi-disciplinary presenters will provide their insights and experiences for care across the lifespan.

The Prosthetic Limb Users Survey of Mobility (PLUS-M) is a new tool developed to measure the mobility of persons with lower limb absences who are current users of lower limb prostheses. Developed at the University of Washington through a grant by the National Institutes of Health (NIH), PLUS-M allows clinicians and researchers to quickly and accurately measure mobility, an important aspect of prosthetics users' health. In this session, we will present the PLUS-M, summarize findings from a large study of 1,000 prosthetic users, and describe health-status profiles of prosthesis users compared to national norms.

Models of rehabilitation care post-stroke include comprehensive integrated acute stroke/rehabilitation units; distinctly separate acute stroke and stroke rehabilitation units in the same institution; acute stroke care in one hospital and stroke rehabilitation in another institution; acute care in one hospital and stroke rehabilitation in a general rehabilitation unit offsite; day hospital rehabilitation; and home-based care. Each of these has different advantages and disadvantages depending on the level of activity and participation restriction. Within these models, there are also variances in therapy and activity levels of the patients and many variables which may affect outcome.

This literature review highlights the positive psychological effect that exercise can have on a person with limb loss.

Researchers attempted to maximize socket flexibility and maintain effective load transfer by constructing a singlewalled, flexible socket reinforced with a rigid carbon fiber frame. In this study, they present the results of a finite element stress analysis evaluation of several frame designs.

Recent study has suggested the need for two separate modes for standing and walking to achieve biomimetic function in a prosthesis. This study developed an ankle-foot prosthesis and measured the effective shapes of the ankle-foot prosthesis in both modes.

Existing research developed a working prototype of a prosthetic ankle-foot system that could adapt to different surface slopes without the use of motors or batteries. This study provides an update on the project, including changes that have been made to make it more clinically and commercially viable.

Researchers used dynamic roentgen stereophotogrammetric analysis data to model bone-stump-socket interaction of persons with transtibial amputations in a finite element model. Socket reaction forces were calculated using non-linear finite element analysis.

This study used a new method of prosthesis evaluation based on step durations and stance phase percentage of prolonged gait of persons with transtibial amputation measured with a wireless gait assessment device, iPecs. Researchers used this method to compare total surface bearing and elevated vacuum socket technologies and their effects on prosthesis kinetics.

Results of a previous study indicated that a mathematical model could measure the magnitude of prosthetic malalignment based on socket reaction moment information, a finding that could help prosthetists align prostheses more consistently in clinical settings. This study evaluated the mathematical model to predict prosthetic malalignment.

Knowledge of the time to evacuation and overall efficiency for vacuum pumps could help prosthetists providing lower limb prostheses with vacuum-assisted suspension to patients. This study tested and compared several mechanical and electric vacuum pumps to assess their performance and efficiency.

This study presents preliminary results on a vacuum suspension system with microprocessor-controlled vacuum levels.

Researchers in this case study provide evidence that elevated vacuum can help wounds of the residual limb in persons with amputations. This hypothesis was tested by tracking the surface area of wounds over a period of time.

The percentage of successful prosthesis fittings in geriatric dysvascular patients is low. This study investigated whether a vacuum-assisted socket suspension system improves control of the prosthetic limb, stability, balance, and walking capabilities in elderly transtibial patients.

This study examined the effect of vacuum pressure on residual limb tissue oxygen while resting, standing, and walking.

There is little data on the effect of removing the Ischial Ramus Containment (IRC) on skeletal kinematics, balance, gait, and interface pressure. This study compares symmetrical sub-atmospheric suspension IRC to brimless interfaces in biomechanics, stability, mobility, gait, and subjective measures.

Anecdotal reports suggest that vacuum suspension might promote healing of residual limb wounds. This study evaluated the benefits to two different vacuum suspension systems in persons with transtibial amputations with unhealed wounds on the residual limb.

Discuss a variety of current evidencebased topics, designs, and clinician problem-solving methods related to the use of the AFO.

Discuss the development of weight bearing in infants and young children. Compare and contrast the impairments seen in children with congenital versus acquired conditions. Identify challenges with measuring outcomes in infants and young children. Discuss the impact of O&P interventions on children having challenges in the acquisition of upright postures and movements and the appropriate age for prostheticcomponent prescription.