Prosthetics, Orthotics and Assistive Devices
Prosthetics, orthotics and assistive devices is the area of physical medicine and rehabilitation concerned with externally applied devices that replace a missing body part (prostheses), support or correct a body segment (orthoses), or substitute for lost function and ease participation (assistive technology, including mobility aids and wheelchairs). It links clinical assessment, device prescription, fitting and training so that people with impairments can move, perform daily activities and participate in life.
Definition
A field of rehabilitation practice and engineering that designs, prescribes, fits and trains the use of external devices — prostheses, orthoses, mobility aids, wheelchairs and seating — to restore, support or substitute for impaired body structures and functions and to enable activity and participation.
Scope
The area surveys the major device categories used in rehabilitation: limb prostheses and amputation rehabilitation, orthotic bracing and splinting, mobility aids and other self-help devices, wheelchairs and seating systems, and the gait training that ties device use to functional walking. It treats these as reference topics within rehabilitation, describing how devices are classified, what they aim to achieve and how function and fit are evaluated, rather than giving prescriptive instructions for any individual.
Sub-topics
Core questions
- Which device category best matches a given impairment and functional goal?
- How are prostheses, orthoses and assistive devices classified and described?
- How is the fit, function and benefit of a device evaluated?
- How does training translate a fitted device into real-world mobility and activity?
Key concepts
- Prosthesis (functional replacement of a missing part)
- Orthosis (support, alignment or correction of a segment)
- Assistive technology / self-help devices
- Mobility aids and wheelchairs
- Activity and participation (ICF framework)
- Device prescription, fitting and follow-up
- Gait training and functional ambulation
Mechanisms
Devices act on the rehabilitation problem in distinct ways: a prosthesis substitutes for a missing segment and transmits load and motion; an orthosis applies external forces to a limb or trunk to support, align, restrain or correct it; mobility aids and wheelchairs offload, stabilise or replace walking; and seating systems distribute pressure and maintain posture. In each case the device is one component of a larger process that also includes assessment, fitting, alignment and progressive training, so that the mechanical solution becomes a usable function (Herr, 2009; Simpson, 2005).
Clinical relevance
Across rehabilitation populations — limb loss, stroke, spinal cord injury, neuromuscular and musculoskeletal conditions — externally applied devices are central to restoring mobility and independence. Understanding how device categories map to impairments and goals supports critical reading of the rehabilitation literature; this entry is descriptive and educational and does not prescribe devices or settings for any individual.
Epidemiology
The need for these devices is large and growing. Limb loss in the United States was projected to rise from about 1.6 million people in 2005 toward roughly 3.6 million by 2050, driven largely by dysvascular amputation (Ziegler-Graham et al., 2008), and global health bodies estimate that more than a billion people need at least one assistive product, a number expected to grow with ageing populations (WHO, 2016).
History
Externally applied aids are ancient — splints, crutches and rigid limb replacements predate modern medicine — but the field was reshaped by twentieth-century war injuries, polio epidemics and the rise of rehabilitation medicine, which professionalised prosthetics and orthotics and added biomechanical and engineering rigour. More recently, microprocessor-controlled prostheses, powered exoskeletons and powered and smart wheelchairs have extended what assistive devices can do (Herr, 2009; Simpson, 2005).
Related topics
Seminal works
- ziegler-graham-2008
- herr-2009
- simpson-2005
Frequently asked questions
- What is the difference between a prosthesis and an orthosis?
- A prosthesis replaces a missing body part, such as a limb after amputation, whereas an orthosis is applied to an existing body part to support, align, restrain or correct it, such as an ankle-foot brace.
- Are wheelchairs and mobility aids part of this area?
- Yes. Mobility aids, self-help devices, wheelchairs and seating systems are forms of assistive technology and are covered alongside prostheses and orthoses because they share the goal of restoring mobility, activity and participation.