Bedotto Robert A
OrthoTherapy LLC at Bray Orthotics and Prosthetics, 217 Old Hook Road, Westwood, NJ 07675, USA.
Phys Med Rehabil Clin N Am. 2006 Feb;17(1):203-43. doi: 10.1016/j.pmr.2005.10.007.
Biomechanical treatment is like a jigsaw puzzle with two complex counterparts having many pieces. The physical and mechanical components are equally important and cannot be separated from each other. The patient with a prosthesis or an orthosis represents a biomechanical system; total treatment is essential. All of the pieces to the puzzle must be used to complete the picture. Given the present structure of the educational system, there is a separation of disciplines necessary to provide one truly biomechanical treatment. Physical therapists are educated in the bio aspect of treatment, whereas prosthetists/orthotists are educated in the mechanical aspect. Biomechanical treatment requires the direct interaction and integration of the two disciplines. Physical therapists and prosthetists/orthotists need each other. One without the other can provide only half of the treatment necessary for optimal outcomes. The patient needs both. Physical therapists need to become more familiar with mechanical treatment and learn how to integrate this into their physical treatment program. Prosthetists/orthotists must become more familiar with the importance of physical treatment and the internal corrective forces necessary for efficient ambulation. The traditional label of orthotics and prosthetics and related technology as products must be replaced with biomechanical treatment that includes orthotics and prosthetics services. Professionals working with each other is a positive step, but they need to be working together as a team toward a common goal. They need to be in the same place at the same time and work together consistently to provide total treatment. This is more than a multidisciplinary approach. It is one treatment. In this way, each benefits the other as they teach and learn simultaneously. At present, this teaching and learning can be done only on an individual basis. It is the author's hope that experienced prosthetists/orthotists and physical therapists reading this article will see the need to combine their efforts to provide truly biomechanical treatment. By working together, they can expand their present knowledge and skills. In this way, treatment and outcomes can improve and serve as the guiding force for a new generation of rehabilitation specialists. This process can be expedited through the educational system by offering advanced clinical degrees specializing in biomechanical treatment specifically designed for clinical practice rather than research, administrative, or academic positions. For this idea to become reality, educational institutions representing the physical and mechanical aspects of biomechanical treatment also must work together; this would expedite the learning curve so that it would not take so long to put the pieces of the puzzle together.
生物力学治疗就像一个拼图游戏，有两个复杂的对应部分，各有许多拼图块。物理和机械组件同样重要，彼此不可分割。佩戴假肢或矫形器的患者代表一个生物力学系统；全面治疗至关重要。拼图的所有部分都必须用于完成这幅图。鉴于当前教育系统的结构，提供真正的生物力学治疗需要学科分离。物理治疗师接受治疗生物方面的教育，而假肢矫形师接受机械方面的教育。生物力学治疗需要这两个学科的直接互动和整合。物理治疗师和假肢矫形师相互需要。缺少另一方只能提供实现最佳效果所需治疗的一半。患者需要双方。物理治疗师需要更熟悉机械治疗，并学习如何将其融入物理治疗方案。假肢矫形师必须更熟悉物理治疗的重要性以及有效行走所需的内部矫正力。必须用包括假肢矫形服务的生物力学治疗取代传统的将矫形器、假肢及相关技术视为产品的标签。专业人员相互协作是积极的一步，但他们需要作为一个团队朝着共同目标努力。他们需要同时在同一地点并持续合作以提供全面治疗。这不仅仅是一种多学科方法。这是一种治疗。通过这种方式，他们在相互教学和学习的同时彼此受益。目前，这种教学和学习只能在个体层面进行。作者希望阅读本文的经验丰富的假肢矫形师和物理治疗师能认识到需要共同努力提供真正的生物力学治疗。通过合作，他们可以扩展现有知识和技能。这样，治疗和结果可以得到改善，并为新一代康复专家提供指导力量。通过教育系统提供专门针对临床实践而非研究、行政或学术职位的生物力学治疗高级临床学位，可以加快这一进程。要使这个想法成为现实，代表生物力学治疗物理和机械方面的教育机构也必须合作；这将加快学习曲线，这样就不会花太长时间来拼合拼图的各个部分。
