Binedell Trevor, Subburaj Karupppasamy, Wong Yoko, Blessing Lucienne T M
SUTD-MIT International Design Centre, Singapore University of Technology and Design, Singapore, Singapore.
Engineering Product Development Pillar, Singapore University of Technology and Design, Singapore, Singapore.
JMIR Rehabil Assist Technol. 2020 Nov 5;7(2):e23827. doi: 10.2196/23827.
The prosthetic and orthotic industry typically provides an artisan "hands-on" approach to the assessment and fitting of orthopedic devices. Despite growing interest in digital technology for prosthetic and orthotic service provision, little is known of the quantum of use and the extent to which the current pandemic has accelerated the adoption.
This study's aim is to assess the use of digital technology in prosthetics and orthotics, and whether its use can help overcome challenges posed by the current COVID-19 pandemic.
A web-based survey of working prosthetists, orthotists, and lower limb patients was conducted between June and July 2020 and divided into three sections: lower limb amputees, prosthetist and orthotist (P&O) currently using digital technologies in their practice, and P&O not using any digital technology. Input was sought from industry and academia experts for the development of the survey. Descriptive analyses were performed for both qualitative (open-ended questions) and quantitative data.
In total, 113 individuals responded to the web-based survey. There were 83 surveys included in the analysis (patients: n=13, 15%; prosthetists and orthotists: n=70, 85%). There were 30 surveys excluded because less than 10% of the questions were answered. Out of 70 P&Os, 31 (44%) used digital technologies. Three dimensional scanning and digital imaging were the leading technologies being used (27/31, 88%), primarily for footwear (18/31, 58%), ankle-foot orthoses, and transtibial and transfemoral sockets (14/31, 45%). Digital technology enables safer care during COVID-19 with 24 out of 31 (77%) respondents stating it improves patient outcomes. Singapore was significantly less certain that the industry's future is digital (P=.04). The use of virtual care was reported by the P&O to be beneficial for consultations, education, patient monitoring, or triaging purposes. However, the technology could not overcome inherent barriers such as the lack of details normally obtained during a physical assessment.
Digital technology is transforming health care. The current pandemic highlights its usefulness in providing safer care, but digital technology must be implemented thoughtfully and designed to address issues that are barriers to current adoption. Technology advancements using virtual platforms, digitalization methods, and improved connectivity will continue to change the future of health care delivery. The prosthetic and orthotic industry should keep an open mind and move toward creating the required infrastructure to support this digital transformation, even if the world returns to pre-COVID-19 days.
假肢与矫形器行业通常采用手工匠人式的“亲力亲为”方法来评估和适配矫形器械。尽管人们对用于假肢与矫形器服务提供的数字技术兴趣日增，但对于其使用量以及当前疫情在多大程度上加速了其采用情况，却知之甚少。
本研究旨在评估数字技术在假肢与矫形器领域的使用情况，以及其使用是否有助于克服当前新冠疫情带来的挑战。
2020年6月至7月间对在职假肢师、矫形师和下肢患者进行了一项基于网络的调查，该调查分为三个部分：下肢截肢者、目前在实践中使用数字技术的假肢师和矫形师（P&O），以及未使用任何数字技术的假肢师和矫形师。为了开展该调查，征求了行业和学术界专家的意见。对定性（开放式问题）和定量数据均进行了描述性分析。
共有113人回复了基于网络的调查。分析中纳入了83份调查问卷（患者：n = 13，占15%；假肢师和矫形师：n = 70，占85%）。有30份调查问卷被排除，因为回答的问题少于10%。在70名假肢师和矫形师中，31人（44%）使用了数字技术。三维扫描和数字成像为主要使用的技术（27/31，占88%），主要用于鞋类（18/31，占58%）、踝足矫形器以及经胫骨和经股骨接受腔（14/31，占45%）。数字技术在新冠疫情期间能实现更安全的护理，31名受访者中有24人（77%）表示它改善了患者治疗效果。新加坡对该行业未来是否数字化的确定性明显较低（P = 0.04）。假肢师和矫形师报告称，虚拟护理的使用对会诊、教育、患者监测或分诊目的有益。然而，该技术无法克服诸如缺乏通常在体格检查期间获取的细节等固有障碍。
数字技术正在改变医疗保健。当前的疫情凸显了其在提供更安全护理方面的有用性，但数字技术必须经过深思熟虑地实施，并设计用于解决当前采用过程中的障碍问题。利用虚拟平台、数字化方法和改善连接性的技术进步将继续改变医疗保健服务的未来。假肢与矫形器行业应保持开放心态，朝着创建所需基础设施以支持这一数字转型迈进，即便世界恢复到新冠疫情之前的状态。
