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Effectiveness and cost-effectiveness of prosthetic and orthotic interventions

Approximately 100 million people globally require prosthetic or orthotic interventions.

Our work examined such interventions to inform policy development, as various organizations have advocated their societal value yet limited research exists to guide policymaking. While prosthetic and orthotic research has grown in recent decades, most focuses on lower limb orthotics in adults within a few countries. Moreover, the array of outcome measures used hinders result comparisons. Our analysis of 342 randomized trials revealed only 4 examined prosthetics while most examined orthotics, categorized by medical condition. We concluded current literature lacks sufficient high-quality evidence to strongly conclude intervention effectiveness and cost-effectiveness. Our program also examined UK orthotic service provision, finding wide discrepancies in service quantity/quality between providers and data capture gaps. Thus, the NHS must establish appropriate processes to record service provision details. Standardizing appointment times and product entitlement guidelines could promote more equitable care. Overall, further research is warranted, particularly on cost-effectiveness. Standardized outcome sets would also enable future result comparisons. Though prosthetic/orthotic research has expanded, it requires greater standardization, generalizability, and linkage to policy to realize the full individual and societal benefits these interventions may provide. 

Some of our key papers

A scoping literature review of studies assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions.

Healy, A., Farmer, S., Eddison, N., Allcock, J., Perry, T., Pandyan, A. and Chockalingam, N., 2019. Disability and Rehabilitation: Assistive Technology.

A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions.

Healy, A., Farmer, S., Pandyan, A. and Chockalingam, N., 2018.  PloS one, 13(3), p.e0192094.

Cross-sectional survey of orthotic service provision in the UK: does where you live affect the service you receive?

Chockalingam, N., Eddison, N. and Healy, A., 2019. BMJ open, 9(10), p.e028186.

Aoife Healy

Associate Professor

Prof. Nachiappan Chockalingam

Professor of Clinical Biomechanics

CBRT Staffordshire University