Meeting the Lower-limb Challenge

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By Andrea Spridgen

Helping patients with lower-limb impairments reach their full mobility potential comes with challenges, including reluctance from third-party payers to reimburse advanced technological solutions, finding the right solution for individual patients, and guiding patients through the rehabilitation process to maximize their devices' functionality. This issue provides insight into ways to address these concerns.

A frequent problem practitioners face when providing the most appropriate care for their patients is increased pressure from third-party payers to fit the least expensive prosthesis or orthosis that provides some level of mobility, rather than the one that may maximize the patient's potential but comes with a higher price tag. In "Making the Reimbursement Case for Advanced Lower-limb Technology," experts share strategies for helping payers understand patients' needs for advanced lower-limb technology and how to make the documentation work for you, starting with the initial consultation. One takeaway—central to patient care but too often lost in documentation where the device takes center stage—is to focus on the patient. This, the experts stress, may be the key to a smoother reimbursement or appeal.

Finding the right solutions for patients also depends on mining data to determine device characteristics that best solve problems such as fall risk. Phil Stevens, MEd, CPO, FAAOP, looks at the principle of minimum toe clearance and the way different types of prosthetic feet can affect fall risk in "Clearing the Stumbling Blocks: Management Strategies Associated With Minimum Foot Clearance in Prosthetic Ambulation." This article also provides information for practitioners to consider that reinforces the need for hydraulic ankle-feet for patients who have a history of falls.

"Motivational Interviewing:Encouraging Healthy Behavior Change" challenges practitioners to examine their communication strategies when helping patients make the most of the devices with which they have been fitted. This method relies on stepping back from directives and instead guiding and partnering with patients' own level of motivation so they are influenced to take the steps that are good for them and are encouraged to find reasons to justify their own healthy choices for compliance.

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Happy reading.