How many C.Peds are utilizing their scope of practice to offer services to minimize fall risk?

A pedorthic device fitted by a Certified Pedorthist can reduce the number of falls in the elderly.

A pedorthist certified by ABC, (The American Board for Certification in Orthotics, Prosthetics and Pedorthics www.abcop.org is bound by the ABC Code of Professional Responsibility

which is enforced by a Professional Discipline program. The Certified Pedorthist is obligated to

support and conform to professional responsibilities that promote and assure the overall welfare

of the patient and the integrity of the profession.

Falls are universally recognized as the leading cause of injury leading to death among older adults. Fall related injuries occur more commonly than strokes and are the most preventable cause of hospitalization. Fall related hip fractures account for 25% of injuries leading to death among those over the age of 65 and 35% among those 85 years plus. Fall prevention strategies have been proven effective for both patient longevity and reducing the burden of associated medical expense.

Recent studies show that fall risk assessments, the subsequent formulation of a treatment plan and the implementation of a pedorthic treatment plan and follow up can reduce the fall risk among the elderly considerably.

Clinical indications for fall risk are ankle instability, peripheral neuropathy, ankle osteoarthritis, mild foot drop, vestibular disease, history of fall or near fall and walking difficulty.

The Scope of Practice for a C.Ped consists of standards set by ABC.

“The profession of pedorthics is the provision of patient care and services by or under the direction and supervision of an ABC certified pedorthist to provide the application of a pedorthic device for the prevention or amelioration of painful and/or disabling conditions of the foot and ankle. A prescription is required for any pedorthic device, modification, and/or prefabricated below the knee orthosis addressing a medical condition that originates at the ankle or below.

Pedorthic devices’ means therapeutic shoes, shoe modifications made for therapeutic purposes, below the ankle partial foot prostheses, and foot orthoses. It also includes subtalar-control foot orthoses (SCFO) designed to manage the function of the anatomy by primarily controlling the range of motion of the subtalar joint. Excluding footwear, the proximal height of a custom pedorthic device does not extend beyond the junction of the gastrocnemius and the Achilles tendon.”

Included within the ABC scope for a C.Ped is the right to provide custom molded ankle gauntlets, which fit the definition of a SCFO (Subtalar Control Foot Orthosis). It is also stated that a C.Ped may provide a “below the ankle partial foot prosthesis”.

So there you have it. Not only are C.Peds are ideally placed to help patients drastically improve their longevity but they are bound by the ABC Code of Professional Responsibility to do so.

Long Live the C.Ped!!