History of Prosthetics and Orthotics

History of Prosthetics and Orthotics

The study of orthotics began with the ancient art of splint and brace making (1,2).  Bonesetters and brace makers eventually developed into what we now call orthopaedic surgeons and orthotists.  The study of prosthetics has been closely associated with amputation surgery performed as a lifesaving measure from the aftermath of battle (3).  Injured soldiers who returned home from battle with traumatic amputations utilized primitive wooden prostheses.  Each major war apparently has been the stimulus for improvement of amputation surgical techniques and for the development of improved prostheses.  It was not until the twentieth century when the most significant contributions to prosthetic/orthotic sciences were made, stimulated by the aftermath of the first and second world wars and the polio epidemics of the late 1940’s and early 1950s (4).  Injured veterans who acquired musculoskeletal and neuromuscular impairments or traumatic amputation and polio survivors with diminished neuromuscular function increased the demand for orthotic and prosthetic services.  To improve the quality and performance of assistive devices at the end of World War II, particularly for veteran amputees, the U.S. Government sponsored a series of research and development projects under the auspices of the National Academy of Sciences that would forever change the manner in which orthotics and prosthetics would be practiced (5).

A consensus conference revealed that few modern scientific principles or developments had been introduced in prosthetics (5). As a result, research and educational committees were formed to advise and work with a number of research groups.  Between 1945 and 1976, universities, the Veterans Administration, private industry, and other military research units were subcontracted to conduct various prosthetic research projects (6). Although the focus of the Artificial Limb Program was prosthetics, it was anticipated that these efforts would also benefit orthotics.

Not until the early 1960s did the National Academy of Sciences National Research Council begin to promote multidisciplinary scientific research efforts into human locomotion, biomechanics, and the development of new materials and devices (7). Innovations in prosthetic and orthotic designs were influenced by the adaptation of industrial techniques for vacuum forming sheet plastics.  By the 1980s the continuing introduction of new materials and methods spurred the profession of prosthetics and orthotics to rapidly evolve as a changing discipline. In an attempt to keep its professionals updated, the 1990s saw significant advancement in the development of educational programs with the establishment of national education accreditation through a subsection of the American Medical Association.

In 1997, Georgia Tech responded to the need for an advanced educational program in prosthetics and orthotics by initiating development of a new multidisciplinary master’s degree program.  After a unanimous decision, the Georgia State Board of Regents officially approved the creation of the School of Applied Physiology and granted Georgia Tech to establish an entry-level graduate degree program in prosthetics and orthotics.  Today, prosthetics and orthotics has developed into a burgeoning multifaceted profession.  Continued technological advancements in engineering and medicine have challenged its educational programs. Health care educators currently face a tremendous challenge to keep pace with the unprecedented growth and development in computer technology, materials science and rehabilitation medicine. The Georgia Tech Master of Science in Prosthetics and Orthotics (MSPO) degree program embraces this challenge.

References
  1. Edwards JW. Orthopaedic appliances atlas, Volume1. Ann Arbor: American Academy of Orthopaedic Surgeons, 1952;5.
  2. Bunch WH. Introduction to orthotics. In: American Academy of Orthopaedic Surgeons. atlas of orthotics Biomechanical Principles and Application, 2nd Ed. St. Louis: C. V. Mosby Company; 1985;3.
  3. Wilson AB. History of amputation surgery and prosthetics. In: Bowker JH, Michael JW eds. Atlas of limb prosthetics surgical, prosthetic, and rehabilitation principles. 2nd Ed. St. Louis: Mosby; 1992;3-13.
  4. Sharrard WJW. Muscle recovery in poliomyelitis. Journal of Bone and Joint Surgery (American). 1955;37B:63.
  5. Committee on Artificial Limbs. National Research Council: Terminal research reports on artificial limbs (covering the period from April 1, 1945 through June 30, 1947). Washington, DC: National Research Council; 1947.
  6. Fishman S. The professionalization of orthotics and prosthetics. O&P Business News. 2001;10:24-30.
  7. Singer B. ABCs 40 years of excellence – a retrospective, 1958-1967, Almanac, June 1988;81-86.