Feasibility of an Interdisciplinary Intervention to Promote Balance Confidence in Lower-Limb Prosthesis Users

In this episode, Dr. Steve Gard, editor-in-chief of the Journal of Prosthetics and Orthotics, welcomes Andreas Kannenberg, MD, PhD, to discuss his JPO article, “Systematic Review of the Clinical and Biomechanical Evidence for Non-Microprocessor Control Knee Mechanisms and Practical Recommendations for Knee Selection.” Dr. Kannenberg explains why non-microprocessor knees remain an important part of prosthetic care, particularly when cost, insurance coverage, and access limit the use of microprocessor technology. He shares findings from a review of 28 studies involving more than 1,000 participants, examining the evidence behind different knee mechanisms and the tradeoffs between stability, function, and the strength required of the user. The conversation explores locked, friction-brake, four-bar, multi-axial, and hydraulic knee mechanisms, how their performance can vary across different terrains, and why some commonly held assumptions about polycentric knees may deserve a closer look. Dr. Kannenberg also discusses gaps in the existing research and the need for larger, higher-quality studies, particularly in countries where non-microprocessor knees remain the standard of care.

In this episode, Dr. Steve Gard, editor-in-chief of the Journal of Prosthetics and Orthotics, welcomes Elaine Owen, MBE, MSc, SRP, MCSP, to examine how well researchers and journals are following best-practice reporting guidelines for ankle-foot orthosis (AFO) interventions in children with cerebral palsy. Owen explains why three key parameters, AFO ankle angle, the shank-to-vertical angle (SVA) of the AFO-footwear combination, and any tuning or optimization, are essential for understanding, replicating and evaluating these interventions. A review of literature published between 2010 and July 2024 found significant gaps in reporting, with only nine of 64 articles focused on rigid AFOs documenting all three parameters. Owen discusses the confusion surrounding alignment terminology and calls for better training, adequate clinical time and resources, greater involvement of experienced orthotists in research, and stronger reporting expectations from journals and peer reviewers. Show notes JPO article: Do Authors and Editors Comply With Best Practice Reporting Guidelines for AFO Interventions in Studies Involving Children With Cerebral Palsy? A Scoping Review

In this episode, Dr. Steve Gard, editor-in-chief of the Journal of Prosthetics and Orthotics, welcomes Szu-Ping Lee, PT, PhD, to discuss his JPO article, "Prosthetic Healthcare Deserts Across the United States." Dr. Lee explores how geographic access to prosthetic care varies across the country, explains the research methods used to identify underserved regions, and highlights the relationship between provider availability, population needs, and O&P education programs. The conversation also examines the challenges faced by individuals living in prosthetic care deserts and considers strategies to improve access through better data, workforce planning, and expanded clinical and educational resources.

In this episode, Dr. Steve Gard, editor-in-chief of the Journal of Prosthetics and Orthotics, speaks with Cody McDonald, PhD, MPH, CPO, assistant professor in the Department of Rehabilitation Medicine at the University of Washington, and Benjamin Darter, PhD, PT, chair and an associate professor in the Department of Physical Therapy at Virginia Commonwealth University, about their JPO article, “Bone-Anchored Prosthesis Users’ Experiences of Altered Lower Limb Prosthetic Attention: A Pilot Focus Group Study.” They explore how bone-anchored prostheses may reduce the cognitive effort required to use a prosthesis, a concept known as prosthetic attention. Drawing on a two-hour online focus group with four individuals who transitioned from socket-based systems to bone-anchored prostheses, the researchers identified themes of increased sensation and control, freedom from socket-related discomfort and stigma, greater awareness of fall risks and injury consequences, and the continued need to monitor terrain and component limitations. They discuss why prosthetic attention matters clinically, the surprisingly low concern about infection among participants, and the importance of helping patients understand both the benefits and ongoing challenges of bone-anchored prosthetic systems. Show notes JPO article: Bone-Anchored Prosthesis Users’ Experiences of Altered Lower Limb Prosthetic Attention: A Pilot Focus Group Study O&P Research Insights is produced by Association Briefings.

In this episode, Dr. Steve Gard, Editor-in-Chief of the Journal of Prosthetics and Orthotics, speaks with Amandi Rhett, MS, CPO, LPO, FAAOP, assistant professor in the Baylor College of Medicine Orthotics and Prosthetics Program and assistant dean of community health at the college’s School of Health Professions, about the impact of microaggressions in healthcare and efforts to address them within the orthotics and prosthetics profession. Rhett explains how subtle verbal, nonverbal, and environmental slights directed toward marginalized groups can affect workplace culture, clinician-patient relationships, and patient outcomes. Drawing from her own experiences and recognizing a lack of O&P-specific training in this area, she and her coauthors developed an interactive workshop using real-world scenarios to help clinicians identify and respond to microaggressions. The conversation explores examples such as mispronouncing ethnic names, assumptions about patient behavior, and misuse of pronouns, along with the workshop’s early results, which showed increased participant confidence and awareness. Rhett also discusses the study’s limitations, future plans to expand the training, and the importance of fostering more inclusive and respectful healthcare environments.