Understanding the adoption of digital workflows in orthotic & prosthetic practice from practitioner perspectives: a qualitative descriptive study (Ngan et al., 2022)

Interviewee: Jan Andrysek, Ph.D., PEng, Associate Professor, Institute of Biomaterial and Biomedical Engineering, University of Toronto, Senior Scientist at the Bloorview Research Institute and Lead of the PROPEL Lab, Holland Bloorview Kids Rehabilitation Hospital

Article: Understanding the adoption of digital workflows in orthotic & prosthetic practice from practitioner perspective: a qualitative descriptive study
Calvin C Ngan, Harry Sivasambu, Kerri Kelland, Sandra Ramdial, Jan Andrysek
Holland Bloorview Kids Rehabilitation Hospital
University of Toronto

Key Takeaways

  • Digital technology is becoming more prevalent in the P&O field, however there are still challenges to fully implementing the technology into clinical practice
  • Three key themes of challenges: technological advancement and scientific evidence; marketplace, economic, and operational factors; mindset shift of embracing digital technology practice
  • Goals of the study were to gain a more in-depth understanding of these challenges from the perspective of practicing professionals and bring awareness to some of the gaps inthe technology and its implementation

Please tell us about your lab, your team, and your research interests
Our team at the PROPEL Lab (Paediatrics, Rehabilitation, Orthotics, Prosthetics, Engineering, Locomotion) is based in the Bloorview Research Institute. Our research lab is comprised of about a dozen students, researchers, and engineers. Our research interests primarily focus on P&O, and the use of technology to enable and improve the lives of children and adults with physical disabilities. We are fortunate to be based out of a hospital, and to work closely with P&O clinicians, technicians and clients on our hospital’s mission to enable the most meaningful and healthy futures for all children, youth and families through cutting-edge treatment, technology, and ground-breaking research. The digital workflow was a good example of this as the team comprised of three individuals from the clinical team and four from the research team.

What are you working on right now that you are most excited about?
The digital technology project is currently most closely related to clinical practice in the hospital, so it has the greatest potential to have the most immediate impact to change and improve the lives of our clients.
In addition to our digital technology projects, we are excited about our work focused on biofeedback and gait training systems, specifically on developing wearable technology to help with the rehabilitation process. Several of our students are researching strategies and approaches on how we can help improve the gait of children and adults using lower limb prostheses. Several other students are also working on upper limb applications, focusing on providing sensory feedback for upper limb prosthetic control. Both of the upper and lower limb feedback research are investigating novel ways of improving physical function.

What are next steps based on your research? How can we integrate your findings into clinical practice?
The devices that we think the digital technology can have the greatest and most immediate impact on are transradial sockets and ankle-foot orthoses (AFO) in terms of being able to provide and improve the methods by which the devices are fabricated. The transradial projects are currently focusing on the socket design, with the goal of eventually being able to provide an entire device. For the AFO project, our lab has teamed up with a local clinic as part of a master’s project to try to advance this research. With all of this research underway, we are trying to not only implement these methods into our own and our partner’s clinics, but we are focused on disseminating our knowledge and information with others in the P&O field. We have been actively sharing our research through
conference presentations, journal publications and medial to make it accessible to other professionals, and as a way of engaging with others that share a similar mission and goals.

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