4.0 Educational Services

Definition:  The communication of information to members of the multidisciplinary team, caregivers, family, and/or the patient to promote a positive outcome of prosthetic/orthotic treatment and the safe and effective use of the prosthesis/orthosis.

Code	Procedure	Description
1	Patient orientation to prosthetic/orthotic treatment	Educate patient / caregiver in the process of treatment. Explain the processes of shape capturing, diagnostic procedures, static/dynamic functional evaluations, anatomical and structural finishing procedures, timelines between stages of treatment, and follow-up treatments.
2	Treatment plan and expectations	Educate patient about the expectations of the prosthesis/orthosis within the treatment plan. How to identify signs or symptoms that require patient/caregiver to contact the prosthetist/orthotist for further intervention or re-evaluation.
3	Initial instructions	Educate first-time users of prosthesis/orthosis. Explain and demonstrate elements of prosthesis/orthosis and their function(s).  Explain donning and doffing procedures, concept of body segment atrophy, importance of skin evaluation, use of interface products and/or socks, and the importance of proper positioning of the prosthesis/orthosis. Explain the influence of footwear on the function of the prosthesis/orthosis.
4	Care and maintenance of prosthesis/orthosis	Instruct patient on regular cleaning and inspection of the prosthesis/orthosis and explain warranty on components. Instruct patient on care of interface and extrinsic components. Bring attention to manufacturer’s recommended use of componentry.
5	Body segment assessment	Educate patient on the importance of caring for the involved body segment. May include: checking for skin irregularities or breakdown, body segment hygiene, monitoring volume changes, instructing how to prevent or limit joint contractures.
6	Acclimation period	Explain and provide verbal and written information relating to the specific prosthesis/orthosis provided. Emphasize the need to gradually increase wearing time until desired protocol is reached. Discuss body segment assessment and when to terminate use of prosthesis/orthosis if necessary.
7	Factors influencing function of the prosthesis/orthosis	Educate patient on factors affecting skin condition and function of prosthesis/orthosis, including control of edema, effective use of socks, regular stretching/ strengthening to minimize joint contractures. Include influence of footwear and stability of body weight on treatment outcomes.
8	Introduction of new component or function affecting the prosthesis/orthosis	Explain function of new components or changes made to improve the function of the current prosthesis/orthosis.  Demonstrate safe and proper use.
9	Initial gait training	Implement a gait training program to teach the patient how to safely use the prosthesis/orthosis in all aspects of activities of daily living, including safe navigation of even and uneven terrain, fall recovery, curbs, ramps, stairs, snow/ice, and the use of gait aids.  May involve multiple sessions.
10	Advanced mobility training program	Implement an advanced mobility program for the patient with a high level of prosthetic/orthotic utilization or potential e.g. running, fast walking, advanced balance and core strength, and specific activity training. May involve multiple sessions.
11	Training for use of upper-extremity prosthesis/orthosis	Demonstrate movements required to optimize function of components.  This will include donning and doffing of the prosthesis/orthosis and training in the use of the prosthesis/orthosis for specific tasks in different positions. May involve multiple sessions.
12	Training for use of myoelectric prosthesis	Instruct patient on control and sequencing of muscle electrical signals required to functionally operate a myoelectric prosthesis.  May involve computer training over multiple sessions.
13	Training for use of Functional Electrical Stimulation/ Neuroprosthetics	Instruct patient on donning, control of functional electrical stimulation, electrode care, and skin integrity. Will involve multiple sessions of training and adjustments.
14	Review of treatment	Review instructions and education previously given to patient or for new caregivers.
15	Pre-surgical consultation	Provide patient with information regarding quality of life, expectations and recovery process following a surgical procedure.