Scope of Practice
Scope of Practice
PFA Canada member certified pedorthist are health care professionals who are specifically educated and trained to manage comprehensive pedorthic patient care. This includes patient assessment, formulation of a treatment plan, implementation of the treatment plan, follow-up and practice management. A PFA Canada certified pedorthist fits, fabricates, adjusts, or modifies devices which reflect his/her education and training. The profession of pedorthics provides 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, partial foot prostheses for transmetatarsal and more distal amputations, 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. Pedorthic devices do not include non-therapeutic inserts or footwear regardless of method of manufacture; unmodified, non-therapeutic over-the-counter shoes; or prefabricated foot care products. “Therapeutic” devices address a medical condition, diagnosed by a prescribing medical professional, while “non-therapeutic” devices do not address a medical condition.
The practice of member certified pedorthists includes:
1) Assessment of patients with impairment of human movement or musculoskeletal abnormalities that would otherwise impede their ability to participate in their social environment or other activities in order to determine a functional intervention. Pedorthic patient assessment may include, but is not limited to, the evaluation and documentation of: • anthropometric data • cognition • circulation • skin integrity • protective sensation • pain • peripheral nerve integrity • respiratory capacity • biomechanics • gait analysis including temporal and spatial assessment • range of motion • muscle strength • posture and balance • proprioception • pedorthic requirements • environmental barriers including social, home, and work reintegration
2) Formulation of a treatment plan based upon a comprehensive assessment to design an intervention to alleviate limitations and enhance function. Pedorthic treatment includes, but is not limited to: • verification of prescription/documentation • evaluation of the prescription rationale • a needs assessment based on patient and/or caregiver input • development of functional goals • analysis of structural and design requirements • consultation with and/or referral to other health care professionals
3) Implementation of the pedorthic treatment plan includes but is not limited to: • acquisition of anthropometric data • modification and/or rectification of anthropometric data • material selection • fabrication of pedorthic devices • device structural evaluation • diagnostic fitting • gait training • assessment of intervention for appropriate outcomes • patient education and instruction • supervision of the provision of care
4) Utilization of a follow-up treatment plan that ensures successful pedorthics outcomes, patient health and quality of life which includes, but is not limited to: • documentation of functional changes • formulation of modifications to ensure successful outcomes • reassessment of patient expectations • reassessment of treatment objectives • development of long term treatment plan • confirmation of patient education and instruction • evidenced based practice