BS ISO 8551-2003 Prosthetics and orthotics - Functional deficiencies - Description of the person to be treated with an orthosis clinical objectives of treatment and functional requ.pdf

1、BRITISH STANDARD BS ISO 8551:2003 Prosthetics and orthotics Functional deficiencies Description of the person to be treated with an orthosis, clinical objectives of treatment, and functional requirements of the orthosis ICS 11.040.40 BS ISO 8551:2003 This British Standard was published under the aut

2、hority of the Standards Policy and Strategy Committee on 13 October 2003 BSI 13 October 2003 ISBN 0 580 42761 7 National foreword This British Standard reproduces verbatim ISO 8551:2003 and implements it as the UK national standard. The UK participation in its preparation was entrusted to Technical

3、Committee CH/168, Prosthetics and orthotics, which has the responsibility to: A list of organizations represented on this committee can be obtained on request to its secretary. Cross-references The British Standards which implement international publications referred to in this document may be found

4、 in the BSI Catalogue under the section entitled “International Standards Correspondence Index”, or by using the “Search” facility of the BSI Electronic Catalogue or of British Standards Online. This publication does not purport to include all the necessary provisions of a contract. Users are respon

5、sible for its correct application. Compliance with a British Standard does not of itself confer immunity from legal obligations. aid enquirers to understand the text; present to the responsible international/European committee any enquiries on the interpretation, or proposals for change, and keep th

6、e UK interests informed; monitor related international and European developments and promulgate them in the UK. Summary of pages This document comprises a front cover, an inside front cover, the ISO title page, pages ii to v, a blank page, pages 1 to 7 and a back cover. The BSI copyright notice disp

7、layed in this document indicates when the document was last issued. Amendments issued since publication Amd. No. Date Comments Reference number ISO 8551:2003(E)INTERNATIONAL STANDARD ISO 8551 First edition 2003-08-15 Prosthetics and orthotics Functional deficiencies Description of the person to be t

8、reated with an orthosis, clinical objectives of treatment, and functional requirements of the orthosis Prothses et orthses Malformations des membres Description de la condition de lutilisateur dorthse, objectifs cliniques, et exigences fonctionnelles et biomcaniques de lorthse BSISO8551:2003IS:1558

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14、4 Description of the person to be treated with an orthosis . 2 4.1 General. 2 4.2 Personal factors 2 4.3 Clinical condition to be treated with an orthosis. 2 4.4 Other clinical conditions 3 4.5 Motivation and perceived needs . 3 4.6 Functional abilities 3 5 Clinical objectives of treatment. 4 6 Func

15、tional requirements of the orthosis 5 Annex A (informative) Biomechanical effects of orthoses. 7 BSISO8551:2003iv Foreword ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies (ISO member bodies). The work of preparing International Standard

16、s is normally carried out through ISO technical committees. Each member body interested in a subject for which a technical committee has been established has the right to be represented on that committee. International organizations, governmental and non-governmental, in liaison with ISO, also take

17、part in the work. ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization. International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2. The main task of technical committees is t

18、o prepare International Standards. Draft International Standards adopted by the technical committees are circulated to the member bodies for voting. Publication as an International Standard requires approval by at least 75 % of the member bodies casting a vote. Attention is drawn to the possibility

19、that some of the elements of this document may be the subject of patent rights. ISO shall not be held responsible for identifying any or all such patent rights. ISO 8551 was prepared by Technical Committee ISO/TC 168, Prosthetics and orthotics. BSISO8551:2003 vIntroduction The orthotic treatment of

20、a person depends not only on the causes and underlying conditions for which the orthosis is being prescribed, but also on other clinical conditions and attributes of the person. The various members of the clinical teams in different countries often develop their own nomenclature to record this infor

21、mation. Hence there is a need for an international system to allow comparisons of clinical practice. The system described in this International Standard is designed to meet the needs of the members of the clinic team to assess the person and to present and evaluate treatment. Such a system will also

22、 allow this information to be recorded in a way which can easily be incorporated into reports and used for analysis. It will also be of value to epidemiologists and government health officials. ISO 8551 defines the minimum information to be described. BSISO8551:2003INTENRATIONAL TSANDADR IS:1558 O30

23、02(E)1Prosthetics and orthotics Functional deficiencies Description of the person to be treated with an orthosis, clinical objectives of treatment, and functional requirements of the orthosis 1 Scope This International Standard establishes a method of describing the person to be treated with an orth

24、osis, the clinical objectives of treatment and the functional requirements of the orthosis. 2 Normative references The following referenced documents are indispensable for the application of this document. For dated references, only the edition cited applies. For undated references, the latest editi

25、on of the referenced document (including any amendments) applies. ISO 8549-1, Prosthetics and orthotics Vocabulary Part 1: General terms for external limb prostheses and external orthoses ISO 8549-3, Prosthetics and orthotics Vocabulary Part 3: Terms relating to external orthoses ICD-10:1992, Intern

26、ational Statistical Classification of Diseases and Related Health Problems, World Health Organization, Geneva 3 Terms and definitions For the purposes of this document, the terms and definitions given in ISO 8549-1 and ISO 8549-3 and the following apply. 3.1 alignment of a skeletal segment spatial r

27、elationship between the ends of the segment NOTE The alignment of a skeletal segment is determined by its integrity and/or shape. 3.2 alignment of a joint spatial relationship between the skeletal segments which comprise the joint NOTE The alignment of a joint is determined by the integrity and shap

28、e of the skeletal segments of which it is comprised, and the action of associated muscular and ligamentous/capsular tissues. These factors also govern the type and range of motion at the joint. 3.3 alignment of the trunk (or any part thereof) spatial relationship between the relevant two end vertebr

29、ae NOTE The alignment of the trunk is determined by the alignment of the intervening skeletal segments and joints. BSISO8551:20032 3.4 instability tendency of a skeletal segment or joint, whose integrity is impaired, to change to an abnormal alignment when subjected to muscle forces and/or external

30、loading NOTE A skeletal segment or joint exhibiting such instability is said to be unstable. 3.5 deformity abnormal alignment of a skeletal segment or joint 3.6 preventable deformity deformity for which the application of an external force system will prevent an unstable skeletal segment or joint mo

31、ving into an abnormal alignment 3.7 reducible deformity deformity for which the application of an external force system will improve the alignment of a skeletal segment or joint 3.8 irreducible deformity fixed deformity deformity for which the application of an external force system has no effect on

32、 the abnormal alignment of a skeletal segment or joint 4 Description of the person to be treated with an orthosis 4.1 General Describe the person to be treated with an orthosis as given in 4.2 to 4.6. 4.2 Personal factors State the persons age, gender, height and weight. Describe, where relevant, th

33、e persons social and physical environments and vocational and recreational activities. Describe any significant and relevant medical history. 4.3 Clinical condition to be treated with an orthosis State the diagnosis and the ICD-10 codes (International Statistical Classification), whether the conditi

34、on is constant or changing, the involved body segment(s) or joint(s) and the presence of pain or tenderness. Describe any abnormalities of the alignment, shape and dimensions (e.g. length and circumference) of the involved body segment(s), the alignment, stability, range(s) of motion and neuromuscul

35、ar control of the involved joint(s), superficial and deep sensations. BSISO8551:2003 34.4 Other clinical conditions Disorders of the following may influence orthotic treatment: a) the cardiovascular system; b) the respiratory system; c) the musculoskeletal system; d) the neurological system; e) endo

36、crine system; f) the special senses; g) the nutritional status; h) the cognitive state; i) the mental and psychological status; j) other systems. State if there is a disorder of any of these which influences the orthotic treatment, and note any other current treatment. 4.5 Motivation and perceived n

37、eeds State the clinical impression of the persons motivation and their perceived needs. NOTE The motivation and perceived needs of the person have a marked effect upon their rehabilitation. They are interdependent and are influenced by the persons clinical condition, personality and physical, social

38、 and cultural environment.s Motivation is difficult to describe but both poorly motivated and highly motivated individuals can be recognized by clinicians. 4.6 Functional abilities The clinical condition and resulting impairments will affect the persons functional abilities and participation in aspe

39、cts of daily life. Any functional limitations should be identified as follows: a) bed mobility: If the person is unable to transfer from bed independently, state whether they are: 1) immobile; or 2) able to change their lying position independently. b) transferring: State if the person is unable to

40、transfer from sitting to standing independently. State if the person is unable to transfer from standing to sitting independently. c) sitting: State if the person requires support in order to sit. BSISO8551:20034 d) standing/walking: Describe the persons standing/walking ability as 1) unable to stan

41、d, or 2) able to stand, or 3) able to walk with an assistant, or 4) able to walk independently on smooth level surfaces, or 5) able to walk independently on smooth level surfaces and can manage stairs or a step with a hand rail, or 6) able to walk independently on uneven surfaces and can manage stai

42、rs or a step without a hand rail. e) upper limb function: If the persons upper limb function is abnormal, state whether 1) the person is able to position the hand in space to allow its use, 2) the person is able to grasp objects, 3) the person is able to achieve prehension. f) use of technical aids:

43、 Specify any technical aids used to assist any of these activities. 5 Clinical objectives of treatment The clinical objectives of treatment may be a) to relieve pain, b) to manage deformities which are preventable (e.g. ruptured collateral ligament of knee), which are reducible (e.g. developmental d

44、ysplasia of the hip), which are irreducible (e.g. a malunited fracture), c) to prevent an excessive range of joint motion (e.g. knee hyperextension), d) to increase joint range of motion (e.g. joint stiffness), e) to compensate for abnormalities of segment length or shape, (e.g. limb length or soft

45、tissue discrepancy), f) to manage abnormal neuromuscular function, which includes compensating for weak muscle action (e.g. poliomyelitis), controlling the effects of muscle hyperactivity (e.g. spasticity); BSISO8551:2003 5g) to protect tissues (e.g. diabetic neuropathy and Charcot neuroarthropathy)

46、, h) to promote healing (e.g. following knee-joint surgery), i) to provide other effects (e.g. placebo, warmth, postural feedback). State the clinical objective(s) of treatment, specifying the joint(s) and/or segment(s) involved. State, where appropriate, what induces the pain; and/or the type of de

47、formity to be managed; and/or the joint motion to be prevented or increased; and/or the alteration of segment length or shape required; and/or the muscle action to be compensated for or controlled; and/or the tissues to be protected or whose healing is to be promoted. 6 Functional requirements of th

48、e orthosis To achieve the clinical objectives, the orthosis may be required to provide the following functions: a) deformities 1) to prevent a deformity (i.e. to stop a joint or segment moving into an abnormal alignment); 2) to reduce a deformity (i.e. to move a joint or segment to an improved align

49、ment and maintain the correction obtained); 3) to stabilize a deformity (i.e. to prevent an irreducible deformity from increasing); b) joint motion 1) to limit the range of motion of a joint; 2) to increase the range of motion of a joint; c) segment dimensions 1) to add to the length of a segment; 2) to improve the shape of a segment; d) muscle activity 1) to compensate for weak muscle activity; 2) to control the effect of mus