This guide is to help you fill in the updated case study template. It is advised that you open the document in word, and fill in electronically. If on any section you run out of space, just keep writing and the boxes will expand. Otherwise, add extra notes on the final pages of the document.
1. Your Details
Fill in name and contact details for yourself. Please add the event number as detailed on the case study template.
2. Job Details
Brief patient description: In here describe the presenting patient including their current complaint, details of your objective assessment with relevant muscle strengths or range of motions, and any extra considerations that you noted in your initial assessment
Orthotic/Prosthetic Aims/Requests: This space is to detail what was requested by the referrer. This may be a specific device or simply to address a patient’s problem. You should include what the requested aim of the orthosis/prosthesis is.
Previous Visits: Detail any previous orthotic/prosthetic managementincluding successes and failures. This is important to show you have considered what the patient may have tried previously. Leave blank if this is the first orthotic/prosthetic involvment for the patient.
An abstract is a brief summary of an article or review, and is used to help the reader ascertain the purpose of the content. In this section you should include brief patient details, methods of treatment, treatment outcome and review.
Eg. 5 year old male idiopathic toe walker presented to the orthotic clinic. He had previously been issued with SB boots to resist toe walking with minimal success. At the initial re-assessment, he was found to have TA shortening and there was concern that this wasn’t going to improve as he was still walking on his toes constantly. Rigid AFOs and night splints were suggested by the orthotist and were discussed with the orthopaedic consultant who oversaw the patient’s care. The night splints were not tolerated well as they rubbed during the night. The rigid AFOs for walking were very effective and tolerated well, the family also reported a strong carryover of flat foot walking when the AFOs were removed. A good stretch of the gastrocnemius was achieved with the AFOs, and after a few months of wear 10 degrees of dorsiflexion could be achieved with the knee extended. The patient was then recast for some hinged AFOs as he still tended to toe walk occasionally. The plan is to wear these for 6-12 months then wean the patient off AFOs altogether.
4. Initial Assessment
Clinical Presentation: Summarise your subjective and objective findings. Subjective should cover what the patient told you, and objective is what you found from a look/touch/move assessment.
Orthotic / Prosthetic Aims: Detail here the specific aims of the orthosis. Eg. Resist foot drop and knee hyperextension by blocking plantar flexion
Discussion with multidisciplinary team: Usually when a new patient presents to the orthotic/prosthetic clinic there will be some discussion with the referrer or other members of the multidisciplinary team. If this didn’t occur in your case study example, just leave blank.
Orthotic/Prosthetic Prescription: Here detail your orthotic /prosthetic prescription. Eg. Rigid plastic AFO set in 10 degrees plantarflexion with heel raise, or boston style TLSO with corrective padding positioned at….etc
Method/Plan: Detail your method of shape capture/measurement if applicable, whether fitting or reviews were required or carried out etc.
5. Literature Review
Here is your opportunity to detail the literature used to help to make your clinical decision. If your decision was based on clinical experience, you should attempt to find some literature to support your prescription. It is imperative that orthotists and prosthetists continue to read upcoming research, and this kind of review helps to understand and build the increasing level of evidence. A simple google scholar search of your topic will help to find appropriate articles, and JPO and ISPO are also good places to look.
Please include a journal reference so the reader can locate the article independently. Then provide a summary and critical appraisal of the article. This should include the aim of the study, methods used and relevant findings. Your critical appraisal should attempt to identify if the results are reliable.
Your journal reference should be in the following style
Order: author(s), year of publication, article title (not in italics), journal name (in italics), volume number (in italics), issue number, and the page number range of the article.
Eg. Castles, F. G., Curtin, J. C., & Vowles, J. (2006). Public policy in Australia and New Zealand: The new global context. Australian Journal of Political Science, 41(2), 131–143.
One appraised article will be accepted, but it is recommended that at least 3 are read and detailed in this section.
6. Visit Details
This should include a summary of your clinical notes of the patient’s appointments. Not all visits need to be filled in if not required, and more rows can be added to the table if there were more than 4 appointments. Use the SOAP note format to ease understanding for the reader.
Subjective – what the patient told you
Objective – what you learned from your assessment
Action – What you did
Plan – What is the plan? Eg. Fitting, review etc
7. Critical Appraisal of the Study
It is important to reflect on what you have learnt from interesting or difficult cases. Here detail what you feel you have learnt from the case and how you will use this knowledge going forward.
Include anything you feel could have been done better.
As we continue to recognise the need for evidence based practice it is important to consider ourselves as contributors to the evidence base. In this final section, reflect on whether your case study presents any new orthotic concepts or if it covers an area which is gapping in evidence. Consider how your case study may inform readers.