Developing a research agenda in digital workflows for the fabrication of prostheses and orthoses

Recent advancements in digital workflows, including the use of 3D printing, are transforming the prosthetics and orthotics (P&O) field. Digital technologies offer opportunities to deliver P&O services that are more efficient by reducing design and fabrication times, are less wasteful through the elimination or reduction of consumables, including plaster, foam and other materials, and are more repeatable by having digitally saved designs. Despite known advantages, the adoption of digital workflows in P&O has been inconsistent, underscoring the need for cross-sector collaboration to guide the field using evidence-informed approaches.

To collaborate with key interest groups to identify priority areas for advancing the adoption and implementation of digital workflows in the P&O field.

A modified Delphi approach was used to inform the structure of a Canada-wide initiative and involved participation of 79 representatives from key interest groups, including prosthetists, orthotists, technicians, biomedical engineers, researchers, and people with limb absence/difference. Research priorities were identified through online surveys followed by a hybrid meeting during which attendees engaged in small- and large-group discussions to refine and select priorities.

Five key digital P&O research priorities were identified: (1) strengthening evidence on device quality and system performance compared to traditional methods; (2) developing economic and reimbursement models to support clinical integration; (3) improving education and training for digital workflows; (4) establishing standardized practice guidelines; and (5) increasing key interest group engagement to better understand user needs and perspectives. While the general components of digital workflows are now broadly understood, future efforts should focus on more specific contexts, and discussions should be more targeted and disaggregated (e.g., by device type, patient population, or care setting) and include experts with context-specific experience.

This collaboration initiative provides a strategic roadmap for advancing the adoption of digital workflows in the P&O field and supports the development of national collaborations aimed at fostering innovations and evidence-based practice.