60 Standards for Prosthetics and Orthotics published by WHO

60 Standards for Prosthetics and Orthotics

The World Health Organization has published new Standards for Prosthetics and Orthotics. They are published in 2 parts (Part 1 Standards and Part 2 Implementation Manual).

There are 60 standards in 4 areas (Policy, Products, Personnel and Provision).

Area 1. Policy

Leadership and governance


1 Governments should assume a leading role in the development and coordination of national prosthetics and orthotics service provision.

2 Governments should involve all relevant stakeholders – including service users, caregivers and user groups – in policy development, planning, implementation, monitoring and evaluating prosthetics and orthotics services.

3 A national prosthetics and orthotics committee or similar entity, with a wide range of stakeholders, should be in place for the coordination and development of national prosthetics and orthotics service provision.


4 There should be a national guiding framework for prosthetics and orthotics service provision.

5 Prosthetics and orthotics service provision should be regulated by the State.


6 Prosthetics and orthotics service should be monitored nationally and regionally.


7 Governments and national stakeholders should collaborate internationally and share experience, data and research on prosthetics and orthotics service provision.


8 International support, when provided, should contribute to the establishment and implementation of national prosthetics and orthotics policies and strategic plans and be aligned with the provision system of the national health and welfare service.



9 The cost of providing prosthetics and orthotics services should be assessed periodically.

10 The direct and indirect economic benefits of prosthetics and orthotics services should be analysed at individual, family, community, society, health sector and national levels.


11 Prosthetics and orthotics services should be an integral part of universal health coverage.

12 Prosthetics and orthotics services should be included in national health and social insurance systems, like other health interventions.


13 Data on prosthetics and orthotics service provision should be collected periodically, analysed at service level and shared at national level.

14 A national prosthetics and orthotics database should be established to identify total need, types of need and unmet need.

Promotion of prosthetics and orthotics services

15 Strategies for raising awareness about prosthetics and orthotics services should be established, including rights-based, social and economic arguments.

Area 2. Products


16 An appropriate range of prosthetic and orthotic products should be available in countries to suit local needs and realities.

17 A national list of priority prosthetic and orthotic products should be drawn up, respected and updated regularly.

18 International standards should be used for national classification of prosthetic and orthotic products.

Supply of materials

19 Components, materials, consumables, tools, machines and other equipment used exclusively for fabrication of prosthetic and orthotic products that are not available in a country should be exempt from import duty and customs fees.

20 Reuse of prosthetic and orthotic components should be regulated by a designated authority or group of experts with no conflict of interests and involve proper quality control and documentation.

Technical standard

21 National regulation of prosthetic and orthotic products, components and materials should be an integral part of the national health care regulatory system.

22 Prosthetic and orthotic products should be tested structurally for compliance with ISO or equivalent standards before being sold on the market.

Research and development

23 Clinical and technical research should be conducted in prosthetics and orthotics, and the results should be shared nationally and globally.

24 Affordable prosthetic and orthotic products that are cost–effective, of good quality and context-appropriate should be developed and made widely available.

Area 3. Personnel

Personnel who provide prosthetics and orthotics services

25 Prosthetics and orthotics services should be provided by competent, adequately trained professionals.

26 Complicated prosthetics and orthotics treatment and care of complex cases should be provided by a multidisciplinary team of professionals with complementary skills.

Training in prosthetics and orthotics


27 Training in prosthetics and orthotics should be aligned with national and international educational standards.

28 Training in prosthetics and orthotics should be available at various levels to fully meet national needs.


29 Health care professionals, especially rehabilitation professionals, who provide treatment relevant to prosthetics and orthotics services should have adequate knowledge about prosthetics and orthotics.


30 Continuing professional development should be compulsory in prosthetics and orthotics professional practice.

Planning the prosthetics and orthotics workforce

31 Workforce planning should take into account all the disciplines required in prosthetics and orthotics services at all levels.

32 Prosthetics and orthotics service units should have at least one prosthetist and orthotist to supervise and guide clinical and technical work.

33 A strategy to retain prosthetics and orthotics personnel should be in place.

Professional regulation and recognition

34 Prosthetics and orthotics clinicians should be regulated by the State within regulations for health professionals.

35 Prosthetists and orthotists should assume responsibility for services provided by associate and nonclinical personnel under their supervision.

36 Prosthetics and orthotics personnel should have a clear career structure and employment conditions that are aligned with those of other health care professionals, associates and technical personnel.

Area 4. Provision of services

User-centred service delivery

37 A documented policy to safeguard the rights of users of prosthetics and orthotics services should be in place and in effect, outlining the features of user-centred services.

38 Service users and their representatives should be involved in policy-making, planning, implementing, monitoring and evaluating prosthetics and orthotics services, take part in decision-making at all levels and be represented on relevant committees.

39 Service users should be given the opportunity to choose their service provider and technology, including components and materials, according to their need, among the options available in the country and the limits set for financing or reimbursement.

Systems for delivering services


40 Prosthetics and orthotics services should be accessible to all the people who need them: girls, boys, women, men and older adults.

41 Prosthetics and orthotics services should be part of the health sector or be closely linked to it.

42 Prosthetics and orthotics services should be delivered in a three-tier system, at primary, secondary and tertiary levels, with established links and two-way pathways for referral and follow-up.

43 Maintenance and repair services should be an integral part of a prosthetics and orthotics service delivery system.


44 The provision of prostheses and orthoses in disaster conditions should be an integral part of the health sector response and be planned to ensure a seamless transition to long-term service provision.

Service units


45 Prosthetics and orthotics service units should be established within or closely linked to health and rehabilitation service facilities, such as district and referral hospitals.

46 The possibility of integrating prosthetics and orthotics service units into broader services for assistive products should be considered and explored.


47 At all service levels, prosthetics and orthotics units should be designed to ensure effective, efficient, high-quality service provision in a user-friendly, barrier-free, safe clinical environment.


48 Prosthetics and orthotics service providers should define and adhere to a plan for equipment maintenance and replacement.


49 The safety of service providers and users should be ensured by the establishment of documented health and safety regulations.

Service unit processes


Identification and referral

50 Prosthetics and orthotics service providers should identify and train partners in identifying and referring potential users.

Service delivery 

51 All steps in the delivery of prosthetics and orthotics services should be based on the best available evidence and should adhere to local, national and international standards and practice.


52 Service providers should involve service users and caregivers in assessment, setting goals and planning treatment.

53 Peer support and counselling should be available to service users as appropriate.

Fabrication and fitting

54 Prosthetics and orthotics personnel should follow the instructions and guidelines of the component manufacturer and document any deviation from standard practice.             

User training

55 Service users should be given sufficient training to ensure safe, effective use of prostheses and orthoses. Family members and caregivers should be involved as appropriate.

Product delivery and follow-up

56 Users or caregivers should make the final decision about the acceptability of the fit and function of the prosthesis or orthosis.

57 The outcome of prosthetics and orthotics treatment should be evaluated and documented.

58 Prosthetics and orthotics service users should be followed up regularly.


59 Annual and long-term strategic and operational plans should be in place, with performance indicators for continuous monitoring.

60 The required quality should be defined and adhered to at all levels and in all parts of the prosthetics and orthotics service delivery system”.


The above standards are summarised from:

Eklund A and Sexton S. WHO standards for prosthetics and orthotics. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.

They can now be downloaded as pdf files in English from the World Health Organization website http://www.who.int/phi/implementation/assistive_technology/prosthetics_orthotics/en/

WHO is printing hard copies and translations to more languages are underway. Progress updates are available via the WHO website.

Research study about myoelectric prosthetic arms

Do you have a myoelectric prosthesis? How easy do you find it to use?

We are looking for adult trans-radial users with a range of experiences to undertake a research study “Understanding the impact of skill, unpredictability and delays on the control of myoelectric prostheses”. This study aims to establish why some people find these devices difficult to control.

What you would be asked to do

PART 1: A series of simple tasks using your myoelectric prosthesis. Time commitment = 1 x 3-4 hour session. Location: University of Strathclyde, Glasgow. Alternative locations in England include: Salford, Manchester, Roehampton, Sheffield or Nottingham. Please contact the researcher for details.

PART 2: Assessment of everyday prosthesis use. Time commitment = 1 week. Location anywhere in the UK. This involves wearing two wristwatch sized sensors during normal daily activity.

for more information about this study please contact Alix Chadwell A.E.A.Chadwell@edu.salford.ac.uk or Supervisor L.P.J.Kenney@salford.ac.uk

The University of Salford, Manchester

Study recruitment to 5 October 2017

Download the PDF Advertisement for research participants Myoelectric prosthesis study

Recruitment for volunteers for study – talking about limb loss

Study title: Talking about limb loss – Development of patient information resources based on “real life” experiences.

Recruitment for volunteers:

Would you be interested in taking part in an interview to discuss your experience of limb loss and prosthesis use?
We would like to produce a series of patient information leaflets giving real life examples of amputation and prosthesis use.
These leaflets would then be distributed via clinics and support groups, as well as being made available online, to help other individuals with this experience. We are looking for individuals with all types of experience so please get in touch!
You must be at least 18 years old, have a lower limb amputation, be a minimum of 6 months post-amputation.
If this is you we would love to hear from you!

Please see our participant Information Sheet – Talking about limb loss study

Study recruitment to 30 September 2017

Please email Rachel Munro at RMunro1@qmu.ac.uk or Dr Clare Uytman at cuytman@qmu.ac.uk, researchers at Queen Margaret University, Edinburgh
Or contact project lead, Dr Clare Uytman on 01314740000 for more information.


Request for participation in a study about spinal cord injury

The Spinal Cord Injury Move More (SCIMM) study

Are you an 18-50 year-old adult with a spinal cord injury T6 to S5?
Heart disease is the leading cause of death in people with spinal cord injury. The Spinal Cord Injury Move More Study is investigating whether breaking up periods of inactivity with very short bursts of exercise over the day helps to reduce risk markers for heart disease.
This study is being run by the University of Bedfordshire. You will be asked to visit the Universities Bedford campus on 4 occasions with all travel expenses paid and you will receive a total of £75 if you finish the study. You will receive feedback on an assessment of your health and a report of the study findings. Please click this link to see the Information Sheet for Participants Spinal Cord Injury.

Study recruitment to October 2018

To express your interest in this study please contact Tom Withers at thomas.withers@beds.ac.uk.

Can you help with a study about walking with a prosthetic leg or if you use an ankle foot orthosis after stroke?

Research participation request: Comparison of biomechanical and muscle activation variables between mobility impaired and unimpaired individuals walking outdoors, indoors and on a treadmill.
Treadmills are used to help people with different medical conditions recover the ability to walk. They are used, for example, in the rehabilitation of stroke survivors and lower-limb amputees. This type of training improves the fitness and the walking speed of the user. However, it doesn’t help as much when it comes to walking around the home environment or outside where individuals face several challenges, such as turns, slopes or obstacles avoidance. A new type of treadmill which adapts its speed to the person’s own speed and change gradient, while projecting a virtual environment, can lead to more variety in walking practice that is closer to a real-life walking experience.

The aim of our study is to investigate how closely this virtual-reality treadmill simulates outdoor walking. We are looking for the help of people who use a lower-limb prosthetic, and people who have been affected by stroke and use a foot-splint or AFO. If you, choose to participate, we will arrange for you to attend a three-hour session at the University of Strathclyde, Glasgow, where you will be monitored while walking outside, inside, and in virtual-reality.

Study recruitment to early August 2017

For more information, please contact: Dr Nicholas Smith at nicholas.l.smith@strath.ac.uk.

Grants awarded to 3 user groups

We are delighted to announce that PORT-ER has awarded 3 grants in our 2017 Grant round with the theme of “User engagement and participation in prosthetics and orthotics developments”. This year the grant round offered “mustard seed” micro grants ranging from £25 to £250 to encourage small ideas and actions to grow – or simply help users to contribute to bigger projects.

We received 4 grant applications and 3 were successful. One application was rejected because it was not aligned with our charity objectives. With the unanimous agreement of our PORT-ER trustees, the 3 successful awards are as follows:

Edinburgh Limb Loss Association (ELLA) awarded £250 for their re-launch.

Moving Forward (Portsmouth) awarded £250 for help with restarting their amputee charity.

Orthotic and Prosthetic Users Stanmore (OPUS) awarded £250 for their work.

We are delighted to be able to support these projects. Our next annual grant round will be announced in January 2018 with applications possible throughout February 2018. Please note that we do not accept grant applications outwith these dates because we are a small charity working in a voluntary capacity. We welcome any donations and help from fundraisers to grow our 2018 available grant funds.


Announcement of grant round 2017: User engagement and participation in prosthetics and orthotics developments.

PORT-ER grants

2017 Grant Theme: User engagement and participation in prosthetics and orthotics developments.

Closing Deadline 5pm GMT 28 February 2017.

Micro grants £25 – £250.

Professionals and organisations: Our 2017 grant round is about encouraging professionals, services and designers to include prosthetics and orthotics service users in planning, improving or evaluation of developments (services, activities, support, advocacy or products).

Users: Our 2017 grants will also support prosthetic or orthotic user group meetings or social activities. Or perhaps a special meeting is called by an organisation locally, but you are an individual user having to fund your own engagement in that meeting. We would like to help you with that.

This year we are offering “mustard seed” micro grants ranging from £25 to £250. We hope that this will help to encourage small ideas and actions to grow – or simply help users to contribute to bigger projects. Sometimes development is hard to achieve without small costs for local travel or coffee being covered.

For more information see our grants page http://port-er.com/grants

2006 – 2007 – PORT-ER is founded


PORT-ER IS FOUNDED: PORT-ER was formed in 2006 in response to the world need for improving the standards of care for people who require the use of artificial limbs or splints – both in the UK and internationally. Some 25.5 million people in the world are estimated to need prosthetic limbs or orthotic devices. The launch of PORT-ER saw the creation of a unique funding source that was conceived by a group of friends aware of the tremendous need for improved provision of prostheses and orthoses both at home and abroad. Key milestones in the first year included:

  • the establishment of PORT-ER
  • the identification of our patron, Michael Caines
  • our inaugural Ball in Devon
  • a fundraising launch event dinner in Glasgow

PORT-ER International grant: our first funding grant was made to support a training course for Pakistani prosthetics lecturers to learn more about prosthetic legs. The course had to be postponed because of bombings in the Pakistan region and eventually was provided in 2008 in Glasgow. The earthquake in Pakistan saw thousands of people injured and disabled as a result of traumatic injuries. News headlines quickly moved away from this natural disaster, however the victims of the earthquake continue to have limited access to rehabilitation services or highly trained allied health professionals.

2007-2008 PORT-ER Grants and PORT-ER Running Master Classes


PORT-ER UK grant: £500 was awarded to Moving Forward, a Prosthetics User Group at the Disablement Services Centre, St Mary’s Hospital, Portsmouth. The aim of the project is to create an information centre /point in the reception area of the Disablement Services Centre (DSC) that is highly visible and accessible to all users of the DSC and which can provide information to prosthetic limb users.

PORT-ER International grant: £400 was Specialist Physiotherapist, Penny Broomhead (right) received £400 towards a training visit to an Ethiopian prosthetic and orthotic rehabilitation centre at the request of Jimma University Hospital, Ethiopia. Penny went with a team from Nottingham who have supported the hospital for some years. Penny taught the Jimma prosthetic rehabilitation team techniques to help people with limb amputations to get as mobile as possible.

PORT-ER granted international flight costs from England for two marathon runners who use prosthetic legs, namely Richard Whitehead who ran the Berlin marathon and Colin Edwards (left) who ran the New York marathon. Colin kindly supported PORT-ER in return and raisedfunds through sponsorship.

PORT-ER Running master classes: we were able to deliver two events in Glasgow (9th June 2007) and Loughborough (29th September 2007). This project brought together prosthetic leg users with sports and rehabilitation specialists (for example, experienced runner Wallace Currie (right) who assisted at the running master classes) to try out fitness techniques and gain confidence in running in two fabulous sporting venues.

The Glasgow event was a collaborative effort with the Murray foundation and was held at Murray Park training ground. We hired the High Performance Athletics Centre in Loughborough for the second master class.

Feedback from the events was very positive and included the following comment:

“It was most certainly one of the best days I’ve had since my new life started and it has returned a bit of myself respect and confidence. I took my eleven year old son to his footy match on Sunday where we had running races to help him cool down afterwards. There aren’t words to describe how I felt, mind you my son just said “not bad for an old man” “



Running Master Class took place in Exeter in May when prosthetic users and sports and rehabilitation professionals came together to share their expertise on running. Feedback from the event was very positive.

PORT-ER UK grant: £400 was awarded toLuton & Dunstable DSC Prosthetic User Group to support their amputee swimming club.

A footwear design collection “Designed by Children” was compiled from entries to a PORT-ER children’s design competition and Footwear_designed_by_children-webversion to inspire special footwear designers to incorporate children’s ideas into their product.


STRATEGIC INPUT: PORT-ER provided strategic input and administrative support under the funding sporting prosthetics for everyday and elite athletes with a disability (SPEEAD) initiative. The SPEEAD was made possible by the Engineering and Physical Sciences Research Council and the University of Strathclyde’s collaborative training account and PORT-ER’s involvement was funded at £9506 over 2008/9 and 2009/1. The initiative involved a number of partner organisations.

Colin Edwards, trustee, formally represented PORT-ER on the steering group for the SPEEAD sporting prosthetics project and also contributed to two master classes and a national conference as an expert user and long distance runner. The remaining trustees all supported the SPEEAD work through registering master class participants, answering queries and promoting the events.

Two SPEEAD Master Classes took place in Glasgow and Loughborough in June 2010. These SPEEAD Master classes brought together over 100 people across two professional sporting venues in Glasgow and Loughborough to try out different sports. A large supportive team of Master class tutors comprised athletes and rehabilitation professionals. Feedback from the events was very positive with many people trying out sports for the first time.

A SPEEAD Scientific Conference with places for over 100 delegates took place at the national sports venue Hampden in Glasgow in September 2010 with national and international experts on prosthetic use, sports and rehabilitation providing a wealth of information to registrants.

SPEEAD administration: PORT-ER was funded to promote the events and also to support registrations. PORT-ER also provided steering group input. A number of people helped PORT-ER deliver this activity, including a group of prosthetist/orthotist students who completed a national mailing of 5000 flyers with a trustee. PORT-ER donated £200 for the students help which was used to help fund a field trip.


4th PORT-ER RUNNING MASTER CLASS: Sunday 20th March 2011, University of Bath, England, fulfilling the information and skills development requests of a number of amputees who wanted to learn to run and improve their technique.

PORT-ER International Grant: £1,500 was awarded to Human Study to supplement the training of 20 prosthetist/orthotist students from landmine affected Bosnia-Herzegovina, Croatia, Serbia, Montenegro and Macedonia.

PORT-ER International Grant: £927 funding for small business skills training for wheelchair users in India.


PORT-ER UK grant: £1,200 was awarded to amputee runner, Colin Edwards to take time out of work for the South West Coastal Path Challenge. He completed a 630 mile challenge run and slashed days off his target finish date. Colin set out on 1st May 2011 and finished clocking up his challenge miles on 18 June 2011. He proved to be a great inspiration to many people and significantly raised awareness of our work. PORT-ER also covered expenses of £2,069.16 in support of the challenge. Colin, in turn, raised much more than the challenge costs for PORT-ER to support us in our work.

PORT-ER International grant: £1,959 was awarded to The Tanzania Training Centre for Orthopaedic Technology (TATCOT) to provide mobility devices for local people with disabilities. This was in response to a grant application. The assessment, design, fabrication, fitting and delivery of all the assistive devices were done by TATCOT Students under close supervision of Clinical/Practical Instructors. TATCOT reported that the project has enabled children and middle-aged adult in acquiring assistive devices otherwise not available to them. The project also enlightened and motivated the school authority to visit schools and other community based centres which are supporting people with physical disabilities and establish collaboration for students’ community based training.

PORT-ER UK grant: £1,500 was awarded to the Luton Limb Fitting Centre User Group’s Step Up project in response to a grant application. The Luton Centre developed a piece of land to have different walking surfaces, steps and cambers to help new amputees do outdoor walking training as part of their rehabilitation.

AWARD TO PORT-ER: £2,000 was received following an application from PORT-ER to Exeter City council. This, along with significant sponsorship from companies, enabled us to deliver our first One Life Live It! Lifestyle Exhibition at Ashton Gate Stadium, Bristol in September 2011. PORT-ER’s first exhibition brought together exhibitors, volunteers and visitors to showcase services, products, experiences and innovations that illustrated the many lifestyle choices for people with physical disabilities. The event provided a fabulous networking forum for 150 people and the combination of local and national exhibitors provided a rich source of displays, information and advice.

EXHIBITION on 11.11.2011: CEO, Diana Corrick represented PORT-ER at the Sporting Prosthetics Conference at Hampden National Stadium, Glasgow, Scotland.

PORT-ER’s ONE LIFE – LIVE IT EXHIBITION. 9 September 2011: Ashton Gate Stadium, Bristol, England, UK. PORT-ER’s 2011 exhibition brought together exhibitors, volunteers and visitors to showcase services, products, experiences and innovations that illustrated different lifestyle choices for people with physical disabilities. The event provided a fabulous networking forum for 150 people and the combination of local and national exhibitors provided a rich source of displays, information and advice. This exhibition show was for people with mobility challenges and their carers and was a showcase for modern, innovative product designs and services. Our focus was on lifestyle – fashion, sports, gadgets, health & beauty, transport, holidays, leisure, legal & financial services, medical devices and employment.

PORT-ER RUNNING COACHING CLASS. 8 September 2011. Filmed with Channel 5 (see below).

PORT-ER ON TV! November 2011 Channel 5’s Celebrity Wish List surprising PORT-ER at One Life Live It! Exhibition



AWARD TO PORT-ER: £9,999 was received following an application from PORT-ER to the National Lottery through the Big Lottery Fund at the end of the previous year for our Raising The Bar project. The project was needed predominantly to help PORT-ER develop a stronger needs-based approach to our work to prioritise our associated activities for persons with disabilities in the UK. The project also delivered improved promotional material about our activities, including this website. We had very limited ability to fund this work independently and this funding award enabled us to progress our work.

We were interested in finding out about development needs for the field of prosthetics and orthotics and so we designed an online market research survey questionnaire. The survey was intended for anyone with an interest in prosthetics and orthotics whether a client using a prosthetic limb, orthotic brace or prescribed footwear, a rehabilitation professional, a disability sports professional or acquaintance. The results of the survey can be seen by clicking on this link. The survey helped us to inform our activities.

PORT-ER International Grant: £1,250 was awarded to the charity 500 miles. The project will support Patrick Govati, from the Prosthetic and Orthotic Centre at Kamuzu Central Hospital in Lilongwe, Malawi to attend training in Orthotics manufacture run by ICRC’s special Fund For the Disabled. We have an update that the course has been postponed as the training facilities are under redevelopment, but we hope to hear that it is underway soon. Mr Govati is Malawian and has worked in the field of prosthetics and orthotics for over 18 years. He is Dedicating his life to helping those with disabilities and is directly responsible for treating over 250 patients every year who will benefit from his increased knowledge and skills.

AMPUTEE RUNNING EVENT: May 2012. Practical training for Prosthetists and Physiotherapists. PORT-ER held an event in Exeter for Prosthetists to learn how to align a prosthesis for running (in the morning) and Physiotherapists to learn how to teach running to prosthetic users (in the afternoon). Each profession was welcome to attend the other’s session. The day was practical and the Keynote speakers were Penny Broomhead, MCSP who is a PORT-ER Trustee and Ollie Smith BSc, MBAPO from Ossur.  Feedback from the event included “Great to see how quickly and simply amputees were encouraged to run”. LINK to programme. LINK to practical tips for Sport and High Activity.