Editorial

摘要

If asked what scientific, medical, or engineering fields relate to limb prosthetics and orthotics, one might suggest, anatomy, neurophysiology, motor control, electrophysiology, kinesiology, biomechanics, cybernetics, robotics, ergonomics, materials science, machine design, structural design, electronic design, instrumentation, psychology, childhood development, gerontology—the list could go on and on. It has been said that if something contains humans it contains almost everything. Hence, we might say that since prosthetics and orthotics involve humans, these fields involve almost everything. This condition is what makes them so interesting—and so difficult. However, just because many scientific and related disciplines are applicable to a field doesn’t make the field itself scientific. In fact, I believe prosthetics and orthotics generally have low scientific content. At best they seem to have only an immature science associated with them. This is not negative. In fact, it is positive for us working in the field. It means there are many opportunities in the field. Not many people are privileged to be present during a field’s pre-scientific development, during the time when its scientific borders are being opened. That prosthetics and orthotics are not very scientific is an indication that they are young and developing fields. All fields begin with little or no science. Physics came, to some extent, from metaphysics. Chemistry from alchemy. Most fields are based on a foundation of knowledge that originated empirically; that is, from practical experience and experiment rather than from theory. A knowledge base usually accrues before a science (theory, etc.) can emerge from it. Some fields remain basically empirical. Surgery has been an example of a highly empirical field, but that is changing. Prosthetics and orthotics will probably always have a strong empirical component. Most fields develop into a healthy mixture of science and empiricism, which complement and support each other. It is to be hoped that science will soon begin to have a stronger presence in prosthetics and orthotics. This does not mean that science has not previously been applied to the fields of prosthetics and orthotics; it has, but these applications seem to have come mainly through other more developed fields (e.g., physics, engineering, etc.), as will be discussed later in more detail. What is contended here is that prosthetics and orthotics do not now have much of a science of their own. It is also suggested that science, which can provide a kind of theoretical framework, would be useful to these fields. We currently lack a broad theoretical framework to guide our thinking and interpretations. Science in prosthetics and orthotics could develop the theoretical framework within which these fields could develop in a more orderly and more accelerated fashion. SCIENCE What is science? This seems an appropriate question; if, as contended in the introduction, a science of prosthetics and orthotics needs to develop. There is no single definition. We know that science is concerned with facts held together by principles (e.g., laws, theories). We know it involves events that can be repeated and that can be measured (quantified). Lord Kelvin said, “If you can’t measure something in numbers, your knowledge of it is not really scientific.” Besides numbers, science frequently involves mathematically-based theory. Einstein said, “The object of all science, whether natural science or psychology is to coordinate our experiences and to bring them into a logical system.” The philosopher of science, (Thomas Kuhn 1970), said that normal science is problem solving within a paradigm (examples of paradigms in science are presented later). He claimed a problem solver (a scientist) needs an agreed upon paradigm in order to carry on science. According to Kuhn, fact-finding is more or less a random activity if it is carried out in the absence of a paradigm. A paradigm permits sele