Foot System Prosthetist Manual

Transcription

1 Introduction Foot System Prosthetist Manual The Motionfoot is a hydraulic ankle, with a carbon fiber foot plate. It features; Very high ankle range of motion, up to 50. Smooth hydraulic transition from heel strike to toe-off. Dynamic toe response. Independent user-adjustability of plantar flexion and dorsi flexion resistance. Set up by prosthetist allows variable heel height and toe stiffness. Ankle lock to fix it in the fully dorsi flexed position (for driving, standing, donning shoes, etc.) Patient Selection The Motionfoot System is made for patients with a foot size between 22-30cm, body weight less than 220 lbs., and are a K2-K4 level ambulator. Dorsi Flexion Adjustment Plantar Flexion Adjustment Split pyramid Lock Button A/B side Plates Spline Sole Plate Main Spring Element 1 PN: Rev. D 06/2012

2 1. User-Accessed Settings 1.1 Foot Adjustments Hydraulic Ankle Adjustments Low number = low resistance & High number = high resistance. PF & DF settings are independently set. Fig. 1.1 PF Adjusts planter flexion resistance Lower the number to soften the heel. Raise the number to reduce foot slap. DF - Adjusts dorsi flexion resistance To control forward movement. Does the wearer feel like they are walking uphill? lower the DF number. Does the wearer feel like they are walking downhill? raise the DF number. 1.2 Lock Function Some activities may need the ankle to be locked. Press the button on the right side to activate the lock (Fig. 1.2a). Press on the button on the left to deactivate the lock (Fig. 1.2b). Fig. 1.2a Note - the toe may need to be loaded to unload the pressure on the locking mechanism before plantar- flexion will be allowed. CAUTION: Do not make any adjustments to the set screws on the anterior side of the pyramid piece. It may result in a malfunction of the locking mechanism. Fig. 1.2b 2

3 2. Prosthetist Adjustments & Set-up 2.1 Large Heel Height Adjustments Side Plate Setting #2 Reset the Side Plates for dorsi flexion settings (or heel height setting) beyond the adjustment of the pyramid. Begin with the foot fully dorsi flexed. Remove spline cap screw. (Fig. 2.1a-#1) Place a mark on the spline and the side plate to record your starting point. (Fig. 2.1a-#2) #4 #3 #1 Remove the two Phillips screws from the side plate. (Fig. 2.1a-#3) Loosen the spline clamp screw. (Fig. 2.1a-#4) Remove the plates from the split pyramid using a 8-32 screw (provided in kit). (Fig. 2.1b) Move the pyramid to the desired starting position and secure with the side plate. (Fig.2.1c) Note: Each notch is a 10 degree adjustment. To make adjustments of 5 degrees, flip both of the plates over. The letters on the plates need to be different from each other. A/B or B/A, never A/A or B/B. Fig. 2.1a CAUTION: When making heel height adjustments, caution should be taken to avoid potential damage. Do not increase the dorsi flexion range of the foot more than 10 (1 notch) from the position set by the factory. Doing so will cause the ankle to crash against the foot housing and cause serious damage to the foot. After any adjustments, flex the foot to make sure the ankle does not contact the foot housing at full dorsi flexion. Fig. 2.1b Tighten the spline clamp screw to 1.7NM (15 in/lbs.). Insert the screws back into the retaining plates with thread locking compound and tighten to 1.3 NM (12 in/lbs.). Tighten spline cap finger tight. Fig. 2.1c 3

4 2.2 Bench Alignment The Motionfoot system should be fully assembled with the footshell. A heel wedge appropriate to the shoes worn should be placed under the heel. Position the pylon perpendicular to the floor. For transtibial fittings, bisect the socket at knee center and position over the foot with flexion according to normal practices. A plumb line should fall through the center of the knee as well as the center of the ankle joint. For transfemoral fittings, the bench alignment line should fall through the trochanter, then the knee according to the manufacturers guidelines, and then the center of the ankle. 2.3 Static Alignment Inside parallel bars, have the patient stand with equal weight distribution on their feet. Evaluate knee stability and shift the foot accordingly. Slide the foot posterior if the knee is being hyper extended. Slide the foot anterior if the knee is unstable or bends too easily while standing. Once the alignment allows the patient to stand with minimal effort proceed to dynamic alignment. Based on lowest heel height of shoe used Based on lowest heel height of shoe used 4

5 2.4 Dynamic (walking) Adjustments Have the patient walk inside parallel bars. Adjust PF resistance to eliminate foot slap or to soften heel. Heel strike should be cushioned while preventing foot slap. Adjust DF resistance to level out the feel of forward progression (Does the patient feel like they are walking uphill or downhill?) Decrease DF resistance if they feel they are walking uphill and increase DF resistance if they feel they are walking downhill. If additional knee stability is needed, Increase DF resistance or slide the foot anterior. Once the patient is secure on the prosthesis, evaluate the adjustments while descending slopes and uneven terrain. For transfemoral users, knee stability may be too great during slope descent preventing step over step walking. Shift the foot posterior to resolve the issue. 2.5 Toe-Stiffness Adjustments Toe stiffness can be changed by adjusting the number of heel spacer plates to preload the toe spring. Remove the foot shell. (Section 2.7) Remove the posterior attachment screws and loosen the anterior attachment screws from the plantar surface of the foot. (Fig. 2.5a) Install the desired spacers and install and tighten screws. (Fig. 2.5b) Note: The spacer plates need to be installed with the proper face to the foot plate. If one Fig. 2.5a Fig. 2.5b 5

6 plate is used, orient the plate so that #1 is towards the foot plate. If two plates are used, orient the plates so #2 is towards the foot plate. The screws should have a removable thread locking compound and set torque to 1.7NM (15 in/lbs) for the anterior screws and 2.6NM (20 in/lbs) for the posterior screws. 2.6 Foot shell Installation & Removal Foot shell Installation Place Spectra sock over the Motionfoot System assembly. Lock the ankle mechanism. Press the toe plate into the foot shell as far as possible Place the footshell tool into the posterior aspect of the footshell completely. Press the Motionfoot System firmly into the footshell until the posterior part of the footplate is securely positioned under the retaining lip in the footshell. (Fig. 2.6a) Fig. 2.6a Foot shell Removal Insert the footshell tool in the posterior corner of the footshell to pry the retaining wedge off of the foot plate. Remove Motionfoot System from the footshell. (Fig.2.6b) Fig. 2.6b 6

7 3. Special Precautions Ankle Lock - Do not use the lock mechanism for walking or running. It is only recommended for light duty, static uses such as standing, driving, or donning shoes. Driving - It is not recommended to use the Motionfoot for driving any vehicle unless the foot is locked at neutral with the ankle lock mechanism. Kneeling - The foot may plantar flex when kneeling. If this occurs, the toe will need to be loaded to return it back to a neutral position for walking to prevent stumbling or falls. Sitting - The foot will sit flat on the ground while the patient is sitting, increasing comfort. This will require that the patient load the toe to flatten the foot prior to walking to prevent from stumbling or falling. Stair Descent -The end of the step should not terminate behind the axis of the ankle to prevent unexpected plantar flexion while descending stairs. If this occurs, the patient will need to stop and load the toe to return the ankle to a neutral position to prevent from falling. Walking on Declines - When changing directions or stopping on a downward slope, the foot may remain plantar flexed. If the patient is unaware of this, it may cause the patient to stumble, which may result in a fall or injury. Dust and Dirt - Excessive dirt and/or dust inside the footshell will lead to premature wear of the foot plate and main spring element. Water - Avoid submersing the foot in water. Ordering Information PART NUMBER DESCRIPTION MOTION FOOT-22CM MOTION FOOT-23CM MOTION FOOT-24CM MOTION FOOT-25CM MOTION FOOT-26CM MOTION FOOT-27CM MOTION FOOT-28CM MOTION FOOT-29CM MOTION FOOT-30CM 7

8 General Specifications & Maintenance No specific maintenance is required for this device. The wearer should be advised; Any changes in performance or function should be immediately reported to their prosthetist (i.e. clicking or other noises, changes in ankle resistance, changes is keel (toe) stiffness). It is recommended that the patient establish an annual check-up with the prosthetist to ensure the prosthesis is fitting and functioning properly. Max. Patient Weight 220lbs (100kg) Build Height 3⅝ (92mm) w/o footshell Component Weight 28oz. (795g) w/o footshell Patient Activity Level K2-K4 Operating / Storage Temp F ( C) Ankle Range of Motion 50 degrees Warranty Standard warranty for Motion Foot: The Motionfoot is provided with a 2-year warranty, with the exception of the Foot Shell, which is provided with a 6-month warranty. Repairs are guaranteed for a period of 90 days. Determination of the damages or defects to be covered under the Standard or Limited Warranty shall be made by Motion Control personnel. WARRANTY DOES NOT INCLUDE: 1. Prosthetic services for fitting and maintaining the prosthesis made with the equipment. 2. Damage caused by neglect, misuse or improper operation by anyone other than the Seller. 3. Damage due to accident, fire, water, vandalism, unsuitable environmental conditions or replacement parts not approved or recommended by Motion Control. 4. Modifications to the equipment which occur during the period of the Agreement except by mutual consent of the parties in writing, including payment of additional charges as specified by the Seller. 8

9 NOTES 9

10 Contact Information Motion Control, Inc. 115 North Wright Brothers Drive Salt Lake City, Utah USA (toll free) (fax) 10