Plié 3 Microprocessor Knee

Plié 3 Microprocessor Knee

01 Plié 3 MPK Key Features

Plié 3 MPK Key Features Ease of Set Up Using Set Up Wizard in Plie Control Software Advanced & Customisable Stumble Recovery Stumble recovery parameters are automatically calculated via the Set Up Wizard, but can be customised to suit particular gait requirements. Rapid Reaction to Gait Changes Microprocessor samples at 1000Hz and with a spool valve response time of 10ms, the reaction speed of the knee control is the fastest on the market. Easy, smooth transition from stance to swing, with maximum safety. Combination of hydraulic/pneumatic system and microprocessor control allows wide range of gait speeds. Water and Particle Proof Rated at IP67, it is totally waterproof and totally resistant to the ingress of any solid particles.

02 Plié 3 MPK Plié Control Software

Plié 3 MPK Plié Control Plié Control Software Download from CD that comes with the knee, or from the Freedom Innovations website http://pliesupport.com/download/ Provides long range Bluetooth connection to knee Set Up Wizard is easy to follow, with instructions provided at each stage Click Next to progress through it Color coded status indicator when sufficient steps have been recorded Settings can be saved and transferred to another knee

Plié 3 MPK Cadence Report Cadence Report can be saved as.pdf file for later comparison Real Time Data recorded at Set Up can be opened in Plié Control Gait Lab

03 Plié 3 MPK How does it work?

Plié 3 MPK How does it work? The knee decides whether it is in swing or stance based on input from the anterior and posterior load sensors A sensor detects the flexion angle of the knee 8 MHz microprocessor Sampling at 1000 Hz (1000/s) Spool valve responds to within 10 milliseconds (0.01s) to release into swing phase or engage Stumble Recovery

Plié 3 MPK How does it work? Toe Threshold determines if there will be a SwingPhase Swing Transition determines when there will be a SwingPhase

Plié 3 MPK How does it work? Stumble Recovery

04 Plié 3 MPK Clinical Application

Plié 3 MPK Clinical Application We are all aware that there are strict patient criteria regarding the clinical application of MPK knees in order to qualify for the NHS England funding. They have been equally strict regarding which knees they believe to be most appropriate and have included the Plié 3 as one of just four options since it is: Suitable for any K3 transfemoral prosthesis user who has adequate strength in hip flexion and extension, is capable of walking a prosthesis with a free knee and who would benefit from a unit that provides the following functional features: A high degree of safety over a range of activities, by means of a customisable stumble recovery system The opportunity to walk at variable cadence over surfaces such as sand, pebbles and through grass Protection from dust, silt, powder and moisture, either in the work place or when pursuing a leisure activity Continuous function even when occasionally totally submersed The ability to walk backwards, or traverse sideways And, for high K3 or K4 users, the opportunity to jog, or participate in a sport where change of pace or direction is required

05 Plié 3 MPK The Plié Package

Plié 3 MPK - 11,795 Plié knee Two batteries Charger - mains and in car adapters Software Long range dongle Pump and spare connectors 5 year warranty Designer fairing options (Standard black provided on the demonstration knee, but the preferred designer fairing stated on the order form will be provided upon on the definitive knee.)

Plié 3 MPK Package - 11,795 Structural component options Two socket adapter, pylon and tube clamp options Three feet options Kinterra Combining hydraulics and carbon fibre technology, the Kinterra provides the user with rock solid stability. Sierra The unique angle-top design increases the length of the carbon fibre spring maximising flexibility. Highlander The Highlander provides active patients with an efficient and smooth gait with excellent energy return.

06 Plié 3 MPK Patient Assessment Alignment

Plié 3 MPK Patient Assessment Hip ROM Check for hip flexion contracture, or extension limitation Thomas Test Lay supine on exam table Flex contralateral hip and knee Measure angle between residual limb and examination table

Plié 3 MPK Bench Alignment To accommodate hip flexion contracture, or extension limitation, add 5 o to result of Thomas test to allow for normal step length. With the hip flexion accommodated in the socket, the knee should be vertical, with the load line passing 5mm anterior to the knee axis and through the ankle in the correct position for the chosen foot. In full flexion, ensure that, if the knee contacts the socket, it is against the chassis and not the hydraulic cylinder.

Plié 3 MPK Static Alignment With the patient standing still check the Static Alignment. Does the patient stoop, or is there evidence of lordosis?

Plié 3 MPK Static Alignment Is the flexion angle more when the patient sits into the socket in a relaxed way? Is the load line (TKA), or midline of socket A/P dimension, in the correct alignment for the knee and foot? If yes proceed to Dynamic Alignment.

Plié 3 MPK Alignment To accommodate hip flexion contracture, or extension limitation To help with this, shift adaptors, such as this OB 4R170, can be useful to help determine the correct alignment Ossur A554700 adaptor helps in some cases, but only up to 100kg limit

07 Plié 3 MPK Preparation

Plié 3 MPK Preparation Verify bench alignment Charge batteries Install the Plié Control Software Download from CD or Freedom website http://pliesupport.com/download/

Plié 3 MPK Preparation To connect to Plié MPC 1. Insert USB Bluetooth adapter 2. Open Plié Control 3. Insert fully charged battery 4. Search for knee 5. SN appears Connect 6. If lights turn from red to green, the knee is remotely connected 7. Once connected, click Reset to ensure the knee is at factory settings

Plié 3 MPK Preparation Ensure manual settings are to factory defaults Swing flexion: 30 PSI Stance flexion: 5 Swing extension: 0

08 Plié 3 MPK Setup Wizard Manual Settings Recording, Applying and Saving Settings

Plié 3 MPK Plié Control Overview There are four Plié Control windows These three open automatically once the knee is connected Real Time Data streams straight away

Plié 3 MPK Set Up Wizard Plié Setup Wizard Feel welcomed Click Next

Plié 3 MPK Calibration Step One Unweight the prosthesis Slightly behind sound limb Click OK

Plié 3 MPK Calibration Step Two Knee fully extended Toe load prosthesis Click OK Click Next on Wizard

Plié 3 MPK Setup Select Experience Level Inexperienced walker Strong walker All patients qualifying for NHS England funding will be a Strong Walker Click Setup Mode

Plié 3 MPK Setup Setup Mode light will turn yellow Words and yellow light will flash Click Next on Wizard

Plié 3 MPK Setup Walk in parallel bars initially because Knee will swing more freely Stumble recovery settings reduced to allow user to walk easily Toe Threshold may need to be lowered if knee does not transition into swing phase.

Plié 3 MPK Manual Settings Follow the on screen instructions and manually set up: Stance Flexion (Yield) Initially adjust for sitting Optimise on stairs and ramps

Plié 3 MPK Manual Settings Follow the on screen instructions and manually set up: Swing Flexion Adjust with air pump Controls heel rise* 20-100psi User to periodically check *It is advisable to keep the air pressure between 30 and 40 PSI and reduce any persistent heel rise on the Max Knee Flexion slider. This allows easy initial flexion, with an increased resistance above the chosen angulation.

Plié 3 MPK Manual Settings Follow the on screen instructions and manually set up: Swing Extension Setting of 0 is often satisfactory and 3 is probably the maximum Caution! It can be turned through more than 360 Click Next

Plié 3 MPK TT and ST To set preliminary thresholds for Toe Threshold and Swing Transition Begin walking the patient: It automatically begins counting steps Sets TT & ST values after just 5 steps, but continue until the status indicator bar goes Red = not enough steps Yellow = minimum steps Green = enough to proceed Click Next

Plié 3 MPK Stumble Recovery Stumble recovery requires recordings of Normal, Fast and Slow Walking. Be sure to cover the full range of walking speeds, including very slow.

Plié 3 MPK Stumble Recovery Click Start Recording Ask the patient to walk at their normal speed Continue until the status indicator bar goes Red = not enough steps Yellow = minimum steps Green = enough to proceed

Plié 3 MPK Stumble Recovery Click Save Data A warning appears Advise the patient to stand still Click OK A download bar appears Wait until the download is complete Click Next

Plié 3 MPK Stumble Recovery Repeat for Fast Walking Impress on the patient the need for this to be only as fast as they currently feel capable of achieving Click Next

Plié 3 MPK Stumble Recovery And for Slow Walking Now impress on the patient the need for this to be as slow as they can possibly manage Click Next

Plié 3 MPK Apply Settings Any changes to the settings from factory default are identified in Red Select Apply To Knee

Plié 3 MPK Apply Settings Green indicates that the settings are saved to the knee Setup Mode is now off Click Next

Plié 3 MPK Saving Settings Having reached Finish Click Save Knee Settings File This file (.ksf) allows you to re-install the settings achieved on the demo unit into the definitive knee. Click Cadence Report Store the (.pdf) file for future reference

Plié 3 MPK Data Recording It s also advisable to save a recording of the Real Time Data Walk the patient and click Record on the Real Time Data Display. Click Save Recording Patient warning appears along with the Download bar, once OK is clicked. Save the file (.kdfx) These files can be opened independently.

Plié 3 MPK Gait Lab Opening a Real Time Data file (.kdfx) causes the Gait Lab window to appear, in which it is possible to analyse the users gait Alternatively, it can be emailed to us for further advice

Plié 3 MPK and Kinterra Set Up If setting up the knee with a Kinterra: Bench Align shoe Static Align with maximum resistances. Now run Wizard, Apply to knee, but don t Finish Dynamic Alignment on slopes Adjust the hydraulics PF/DF on slopes by 3 x walking slopes with maximum resistances 3 x walking on slopes with minimum resistances PF/DF both on 50% resistance From then on it s up to the user to decide If the knee fails to transition into swing at any point, try lowering TT no result, refer to next section Max Min

09 Plié 3 MPK Customising Stumble Recovery

Plié 3 MPK Customising Customising after Set Up Wizard has been completed The Set Up Wizard will achieve the optimum settings for the gait speed and terrain encountered at the set up stage, but on occasions there may be a need to customise the settings to accommodate a particular activity or terrain. This requirement will always be made obvious by the knee being reluctant to transition into swing phase. If this occurs, determine when it does so and then open the More Parameters window and call one of the Sales Team for advice. They will be able to tell from their experience which of the settings may need to be adjusted to improve the situation.

Plié 3 MPK Plié Control Overview More Parameters can be opened from the Plie Control window and then from one another Additional Parameters for Stumble Recovery Levels 1 and 2

Plié 3 MPK Customising If any changes are made to the settings after the Set Up Wizard has been run and the settings applied, such as those just outlined, or the Maximum Heel Rise Angle, do not click Apply to Knee. This will just apply the Wizard settings again. Simply go to Finish and Save Knee Settings File. If, having saved the settings, further changes have been made without running the Wizard, just go to File on the Plié Control window and click Save Knee Settings there. Likewise, when wanting to load existing settings to another knee, go to File, select Load Knee Settings, chose the file and Open. All the settings will then be automatically loaded to the knee.

10 Plié 3 MPK The Plié Process

Plié 3 MPK - The Process Use the Plié 3 MPK Package Order Form, complete it on screen, save as pdf and email or fax to Customer Services. It will be presumed that a Demo Unit is required, but if it has been agreed that the Plié is definitely the option that is most appropriate for the patient and it is understood that it cannot be returned, please indicate that in the notes section and the definitive knee will be supplied. The foot option would still have a 30 day trial period. With a Demo Unit a foot and structural components will be ordered on a trial basis and once the evaluation is completed and you are ready to order the definitive knee, email or phone Customer Services, quoting the Order Number you will have been sent and the knee will be supplied and the whole package will then be invoiced. If you do not wish to go ahead, please return the foot in a resalable condition. If it has been damaged, you may be charged for it.

Plié 3 MPK - The Process

Any Questions?