Prescription Form Guide - Cad-Cam Orthotics - Home Guide.pdf · patient shoe last be provided in...

Prescription Form Guide

CAD-CAM ORTHOTICS

CAD-CAM ORTHOTIC PRESCRIPTION

39 Phillips St.

Thebarton, S.A. 5031

IMPORTANT NOTE: SHADED AREAS MUST BE COMPLETED

Telephone: (08) 7127 8471

Office use only: S: A: G: C: B:

Fax: (08) 8354 4897

Email:

FILE NO:

DATE RECEIVED:

[email protected]

PATIENT'S NAME: 1

CLINIC: 2

(In block letters)

AGE: 3 SEX: 4

POD: 5

EVA DENSITY: 125 190 220 Blue260 Black260 400

DISPENSE DATE: 7

6 Grey350 Black350 Other 350________________

TIME:

AM/PM

(Standard Grey350 assumed unless otherwise marked)

ORTHOTIC STYLE: Mens Womens Athletic

Womens Dress

PRIORITY RETURN: Tick if required

8 (Wide)

(Medium Width)

(Narrow Width)

9

(will incur 20% loading)

TEMPLATE SIZE: 10

Left Foot Right Foot TOP COVERS: HEEL SKIVE mm

11 VINYL blue green purple cream

deg

27

MULTIFORM 1mm blue red black multi

neutral 12

2mm blue red green black multi jellybean

inverted

3mm blue red green black SCAN everted

POSITION on computer* 13 VITA brown black cream

*(provide date

(Forefoot Correction) or file nunber) P. U. LINING biscuit CAMBRELLE black

14

INVERSION RAMP ( 0 to 12 deg)

SPENCO 1.5mm 3mm 1.5mm: blue black

15

3mm: green black

EVERSION RAMP ( 0 to 12 deg)

16 PPT/PORON 1.6mm 3.2mm 6mm

THICKNESS mm (1-18mm)

(Standard thickness is 1.5mm) PS VLIES black

KANGAROO black

17

ARCH FILL % ( -30 to +30%) PIGSKIN LEATHER SUEDE LEATHER

OTHER OPTIONS:

18 28 LAMINATED ARCH LOW HEEL GRIND 33 33

LAT ARCH FILL % ( -30 to +30%) 28 HOOKS

3/4 LENGTH 32

19 29 1st MPJ CUTOUT HEEL LIFT EXT (mm) 33

HEEL LIFT mm (0-12mm)

30 45 DEG CUTOUT 1ST RAY GRIND (mm) 34

20

HEEL CUP % ( -30 to +30%) 31 SULCUS LENGTH PLANTAR GRIND(mm) 35

21

REARFOOT POSTING (0-24 deg)

(Medial unless Lateral specified)

(Medial Heel Wedge)

22

METATARSAL WEDGES (0-12 deg)

(Lateral unless Medial specified)

23

METDOMES size (1, 2, 3, 4)

or Briggates type size (S, M, L)

24

METPADS size (s, m, l)

25

PFA (mm)

OTHER INSTRUCTIONS:

36 26

Version 7/2/2012

mailto:[email protected]

Contents 1. Patient's Name.................................................................................................................................................................... 3

2. Age ....................................................................................................................................................................................... 3

3. Sex ....................................................................................................................................................................................... 3

4. EVA Density ........................................................................................................................................................................ 3

5. Orthotic Style ...................................................................................................................................................................... 5

6. Template Size ..................................................................................................................................................................... 5

7. Clinic..................................................................................................................................................................................... 5

8. Podiatrist .............................................................................................................................................................................. 5

9. Dispense Date .................................................................................................................................................................... 5

10. Priority Return ................................................................................................................................................................... 5

11. Heel Skive ......................................................................................................................................................................... 6

12. Scan Position .................................................................................................................................................................... 6

13. On Computer .................................................................................................................................................................... 7

14. Inversion Ramp ................................................................................................................................................................ 7

15. Eversion Ramp ................................................................................................................................................................. 7

16. Thickness .......................................................................................................................................................................... 8

17. Arch Fill % ......................................................................................................................................................................... 8

18. Lateral Arch Fill % ............................................................................................................................................................ 9

19. Heel Lift (mm) ................................................................................................................................................................... 9

20. Heel Cup % ..................................................................................................................................................................... 10

21. Rearfoot Posting ............................................................................................................................................................. 11

22. Metatarsal Wedges ........................................................................................................................................................ 13

23. Metdomes ........................................................................................................................................................................ 14

24. Metpads ........................................................................................................................................................................... 14

25. PFA .................................................................................................................................................................................. 15

26. Other Instructions ........................................................................................................................................................... 15

27. Top Covers ...................................................................................................................................................................... 15

28. Hooks ............................................................................................................................................................................... 20

29. 1st MPJ Cutout ............................................................................................................................................................... 20

30. 45 Degree Cutout ........................................................................................................................................................... 20

31. Sulcus Length ................................................................................................................................................................. 21

32. 3/4 Length ....................................................................................................................................................................... 21

33. Heel Lift External (mm) .................................................................................................................................................. 22

34. 1st Ray Grind (mm) ........................................................................................................................................................ 23

35. Plantar Grind (mm) ........................................................................................................................................................ 23

36. Plantar View .................................................................................................................................................................... 24

1. Patient's Name

Input the patient's first and last name into this section. For the convenience of the orthotics laboratory please do not abbreviate the name in any way. Please stick to using a standardised ‘Maiden Name -> Surname’ structure for your own convenience as well as ours.

2. Age

Please input the patient's age for your records as well as ours. This will occasionally provide orthotics technicians with a useful reference.

3. Sex

Please input the patient's sex for your records as well as ours. This will occasionally provide orthotics technicians with a useful reference.

4. EVA Density

Please select the EVA density that you feel is appropriate for your patient. Our densities are laid our clearly on the script that is provided. Our densities ranging from 125; the lowest, to 400; the highest. Please note that if no density is specified in this section we will assume that 350 Grey EVA is the preferred orthotic medium.

220 350

190 220 260

400 350 260

120

350 350 350

190 350 350

350

350 350 350

5. Orthotic Style

Please select an orthotic style. This orthotic style is in relation to the size of the patient’s footwear. Cadcam Orthotics uses US sizing - please refer to the sizing conversion chart for an efficient way to convert other shoe sizing systems. If the patient requires a custom fitted orthotic please indicate in this section. We recommend that a direct photocopy, correctly scaled photograph or tracing of the patient shoe last be provided in order for orthotic technicians to correctly fit orthoses to footwear. A men’s last will have a higher heel cupping of between 10-20mm, a women’s athletic last will have a lower heel cupping of between 10-15mm and a women’s dress last will have an even lower heel cupping of between 5-10mm. If no size is selected then we will assume that a 'Men’s (Wide)' orthotic style is wanted for a male prescription and a 'Women’s Athletic (Medium Width)’ for a female prescription.

6. Template Size

Please input the size of the orthoses you require for your patient. Cadcam Orthotics uses Australian sizing - please refer to the sizing conversion chart for an efficient way to convert other shoe sizing systems. If you require a custom cut orthoses then please indicate whether or not you have attached a diagram, or template to the script or within the package sent to Cadcam Orthoses. This will prevent orthotic technicians from overlooking attached diagrams, or templates. A universal sizing chart has been attached to the end of this guide for your convenience.

7. Clinic

Please include the name of your clinic if it is not already permanently included on the scripts that are provided.

8. Podiatrist

Please include the name of the podiatrist that is prescribing the pair of orthoses. This helps orthotic technicians as occasionally we will need to converse with podiatrists in order to make the orthoses to the required specifications.

9. Dispense Date

If you require your orthoses on a particular day at a particular time you may indicate it in this section.

10. Priority Return

If you require the patient's orthoses back at your clinic within four working days then Cadcam Orthotics reserves the right to charge a 20% priority loading charge on the prescribed orthoses.

11. Heel Skive

When the axes of the forces of the patients foot are low and medially deviated a heel skive may be used to redirect forces in an appropriate way. Please indicate the angle (degrees) and the depth (mm) that you wish the heel skive to have.

12. Scan Position

Please input an amount in degrees that you wish the orthotics to be held when three-dimensionally scanned. If no scan position is entered then the orthotic will be modeled perpendicular to the bisection of the calcaneus. Increasing the inversion in degrees will create an increase in the medial arch height, medial rear foot posting and total medial support of the orthotic. Increasing the eversion in degrees will create an increase in the lateral arch height, lateral rear foot posting and total lateral support of the orthotic. If you are requesting a repeat pair then this value will be stored electronically and there is no need to input this data.

13. On Computer

Please include the previous job number as displayed in the top left corner of the patient's previous pair of orthoses from Cadcam Orthoses. As all of our orthotic data is stored electronically there is no need to recast the patient. Instead, you may simply send a new script, with any changes that the patient requires included on the script.

14. Inversion Ramp

Enter the measurement of inversion that you would like built into the orthotic device in degrees. Inputting an inversion ramp figure will create a full length inversion wedge in the orthotic device, which will build up the medial aspect of the orthotic model. You may manually request alternate parameters of the inversion ramp in section 26, or 36.

15. Eversion Ramp

Enter the measurement of eversion that you would like built into the orthotic device in degrees. Inputting an eversion ramp figure will create a full length eversion wedge in the orthotic device, which will build up the lateral aspect of the orthotic model. You may manually request alternate parameters of the eversion ramp in section 26, or 36.

16. Thickness

Please input the thickness that you would like the orthotic device to have at the thinnest points. The thickness of the device can be altered on each device if a patient has a defined limb length difference. The thickness can be set between 1.5 and 8.0mm it is recommended that a limb length difference of more than 5.0mm should be treated with additional extrinsic wedging. The thickness of the device is measured from the thinnest point of the device, which should be the ball of the heel and the 1st, or 5th MPJ contact points. If no thickness is selected then it will be assumed that 1.5mm is being requested.

17. Arch Fill %

Enter the amount of additional medial arch fill you would like the orthotic model to have in percentage, or conversely the amount of reduction of medial arch fill you would like the orthotic model to have. By inputting a percentage it will proportionately increase, or decrease the total medial arch fill in the orthotic model. The percentage that is calculated will increase the medial arch support in (mm) as a proportion of the total medial arch area. For example if the total surface area under the medial arch was measured at 30mm2, then a percentage of 10% entered in the input box would mean an increase in total medial arch area to 33mm2.

18. Lateral Arch Fill %

Enter the amount of additional lateral arch fill you would like the orthotic model to have as a percentage. Conversely, you may enter the amount of reduction of lateral arch fill you would like the orthotic model to have as a percentage. By inputting a percentage it will proportionately increase, or decrease the total lateral arch fill in the orthotic model. The percentage that is calculated will increase the lateral arch support in (mm) as a proportion of the total lateral arch area. For example if the total surface area under the lateral arch was measured at 10mm2, then a percentage of 20% entered in the input box would mean an increase in total medial arch area to 12mm2.

19. Heel Lift (mm)

Enter the amount of additional heel thickness (mm) you would like added to the orthotic device. This additional heel lift will be added to the total thickness of the heel at the thinnest point. For example if the ‘Insole Thickness’ is set at 2mm and a heel lift of 3mm is entered into the heel lift input box, then the total thickness of the heel will be 5mm.

20. Heel Cup %

Enter the amount of additional support you would like the orthotic model to have at the heel as a percentage (%). This additional heel cup support will be calculated based on a percentage of the total area of the heel cup surrounding the heel contour. For example if a heel cup is 20mm in height then a percentage increase of 10% will result in a new heel cup height of 22mm. This percentage increase will predominantly affect the outer margin of the heel cup. There will be some tapering into the heel contour area. If a great increase in heel cup height is needed then the total width of the patient’s foot compared to the size of the foot selected should be considered. For example if the patients heel is quite narrow compared to the foot size selected, then a heel cup increase will work successfully. Conversely a larger heel in comparison to the total width of the foot size will not work as successfully as the orthotic model will contact the outer edges of the patient’s foot vertically. If additional heel support is needed then it can be included in the ‘Notes’ section and a customised blank can be used during the milling of the device. It should be also requested that the orthotic be tapered slightly more to ensure that it fits properly into the patient’s shoe.

21. Rearfoot Posting

Enter the amount of rear foot posting in degrees that you would like the orthotic model to have at the medial or lateral aspect of the rear foot of the device. Rear foot posting, sometimes referred to as a medial heel wedge, will help the orthotic to have additional control at the medial aspect of the rear foot. The parameters that the rear foot posting will span from are the centre line of the heel to medial edge of the device (mediolaterally) and the proximal aspect of the heel to slightly distal of the centre point of the heel (proximodistally). The rear foot posting is specified in degrees, which means that a wedge of defined degrees will be inbuilt into the orthotic model at the previously defined areas. It is a basic rule of thumb that the rear foot posting should be calculated as the difference between the patient’s RCSP and the NCSP. Lateral rear foot posting, sometimes referred to as a lateral heel wedge, will help the orthotic to have additional control at the lateral aspect of the rear foot. The parameters that the rear foot posting will span from are the centre line of the heel to lateral edge of the device (mediolaterally) and the proximal aspect of the heel to slightly distal of the centre point of the heel (proximodistally). The rear foot posting is specified in degrees, which means that a wedge of defined degrees will be inbuilt into the orthotic model at the previously defined areas.

22. Metatarsal Wedges

Enter the angle of the metatarsal wedge in degrees. Enter a positive value for a medial metatarsal wedge and a negative value for a lateral metatarsal wedge. Or simply indicate that you would like a lateral metatarsal wedge. The metatarsal wedge will automatically be built into the orthotic device. The parameters and exact specifications of the metatarsal wedge are modifiable within our software, therefore we ask you to indicate within section 38 the exact location in which you would like the wedge to be placed.

23. Metdomes

Please indicate in this section whether you would like metdomes included under the covers of your orthoses. It is preferred if you included a diagram, or template that provides orthotic technicians with reference as to the exact location you would like your metdomes. Alternatively you may request that the orthoses be dispensed to your clinic uncovered with metdomes included so that you may position them yourself. Metdomes come in standard sizes of 1,2,3,4 (smallest -> largest). Cadcam Orthotics will provide your clinic with a sample of each metdome to aid you in your orthotic prescription.

24. Metpads

Please indicate in this section whether you would like metpads included under the covers of your orthoses. It is preferred if you included a diagram, or template that provides orthotic technicians with reference as to the exact location you would like your metpads. Alternatively you may request that the orthoses be dispensed to your clinic uncovered with metpads included so that you may position them yourself. Metpads come in standard sizes of S, M and L (smallest -> largest). Cadcam Orthotics will provide your clinic with a sample of each metpad to aid you in your orthotic prescription.

25. PFA

Specify the depth in mm of the plantar fascia accommodation (PFA) you would like the device to contain. There is also the option of requesting a straight, or curved PFA, simply indicate this next to your PFA depth number (mm) so that orthotic technicians may know. It is helpful for orthotic technicians and far more comfortable for your patient if you simply provide a tracing of the shape of the patient’s plantar fascia when the hallux is dorsiflexed. This will allow orthotic technicians to perfectly position the PFA grind within the device for maximal comfort.

26. Other Instructions

This section should contain all information that you were not able to enter during the scripting process. Do not be afraid to ask for anything in this section. If there is something that is unclear then the orthotics technicians at CadCam Orthotics will contact you. At CadCam Orthotics we do not make orthotics without being completely clear as to what is being requested. We believe that lab discretion is not something that should be used, as we prefer to make what a podiatrist wants, not what we think they want.

27. Top Covers

Select the top covers that you would like your orthoses to have. You may select as few, or as many as you like. Be sure to select which cover you would like as an undercover and which cover you would like as a top cover.

Cover Name Suede Tan Suede Black

Pigskin Tan Pigskin Black PS Vlies

HS Brown Ultralux Cushmax

Vita Brown Vita Cream Vita Black

Cambrelle Kangaroo Vinyl Cream

Vinyl Red

Vinyl Purple Vinyl Yellow

Vinyl Green Vinyl Blue

Vinyl Navy

Vinyl Aqua

Vinyl White Multiform Red

Multiform Black Spenco Green Spenco Blue

Spenco Black Spenco Bamboo Lunasoft BL

Lunasoft BY Lunasoft WLR Lunasoft Jellybean

Lunasoft RB Lunasoft Cork Lunasoft BBG

Lunasoft PPW Multiform Blue Multiform Red

Multiform Green PU Black PU Biscuit

PU Green PU Purple PU Pink

Cover Name Description Thickness

Options Poron - Slow Release

Slow release poron offers additional rebound, which results in a unique adaptive fit during each use.

3.2mm, 6.0mm

Poron – Blue/Fawn/Black

Poron is commonly used as an undercover to help offload pressure points of the foot, or to provide additional comfort. Features include comfort, breathability and antifungal properties

1.6mm, 3.2mm, 6mm, 10mm

Cambrelle A hard wearing cover that is breathable, absorbent and cool to wear, making it perfect for orthotic top covers.

0.8mm

PS Vlies PS Vlies is a black cotton polyester based material that is highly durable. It absorbs moisture effectively and dries without undergoing any lasting damage.

1mm

Kashmere Kashmere is a highly water absorbent, abrasion resistant cover that is treated with antimicrobial agents to prevent the growth of bacteria and fungae

1mm

Multiform - Black Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

1mm, 2mm, 3mm, 4mm

Multiform - Blue Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

1mm, 2mm, 3mm, 4mm

Multiform - Red Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

1mm, 2mm, 3mm

Multiform - Green Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

2mm, 3mm

Lunasoft - Jellybean

Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

2mm

Lunasoft - Multicolour


1mm, 2mm

Lunasoft - PPW Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

2mm

Lunasoft - BBA Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

2mm

Lunasoft - Purple/Black


2mm

Lunasoft - GPW Multiform is an Ethylene Vinyl Acetate (EVA) foam that is a wonderful shock absorber with excellent shape retention. It is among the most popular of our covering options due to its versatility.

2mm

Lunasoft - Yellow/Black


2mm

Lunasoft - Red/Black


2mm

Spenco - Bamboo

Spenco X-Static provides the comfort of traditional spenco with nano-silver technology, making the product antimicrobial and antibacterial

1.5mm, 3mm

Spenco - Black Spenco has fantastic cushioning, insulation and anti-ageing properties making it an ideal top cover for all types of orthotic devices

1.5mm, 3mm

Spenco - Blue Spenco has fantastic cushioning, insulation and anti-ageing properties making it an ideal top cover for all types of orthotic devices

1.5mm

Spenco - Green Spenco has fantastic cushioning, insulation and anti-ageing properties making it an ideal top cover for all types of orthotic devices

3mm

Ultralux Ultralux keeps the feet cool, dry and comfortable by absorbing moisture, while the PPT underlayer provides additional comfort

1.6mm, 3.2mm

Pigskin - Black Natural pigskin leather is sourced from high quality suppliers. For those who wish to use a non-synthetic covering option.

~ 0.8mm

Pigskin - Tan Natural pigskin leather is sourced from high quality suppliers. For those who wish to use a non-synthetic covering option.

~ 0.8mm

Velousana Velousana is a highly durable and absorbent top cover material with a luxurious, soft plush finish.

1mm

PU - Purple An appropriate cover when cost is important. PU keeps the foot cool, dry and comfortable.

0.8mm

PU - Biscuit An appropriate cover when cost is important. PU keeps the foot cool, dry and comfortable.

0.8mm

PU - Black An appropriate cover when cost is important. PU keeps the foot cool, dry and comfortable.

0.8mm

PU - Green An appropriate cover when cost is important. PU keeps the foot cool, dry and comfortable.

0.8mm

Suede - Black Natural suede is sourced from high quality suppliers. For those who wish to use a non-synthetic covering option. Suede is supple and soft to touch.

1mm

Suede - Tan Natural suede is sourced from high quality suppliers. For those who wish to use a non-synthetic covering option. Suede is supple and soft to touch.

1mm

Vinyl - Purple Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - Aqua Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - Blue Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - Cream Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - Navy Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - Green Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - Red Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - White Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vinyl - Yellow Highly durable orthotic top cover with high resistance to water, UV, fungal and microbial damage. Extremely easy to clean and maintain.

0.8mm

Vita - Black Vita has extremely high absorbption abilities helping keep feet free from unwanted moisture. Vita is also treated with an antimicrobial additive to help protect against bacteria and fungae

0.8mm

Vita - Brown Vita has extremely high absorbption abilities helping keep feet free from unwanted moisture. Vita is also treated with an antimicrobial additive to help protect against bacteria and fungae

0.8mm

Vita - Cream Vita has extremely high absorbption abilities helping keep feet free from unwanted moisture. Vita is also treated with an antimicrobial additive to help protect against bacteria and fungae

0.8mm

HS - Brown HS is a microfleexe material that is durable and absorbent. It does not wrinkle or tear, even under harsh conditions and is supple and soft to touch.

1mm

28. Hooks

Select this option if you would like the prescribed orthoses to be hook shaped. Applications for hook orthoses include high heeled shoes. The heel of the device is able to curl and narrow. The mid foot area of the device is also narrower in a hooked device.

29. 1st MPJ Cutout

Select this option if you like your orthoses to have a cutout underneath the 1st MPJ. If you would like the MPJ cutout to be backfilled with a soft poron material please indicate in section 26. If not specified standard poron will be used, however for diabetic patients slow release poron is also available.

30. 45 Degree Cutout

Select this option if you would like a 45 degree cutout on the medioplantar surface of the device. By grinding a 45 degree cutout into the device it will help the orthoses to fit in the patient’s shoes. If you would like a greater angle cut into the device so that they correctly fit into the shoes then specify the exact angle in section 26 so that the orthotic technician making the devices can grind the orthotics correctly.

31. Sulcus Length

Select this option if you would like a sulcus length device. If a sulcus length device is requested the orthoses will be cut at the sulcus of the device to shorten the overall length of the device. The orthoses will be slightly tapered distally to avoid irritation at the interphalangeal joints.

32. 3/4 Length

Select this option if you like a ¾ length device. CadCam Orthotics laboratory will cut the orthoses so they end slightly proximal of the metatarsal head parabola. This ensures that the metatarsal heads are not contacting the orthoses, preventing irritation.

33. Heel Lift External (mm)

Select this option if you would like an external heel lift added to your device. Selecting this option will instruct orthotics technicians to add an external heel lift of specified thickness to the heel area of the device using the material specified. The standard material that is used is a 260kg/m3 density black EVA.

34. 1st Ray Grind (mm)

Select this option if you would like additional material taken out of the arch of the orthoses, spanning from the 1st MPJ to the highest point of the medial arch. By grinding a first ray grind the orthoses will be more accommodative of the patient’s first ray. 1st ray grinds are often used concurrently with a 1st MPJ cutout, which provide additional comfort and accommodation for the 1st ray.

35. Plantar Grind (mm)

Select this option if you would like a plantar grind on the plantar surface of the orthoses. A plantar grind in the orthoses is a grind on the plantar surface of the orthoses that allows a device to better fit into a shoe. By removing material directly below the medial and lateral arches plantarly the orthoses will have a decreased arch height during weight bearing. This is allows for more accommodation of the patient’s foot and a device that is less ‘firm’ under the patient’s foot. A plantar grind also helps decrease the feeling of an EVA orthoses bulging out of the patient’s shoes, which is a feeling that some patient’s often get when wearing EVA orthoses for the first time. A plantar grind is deepest at the medioplantar aspect of the device and shallowest at the lateroplantar aspect of the device.

36. Plantar View

Please illustrate on this diagram any relevant information to your patient’s script that you need to be conveyed visually. If this area is too small, or you need a diagram that is to scale please include this separately.

Universal Orthotic Sizing Chart

System Sizes

Europe 35 35 ½ 36 37 37 ½ 38 38 ½ 39 40 41 42 43 44 45 46 ½ 48 ½

Mexico 4.5 5 5.5 6 6.5 7 7.5 9 10 11 12.5

Japan M 21.5 22 22.5 23 23.5 24 24.5 25 25.5 26 26.5 27.5 28.5 29.5 30.5 31.5

W 21 21.5 22 22.5 23 23.5 24 24.5 25 25.5 26 27 28 29 30 31

UK M 3 3 ½ 4 4 ½ 5 5 ½ 6 6 ½ 7 7 ½ 8 8 ½ 10 11 12 13 ½

W 2 ½ 3 3 ½ 4 4 ½ 5 5 ½ 6 6 ½ 7 7 ½ 8 9 ½ 10 ½ 11 ½ 13

Australia M 3 3 ½ 4 4 ½ 5 5 ½ 6 6 ½ 7 7 ½ 8 8 ½ 10 11 12 13 ½

W 3 ½ 4 4 ½ 5 5 ½ 6 6 ½ 7 7 ½ 8 8 ½ 9 10 ½ 11 ½ 12 ½ 14

US & Canada M 3 ½ 4 4 ½ 5 5 ½ 6 6 ½ 7 7 ½ 8 8 ½ 9 10 ½ 11 ½ 12 ½ 14

W 5 5 ½ 6 6 ½ 7 7 ½ 8 8 ½ 9 9 ½ 10 10 ½ 12 13 14 15 ½

Korea (mm) 228 231 235 238 241 245 248 251 254 257 260 267 273 279 286 292

Inches 9 9 1/8

9 ¼ 9 3/8

9 ½ 9 5/8

9 ¾ 9 7/8

10 10 1/8

10 ¼ 10 ½ 10 ¾ 11 11 ¼ 11 ½

Centimetres 22.8 23.1 23.5 23.8 24.1 24.5 24.8 25.1 25.4 25.7 26.0 26.7 27.3 27.9 28.6 29.2

Mondopoint 228 231 235 238 241 245 248 251 254 257 260 267 273 279 286 292

Prescription Form Guide - Cad-Cam Orthotics - Home Guide.pdf · patient shoe last be provided in...

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Transcript of Prescription Form Guide - Cad-Cam Orthotics - Home Guide.pdf · patient shoe last be provided in...