Fabricating for Tone Reduction n Tony Wickman R.T.(O,P) n freedom fabrication inc.

What Is Tone? n Tone literally means activation of a muscle. n Spasticity is derived from the Greek word meaning to pull or draw.

Cast Correction: n Cast may require greater than normal correction n Make sure to correct cast at the articulating surfaces

Dorsiflexion Angle n Maximum dorsiflexion deviation should be no more than 20 degrees. n Watch for cavus arch !

Plantarflexion Angle n Plantarflexion angle should be no more than forty degrees. n Watch for plantarflexed metatarsals

Inversion/Eversion Angle n +/- 15 degrees n Cast corrections are difficult

Mold Modification n The model must accurately mimic the patients physiology n You have to have intimate knowledge of skeletal structures!

Maleoli Buildups n Buildups should be more “extreme” than usual n Take into consideration varus valgus tendencies

Medial Maleoli/Navicular n Two apexes n Blend well into surrounding soft tissue

Calcaneal Cuboid Buildup n Include achilles tendon extension n Be sensitive to prominent heels

Heel Buildup n Heel should be rounded n Heel should be symmetrical

S.T. Groove n Anatomy rules n Blend into longitudinal arch

Medial/Lateral Arches n Smooth transition n Connect around to plantar surface of calcaneus

Cuboid/ Lateral Fifth Met Head n Relieve mm n Be careful to maintain radius of plantar lateral surfaces

Metatarsal Relief n Proximal edge relief n Distal edge relief

Padding Techniques n Bony prominences only n Blend edges smoothly n Colored foams

Material Selection n Polypropylene n Polyethylene n Copolymer

Pulling Plastic n Focused stretch n Proper temperature n Maximum vacuum

Trimming Plastic n Establish trim lines n Poly posting is ground first n Trim lines must be smooth

Finishing & Decorating n Colored Velcro n Foams n Ribbon n Transfers

For additional information on this subject: n Tony Wickman at Freedom Fabrication 815-B north main St. Havana Fl n n n or visit our web site at: fabrication.com