Custom ToeOFF Custom ToeOFF & BlueRocker Achieving Success! After viewing this presentation you should be made fully aware of the proper techniques required to fit a Custom ToeOFF or BlueRocker.

Custom ToeOFF Indications Applications Process and procedures Model acquisition Reimbursement Agenda This presentation will cover

Custom ToeOFF CVA MS CMT ALS TBI GB SCI Neuropathy Post-Polio Soft-tissue Injuries Indications Some of the indications that have been successfully fit with both Standard and Custom ToeOFF products are:

Custom ToeOFF Applications Atrophy Obesity Deformity Modified ToeOFF or Blue Rocker properties The primary reasons you would use a Custom over a standard product are for the following conditions:

Custom ToeOFF Some additional applications include: Change support level AP (crouch gait) ML (Trunk sway) Change heel rise Incorporate relief Tibial crest Cavus foot

Custom ToeOFF A Custom ToeOFF NOT an application for: Delamination  Refer to the ToeOFF Customization guide to resolve delamination issues.

Custom ToeOFF Evaluate patientAssess in standard ToeOFF or BlueRocker whenever possible  Establishes baseline for required dynamic response Process & Procedures

Custom ToeOFF Evaluate patient Complete forms Process & Procedures

Custom ToeOFF Evaluate patient Complete forms Important to fill out information on size used for evaluation purposes. Process & Procedures

Custom ToeOFF Evaluate patient Complete forms Page 4 allows changes to be made to the dynamic properties. Fill out all grey boxes. Process & Procedures

Custom ToeOFF Evaluate patient Complete forms Measure the heel height of the patient’s shoe to make sure the Custom ToeOFF is aligned properly. Process & Procedures

Custom ToeOFF Evaluate patient Complete forms Page 5 is only to be used when ordering by measurements. Photo must accompany the forms. Don’t forget to attach pages 3 & 4. Process & Procedures

Custom ToeOFF Evaluate patient Complete forms Select footwear Process & Procedures Shoe selection Shank & counter Rocker sole Facilitate 3 rd rocker Measure Heel Rise

Custom ToeOFF Evaluate patient Complete forms Select footwear Determine heel rise Process & Procedures Inside heel = 5/8” Inside ball = 1/8” Needed rise = 1/2”

Custom ToeOFF Evaluate patient Complete forms Select footwear Determine heel rise Manage the foot biomechanics. Process & Procedures Foot orthotic shell At a minimum Custom if necessary Capture if casting or scanning

Custom ToeOFF Evaluate patient Complete forms Select footwear Determine heel rise Manage the foot What is possible Process & Procedures

Custom ToeOFF What is possible? Modify the properties of a Standard ToeOFF!

Custom ToeOFF What is possible? Extra small  No height restrictions on the low end.  Smallest footplate is 190mm or 7 ½” Process & Procedures

Custom ToeOFF What is possible? Extra small Extra tall  Up to ¾” taller than an XL  Max. Footplate length 310mm or 12¼” Process & Procedures

Custom ToeOFF What is possible? Extra small Extra tall Increase or decrease stiffness by up to 2 times a standard product. AP ML Process & Procedures

Custom ToeOFF Cast-requirements Fiberglass only Posterior-medial opening Neutral in sagittal plane Or to proper heel height Anterior & Lateral plumb lines Model Acquisition

Custom ToeOFF Cast Note: If there are any uncorrectable deformities in the frontal plane, they should be represented by standing the patient and then marking the plumb lines. Model Acquisition

Custom ToeOFF Cast Measurement  All forms must be completely filled out  4”(exactly) Piece of tape, placed vertically on calf  Photo must accompany the forms Model Acquisition

Custom ToeOFF Cast Measurement Scan Must have extension “.cxpxp” or export as a STL File Model Acquisition

Custom ToeOFF Two replacements within one year If on using the left side of form Heel height from ¼” to 1” Standard lateral strut Greater than 1”, covered 6 months under GMP (Good Manufacturing Practices) Warranty

Custom ToeOFF Casts shipped to Allard USA, then to Sweden 3 – 4 week turnaround Scans or measurements ed to Sweden 2 – 3 week turnaround Turnaround Time

Custom ToeOFF Cost Materials$ 60 Labor$ 150 Total$ 210 Solid Ankle Reimbursement Allowable Ceiling Floor L1960 $ 625 $ 469 L2270 $ 61$ 45 Total $ 686$ 514

Custom ToeOFF Cost Materials$ 100 Labor$ 150 Total$ 250 Hinged AFO Reimbursement Allowable Ceiling Floor L1970 $ 802 $ 602 L2220x2 $ 92$ 69 L2270 $ 61$ 45 Total $ 955$ 716

Custom ToeOFF Cost Base$ 695 SoftKit$ 36 Total$ 731 Custom ToeOFF Reimbursement Allowable Ceiling Floor L1945 $1,044 $ 738 L2232 $ 105 $ 79 L2755x2 $ 282$ 212 L2820 $ 98$ 73 Total $1,529$1,147

Custom ToeOFF Contact Additional Information Scott Hennessy, CO National Product Manager Office Fax Cell