2. 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.

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

4. 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:

5. 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:

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

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

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

9. Custom ToeOFF Evaluate patient Complete forms Process & Procedures

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

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

12. 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

13. 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

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

15. 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”

16. 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

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

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

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

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

21. 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

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

23. 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

24. 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

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

26. 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

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

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

29. 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

30. 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

31. Custom ToeOFF Contact Additional Information Scott Hennessy, CO National Product Manager Office 888-678-6548 Fax 800-289-0809 Cell 210-874-1599 scott.hennessy@allardusa.com www.allardusa.com