Freedom of movement, controlled.

Freedom of movement, controlled.
BACKGROUND
Freedom of movement, controlled.
DEVELOPMENT
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Developed by Dorset Orthopaedic, UK
SAFO (Silicone Ankle Foot Orthosis)
Launched 13 years ago in UK
Patented design
Designed for “drop foot”
10,000 + sold
Freedom of movement, controlled.
Award Winning
THE QUEEN'S AWARD RECIPIENT
UK highest official award for
British businesses that excel at
innovation.
Freedom of movement, controlled.
Product Specifications
Freedom of movement, controlled.
Specifications
• Custom-total contact AFO
• Medical grade silicone
• Layers of different shore elastomers vary the AFO
control (stiffness).
• Rolling machines are used to control silicone
thickness.
Differentiation from Standard AFO
• SiAFO: lifts the foot from dorsum vs. push from the
plantar surface
• SiAFO: Allows controlled physiological tri-planar
motion
Freedom of movement, controlled.
Product Portfolio
Two Designs Available:
• SiAFO-Standard
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– Replaceable Velcro straps
SiAFO+
– Integrated silicone straps
– Lab must replace straps
– Improved hind foot control
• Color Options (5)
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Three skin tone options:
Caucasian, Latino, Negroid
Red, Blue
*limited colors available
with initial launch
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Diagnostics: i-Fit Kit
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Simulates SiAFO
Assess patient candidacy
Instant fitting
Adult and pediatric kits
are available
Material & Functional
Benefits
Freedom of movement, controlled.
BAREFOOT
SiAFO
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Material & Function Benefits
Allows physiological movement and
passive muscle function
Improves sensory feedback
Facilitates joint receptor response
impacting Proprioception and Balance
Greater distribution of impact, weight
bearing forces and shear distribution
Improved cosmesis
Does not restrict crawling, kneeling, or
pull to stand activities
Protects fragile skin
Water resistant (showering, swimming
therapy and ADLs)
Accommodates normal shoe wear, a variety
of heel heights, or worn without shoes
Dampens movement without inhibiting
Freedom of movement, controlled.
Clinical Foundation
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RESEARCH
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The Impact of Silicone Ankle Foot Orthoses (SAFO’s) on Cadence
Balance and Falls in Patients with Neurological Diagnoses.
Sally Glover MSC MCSP and Nicola Cartwright BSC MCSP Physiotherapy Department;
Queen Elizabeth Hospital Birmingham NHS Foundation Trust, UK
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The Use of a Silicone Boot Orthosis on the Speed and Effort in
Walking in Patients with Lower Motor Neuron Lesions.
Wright P A (1), Morant S (1), Watts R (2), Swain I D (1)
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Comparison of Silicone-Ankle-Foot Orthoses vs Plastic Ankle Foot
Orthoses in subjects with Lower Motor Neurone Lesions using the
CODA mpx30 gait analysis system.
Peter McLachlan B.Sc.(Hons), MBAP Meadows BSc, PhD, CEng, EurIng, CS, MIMechE,
MIPEM, FISPO
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CLINICAL IMPACT
• Increase Walking Speed
• Decrease PCI (Perceived
exertion)
• Improved timed 360
degree turn
• Reduction of falls
• Improved balance
• Improved
proprioception
• Improved Compliance
• Improved Comfortpreferred over standard
• Improved Cosmesis
• Increased Satisfaction
• Increased Confidence
• Improved ability to
navigate external
environments
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PATIENT SATISFACTION
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Patient Selection
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PATIENT SELECTION
PATIENT PROFILES
Charcot Marie Tooth (CMT)
Peripheral Neuropathy
Trauma (Peroneal / Sciatic nerve)
Incomplete Spinal Cord injury (iSCI)
Hemiplegia (CP)
Spastic Diplegia (CP)
Stroke (CVA)
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PATIENT SELECTION
INDICATIONS
CONTRAINDICATIONS
Flaccid foot drop
Knee Hyperextension
DorsiFlexion weakness with functional
Plantarflexion
Open wounds-sores
Weak Dorsi/plantarflexion (>+3)
Uncontrolled closed chain
pronation/supination
Mild forefoot pronation/supination
Uncontrolled edema
ML ankle instability
Acute fractures or dislocations
Acute skin rashes or dermatitis
Inability of patient to control tibial
inclination at midstance to terminal
stance (platarflexion <3)
ROM 3-5▫ DF *
*Patient casts with insufficient DF are subject to consultation and pre-approval.
Freedom of movement, controlled.
PATIENT CONSIDERATIONS
CONSIDERATIONS
Fluctuating Edema
Spasticity (Strong Extensor Pattern)
Shortened/tight Achilles
Ischemic foot
Peripheral neuropathy-insensate
Excessive hind foot varus/valgus
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How to Measure
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Materials Needed:
• Plaster Bandage
*Fiberglass casts will NOT be accepted
• Measuring tape
• Indelible pencil
• Nylon sheath
• Plastic wrap
• Bucket for water
*Order form: www.SPSNationalLabs.com
Freedom of movement, controlled.
CAST IS CRITICAL
• The quality of the cast is
CRITICAL for controlling the
patient outcome experience.
• If the cast does not meet required
criteria, National Labs will review
findings and options with the clinician:
1) Re-cast/re-measure
2) Fabricate at risk:
– Waive Warranty
– Re-make at charge to clinic
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1. Complete Basic Order Information
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2. Select Design and Color Options
SiAFO: Standard, circumferential Velcro straps, (straps replaceable at clinic)
SiAFO+: Integrated silicone straps and increased hind foot control, (straps
replaced by National Labs only)
Colors: B4 (Caucasian), B5 (Latin), B7 Negroid, Red, Blue
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3. Complete Measurements
ALL measurements are required to process the SiAFO.
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Measurements
All measurements should be taken in the semi-weight
bearing position. They should be snug but not overly tight.
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4. Cast patient
Angle: All casts should be in 3 degrees of dorsiflexion. Any deviation from the 3
degrees should be documented on the measurement form; consultation is required.
Height of cast: Adult : 28cm Pediatric: just distal to the fibular neck.
Length: Full foot casts are required.
Markings: All boney prominences should be marked with indelible marker. Special
attention must be taken when marking the dorsum of the foot.
Freedom of movement, controlled.
Casting Preparation
Determine if the patient will be wearing the SiAFO directly against the
skin or over a lightweight sock.
Casting over a sock:
• A sock fit offers greater wicking of moisture and
gives the ability to ply fit if needed.
• Use the actual sock the patient will wear and
wrap in clear plastic wrap
• Then apply a lightweight nylon to allow for the
indelible markings
Skin-fit:
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A skin fit offers more control.
Apply only a lightweight nylon
Casting Criteria
• Cast in Semi-Weight Bearing
• Cast in the finished DF angle
– Correcting the cast after removal will
compromise fit.
– Clinical consultation will be required if the cast
is outside of acceptable ROM (3▫ DF); request
consult on work order.
– Corrected casts will not be accepted.
• Cast Removal
– Slight lateral placement of the cut off strip is
recommended
– Be careful not to place the cut strip over the
dorsal boney area or any marked surface.
Casting Criteria
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• *The correct sagittal ankle angle must be in the final negative mold.
No sagittal correction cuts will be accepted.
• There should be no more than a 9mm modification needed to the
forefoot of the cast to balance and align the forefoot to neutral.
• The cast must have minimal wrinkles, creases and roping. Casts can
be rejected for excessive wrinkles, creases or roping.
• The cast must be of proper length and height based on the
orthometry form measurements.
• The measurement form must be completely filled out and accurate.
• All fixed/rigid deformities must be noted on the measurement form if
deviating from the standard 3 degrees of dorsiflexion.
Shipping Information:
Ship the sealed and dry cast with the
completed measurement form to:
National Labs-Orlando
9561 Satellite Blvd., Suite 350
Orlando, FL 32837
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Reimbursement
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Reimbursement
• Clinical Justification and Rationale Guide is provided for reference.
• http://www.spsnationallabs.com/products/doc/silicone-afo/SiAFOCodingRecommendations.pdf
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SiAFO Support Team
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Support:
National Labs-Orlando
Wendy Thompson
SiAFO Team Lead
P (407) 852-6170 x1681
NationalLabs_orlando@spsco.com
Hours of Operation (EST)
8:00 am to 6:00pm
Mon thru Fri
P (407) 852-6170
F (866) 855-1486
http://www.spsnationallabs.com/products/siafo.php
Freedom of movement, controlled.
Summary
Freedom of movement, controlled.
SiAFO Summary
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SPS National Labs: US Exclusive SiAFO Manufacturer (Orlando)
SiAFO: Custom, total-contact, medical grade silicone AFO
(2) Design Options: Standard and SiAFO+
Diagnostic Kit: Available in Adult and Pediatric sizes
Primary functional benefits: allows physiological movement , passive
muscle function, improved proprioception, shear distribution,
comfort and cosmesis.
Patient Profiles : UMN and LMN dorpfoot with good midstance knee
control.
The cast quality is CRITICAL (Finished cast must be semi-weight
bearing and 3▫DF, corrected casts will not be accepted.
SiAFO Team Lead: Wendy Thompson, National Labs-Orlando
SiAFO Clinical Lead: Curt Bertram, National Orthotics Program
http://www.spsnationallabs.com/products/siafo.php
Freedom of movement, controlled.
For More Information:
http://www.spsnationallabs.com
Freedom of movement, controlled.