3.5.2 Orthotic Evaluation, Adjustment, and Restoration

3.5.2    Orthotic Evaluation, Adjustment, and Restoration

NOTE: The definitive orthosis, which has been moulded over a positive patient model, may require localized flaring, integration of pads, adjusting or repositioning of joints and uprights, and alteration of trim lines in order to arrive at the optimum design.

Code             Procedure Description
1 Tri-planar alignment management Evaluation of orthotic alignment prior to positioning on the patient.

Verification of the orthotic design, component alignment and initial joint control settings, height, location of straps, suspension, and attachment to the orthosis. This includes shoe evaluation of the orthosis.

Adjust sagittal/ frontal/ transverse plane alignment of orthosis. This may include adjustments to accommodate change in footwear, joint range of motion (contracture), muscle strength, joint pain/ instability, areas of socket pressure. May also include tilt/shift of orthosis relative to ground using adjustment screws/ plates, alignment tools/ adaptors or removing and reattaching the orthotic joints.

2 Strategic surface/ volume management Adjusting orthosis to optimize intimacy of strategic surface contact on the body segment. May include application of localized heat to relieve excessive contact, sanding out areas of socket, applying counter pressure pads, full or partial linings to equalize contact or altering trim lines.
3 Orthosis evaluation Assess orthosis for performance issues, including orthosis or component failure and maintenance requirements. May include assessing performance limitations, safety issues, excessive wear of mechanical joints, padding, liners, components straps and attachment points.
4 Height/Length management  Adjusting length/height to accommodate physiological growth, change in status of contralateral limb, change in client function or medical changes.
5 Suspension management Adjustments to optimize suspension.  May include the use of heat to enlarge or reduce suspension areas, adjust or replace straps, or liners including locking mechanisms, adjustment application of heat, pads or linings.
6 Control systems management Adjusting settings on orthotic components to optimize function. Includes joint control setting, FES setting, orthotic stance control and cabling.
7 Disassembly/ assembly of orthosis Disassembling and re-assembling orthotic components required to make modifications or restoration.
8 Adjustment to orthosis Reshaping areas of anatomical form



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