Footwear selection:
► Choose a sturdy lace-up shoe with solid heel cup to ensure the optimum effectiveness of the
orthosis. The effective heel height should be between 0.5 cm and 1.5 cm.
Adapting the orthosis size:
1) As needed: If the patient uses footwear with removable insoles, take the insole out of the
shoe on the fitting side.
INFORMATION: Keep the insole in order to use the shoe without the orthosis.
2) Have the patient sit on a chair with the shoe and without the orthosis, and position the foot at
a 90° angle to the lower leg (see fig. 1).
3) Mark the position of the malleoli in the shoe with a small piece of adhesive tape (see fig. 1).
4) Have the patient sit on a chair without the shoe and with the orthosis, and position the foot at
a 90° angle to the lower leg.
INFORMATION: Apply the orthosis to the patient so that the ankle joint has sufficient
freedom of movement and does not impact the hard medial spring.
5) Determine the position of the ankle according to the "WalkOn® Reaction" lettering (see
fig. 2).
6) Trim the orthosis sole (see fig. 3) so that the mark on the shoe corresponds to the position on
the orthosis (see fig. 4).
7) Adapt the sole shape according to the removable insole. Note that the required exterior rota
tion of the foot must be maintained (see fig. 3).
Adapting the orthosis:
1) Insert the orthosis in the shoe and cover it with an insole if required (see fig. 5).
2) Put on the orthosis together with the shoe (see fig. 6).
3) Measure the correct AP position of the knee joint (e.g. on the L.A.S.A.R Posture).
INFORMATION: The load line of the knee joint in the AP position lies approx. 15 mm in
front of the knee compromise pivot point according to Nietert.
4) As needed: Wedges can be used to provide a comfortable base of support. For example, an
extrinsic forefoot wedge can be used to increase knee extension force (see fig. 10). An
extrinsic heel wedge can be used to reduce knee extension force (see fig. 11).
INFORMATION: Materials other than those supplied may also be used to build up the
bottom sole if needed.
5) As needed: Sand the top edge and wings of the front support and modify the padding
accordingly.
NOTICE! The functionality of the orthosis must not be impaired. Do not sand in the
area of the medial spring or the surfaces!
6) As needed: If the patient has a foot deformity, correct it with an insole or a custom moulded
medical device.
INFORMATION: The manufacturer offers lateral pronation traction (28Z10) which
attaches to the lateral sole with hook-and-loop fasteners. Frontal and dorsal traction
stabilise the foot with the help of hook-and-loop fasteners in the area of the spring.
7) Close the textile component at calf height (see fig. 6).
8) CAUTION! The child size closures may be swallowed by young children.
Sew the closures of the hook-and-loop straps to the hook-and-loop straps after fitting.
Final inspection:
► Conduct trial walking with the patient. Testing on inclines, ramps and stairs is mandatory.
Fine tune as required.
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