Fabricating for Tone Fabricating for Tone Reduction Reduction

Tony Wickman Tony Wickman R.T.(O,P)R.T.(O,P)

freedom freedom fabrication inc.fabrication inc.

What Is Tone?What Is Tone?

Tone literally Tone literally means activation means activation of a muscle.of a muscle.

Spasticity is Spasticity is derived from the derived from the Greek word Greek word meaning to pull or meaning to pull or draw.draw.

Cast Correction:Cast Correction:

Cast may require greater than Cast may require greater than normal correctionnormal correction

Make sure to correct cast at the Make sure to correct cast at the articulating surfacesarticulating surfaces

Dorsiflexion AngleDorsiflexion Angle

Maximum Maximum dorsiflexion dorsiflexion deviation should deviation should be no more than be no more than 20 degrees.20 degrees.

Watch for cavus Watch for cavus arch !arch !

Plantarflexion AnglePlantarflexion Angle

Plantarflexion Plantarflexion angle should be angle should be no more than no more than forty degrees.forty degrees.

Watch for Watch for plantarflexed plantarflexed metatarsalsmetatarsals

Inversion/Eversion AngleInversion/Eversion Angle

+/- 15 degrees+/- 15 degrees Cast corrections Cast corrections

are difficultare difficult

Mold ModificationMold Modification

The model must The model must accurately mimic accurately mimic the patients the patients physiologyphysiology

You have to have You have to have intimate intimate knowledge of knowledge of skeletal skeletal structures!structures!

Maleoli BuildupsMaleoli Buildups

Buildups should Buildups should be more be more “extreme” than “extreme” than usualusual

Take into Take into consideration consideration varus valgus varus valgus tendenciestendencies

Medial Maleoli/NavicularMedial Maleoli/Navicular

Two apexes Two apexes Blend well into Blend well into

surrounding soft surrounding soft tissuetissue

Calcaneal Cuboid BuildupCalcaneal Cuboid Buildup

Include achilles Include achilles tendon extensiontendon extension

Be sensitive to Be sensitive to prominent heelsprominent heels

Heel BuildupHeel Buildup

Heel should be Heel should be roundedrounded

Heel should be Heel should be symmetricalsymmetrical

S.T. GrooveS.T. Groove

Anatomy rules Anatomy rules Blend into Blend into

longitudinal archlongitudinal arch

Medial/Lateral ArchesMedial/Lateral Arches

Smooth transitionSmooth transition Connect around Connect around

to plantar surface to plantar surface of calcaneusof calcaneus

Cuboid/ Lateral Fifth Met Cuboid/ Lateral Fifth Met Head Head

Relieve 1.5-3.0 Relieve 1.5-3.0 mmmm

Be careful to Be careful to maintain radius of maintain radius of plantar lateral plantar lateral surfacessurfaces

Metatarsal Relief Metatarsal Relief

Proximal edge Proximal edge relief relief

Distal edge reliefDistal edge relief

Padding TechniquesPadding Techniques

Bony Bony prominences onlyprominences only

Blend edges Blend edges smoothlysmoothly

Colored foamsColored foams

Material Selection Material Selection

PolypropylenePolypropylene PolyethylenePolyethylene CopolymerCopolymer

Pulling Plastic Pulling Plastic

Focused stretchFocused stretch Proper Proper

temperaturetemperature Maximum vacuum Maximum vacuum

Trimming PlasticTrimming Plastic

Establish trim Establish trim lineslines

Poly posting is Poly posting is ground first ground first

Trim lines must Trim lines must be smooth be smooth

Finishing & DecoratingFinishing & Decorating

Colored VelcroColored Velcro FoamsFoams RibbonRibbon TransfersTransfers

For additional information For additional information on this subject:on this subject:

Tony Wickman at Freedom Tony Wickman at Freedom Fabrication 815-B north main St. Fabrication 815-B north main St. Havana Fl. 32333Havana Fl. 32333

1800.304.37331800.304.3733 freedomfab@aol.comfreedomfab@aol.com or visit our web site at: or visit our web site at:

www.freedom fabrication.comwww.freedom fabrication.com