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