FW: Responses to the Time Frames for fitting AFO's - both articul ated and non
Prior, Heather
Description
Collection
Title:
FW: Responses to the Time Frames for fitting AFO's - both articul ated and non
Creator:
Prior, Heather
Date:
4/8/2004
Text:
> Hi everyone,
> thanks for your responses to my question how much time do you
> allocate toward the fitting of your AFO's - both
> articulating and non-articulating.
>
> Here is a summary and my apologies if I missed anyone in my attempt to cut
> and paste!
>
> The reason I asked was; I am trying a pilot exercise for those who must
> travel for many hours to see us - I am booking them for 3 hours which
> means they get 60 mins of fitting time, the chance to walk for as long as
> they need, have any final adjustment and leave. While they are walking I
> am fitting others. Interestingly enough, to date, I haven't had to make
> any adjustment appointments on these clients and I think it has been just
> as time efficient.
>
> Best regards,
>
> Heather Prior C.O. (NZ), C.O. (c)
>
>
>
> Non-articulating 15 minutes
> articulating 30 minutes
>
> We allocate one hour for both articulated and solid ankle for fitting. We
> also allocate an hour if they are bilateral or unilateral.
>
> It really depends on your casting skills and modification skills!!
> In the beginning it took a lot of trips back and forth to the grinder
> and heat gun to get the fitting right. Now I can spend about 20-30
> minutes with the patient, making sure they can walk in it, don and doff
> it, and learn to care for it. Then there are some minor adjustments
> occasionally so I always schedule at least 30 minutes.
>
> I generally allocate 1/2 hour. This gives time for adjustments, answering
>
> questions, giving patient instructions, and charting the visit.
>
> we allocate 30mins to fit , adjust if necessary - including removing
> insoles from shoes (most times glued) to allow extra depth if
> required..... We then do a reasonably quick gait analysis - as we video
> all, we are able to do comparitive assessments - necessary when dealing
> with clients over a long period and mostly with degenerative conditions,
> articulated afos...usually the same time.....
>
> But as well we review our clients , as working in a team, they are seen
> regularly by Physios and O/Ts who provide feedback and most clients attend
> once a fortnight for either hydro or training at our facility. They are
> also provided with pages of written information and instructions on things
> to watch out for, maintenance and cleaning.
>
> Sometimes, conditions such as extreme type 2 or 3 charcot marie tooth
> require further time and up to an amount of at least one and a half hours,
> especially if weight bearing excessively on the lateral side as most do.It
> requires gel inserts moulding in between layers in the splints and they
> can be difficult to remove and distribute pressure evenly.
>
> CVA's and straightforward hemiplegias probably require less reviewing, and
> less allocation of time but I guess its up to the facility as constant
> reviews for these conditions would not provide much change over a period
> of time and perhaps waste resources and funds.
>
> Generally an hour. This includes all associated paperwork, dictation,
> and cleanup. I generally allow 30-45 minutes for fitting a standard AFO,
> jointed or
> unjointed
>
> I typically allocate 1/2 hour for a single afo and 3/4 hr. for a bilateral
> set. However, this is for my typical clients who are pretty
> straightforward and who I anticipate will do well and don't have any
> complicating factors such Varus or Valgus tone, or bony prominences which
> may require expected modifications. I think I would allocate an
> additional 15 minutes for adjusting the motion controls during a gait
> evaluation and training session for articulated AFOs. This will iinclude
> instructing the patient on donning/doffing and care and maintenance as
> well as reviewing our warranty and service policy.
> approx. half hour.
>
> My formula is an articulated vs a posterior leaf AFO is at least twice the
> time for the articulated and can go up to three times to time.
>
> I allow a minimum of 30 minutes for a posterior leaf to do all the patient
> training required. Thus would schedule approximately 1 hour for the
> articulated AFO.
> I allow about 1/2 hour for articulated and one hour for non articulated I
> also allow one hour for most of my CMT and charot patients. The extra time
> is not so much for the AFO as it is to obtain the proper shoe mechanics
> (i.e. rocker, lift, wedges and or postings).
> Hard to answer your question without a few qualifications. If it is an
> adult vs a child. If the design is more simple or complex(I am thinking of
> dorsum coverage or not - tone reducing foot plate design, etc...)
> Cooperative patient or not. To give an average answer, we would allocate
> between 30 to 60 minutes for this type of an appointment. The 30 would be
> for unilateral and more simple design fittings, the 60 would be for
> bilateral and more complex(pediatric) types of patients.
>
>
> thanks for your responses to my question how much time do you
> allocate toward the fitting of your AFO's - both
> articulating and non-articulating.
>
> Here is a summary and my apologies if I missed anyone in my attempt to cut
> and paste!
>
> The reason I asked was; I am trying a pilot exercise for those who must
> travel for many hours to see us - I am booking them for 3 hours which
> means they get 60 mins of fitting time, the chance to walk for as long as
> they need, have any final adjustment and leave. While they are walking I
> am fitting others. Interestingly enough, to date, I haven't had to make
> any adjustment appointments on these clients and I think it has been just
> as time efficient.
>
> Best regards,
>
> Heather Prior C.O. (NZ), C.O. (c)
>
>
>
> Non-articulating 15 minutes
> articulating 30 minutes
>
> We allocate one hour for both articulated and solid ankle for fitting. We
> also allocate an hour if they are bilateral or unilateral.
>
> It really depends on your casting skills and modification skills!!
> In the beginning it took a lot of trips back and forth to the grinder
> and heat gun to get the fitting right. Now I can spend about 20-30
> minutes with the patient, making sure they can walk in it, don and doff
> it, and learn to care for it. Then there are some minor adjustments
> occasionally so I always schedule at least 30 minutes.
>
> I generally allocate 1/2 hour. This gives time for adjustments, answering
>
> questions, giving patient instructions, and charting the visit.
>
> we allocate 30mins to fit , adjust if necessary - including removing
> insoles from shoes (most times glued) to allow extra depth if
> required..... We then do a reasonably quick gait analysis - as we video
> all, we are able to do comparitive assessments - necessary when dealing
> with clients over a long period and mostly with degenerative conditions,
> articulated afos...usually the same time.....
>
> But as well we review our clients , as working in a team, they are seen
> regularly by Physios and O/Ts who provide feedback and most clients attend
> once a fortnight for either hydro or training at our facility. They are
> also provided with pages of written information and instructions on things
> to watch out for, maintenance and cleaning.
>
> Sometimes, conditions such as extreme type 2 or 3 charcot marie tooth
> require further time and up to an amount of at least one and a half hours,
> especially if weight bearing excessively on the lateral side as most do.It
> requires gel inserts moulding in between layers in the splints and they
> can be difficult to remove and distribute pressure evenly.
>
> CVA's and straightforward hemiplegias probably require less reviewing, and
> less allocation of time but I guess its up to the facility as constant
> reviews for these conditions would not provide much change over a period
> of time and perhaps waste resources and funds.
>
> Generally an hour. This includes all associated paperwork, dictation,
> and cleanup. I generally allow 30-45 minutes for fitting a standard AFO,
> jointed or
> unjointed
>
> I typically allocate 1/2 hour for a single afo and 3/4 hr. for a bilateral
> set. However, this is for my typical clients who are pretty
> straightforward and who I anticipate will do well and don't have any
> complicating factors such Varus or Valgus tone, or bony prominences which
> may require expected modifications. I think I would allocate an
> additional 15 minutes for adjusting the motion controls during a gait
> evaluation and training session for articulated AFOs. This will iinclude
> instructing the patient on donning/doffing and care and maintenance as
> well as reviewing our warranty and service policy.
> approx. half hour.
>
> My formula is an articulated vs a posterior leaf AFO is at least twice the
> time for the articulated and can go up to three times to time.
>
> I allow a minimum of 30 minutes for a posterior leaf to do all the patient
> training required. Thus would schedule approximately 1 hour for the
> articulated AFO.
> I allow about 1/2 hour for articulated and one hour for non articulated I
> also allow one hour for most of my CMT and charot patients. The extra time
> is not so much for the AFO as it is to obtain the proper shoe mechanics
> (i.e. rocker, lift, wedges and or postings).
> Hard to answer your question without a few qualifications. If it is an
> adult vs a child. If the design is more simple or complex(I am thinking of
> dorsum coverage or not - tone reducing foot plate design, etc...)
> Cooperative patient or not. To give an average answer, we would allocate
> between 30 to 60 minutes for this type of an appointment. The 30 would be
> for unilateral and more simple design fittings, the 60 would be for
> bilateral and more complex(pediatric) types of patients.
>
>
Citation
Prior, Heather, “FW: Responses to the Time Frames for fitting AFO's - both articul ated and non,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/222910.
