Responses: Exoskeletal Feet Recommendations & Exo Finishing - Part II
Lisa Urso, CPO
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Title:
Responses: Exoskeletal Feet Recommendations & Exo Finishing - Part II
Creator:
Lisa Urso, CPO
Text:
1) Based on your experience, what is the most durable covering for an
endoskeletal prosthesis?
Try the cover from PRS (Ronnie Graves) and use scuba suit slipper on the foot.
2) Which exoskeletal prosthetic foot would you use that has some energy
return and can (at least somewhat) accommodate to uneven terrain?
The Otto Bock 1D10. There is a study that shows SACH feet are energy storing.
I haven't used the College Park True Step foot for a while but the end/exo
ankle block looks like a good idea.
I have used a low profile variflex with the exo lamination kit and I really
like it. You have to do two laminations to get the exo cover to fill out
right at the foot shell - or you can use foam to fill in the void left by the
recommended lay-up shape (you can see this on-line at ossur's web site).
The Greissinger has been an excellent adaptive foot. The plus gives some
small return, but not much. The compliance seems to make it a likable foot. I
don't know if it is available with the ankle lamination block. This same
compliance is noticed in the College Park TruStep, but with better return and greater
flexibility. College Park has a lamination ankle block, but I am not sure if
that is applicable to the TruStep or their Venture. I would encourage the
College Park Venture, due to the ladder climbing and it's stronger/more stable toe
design. You could do a 4C exoskeletal with a firm polyurethane foam (endofoam)
style shell and just replace them frequently. It has to be easier on his
slacks. Otherwise, standard exo (undersized) with a bocklite/colored pelite A20
firm 5mm wrap for greater durability with reduced wear on slacks. Guys that
really work in a leg can tend to be nostalgic for the exos. Hope this helps.
Two issues, I have in the past to make the cover more durable on an AK endo
made a discontinuous cover and wrap the upper section with 1 plastizote then
use a plastizote lower preshaped cover and this has worked on many in Florida
who get is soaking wet in the water I just have them rinse it out after salt
water.
The Seattle lite foot work well to after about 2-21/2 years it about time to
change the foot depending of the activity.
I like the college park foot. It can be used as a exo, you will have to
disassemble and attach the ankle block and reassemble. Increase you bumpers at
least one over your recommend rating from the manufacture. This will eliminate
fatigue and failure.
I recently used the Flex Walk foot with exoskeletal design. Worked well.
The most durable covering for an endo is the sprayed on skin, brand name 2nd
Skin, I believe Bock also has a spray skin. Contact Grace prosthetics in
Florida or Ronnie Graves, they both did custom spray skins.
For the exo, I have used the College Park foot with the SACH bold ankle, need
to check on the weight limits. This has dynamic responce and
inversion/eversion with planter/dorsi flexion. Can also use the Seattle type feet, but not
as much action.
If I am of any help to you I would suggest that for a exo-skeletal prosthesis
foot piece we think of for more durable is Cosmetic foot-Jaipur-foot, and
regarding outer shell we
either use a laminated shell or PVC Pipe- outer shell.
I'm not certain they still make it, but I've always had good luck with
Ossur's Flex-Walk (without the pyramid attachment). This may be used with a foot
bolt for attachment to an exoskeletal ankle.
I gave up doing exo's on the last guy who wanted one. I likely won't do
another. What we did on the last one is we made an endoskeletal prosthesis with a
rigid hollow cover. The way we did it was to cover pylon with tape/saran
wrap, foam with rigid foam, shape as you would for an exo, put a pva bag on,
laminate, pull it all apart and dig out the foam and put back together. Worked
well and patient was pleased. The reasons I don't like to do an exo are 1. very
labor intensive, and the reimbursement stinks (you essentially build an endo
leg then the exo when you're done aligning it.) Really costs way more than an
endo to build. 2. almost invariably, I find that we wanted to change the
alignment somehow. Band saw and relaminate is only way with exo. Not practical.
End Responses
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endoskeletal prosthesis?
Try the cover from PRS (Ronnie Graves) and use scuba suit slipper on the foot.
2) Which exoskeletal prosthetic foot would you use that has some energy
return and can (at least somewhat) accommodate to uneven terrain?
The Otto Bock 1D10. There is a study that shows SACH feet are energy storing.
I haven't used the College Park True Step foot for a while but the end/exo
ankle block looks like a good idea.
I have used a low profile variflex with the exo lamination kit and I really
like it. You have to do two laminations to get the exo cover to fill out
right at the foot shell - or you can use foam to fill in the void left by the
recommended lay-up shape (you can see this on-line at ossur's web site).
The Greissinger has been an excellent adaptive foot. The plus gives some
small return, but not much. The compliance seems to make it a likable foot. I
don't know if it is available with the ankle lamination block. This same
compliance is noticed in the College Park TruStep, but with better return and greater
flexibility. College Park has a lamination ankle block, but I am not sure if
that is applicable to the TruStep or their Venture. I would encourage the
College Park Venture, due to the ladder climbing and it's stronger/more stable toe
design. You could do a 4C exoskeletal with a firm polyurethane foam (endofoam)
style shell and just replace them frequently. It has to be easier on his
slacks. Otherwise, standard exo (undersized) with a bocklite/colored pelite A20
firm 5mm wrap for greater durability with reduced wear on slacks. Guys that
really work in a leg can tend to be nostalgic for the exos. Hope this helps.
Two issues, I have in the past to make the cover more durable on an AK endo
made a discontinuous cover and wrap the upper section with 1 plastizote then
use a plastizote lower preshaped cover and this has worked on many in Florida
who get is soaking wet in the water I just have them rinse it out after salt
water.
The Seattle lite foot work well to after about 2-21/2 years it about time to
change the foot depending of the activity.
I like the college park foot. It can be used as a exo, you will have to
disassemble and attach the ankle block and reassemble. Increase you bumpers at
least one over your recommend rating from the manufacture. This will eliminate
fatigue and failure.
I recently used the Flex Walk foot with exoskeletal design. Worked well.
The most durable covering for an endo is the sprayed on skin, brand name 2nd
Skin, I believe Bock also has a spray skin. Contact Grace prosthetics in
Florida or Ronnie Graves, they both did custom spray skins.
For the exo, I have used the College Park foot with the SACH bold ankle, need
to check on the weight limits. This has dynamic responce and
inversion/eversion with planter/dorsi flexion. Can also use the Seattle type feet, but not
as much action.
If I am of any help to you I would suggest that for a exo-skeletal prosthesis
foot piece we think of for more durable is Cosmetic foot-Jaipur-foot, and
regarding outer shell we
either use a laminated shell or PVC Pipe- outer shell.
I'm not certain they still make it, but I've always had good luck with
Ossur's Flex-Walk (without the pyramid attachment). This may be used with a foot
bolt for attachment to an exoskeletal ankle.
I gave up doing exo's on the last guy who wanted one. I likely won't do
another. What we did on the last one is we made an endoskeletal prosthesis with a
rigid hollow cover. The way we did it was to cover pylon with tape/saran
wrap, foam with rigid foam, shape as you would for an exo, put a pva bag on,
laminate, pull it all apart and dig out the foam and put back together. Worked
well and patient was pleased. The reasons I don't like to do an exo are 1. very
labor intensive, and the reimbursement stinks (you essentially build an endo
leg then the exo when you're done aligning it.) Really costs way more than an
endo to build. 2. almost invariably, I find that we wanted to change the
alignment somehow. Band saw and relaminate is only way with exo. Not practical.
End Responses
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Lisa Urso, CPO, “Responses: Exoskeletal Feet Recommendations & Exo Finishing - Part II,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/224402.
