TamarackFlexureJoint

IndicationsforUseGuide
AclinicalreferenceforCustomAFOFabrication

TamarackHabilitationTechnologiesInc.,August2013

TamarackFlexureJointIndicationsforUseGuide

TableofContents
Acronyms and Terminology used:
IFU: Instruction for Use
AFO: Ankle Foot Orthosis
ML: MedioLateral
Plantarflexion the motion of the foot toward distal (forefoot down)
Dorsiflexion the motion of the foot toward proximal (forefoot up)
Plantarflexion stop: Device disallowing partial or full plantarflexion
Dorsiflexion stop: Device disallowing partial or full dorsiflexion
Durometer: A unit of measure to describe the level of assist or resistance
offered by a specific material hardness. Application of various durometers
In the Flexure Joint allows for a wide range of assistive and resistive
response to gait forces.

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Table of Contents
Tamarack Flexure Joint Product Line Overview
AFO w. Free Motion Joints, free plantarflexion and dorsiflexion
AFO w. Free Motion Joints and plantarflexion stop
AFO w. Dorsiflexion Assist Joints and plantarflexion stop
AFO with Variable Assist Joints and hyperextension control strap
PTTD/Stirrup AFO with various joint options
AFO custom composite with Dorsiflexion Assist Joints
AFO Floor Reaction Orthosis type with Free Motion Flexure Joints
AFO with custom fabricated plantarflexion and dorsiflexion stops
Caps for external mounting and /or retrofitting of joints
Acknowledgements
Disclaimer

TamarackFlexureJoint
ProductLineOverview
Free Motion (Model 740)
Standard Tamarack Flexure Joint in 3 sizes, and 2 colors.
All Tamarack Flexure Joints are tested for tensile flexural
durability in cyclic shock application for > 3 Million cycles.

Dorsiflexion Assist (Model 742)

Forefoot lift; in 3 sizes, 2 colors and 3 durometers.
Allows for a wide range of assistive/resistive responses
to gait forces. Choose from light (75Shore A),
medium (85Shore A) or, strong (95Shore A).

Variable Assist (Model 743)

Adjustable forefoot lift, available in 2 sizes.
The Variable Assist consists of a Dorsiflexion Assist type joint
and an adjustment gear drive. It allows for finetuning of
assistive/resistive force by angular pretensioning.

TamarackFlexureJointCaps(Model741CAP)
Alternativeprefabjointcavityin3sizesand2colors.
Designedforexternalmountingatinitialfabricationorretrofit
devicearticulationsforboththermoplasticandthermosetAFOs.

TamarackFlexureJointisaregisteredtrademarkof
TamarackHabilitationTechnologies.ManufacturedintheU.S.A.

TamarackFlexureJointIndicationsforUseGuide

FreeMotionAFO
JointSelection:FreeMotion(Model740)

AFODesign:
Thermoplastic/fiber/hybriddesigns.
FreeMotion(Model740)withfull
dorsiflexionandplantarflexion.
Varyingfootplatelengths.
Allcomponentsarewaterproof.
Functionalconsiderations:
Allowingfullplantarflexion
anddorsiflexion.
Frontalplane talar and sub
talar jointalignmentcontrol.
ClinicalIndications:
Posteriortibial tendondysfunction
Frontalplaneinstabilitiesofthe
subtalar and/ortalar joint.

Options:
Proximalclosuresarerequired
(hook&loopstrapsorsimilar).

ClinicalContraindications:
Weakquadriceps
Significantsagittalplaneankle
weakness/instability
Highimpactsports

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

TamarackFlexureJointIndicationsforUseGuide

Plantarflexion StopAFO
JointSelection:FreeMotion(Model740)
AFODesign:
Thermoplastic/fiber/hybriddesigns.
Joint:FreeMotion(Model740)
Plantarflexion stopatdesiredangle.
Varyingfootplatelengths.
Allcomponentsarewaterproof.
Functionalconsiderations:
Preventsunwantedplantarflexion
whilepermittingfreedorsiflexion
ProvidesMLstabilization,talar and
subtalar jointstabilization.

Options:
Proximalclosuresarerequired
(hook&loopstrapsorsimilar).
Instepstrapmayberequired
MotionControl:Plantarflexion
stopatdesiredangle tobe
modifiedbycarefulgrinding.

ClinicalIndications:
Weakdorsiflexors /dropfoot
Tightplantarflexors
Cerebralpalsy
CVA
Peroneal nerveparalysis
Kneehyperextension
Frontalplaneinstabilitiesofthe
subtalar and/ortalar joint.
ClinicalContraindications:
Weakquadriceps
Kneeflexioncontractures
Highimpactsports

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

TamarackFlexureJointIndicationsforUseGuide

DorsiflexionAssistAFO
JointSelection:DorsiflexionAssist(Model742)

AFOdesign:
Thermoplastic/fiber/hybriddesigns.
DorsiflexionAssist(Model742)
Varyingfootplatelengths.
Allcomponentsarewaterproof.
Functionalconsiderations:
Providingdorsiflexionassist
withorwithoutplantarflexion stop.
W/Oplantarflexion stop:facilitates
morenaturalfirstrocker
Providesasignificantdorsiflexion
moment.
Supportofligamentinstabilities.
Options:
Jointdurometers shouldbe
selected/exchangedtoprovidere
quired resistance/assistance.
Threedurometer choicesareavail
ableforthispurpose.
Optionalmotioncontrol:Plantarflexion
stopatdesiredangle tobemodified
bycarefulgrinding.
Proximalclosuresarerequired
(hook&loopstrapsorsimilar).

ClinicalIndications:
CP,CVA,weakdorsiflexors
Frontalplaneinstabilitiesofthe
subtalar and/ortalar joint.
Peroneal Palsy
ClinicalContraindications:
WeakQuadriceps
Spasticplantarflexors
Kneeflexioncontracture
Highimpactsports

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

TamarackFlexureJointIndicationsforUseGuide

VariableAssistAFO
JointSelection:VariableAssist(Model743)

AFOdesign:
Thermoplastic/fiber/hybriddesigns.
VariableAssist(Model743)
Varyingfootplatelengths.
Allcomponentsarewaterproof.Metal
partsarestainlesssteelandbronze.
Functionalconsiderations:
Liftsfoottopreventfootdrop.
Assistiveforceforforefootliftis
continuouslyadjustable
HyperDorsiflexionrestraintstrap

Options:
Jointiscontinuouslyadjustabletoin
crease/decreaseassistiveforce
Proximalclosuresarerequired
(hook&loopstrapsorsimilar).
Withorwithoutdorsiflexionrestraint
strap
Model743maybepairedwith
740or742.

ClinicalIndications:
CP,CVA,weakdorsiflexors
MildSCI
Peroneusparalysis
Pathomechanics ofALS,MD,MS
Frontalplanesubtalar andtalar joint
aswellasligamentinstabilities.
ClinicalContraindications:
Weakquadriceps
Uncontrolledfluctuatingedema.
Highimpactsports

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

TamarackFlexureJointIndicationsforUseGuide

PTTD/StirrupStyle AFO
Withcustomfootplate JointSelection:Variable

AFODesign:
FreeMotion(Model740)withoptional
Model741TamarackFlexureJointCaps
Or:w.DorsiflexionAssist FlexureJoints
Or:w.TamarackFlexureJointCaps
Compositeorhybriddesigns.
Fullrangeofdorsi/plantarflexion.
Allcomponentsarewaterproof.
Functionalconsiderations:
ProvidesmildMLstabilization
Permitsfreedorsi/plantarflexion.
Moderatetorsioncontrol.
Footplateshouldstabilizesubtalar
alignment.
ClinicalIndications:
Posteriortibialtendondysfunction
Mildormoderatefrontalplane
instabilities oftalar/subtalar joints.
Options:
Dependingonrequiredresistance/
assistance,jointsmaybe
selected/exchanged
forvariousdurometers.
TamarackFlexureJointCaps

ClinicalContraindications:
Weakquadriceps
Kneeflexioncontractures
Spasticplantarflexors
Highimpactsports

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

TamarackFlexureJointIndicationsforUseGuide

DorsiflexionAssist
CarbonFiberAFO
JointSelection:DorsiflexionAssist(Model742)
AFODesign:
FreeMotion(Model740)withoptional
Model741TamarackFlexureJointCaps
Compositedesign.
Assisteddorsiflexion
Resistedplantarflexion.
Allcomponentsarewaterproof
Functionalconsiderations:
Providesdorsiflexionassistwith
resistedplantarflexion.
Heavyduty/lightweightdesign.
Openframedesign(improved
aircirculation&heatdissipation).

Options:
Dependingonrequiredresistance/
assistancejointsmaybe
selected/exchangedfor
variousdurometers.
TamarackFlexureJointCaps

ClinicalIndications:
Weakdorsiflexors
Frontalplanesubtalarandtalar
jointandligamentinstabilities.
Needforhighstrength,low
profile,lightweightdesign.
ClinicalContraindications:
Weakquadriceps
Kneeflexioncontractures

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

TamarackFlexureJointIndicationsforUseGuide

FloorReactionAFO
JointSelection:FreeMotion(Model740)

AFODesign:
FreeMotion(Model740)withoptional
Model741TamarackFlexureJointCaps
GroundReactionForceAFO
ReinforcedcarbonfiberAFOwith
posteriorentry.
Dorsiflexionstopbuiltin
Allcomponentsarewaterproof
Functionalconsiderations:
Heavyduty lightweightdesign.
Openframedesign(airexchange).
Controlofkneejointinstabilities
viarigid,longforefootleverarm.
Jointpermitsplantarflexion
Normalizesgaitcyclefromheel
striketomidstance.
ClinicalIndications:
Mildquadricepsweaknessasis
typicalofambulatorypostpolio
Options:
Proximalclosuresarerequired
(hook&loopstrapsorsimilar).
TamarackFlexureJointCaps

ClinicalContraindications:
Kneeflexioncontracture
Completequadricepsparalysis
Uncontrolledfluctuatingedema.

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

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TamarackFlexureJointIndicationsforUseGuide

CustomFab.JointStops
JointSelection:FreeMotionorDorsiflexionAssist

AFODesign:
A.Reinforcedshellwithplantar
flexionstopinposteriortrimline.
B.Posteriorstrapasdorsiflexion
control/stop.

A.

B.

Options:
Thedorsiflexioncontrol
strapIsfrequently
usedtoavoidoverstretch
oftheAchillestendon.
TamarackFlexureJointCaps

Functionalconsiderations:
Useofstopstolimitmotion:
A.Theplantarflexion stopprovides
footdropcontrol.
A.Thestopcanbeadjusted(by
grinding)tofinetunejointangle
B.Thedorsiflexioncontrolstrap
providessagittalstabilizationof
theknee(assistingkneeextension).
ClinicalIndications:
A.Dropfoot
A.CVAandflaccidparalysis
B.Moderateweaknessofthe
quadricepsmuscleandrelated
kneeinstabilities.
B.Whenadjustablerangeof
dorsiflexionisrequired.

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TamarackFlexureJointIndicationsforUseGuide

TamarackFlexureJointCaps
JointSelection:FreeMotionorDorsiflexionAssist
AFOdesign:
A. Rigid(nonarticulated)AFOforthe
earlyphasetreatmentprotocol.
ExternalFlexureJointCapscanbe
usedtotransformanonarticulated
(solid)AFOintoanarticulateddesign.
(RequiresTamarackFlexureJoints)
B. FacilitatinginstallationofFlexure
Jointsincompositematerials.

A.

A.Functionalconsideration:
Easyconversionofanonarticulated
AFOintoanarticulatedone.
B.Functionalconsiderations:
CapsforCompositeAFOs
Eliminatesnecessityfordummy
Facilitatesmanufacturingprocesses

B.
Capsasajoint
cavityoptionfor:
Carbonfiberor
PrePregAFO

ClinicalIndications:
Whentherehabilitationprocess
allowsfor/requiresincreasedROM.
Articulatedversionwhenuseofdummy
and/orvacuumformingisdifficult.
ClinicalContraindications:
Weakquadriceps
Uncontrolledfluctuatingedema
Highimpactsports

Drawingsdonotsuggestaparticularlengthoffootplate.Footplatelengthand
shoefeatureshaveasignificanteffectongaitsafetyandgaitefficiency.

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TamarackFlexureJointIndicationsforUseGuide

Acknowledgements

TheTamarackFlexureJointIndicationsforUseGuidewasdesigned
byWielandKaphingst,CPOofTamarackHabilitationTechnologies
andeditedbythefollowingclinicalexperts:
GaryBedard,CO
DanielBrams,CPO
CharlesKuffel,CPO
NickLeCursi,CO
PeterPoetsma,CPO
Wilfried Raab,CPO
PhilStevens,CPO
HeinzTrebbin,CPO
2013TamarackHabilitationTechnologies.AllRightsReserved

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TamarackFlexureJointIndicationsforUseGuide

Disclaimer

TheTamarackFlexureJointIndicationsforUseGuide
wasdesignedbyTamarackHabilitationTechnologiesInc.
andwasclinicallyeditedbyexternalprofessionalpeers.
TheGuidecannotbeconsideredthesoledeterminantofthe
optimalsolutionforanyspecificindividualwithadisability,
pathologyortraumarelatedorthoticproblem.Individualcases
mayvarygreatlyfromanynorm.Departuresfromcomponentry
andotherdesignfeaturessuggestedinthisdocument
maythereforebeappropriateinsuchcases.

1670 94th LaneNE,Minneapolis,MN55449USA

Tel:++7637950057TollFree:18667950057
Visitourwebsite:www.tamarackhti.com

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