Infinite Technologies Orthotics and Prosthetics

The Direct Socket: The Science Behind This Innovative New Technology, How It Compares To Traditional Prosthetic Casting, And If It Is Right For You

Tue, 07 Jun 2022 16:56:58 GMT

Infinite Technologies Orthotics and Prosthetics has geographically partnered with Össur, the inventors of the Direct Socket, as the premier facility in the Capital Region to offer this exciting new prosthetic socket technology. With the Direct Socket system, a definitive prosthetic socket can be made right on an amputee’s leg in only a few hours instead of over several weeks. This blog will outline the benefits of direct socket vs traditional socket fabrication methods, science behind the direct socket, who is a good candidate for the direct socket, and how patients are doing in the direct socket.

Benefits of direct socket vs traditional socket fabrication methods

The traditional method of making prosthetic sockets typically consists of several steps spanning over an average of 16 weeks from initial evaluation to final delivery1. First, a cast or scan is taken of an amputee’s leg. Then, plaster is poured into a mold and modifications to the mold are made by a prosthetist. After the mold is ready, a plastic “check socket” is made then worn by the patient for several weeks. Issues with the fit of the check socket are then reviewed, and then a new check socket is made for and worn by an amputee for several more weeks. After an average of 2-3 check sockets, a definitive socket made of carbon fiber and resin is laminated on a mold of the inside of the patient’s most recent check socket. With the Direct Socket system, a definitive socket is laminated directly on a patient’s leg in only 4 hours, with no molds, no check sockets, and less visits into the office.

There are several advantages with being able to craft a definitive socket in one appointment. These include:

Less trips and time spent in the office – Traditional socket fabrication takes an average of about 4 one-hour visits over a 16-week time span, with additional follow up appointments necessary1. The direct socket requires on average 2 appointments (measure for liners and then fabrication), with an average of only 1/3 of patients needing to follow up following delivery1.
Ability to fabricate in clinical or rehab settings – Due to the direct socket being made directly on a patient’s limb in one appointment, a prosthetist is more portable than in the past.
Optimized suspension and limb control – Traditional socket fabrication techniques require a clinician to perform modifications to a mold of an amputee’s leg. This leaves room for possible error. The direct socket is formed on a patient’s leg in real time, resulting in better socket fit, and reducing the chances of a socket not fitting correctly.
Overall cost of rehabilitation and time from amputation to definitive leg is drastically reduced – It is estimated that a prosthesis accounts for only about 10% of total rehabilitation costs following amputation1. The bulk of rehab expenses come from the amount of time spent in rehabilitation. Reducing the amount of time between amputation and leg delivery can reduce rehabilitation costs by upwards of 25%, and research shows that shorter time to prosthetic fitting led to improved functional outcomes 6 months following amputation1.

Benefits of direct socket vs traditional socket fabrication methods

The technology for the direct socket originated in Scandinavia in the 1990s, but has only recently undergone rigorous testing and approval in the United States1. The direct socket laminates a final socket directly on a patient’s leg instead of on a mold.

First, a special casting liner is worn by the amputee, as well as a silicone protective sheath.

The materials for the socket are then applied to the limb, and a resin is added to harden the socket.

After the socket has hardened, a prosthetist draws on trimlines, and you get to walk out with a new definitive socket the same day.

Who is a good candidate for the direct socket?

Transtibial and transfemoral amputees – The direct socket is available for transtibial, or below knee, and transfemoral, or above knee, amputees. If you have a bulbous end to your residual limb, or are a knee disarticulation patient, talk to your prosthetist and see if a direct socket could be right for you.
All K Levels – Research has proven that amputees of all K levels, spanning from K1-K4 can benefit from the direct socket1,2.
New and experienced prosthesis users – Research demonstrates the direct socket benefits new1 and experienced prosthesis users2 alike, with both groups significantly improving their Timed-Up-and-Go (TUG) Test and AMPPRO (the test which determines K level) scores when using a direct socket interface instead of a traditionally made socket, regardless of suspension style2. In the same study, even amputees who did not necessarily need a new socket due to improper fit or function scored better on their clinical outcome tests and overall comfort scores when wearing their direct socket at their 6 month follow up appointments2.

Who is a good candidate for the direct socket?

Research shows promising data on how patients are doing in the direct socket compared to traditional sockets.

Recent research demonstrates that amputees reported the direct socket significantly improved their stability, suspension, comfort, and they preferred the socket appearance compared to a socket made with traditional methods2. Not only are patients saying their direct sockets fit and feel better, but they are performing better on outcome measure tests in the direct socket. Direct socket users improved their Timed-Up-and-Go (TUG) Test by an average of 2-3 seconds compared to their baseline scores2. Multiple studies have shown that AMPRO scores, the test which determines K Level, have improved by an average of 2 points when using the direct socket system over a traditionally-made socket1-3.

If you have any questions about the direct socket system, please feel free to reach out to Infinite Technologies Orthotics and Prosthetics via email Contactus@infinitetech.org. Talk with your prosthetist and see if the direct socket is a good option for you, or call (703) 807-5899 to schedule your free consultation today!

References:

Marable W.R, et al. Transfemoral socket fabrication method using direct casting: outcomes regarding patient satisfaction with device and services. Canadian Prosthetics and Orthotics Journal. 2020; Volume 3, Issue 2, No. 6. https://doi.org/10.33137/cpoj.v3i2.34672
Walker J, et al. Clinical outcome of transfemoral direct socket interface (part 2). Canadian Prosthetics and Orthotics Journal. 2021; Volume 4, Issue 1, No.6. https://doi.org/10.33137/cpoj.36065
Ennion, L et al. The use of a direct manufacturing prosthetic socket system in a rural community in South Africa: A pilot study and lessons for future research. Prosthetics and Orthotics International. 2017; Volume 4, Issue 5, pp 455-462. Https://doi.org/10.1177/03093646166839982

SDO Vs SPIO

Mon, 21 Feb 2022 16:27:17 GMT

The sensory dynamic orthotics (SDO) are a custom made to measure product, designed to provide compression to increase sensory and proprioceptive feedback as well as support to the musculoskeletal system [1]. The compressive garment comes in a wide range of designs and style options, from a glove to a full body suit.

SPIO which stands for stabilizing pressure input orthosis by SPIO, is a compressive garment that is useful for providing sensory input to improve trunk tone, function, and posture [2]. The garments can be custom to measure or chosen from a range of off the shelf sizes. There are different types of compressive garment, including a TLSO, upper body long sleeve and short sleeve, lower body ankle and knee length orthoses.

Indications for the use of the SDO in the management and reduction of abnormal tone in neurological conditions include cerebral palsy, TBI, spinal injury, cerebellar ataxia, spina bifida, CVA/stroke, multiple sclerosis (MS), and focal dystonia [1]. The use of SPIO is ideal for people with hypotonia, cerebral palsy, down syndrome, muscular atrophy, athetosis, autism, spastic diplegia and sensory processing disorders [2].

Figure 1 - Pro-Tech garment guide [1]

Figure 2- SPIO classic TLSO and lower body orthosis [2]

Clinical observations and studies have shown that people with abnormal muscle tone can achieve more control over movement when suitable feedback is provided [1]. These devices aim to provide support and stability to the Musculo-skeletal system, as well as increase sensory and proprioceptive feedback. These garments are best used in conjunction with physical therapy for the patient to learn proper control of their body while using the compressive garment [1].

References:

[1] Protech SDO brochure – Pro-Tech International. (n.d.). Retrieved February 24, 2022, from http://protech-intl.com/assets/pdf/ProTech_SDO_Brochure.pdf

[2] SPIO. (n.d.). Retrieved February 24, 2022, from https://www.spioworks.com/

Osseointegration

Sun, 31 Oct 2021 16:22:07 GMT

What is Osseointegration?

Figure 1: Diagram demonstrating osseointegration implant within bone and exiting limb.

Osseointegration is a surgery that inserts a metal implant into a bone. Osseointegration was first introduced in the 1950s and today is commonplace in dental implants, hip and knee replacements, and newly with prosthetic limbs. With amputees, the implant is fixed within the bone and extends out of the end of the patient’s limb. This is demonstrated in Figure 1 to the right. The surgical process varies depending on which type of implant is used.

Prosthetic components can be attached to the end of the implant that is outside at the end of the limb. This is demonstrated in Figure 2, left below. The components are attached to the implant instead of a socket. Osseointegration eliminates the need and use of prosthetic sockets.

What Are the Benefits of Osseointegration?

Osseointegration has been demonstrated to result in dramatic improvements for patients. Since the prosthetic componentry is connected directly through the patient’s bone, the patient experiences osseoperception. Osseoperception is the ability to perceive where the limb is in space. This is possible due to the nerves in the surrounding tissues providing feedback information on where the bone, and connected prosthesis, are. With an osseointegrated prosthesis, the prosthetic components move with the bone, instead of with slight delay present in even the best fitting sockets. Patients both feel better and perform better with osseointegration. Patients report they feel more comfortable and confident. They feel more comfortable sitting with their prosthesis on and can take their prosthesis on and off much more quickly. Performance outcomes improve in that patients have fewer deviations from a natural gait. Patients walk more quickly and are expending less energy to do so, measured by oxygen requirement. Due to all these reasons, there is also an increase in the amount of time throughout the day that a patient wears their prosthesis.

Figure 2: Diagram demonstrating prosthetic components attached to an osseointegration implant.

Am I a Candidate for Osseointegration?

References:

https://journals.lww.com/jbjsreviews/Fulltext/2020/03000/Osseointegration_for_Amputees__Current_Implants,.9.aspx

https://integrum.se/what-we-do/our-products-future-solutions/opra-implant-system/transfemoral-above-knee-amputations/

https://www.sciencedirect.com/topics/engineering/osseointegration#:~:text=Osseointegration

How Will You Know When The Time Comes To Replace Your Device?

Thu, 12 Nov 2020 16:06:54 GMT

First, check for signs of physical wear. Signs of damage such as cracks, warping and compressed padding are the first indicators there may be an issue. Check the arch of the orthotic. When the arch is compressed it should retain a sturdy shape. Arches that collapse too easily do not provide the support you need.

Pain is a sign. If the device is causing pain it may be time for a replacement. Check your shoes too! If your shoes are showing odd signs of wear on the tread, it’s a sign the device may not be properly aligned. Another sign is motion in the orthotic that was not there before. If your orthotic wobbles you may fall and cause further damage or injury. Remember never to try to fix your device with tape or glue. Home modifications will not suffice. They could cause new or further damage and hurt your progress in rehabilitation.

While most of these signs are important to look for in both prosthetic and orthotic devices, there are a few extra to look for in your prosthesis.

Overuse syndrome is well documented in amputees. This is where additional and atypical amounts of time and pressure are borne down through the intact limb. Over time, this will cause early degeneration of the lower back, hip, knee and ankle resulting in discomfort and other complications.

General fatigue and reduced mobility may be due to your prosthesis not fitting properly. Socket fitting requires a skilled clinician with a plan tailored to everyone’s needs. If it is possible to increase or decrease the size of the socket, the entire prosthesis will need to be replaced.
If your weight is not within the range of safety of the components or the components themselves are no longer working to the proper specifications, you may need to replace your device. If your activity level is not compatible with the device, changes may need to be made. The best and easiest way to determine if you require a replacement is to contact your prosthetist or orthotist at our office for assistance.

If you encounter any of these problems, please come in and see our practitioners. Whether you need a device replaced, modified or repaired, we at Infinite Technologies are happy to help with all your needs.

Benefits Of A Resting AFO, Aka Stretch Brace

Sat, 03 Oct 2020 16:06:53 GMT

No matter what your activity level is, it is important to stretch your ankles and calves every single day. Whether you are an active person or someone who is required to be seated majority of the day, stretching consistently will allow an increase in flexibility, decrease pain, and reduce your risk of injury such as Achilles tendinitis.

Achilles tendinitis is an overuse injury of the Achilles tendon; the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. This tendon is used when you walk, run, jump or push up on your toes. There are many factors as to why and how you can become injured or may increase your risk of Achilles tendinitis. Your age, level of physical activity, certain medications taken, medical conditions such as high blood pressure, shoe selection, men are at a higher risk than females, and your physical condition such as a naturally flat arch in your foot, obesity, and/or tight calf muscles. Symptoms may be heel stiffness, swelling, or tenderness. Your doctor will evaluate and determine if you have Achilles tendinitis and guide you in the right direction for treatment such as physical therapy, medication for pain management and/or swelling, orthotic devices, and possibly surgery. While it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk by increasing your activity level gradually, properly warming up before strenuous activity, wearing the correct size shoe, stretching daily, and strengthening your calf muscles. Stretch splints are a great way to treat and/or prevent further injury.

Stretch braces are worn while resting and/or sleeping. Stretch Splints work by stretching the calf and plantar fascia (connective tissue) of the foot as you rest/sleep. This helps to minimize stress on the areas of the foot that are inflamed, irritated, or tight. Your doctor, physical therapist, or orthotist might recommend that you wear a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight and facilitates stretching. The amount of flexion and extension can be adjusted as needed.

There are many options on the market for stretch splints. Speaking with your doctor, therapist, or orthotist will guide you in the right direction for the perfect brace for you! For example, A popular splint offered has a rigid exterior shell, a soft padded lining for comfort and to prevent skin irritation, and adjustable straps to ensure immobilization. The straps are adjustable to increase or decrease the amount of flexion and extension. Over time, patients can increase the degree of stretch to reach their full potential.

An Infinite Technologies clinician will conduct a very detailed assessment to determine the proper orthosis for you. By request, we can coordinate a joint evaluation with your physician, therapist, or other healthcare professional. Walking evaluations, muscle strength and flexibility, and lifestyle goals are some categories that will be focused on at your evaluation. Your practitioner will continue to follow up and track your progress. Our office is more than happy to answer any questions you may have about this specific brace, other products, or our company.

Management of Adolescent Idiopathic Scoliosis

Thu, 13 Feb 2020 01:10:00 GMT

Adolescent Idiopathic Scoliosis is an abnormal curvature of the spine that appears in late childhood and into a patient’s teenage years. It is diagnosed through physical exam and x-rays. The spine develops a curvature, usually presenting as an “S” or “C” shape and can also have slightly twisted or rotated presentation. The curve can span the entire spine or just affect part of the spine. The term idiopathic means that we do not know the exact cause of the condition.

There are a few ways to manage scoliosis. This usually begins with observing the curve through x-ray and monitoring the degree of the curvature. Should the curve reach 25 degrees of magnitude a scoliosis brace may be recommended to help manage this. This type of orthosis is called a TLSO (thoracic lumbar sacral orthosis). At times, even with compliant brace treatment, surgery is the only way to correct a patient’s spine if the curve becomes severe enough.

Once prescribed by a pediatrician or an orthopedic specialist, a TLSO is generally worn until the patient reaches skeletal maturity. This often means a brace may be worn for several years. TLSO’s are worn on average anywhere from 18-23 hours a day. They are removed for bathing, sports and to take a break during the day for skin checks. There are also options for braces that are only worn at night if ordered by the doctor and appropriate for the patient’s curvature.

The role of the orthotist is to evaluate a patient in person but also assess their x-ray. Each patient’s curve will present different and the TLSO is designed to address the curve through biomechanical points of pressure. The brace is made of a rigid plastic with foam lining. The trimlines of this brace along with padding on the inside are placed such that they are providing corrective forces to the spine. The brace will hold the spine straight when the patient has the brace on, but it will not correct the patient’s spine and keep it straight. There are times when a few degrees of correction can be gained that remains when the brace is discontinued but overall the goal is to halt progression of the scoliosis while the patient is still growing.

Orthotists frequently follow-up with these patients to assess the fit of the brace to be sure it is still fitting appropriately based on growth. Patients also follow-up every 4-6 months with their prescribing physician to check on the curve and determine how much growth is left to get an idea of how much longer a patient will need to wear the brace.

With compliant wear and maintaining proper follow-up protocol chances of successful outcomes with orthotic management of Adolescent Idiopathic Scoliosis are typically very high. Patient’s are able to maintain their active lifestyles and be involved with sports, dancing and any activities of daily living that they enjoy!

Taking The Next Steps- Your Therapist And Orthotist/Prosthetist Working Towards One Common Goal

Mon, 13 Jan 2020 15:53:20 GMT

The world of Orthotics/Prosthetics and the world of Physical Therapy. Two worlds that at times have collided, but when collaborative they can have a profound impact on the outcome of a patient’s care. A team approach between the two fields, an acknowledgement of each field’s unique skillset and an open line of communication between the two parties leads to better patient outcomes. Therapists and orthotists/prosthetists make up a foundation that can support a patient’s rehabilitation pathway to reach their goals and maintain their activities of daily living.

The therapists usually lay the ground work by recommending that a patient be evaluated for an orthotic or prosthetic device. Therapists often will make this recommendation when the program they’ve created for the patient is working, but a deficit or hurdle is still present. They may suggest an orthotic or prosthetic device as an additional tool in their rehabilitative toolbox.

The role of the orthotist/prosthetist is to evaluate the patient and understand their diagnosis. The orthotist/prosthetist also needs to have knowledge of the patient’s goals, functional abilities, daily life routines and any obstacles that could hinder use of a device. Asking these important questions and understanding how they can affect outcomes will help to develop the proper design, fabrication, fitting and follow-up of the device. The orthotist/prosthetist will then deliver the device to the patient ensuring proper fit and function.

The orthotist/prosthetist is responsible for ensuring that the patient and/or caretakers understand why the device should be used and how to use it appropriately. They will give patients guidelines on proper skin care and maintenance procedures, explain the risks, benefits and potential malfunctions, and what to do if there is a problem. They give the patient the basics and ensure the device is properly functioning for the goals that have been set. The orthotist/prosthetist will often recommend the patient continue with physical therapy even once they have the device.

Physical therapy is often integral when learning how to properly use a new device. Through therapy, patients now learn better methods for donning/doffing the device, how to take proper steps and how to initiate biomechanically efficient movements. Therapists teach patients how to properly fire certain muscles in order to avoid compensatory motions that could lead to further injury. The orthotist/prosthetist is still involved with frequent follow-ups with the patient to ensure the device is fitting and functioning properly for the patient as they progress through their rehabilitation.

Therapists may suggest patients return to see their orthotist/prosthetist if the device needs any type of modification. This could be adjusting the device to avoid skin irritation or making modifications to improve the overall function of the device. The job of the orthotists/prosthetist is to evaluate if the device the patient is still appropriate as a patient progresses. If it isn’t, then it is their job to determine what changes need to be made or if it is necessary to provide a different device.

Orthotists/Prosthetists may also suggest more physical therapy if it has been a long time since a patient last participated in any type of therapy program. Factors like aging, deconditioning or possible progression of a condition can cause patients to start noticing difficulty with a device that was not previously present. At times there can be difficulty adjusting to a new device or the device is a different design from what they’ve previously been used to.

Collaboration and open communication between a patient’s therapist and their orthotist/prosthetist is a practice that needs to be maintained for better long term outcomes and patient satisfaction. Understanding this important relationship and team approach will continue to yield more chances for successful outcomes and achievement of long-term goals.

Pain in the neck: The need to knows of Cervical/Cervical-Thoracic Orthosis

Sat, 13 Jul 2019 00:11:00 GMT

Have you been in an accident and injured your cervical spine? Have you had corrective surgery in cervical or upper thoracic spine? Here is some information that will help you during your healing process and how to properly wear your doctor prescribed cervical collar or cervical-thoracic orthosis (CTO).

To begin you must understand the cervical spine. The cervical spine has seven vertebrae, it houses and protects the spinal cord, supports the head and its movement, and facilitates flow of blood to the brain. Knowing the key roles that your cervical spine serves, any injury to the neck or cervical spine should warrant an appointment with a physician right away for medical intervention as further damage can be done. Your physician will determine if surgery is required or if the injury will heal on its own. Often, even if surgery is required, a cervical orthosis may be worn after the surgery to stabilize the affected cervical area to allow the surgical site to heal. If surgery is not required, a cervical orthosis may be used to prevent further injury while the area heals on its own. If the injury involves the lower cervical vertebra or upper thoracic vertebra a cervical-thoracic orthosis (CTO) maybe prescribed. A CTO is designed to keep your cervical and upper thoracic spine from flexing and extending. The orthosis works to immobilize the head and upper body with an occipital section in the back and the chin piece in the front which is then anchored to the upper body with a vest for stabilization. The front and back sections are held together with two Velcro straps at your neck, two shoulder straps and two waist straps.
There are several different types and styles of cervical collars and CTOs. Below you find some helpful fitting tips, wearing and caring for your orthosis, and some common problems people have and how to mitigate it.

Soft Collar
Description: Soft collars are less restrictive than rigid collars, and therefore typically used with less severe injuries, where flexion, extension, and rotation should be limited but not necessarily prohibited. The collar is secured by a Velcro strap and is considered more comfortable and easier to take on and off when compared to more rigid devices.

Fitting tips: To properly apply your collar, look straight ahead and keep your chin parallel to the floor. Fit the collar snugly around your neck with the “dip” in the collar lined up against your chin and attach the Velcro at the back of your neck.
Wearing and Caring: Your referring physician determines the wearing schedule for the brace. Should the collar get soiled, it can be handwashed with mild soap and water and air dried.

Common Problems: Over-tightening the collar may lead to breathing and comfort issues. Ensure the fit is snug but not too tight. Skin breakdown may also occur with persistent wearing, so check the skin daily for any skin irritations.

Semi-Rigid/Rigid Collar
Description: The more rigid collars have a plastic frame and holds your head in a neutral position while preventing flexion, extension, and rotation. The brace will be adjusted to a tight fit to promote stability and should lie evenly around your neck. Typically, these braces come in two parts – a posterior and anterior part and are attached via two Velcro straps on either side.

Fitting tips: The cervical collar should be applied either lying down or with your head in a neutral position, and someone should stabilize your head and neck. Apply the back portion of the collar so it wraps around your neck and cups the back of the head. Apply the front section so it cups under the chin and rests on the upper chest. The front slides inside the back portion and Velcro straps are pulled as tight as tolerated to secure the brace in place. When fastening Velcro straps ensure they are pulled to equal length on either side, this will ensure the brace on straight.
Wearing and Caring: Your referring physician determines the wearing schedule for the brace. Should the collar get soiled, the pads can be removed, handwashed with mild soap and water, and air dried. Extra padding sets are available for purchase if you call our office. You need approval from your doctor to take the collar on and off while sitting up. Follow up with your practitioner if you are experiencing any difficulty with comfort or fit.
Common Problems: Over-tightening the collar may lead to breathing and comfort issues. Ensure the fit is snug but not too tight. Skin breakdown may also occur with persistent wearing, so check the skin daily for any skin irritations. Under-tightening may cause chin slipping issues, where the chin tucks down into the brace. If this occurs, check the tightness, most likely the brace was not fastened tight enough to hold the chin piece in place.

Cervical/Thoracic Orthosis (CTO)
Description: CTO’s are used to treat fractures in the cervical spine (neck) and the upper part of the thoracic spine (upper back). It maintains the head in a neutral position, reduces pain, prevents further injury and promotes healing. The brace will stabilize your cervical and thoracic regions and typically has a cervical collar component attached to a vest that anchors at your waist to prevent rotation. This brace is more restrictive than the cervical collar and provides more stability over a greater area. The CTO consists two pieces, a front and back. The front piece has a plastic mandibular support attached to a chest piece. The back piece has a plastic occipital support attached to a back portion of the vest piece. You will find that there are a couple of different styles of CTO braces, including some prefabricated styles such as Minerva and Aspen. For additional support, or for patients who don’t fit into prefabricated braces, custom CTO braces can also be made for the patient, this will provide a personal fit for that specific to a patient’s measurements.
Fitting tips: The CTO should be applied while lying down with your head in a neutral position. This enables gravity to draw the abdomen and unloads and relaxes the spine. While lying completely flat, log roll onto your side with someone stabilizing your head and neck. The front and back sections are marked respectfully, so apply the back piece so that the cervical extension follows the curve of the head. The bottom edge of the brace should be placed at the waist just above the hips. Make sure the brace is LOW enough on the patient and roll back into the brace. Apply the front half of the brace making sure the bottom edge is placed at the waist, lining up with the back portion. The chin section should be under the chin, cupping the mandible. Clip or Velcro the chin straps to the back headpiece. Clip or Velcro the waist straps and any shoulder straps. Please note the shoulder straps should not be tight on the patient. Fasten forehead strap (if provided).
Wearing and Caring: Wear the brace over a single layer of clothing, such as a T-shirt or undershirt. All other clothes should be worn on the outside of the brace. Be sure to check your skin each day for any red, sore or irritated spots. Your caregiver will need to help you with this. Call your doctor, nurse, or therapist if you see any spots on the skin from the brace that do not go away within 15-20 minutes.
Instructions on how to put on the brace…

1. Log roll onto your side keeping your head, neck, shoulders, and hips in a straight line. Do not bend or turn your neck to the side without the rest of your body turning as a whole.
2. Your caregiver should place the back piece of the collar on the back of your neck, so it is centered.
3. Place the back piece of the brace on the bed with the shoulder and trunk straps spread out behind you.
4. Log roll back onto the back piece of the brace, keeping your head, neck, shoulders, and hips in a straight line while holding the back piece of the cervical collar.
5. Your caregiver should hold the front of the collar and slide it up until it rests under your chin. The sides of the collar front should be off the collar bone, angled toward your ears. The front collar ends are to be inside the back piece of the collar. The lower edge of the front part of the brace should be resting against the rib cage or just below the breasts.
6. Attach the Velcro straps on each side. Tighten side straps so they are equal in length on both sides.
7. Be sure the back part of the brace is in the center of your back.
8. Connect the shoulder straps to attach the front of the brace to the back. Both shoulder straps should be of equal length. These may be loose when you are lying flat. Adjust these straps for a snug fit after you sit up.
9. Buckle rib straps, pulling straps even and tight.
10. Make sure that all straps lie flat with no slack or gaps.

Common Problems Over-tightening the collar may lead to breathing and comfort issues. Ensure the fit is snug but not too tight. Skin breakdown may also occur with persistent wearing, so check the skin daily for any skin irritations. Under-tightening may cause chin slipping issues, where the chin tucks down into the brace. If this occurs, check the tightness, most likely the brace was not fastened tight enough to hold the chin piece in place.
The CTO is designed to protect your spine, you will not be able to bend or twist in it. The CTO will not allow a forward slouch of the head and shoulders and may feel uncomfortable if you try to do so. These devices require patience, as they are not comfortable and may need several adjustments. These devices tend to ride up on the body towards the head over time. This is unavoidable and the device will require repositioning from time to time.
When you are fit with one of these braces, you should not hesitate to ask your medical provider any questions you have. Just remember, knowledge is power!

Microprocessor vs. Non-Microprocessor Prosthetic Feet

Thu, 04 Jul 2019 17:16:00 GMT

One of the important features of a prosthesis for lower limb amputees is the prosthetic foot. There are many different models of feet by several companies, such as Otto Bock, Ossur, Endolite, Freedom Innovation and College Park. As the prosthetist knows, choosing the right prosthetic foot is very important for the patient. The foot can help the patient perform specific tasks, such as running, or just help with every day walking. As the field of Prosthetics has evolved, so has the feet. There are now feet made of carbon fiber, instead of wood and rubber, and even microprocessor (MCP) feet. These feet use computers and programing to assist with walking to make the patient’s gait feel more natural. With the release of the MCP, the following question now comes to mind- is a MCP foot right for me? Here, we will discuss and compare the features of a MCP prosthetic foot to a static carbon fiber prosthetic foot.

Microprocessor feet
There are distinct advantages of choosing a MCP foot over a static carbon fiber prosthetic foot. MCP feet have a hydraulic ankle that is controlled through computers and programming. The MCP foot will allow the patient to feel the advantages on a level ground. This hydraulic ankle helps mimic the three rockers of the stance phase over level ground. This requires a rapid foot flat, while maintaining balance/stability for weight acceptance. For the second rocker, the MCP provides articulation at the ankle. This gives the patient a more natural tibial progression through the second rocker. Resistance of the ankle is controlled by the MCP to adapt ankle stiffness to changes in the patient’s walking speed. During the third rocker, the MCP modulates ankle stiffness to gradually provide a transition from ankle dorsiflexion to deflection of keel during tibial progression. This all allows the patient to get a more natural gait, and not have those “dead spots” often felt in static carbon fiber feet. (Kaluf, B. & Smith, C.,, 2018; Agrawal, V. et al., 2013)

The MCP foot also has distinct advantages on stairs and ramps. While ascending stairs, the MCP foot is able to dorsiflex to allow adequate toe clearance. This helps prevent stumbling and catching the foot on the stair. In a study by Agrawal at el. (2013), a MCP foot showed to have a significant improvement in symmetry while ascending stairs as compared to carbon fiber feet and a SACH foot. The MCP foot also helps control how fast tibial progression occurs on a ramp. By increasing the dorsiflexion resistance while descending a ramp, the tibial progression velocity was significantly slower when compared to elastic feet and carbon fiber feet in a study by Struchkov & Buckley (2015). This reduced tibial progression gave the patient more control and reduced amount of knee flexion. This made the MCP foot safer than other feet while descending ramps. Just like any other device on the market, while MCP feet come with their distinct advantages, they also come with their disadvantages. MCP are generally heavier than static carbon fiber feet. MCP feet generally weight between 749-1488 grams, which is about two times heavier than the standard carbon fiber foot. Sometimes, the improved function of the MCP is not enough for the patient to not notice the weight. This can cause discomfort to the patient or lack of prosthetic use. Another disadvantage is the cost of a MCP foot. MCP cost two to three times more than a static carbon fiber foot. Not all insurance companies cover MCP feet, so there may be a large out of pocket cost. Lastly, due to the high number of mechanical and electronic parts, these feet are more susceptible to accidental damages and normal wear. This will require necessary routine maintenance to be performed. MCP feet are not recommended for use in a wet environment due to the electronic failures that could occur when water comes in contact with the foot.

Static Carbon Fiber Feet
A different option for prosthetic feet is static carbon fiber feet. These feet have a fixed ankle, and not an articulating one like a MCP. These feet are more common. Carbon fiber feet fall into different sub categories such as dynamic response, multi-axial, and multi-axial dynamic response. There are a multitude of carbon fiber feet on the market. Each foot has their own features that make is beneficial for a specific amputee population, such as multi-axial dynamic response feet for individuals that do a lot of hiking and walking on uneven terrain.
There are advantages to using a static carbon fiber foot when compared to a MCP foot. For the dynamic response and multi-axial feet, they help store energy and return it during propulsion during gait. While the patient is starting to progress their tibia and move into dorsiflexion during the stance phase, the energy starts to store in the keel of the foot. Then when the patient progresses to push off, the energy is used to help propel the patient and move the limb forward. This is a feature that MCP feet and non- MCP single axis/hydraulic feet don’t have as they have an articulating ankle, and don’t load the keel to store as much energy for propulsion. This is why the static carbon fiber feet are typically used for more active amputees. Static carbon fiber feet have several other beneficial features. These feet tend to be lighter weight, which is appealing to many patients. They have shock absorbing features that make these feet appealing to amputees, as it helps take pressure absorbed by the residual limb to allow the patient to walk longer and further. Due the design of the feet, there are fewer mechanical parts. This helps reduce the need for routine maintenance and failures by the device. These feet are able to get wet without failing, but it is still recommended that post of these feet do not go into salt water. These prosthetic feet are also easier to get coverage for by insurance as they do not have any microprocessor parts, which some insurances exclude from their coverage.
While the static carbon fiber prosthetic feet have their advantages, they also have their disadvantages. Static feet might make it hard for some patients to ascend stairs. The patient might not have enough strength or range of motion to lift their foot high enough to not catch the toe. Due to the lack of dorsiflexion in these feet, it is common for the patient to catch their toe. This increases their fall risk and the need for medical attention. Static carbon fiber feet also can cause excessive pressures on the residual limb when descending. Since there is no ankle, these feet will lack proper dorsiflexion while the tibia progresses over the foot while descending the stairs. This will cause extension at the knee when the patient should be flexing the knee to progress her limb. In the study by Agrawal et al. (2013), a static carbon fiber foot has significantly lower symmetry in gait when ascending/descending stairs when compared to a MCP foot. This causes the patient to require more work to achieve balance and stability on the stairs. On uneven ground and hills/slopes, a static carbon fiber foot doesn’t allow the same tibial progression as a MCP foot. This can cause uneven gait and loss of stability. For inclines and declines, a lot of patients with static carbon fiber feet will not be able to traverse going straight up or down. They will need to ascend/descend at an angle as there is not articulating ankle to properly meet the ground after initial contact. This can cause excessive socket pressure which can lead to discomfort and pain in the residual limb.

In conclusion, knowing the advantages and disadvantages to MCP feet and static carbon fiber feet is not only important for the prosthetist, but their patient as well. The MCP foot shows significant benefits with having an articulating ankle to help the foot get to slap quicker while walking and to help produce a more natural gait. The downsides include weight, cost, and routine maintenance. The static carbon fiber feet show promise in having more energy return during propulsion, while being lighter and not requiring routine maintenance. They do fall short on traversing uneven terrain, hills and stairs due ot their lack to be able to mimic an articulating ankle. These can understanding can provide much needed insight to ensure the success of any amputee.

References
Agrawal, V., Gailey, R., Gaunard, I., O’Toole, C., & Finnieston, A. Comparison between microprocessor-controlled ankle/foot and convential prosthetic feet during stair negotiation in people with unilateral transtibial amputation. Journal of Rehabilitation & Research Development. 2013; 50 (7): 941-950.
Kaluf, B. & Smith, C. Advantages and Disadvantages of Microprocessor-Controlled Prosthetic Ankles. O&P News. August 2018.
Struchkov, V. & Buckley, J. Biomechanics of ramp descent in unilateral trans-tibial amputees: Comparison of a microprocessor controlled foot with convential ankle-foot mechanisms. Clinical Biomechanics. 2016; 32: 164-170.

What is a Detailed Written Order?

Wed, 05 Jun 2019 16:53:00 GMT

A detailed written order is a document used to authorize what was ordered by a patient’s treating/prescribing physician. Detailed written orders must include all billable items, accessories or supplies related to the base item that is ordered.

Some DME suppliers use prepopulated forms for their detailed written orders. If the supplier provides their own form, on these forms, the final document that is signed by the physician must clearly state what item(s) is being ordered for the patient. This may be done in two ways:
• The DME supplier may indicate the items that are being provided before sending the form to the physician. The physician can then review the form and accept the items marked by the supplier or, make any necessary changes. The physician must then initial and date the revised entries.
• The DME supplier may send the form to the physician without any items selected and ask the physician to indicate which items are being ordered. The physician must make their choice very clear.

In each case, the physician must sign and date the form before returning it to the supplier. A DWO is required prior to billing. All DWO’s must include: Patient/Beneficiary’s name, date of the order, detailed description of all items, prescribing physician’s signature and date.

Friendly Reminders
• Medicare requires an order for every item of durable medical equipment.
• Signature and date stamps are not allowed. Signatures must comply with the CMS signature requirements outlined in PIM 3.3.2.4.

• If a DME supplier does not have a faxed, photocopied, electronic or pen and ink detailed written order signed and dated by the prescribing physician in their records before they submit a claim to Medicare, the claim will be denied.

• If the claim is for an item for which an order is required by statute (e.g., therapeutic shoes for diabetics), the claim will be denied as not meeting the benefit category and is therefore not appealable by the supplier (see CMS Manual System, Pub. 100-04, Medicare Claims Processing Manual, Chapter 29).

• For all other items, if the DME supplier does not have an order that has been both signed and dated by the treating physician before billing, the item will be denied as not reasonable and necessary, except for items requiring a written order prior to delivery. If an order is taken verbally and sent to the physician for a signature and date, there are two documents: the verbal order and the written order with the physician’s signature and date. If a beneficiary comes in with a prescription containing all the elements of a detailed written order, then one document is on file. It is important to remember that if an item is dispensed based on a verbal order and a written order is provided afterwards, both orders must be retained. It is not adequate to only have a written order after dispensing an item. There must be documentation to show the verbal order was received prior to dispensing the item.

Resources:

https://med.noridianmedicare.com/web/jddme/topics/documentation/detailed-written-orders

https://cgsmedicare.com/jc/pubs/news/2010/0410/cope12010.html

What does ‘Medically Necessary’ Mean?

Mon, 03 Jun 2019 16:54:00 GMT

What does ‘Medically Necessary’ Mean?

According to HealthCare.gov, medically necessary services are defined as “health care services or supplies that are needed to diagnose or treat an illness, injury, condition, disease, or it’s symptoms – and that meet accepted standards of medicine”

If you are a Medicare beneficiary, the term ‘medically necessary’ applies to you directly because it refers to services covered or not covered by Medicare.

The Centers for Medicare & Medicaid Services gives some further detail about medically necessary services. According to them, medically necessary services or supplies:
• Proper and needed for the diagnosis or treatment of your medical condition
• Are provided for the diagnosis, direct care, and treatment of your medical condition.
• Meet the standards of good medical practice in the local area and are not mainly for the convenience of you or your doctor.

What determines what is Medically Necessary?

To find out if Medicare covers what you need, talk to your doctor or healthcare provider about why certain services and supplies are necessary. You can visit the official U.S. Government site for Medicare (https://www.medicare.gov/coverage) to find out coverage information.
There is no difference in the definition of “medical necessity” based on whether you are on Medicare vs. Medicaid, however the list of included services in any health plan may vary because the federal government will create the guidelines on some levels, and then the individual provider of the Medicare plan and local state guidelines will also dictate what will be covered
Before getting a medical procedure or tests, you should do your best to understand if it will be covered by your healthcare plan first. The first step is making sure a doctor has approved or requested the necessary treatment or tests. Besides having a doctor’s assessment, you will also have to meet additional criteria. Just because a doctor orders tests, it does not mean they will be considered medically necessary by your health insurance.

What if Medicare doesn’t cover a service I think is medically necessary?

In most cases, if Medicare decides that your service or equipment doesn’t meet its definition of medically necessary, you won’t be covered, and you’ll have to pay for the full cost out of pocket.

However, you have a few options if Medicare doesn’t cover a health-care service or item that you think you need.

• Requesting an advance coverage decision

• Appealing a noncoverage decision

Advance Beneficiary Notice of Noncoverage (ABN)

If you need something covered but your doctor, healthcare provider, or supplier thinks that Medicare won’t cover it, you will have to read and sign a notice called an “Advance Beneficiary Notice of Noncoverage”, this form serves as your acceptance that you may have to pay for the service or supply if coverage is denied. This form also gives your doctor, healthcare provider, or supplier the opportunity to appeal on your behalf.

Source:
What Does ‘Medically Necessary’ Mean? (n.d.). Retrieved February 15, 2019, from https://www.medicare.org/articles/what-does-medically-necessary-mean/

What Is A TLSO And What Is It Used For?

Sun, 05 May 2019 03:10:00 GMT

The acronym TLSO is used to refer to thoraco-lumbo-sacral orthosis, which is a brace that provides support from mid to the lower portion of the spine. This brace is most commonly used to provide support and stabilization of the spine after a back injury and/or surgery.

There are a many different types of TLSOs, but the common styles are either Off the Shelf or Custom Fabricated. The decision of which type to use is up to the discretion of your medical provider and is often based off the severity of the injury, degree of control needed, and body shape/size.

Custom:
A custom brace is made of plastic with a soft foam liner for patient comfort. It can be made in one piece with a single opening in front or back but is more commonly made with two overlapping pieces that connect on the sides. This design is referred to as a clam-shell style. This brace is custom fabricated to either a mold or measurements of the patient’s body. The TLSO’s waist grooves must be placed low on the waist (the soft space on the side between the hipbone and ribs). Close the straps evenly and snugly (patient may need help). The orthotist can make marks on the side straps a guideline as to how tightly the TLSO should be fastened.

Off the Shelf:
An off the shelf is a prefabricated brace that is fit to your body based on your waist measurement which determines the size that will fit appropriately. The brace is then adjusted to match the patient’s size and shape in order to fit correctly.

Putting on the Brace:
• Putting a brace lying down (the safest way, but requires a helper)
• Move to one side of the bed by using your arms and legs to move your hips over or by having a helper pull the sheet under you over to one side.
• Roll to your side, away from the edge of the bed and onto your hip. Don’t twist your back, keep it straight by shifting your hips and shoulders at same time, rolling like a log.
• Have the person helping you position the back half of the brace on your back, making sure the waist indentations on the inside of the brace are just above your hip bones and below your ribs. The bottom edge of the brace should be near your tailbone.
• Have the person helping you hold the brace in place on your back while you log-roll flat onto your back.
• Position the front half of the brace, lining it up with the back half. Fully tighten all the straps, moving from the bottom to the top, making sure they are snug enough to provide support but still allow normal breathing.
• Secure any shoulder straps or under arm straps, these do not need to be pulled tight.
• Before getting up, make sure that the brace is aligned properly; adjust it, if necessary.
• Drop your legs over the side of the bed and push yourself up to a sitting position. Then slowly raise yourself to a standing position.

• Putting a brace on sitting up (easier, but can only be done with approval from your doctor)
• If you are sitting up while applying the TLSO, be sure to sit with your feet firmly on the floor.
• Align the back of the brace at the top of your tailbone and centered on your back
• Wrap the front panel around you keeping it in line with back panel
• Secure all Velcro straps starting at the bottom and working your way up, making sure they are snug enough to provide support but still allow normal breathing.
• Secure any shoulder straps or under arm straps, these do not need to be pulled tight.
• Check your brace to make sure it is fitting snugly, and that it is correctly aligned before you get up and move around.

Things to Remember:
When wearing the TLSO, it should be as TIGHT as possible/tolerable, with no gaps between the TLSO and the body or it will tend to “ride up”. If this is the case, lower the TLSO into the proper position and make it tighter than it was previously. Always wear a T-shirt under the brace to provide a barrier between the skin and the plastic and to absorb perspiration. If your brace has a chest piece (also known as the sternal shield), it should sit 2-3 fingers below the notch at the bottom of your neck to ensure proper positioning. These braces are specifically designed to protect and stabilize the spine. One should be able to sit in it and but will only be able to bend forward at the hips. The TLSO WILL NOT ALLOW A FORWARD SLOUCH of the head and shoulders. The front top portion of the TLSO will resist a forward slouch by becoming tight and uncomfortable on the chest and lower neck. If this occurs, sit as upright as possible. Inspections of the skin under the brace should be check daily for any breakdown. If any areas of breakdown or localized redness are noticed, please call the orthotic clinic to have the brace adjusted.

Why Physicians Need To Sign Paperwork?

Sat, 04 May 2019 16:51:00 GMT

According to Medicare’s learning network, “The law requires that a physician must document that a physician, nurse practitioner (NP), physician assistant (PA) or clinical nurse specialist (CNS) has had a face-to-face encounter with the patient. The encounter must occur within the six months before the order is written for the DME or Durable Medical Equipment. A detailed written order shows the diagnosis as well as the codes that are needed for the insurance to verify that the physician signed off on. It is necessary to have the prescription signed within 6 months of the physician evaluating the patient so that the specific diagnosis is as up to date and as accurate as possible as well as ensuring the doctors ability to order it. The physician also needs to deem this medically necessary for the patient for the insurance to be able to approve the device.

While the patient is in the office the practitioner must assess the patient to determine the next steps for the patient regarding the need for DME. The Centers for Medicare and Medicaid Services (CMS) manuals state the following must be provided in order to obtain the proper information: the beneficiary’s name, item of DME ordered, prescribing practitioner’s National Provider Identifier (NPI), signature of the ordering practitioner and the date of the order. Neglecting to meet these requirements for the equipment can result in the denial of the claim. According to the CMS, if a DME item is ordered by a PA, NP, or CNS, a physician must document the initial encounter of the patient by signing and dating the pertinent portion of the medical record. It is very important that all the necessary documents are signed and dated properly to ensure the ability to obtain the DME. The prescription is required stating the physician stated it is medically necessary and needs to be within six months to clarify accuracy as well as being medically required for the patient. The prescription needs match the date of service for the patient to be able to obtain the proper notes from the visit as well as what is needed for the patient. It is very important all the necessary documents are signed.

What is Phantom Limb Pain?

Sat, 04 May 2019 03:08:00 GMT

It is estimated that 60-95% of all amputees experience phantom limb syndrome. This occurs when an amputee feels that their limb is still attached and presents as phantom limb pain or phantom limb sensation. Phantom limb syndrome is a complex pain syndrome with no true known cause. Most amputees report having phantom limb pains after amputation however, there is still some confusion about what the difference is between phantom limb pain and phantom limb sensation.
Phantom limb sensation is a painless phenomenon in which an amputee feels as though their amputated limb is still attached and is experiencing a change in shape, length, movement, and posture. Amputees often feel that they need to reposition their amputated limb or that it is moving on its own. This sensation causes no physical pain but can often be a source of anxiety and confusion for amputees.
Phantom limb pain can present as burning, aching, itching, stinging, throbbing, pressure, and cramping. It has been suggested that phantom limb pain is the leading cause of stress and disability in amputees. Chronic phantom limb pain can prevent the completion of activities of daily living due to a decrease in mobility.
Phantom limb syndrome can be treated in a variety of ways including; pain medication, cognitive therapy, and mirror therapy. These are many treatment protocols for phantom limb syndrome and amputees should discuss with their doctor the best way to treat their phantom limb syndrome. If amputees have questions about phantom limb syndrome they should contact their doctor or prosthetist.

What is an SMO and its function?

Thu, 04 Apr 2019 03:05:00 GMT

SMO is the acronym for Supra-Malleolar Orthosis, meaning it supports the foot just above the anklebones or malleoli. They are used primarily to control subtalar joint alignment. The subtalar joint can be described as the joint in the foot located at the meeting point of the talus and calcaneus, more commonly referred to as the heel bone (Figure 1). This joint is crucial to movement as it helps adjust the mediolateral movement (side-to-side) of the foot while navigating through uneven and shifting terrain as well as allow us to perform dynamic movements with precision. As vital as the subtalar joint is, it is vulnerable to wear and tear, trauma, and other joint-specific disorders. Any impairments to this area of the foot or supporting connective tissue can induce pain, lead to foot deformities, and affect gait and mobility in both adults and children.

When the subtalar joint is compromised, SMOs are often prescribed and designed to maintain a vertical, or neutral heel to help improve standing balance and walking. SMOs are typically prescribed to those with soft, flexible, flat feet, who tend to excessively pronate (Figure 2), walk on their toes, or have low muscle tone. Over time, excessive pronation can cause stress on the knees, hips and lower back by changing the natural alignment of the lower extremities which fatigues leg muscles at a faster rate. Lower extremity changes are also a consequence in those who naturally walk on their toes; muscle stiffness, tightening, and pain can be seen in long-term toe walkers. Those with low muscle tone often have gross motor and developmental delays due to muscle weakness and ligamentous laxity affecting overall joint stability. Fortunately, SMOs aid in controlling excessive pronation and toe walking and provide stability to individuals with low muscle tone.

As a result of innovative companies, such as SureStep (Figure 2), pediatric SMOs are made from extremely thin, flexible thermoplastic and have patented trimlines. They are designed to compress the soft tissue of the foot in order to stabilize the foot and ankle by maintaining appropriate and neutral alignment while still allowing the child to develop their own muscle movements and patterns. For this reason, they can be worn comfortably inside a pair of shoes giving the child the freedom to run, jump, and play naturally. Adult SMOs function in the same way as pediatric SMOs by maintaining and improving ankle-foot alignment, however, adult SMOs are sometimes crafted from highly durable carbon fiber material. Carbon fiber SMOs are lighter weight and thinner when compared to plastic adult SMOs. The decision regarding material choices is left up to your practitioner.

Copay VS. Deductible? Out of Pocket? What does it all mean?

Tue, 05 Mar 2019 03:55:00 GMT

WHAT’S A COINSURANCE?

It’s your part of the cost of a claim reviewed by your insurance company. Very often when you file a claim, you pay a small part of the cost, and your insurance company pays the rest. The part you pay is called a coinsurance because you’re jointly paying for your health service with your insurance company.

DO I ALWAYS HAVE A COPAY?

Not all plans have copays to share in the cost of covered expenses. Some insurance plans may use both copays and a deductible/coinsurance, depending on the type of covered service.

WHAT IS A DEDUCTIBLE?

A deductible is the amount you pay each year for eligible medical services or medications before your health plan begins to share in the cost of covered services. For example, if you have a $1,500 yearly deductible, you will need to pay the first $1,500 of your total eligible medical costs before your plan helps to pay.

Deductibles for family coverage and individual coverage are different. Even if your plan includes out-of-network benefits, your deductible amount will typically be much lower if you use in-network doctors and hospitals.

WHAT IS THE DIFFERENCE BETWEEN A DEDUCTIBLE AND A COPAY?

Depending on your insurance plan, you may have a deductible and copay. A deductible is the amount you pay for eligible medical services or medications before your health plan begins to share in the cost of covered services. If your plan includes copays, you pay the copay flat fee at the time of service (For example, at the doctor’s office). Depending on your plan, what you pay in copays may count toward meeting your deductible.

WHAT IS COINSURANCE?
Coinsurance is a portion of the medical cost you pay after your deductible has been met. Coinsurance is a way of saying that you and your insurance carrier each pay a share of eligible costs that add up to 100 percent.
For example, if your coinsurance is 20 percent, you pay 20 percent of the cost of your covered medical bills. Your health insurance plan will pay the other 80 percent. If you meet your annual deductible in June, and need an MRI in July, it is covered by coinsurance. If the covered charges for an MRI are $2,000 and your coinsurance is 20 percent, you need to pay $400 ($2,000 x 20%). Your insurance company or health plan pays the other $1,600. The higher your coinsurance percentage, the higher your share of the cost is. You are also responsible for any charges that are not covered by the health plan, such as charges that exceed the plan’s Maximum Reimbursable Charge.

WHAT IS AN OUT-OF-POCKET MAXIMUM?
Out-of-pocket maximum is the most you could pay for covered medical expenses in a year. This amount includes money you spend on deductibles, copays, and coinsurance. Once you reach your annual out-of-pocket maximum, your health plan will pay your covered medical and prescription costs for the rest of the year.

Here is an example.
** You have a plan with a $3,000 annual deductible and 20% coinsurance with a $6,350 out-of-pocket maximum. You haven’t had any medical expenses all year, but then you need surgery and a few days in the hospital. That hospital bill might be $150,000.
You will pay the first $3,000 of your hospital bill as your deductible. Then, your coinsurance kicks in. The health plan pays 80% of your covered medical expenses. You’ll be responsible for payment of 20% of those expenses until the remaining $3,350 of your annual $6,350 out-of-pocket maximum is met. Then, the plan covers 100% of your remaining eligible medical expenses for that calendar year.
Depending on your plan, the numbers will vary—but you get the idea. In this scenario, your $6,350 out-of-pocket maximum is much less than a $150,000 hospital bill!

I HAVE A SECONDARY INSURANCE. HOW DOES IT WORK?

HOW COORDINATION OF BENEFITS WORKS

There is a way for you to get covered by two health insurance plans. It is called coordination of benefits (COB), which allows you to have multiple health plans.

Health insurance companies have COB policies that allow people to have multiple health plans, but it also makes sure insurance companies do not duplicate payments or reimburse for more than the healthcare services cost.

COB policies create a framework for the two insurance companies to work together to coordinate benefits, so they pay their fair share. COB decides which is the primary plan and which one is secondary. The primary plan pays its share of the costs first, and then the secondary insurer pays up to 100 percent of the total cost of care, as long as it is covered under the plans. The plans will not pay more than 100 percent of the treatment cost, so you are not going to get double the benefits if you have multiple health plans.

Here is an example of how COB works:
Let’s say you visit your doctor and the bill comes to $100. The primary plan picks up its coverage amount. Let’s say that is $50. Then, the secondary plan picks up its part of the cost up to 100% — as long as the services are covered by that insurer.

WILL MY SECONDARY INSURANCE COVER THE PRIMARY PLAN’S DEDUCTIBLE?

The secondary plan can pick up the tab for anything not covered, but most of the time it will not pay anything toward the primary plan’s deductible. If both plans have deductibles, you will have to pay both before coverage kicks in for each individual insurance. Meaning you will pay the deductible for the primary and then it will pay at its covered percentage. The balance will be forwarded to the secondary. You will have to meet the deductible for the secondary before their coverage kicks in.

Carbon fiber Vs. Thermoplastic in Prosthetics and Orthotics

Tue, 05 Feb 2019 03:54:00 GMT

There are two common types of materials that are used in the field of prosthetics and orthotics; these materials are thermoplastics and carbon fiber. Each of these types of materials have different uses and applications and are used based on the needs of each patient and the type of device they are receiving.
Carbon is among one of the most valuable materials used in orthopedic applications. Carbon is very light, rigid, and able to hold its shape under stress. This is due to its high tensile strength under both tension and compression. Carbon has a bi-directional woven pattern that allows for an increase in the fracture resistance, allowing for a uniform strength throughout the device (Berry). This means that the carbon socket (prosthetics) or the brace (orthotics) is very durable and can withstand a lot of pressure from patient use.
Carbon fiber is used in prosthetics for the definitive socket that the patient will receive after the test socket has been approved by the patient. The design of the socket is determined by the type of prosthesis that the patient is receiving and the patient and customize the outer design of the socket to their liking. In orthotics, carbon fiber is used based on the type of brace and activity level of the patient. Carbon fiber allows for increased rigidity in the brace which is needed for braces that allow for an articulating ankle or for braces that need increased stability.
The use of thermoplastics delivers many design improvements over carbon and other traditional systems due to design options that allow increased contact and support on the limb, simple fabrication process, a reduction in weight with retained strength, and cosmetic improvements allowing for a variety of options for color and decorative transfer patterns (Thermoplastics). Although thermoplastics are not as rigid as carbon fiber, they still offer man benefits for the patient and are a great option for patient use.
There are different types of plastics used in prosthetics and orthotics. For prosthetics, thermoplastics are used for diagnostic or test sockets for the patients when they are working out the fit of the socket before they are transferred to a carbon fiber socket. The thermoplastics used are Thermolyn also know and Orffitrans; commonly used for below the knee sockets, and Vivak also known as DurrPlex; commonly used in above the knee sockets.
There are 2 common thermoplastics used in orthotics; Copolymer and Polypropylene. Polypropylene, also known as Polypro, has high elasticity and stiffness and is good for producing very thin-walled, lightweight, and stable orthotic devices, although can be brittle and easily broken. Copolymer, also known and Copoly, has a high impact strength and is easily formed with low temperatures, which makes it easily adjustable to suit the patient’s needs (Smit).
These materials allow for the best possible device to be created for the patient, different strengths, rigidity and weights allow for a variety of options to create the best possible custom device based on the patient’s activity level and use of the device.

Works cited
Berry, D. A. (n.d.). Composite Materials for Orthotics and Prosthetics. Orthotics and Prosthetics,40(4), 35-43. Retrieved February 15, 2019.
Smit, E. (2014, March 4). Thermoplastic materials used in Orthotics and Prosthetics. Retrieved February 15, 2019, from https://prezi.com/yr0h-jvqt_nn/thermoplastic-materials-used-in-orthotics-and-prostetics/
Thermoplastics for Orthotic and Prosthetic Devices and Components. (n.d.). Retrieved February 15, 2019, from https://tamarackhti.com/blog/thermoplastics-for-orthotic-and-prosthetic-devices-and-components/

July 2017 Newsletter

Thu, 20 Jul 2017 18:47:00 GMT

You will never have this day again, so make it count! Patient Newsletter July 2017 So much is happening with us, that we wanted to share it with you. #StopBullying Infinite Tech Celebrates The Unique!!! At Infinite Technologies, we LOVE seeing our patients embrace their unique differences and showcase their talents and abilities! If you … Continue reading July 2017 Newsletter

The post July 2017 Newsletter appeared first on Infinite Technologies Orthotics and Prosthetics .

September Support Groups

Fri, 26 Aug 2016 14:22:00 GMT

Hello! Here is a short list of local Stroke and Amputee Support Groups in the area for the month of September. If you would like additional information about these support groups, including times and locations, please feel free to call our office at 877-424-7179 and ask for Kady!

September 6th: Inova Fairfax Hospital, Stroke Support Group, For more information, click here

September 6th: Georgetown University Hospital, Amputee Support Group, For more information, click here

September 7th: Inova Fair Oaks Hospital, Stroke Support Group, For more information, click here

September 14th: Inova Alexandria Hospital, Stroke Support Group, For more information, click here

September 14th: Inova Loudoun Hospital, Stroke Support Group, For more information, click here

September 15th: HealthSouth Rehabilitation Hospital, Stroke Survivor Group, For more information, click here

Patient Spotlight: Meet Trace!

Fri, 12 Aug 2016 11:33:00 GMT

Meet Trace! Trace was born without a right hand and in 2015, he decided to write a children’s book, Uniquely Me. This book has touched the lives of children from all over and has helped spread the word that it’s okay to be different. We love his message and we are so honored to be working with him on his upper extremity prosthesis. Recently, we asked Trace to answer a few questions for us to learn more about him and Uniquely Me. Here is what he had to say!

Q. Trace, can you tell us a little about yourself?

Sure! I recently graduated from George Mason University with a degree in Marketing, and I’m currently working for an event staffing company in Richmond, Virginia. Aside from being a published children’s author and having one hand, I’m a pretty typical 22-year-old! I play videogames, hang out with friends, attend concerts, and sleep in past noon on weekends. I have three siblings and an adorable nephew, and I’m very grateful to have had the support of friends, family, and the community throughout my journey of writing and publishing Uniquely Me!

Q. How did you find Infinite Technologies?

I had actually been looking into upper extremity prosthetic devices and the different options available for a few months before I found Infinite Technologies, but I hadn’t really acted on my interest. I was attending George Mason at the time and happened to drive past the office with a few friends on my way back to campus one day! I did some research into Infinite Technologies and decided it would be the best place for me to start!

Q. Why did you decide to write Uniquely Me?

When I was younger there were very few, if any, resources for children with limb differences or for their parents. There certainly weren’t many children’s books for them, and while that number has started to increase recently, there is still a huge need for such books. I knew that I wanted to help kids with disabilities overcome some of the same challenges I faced when I was young, and decided the best way to achieve that was to write a book! My hope is that Uniquely Me will help not only children with disabilities, but any child who worries about being different.

Q. How have things changed for you since you wrote this book?

Since writing Uniquely Me, I have been introduced to some of the most incredible people I have ever had the pleasure of meeting. Until a few years ago, I had no idea just how large the limb-different community truly is, and now I am proud to say that I have not only become a part of that community, but through Uniquely Me I have been able to make a positive impact on it as well.

Q. Will there ever be a sequel to Uniquely Me?

I am actually in the middle of a Kickstarter campaign right now, with about 25 days left, to fund a second book titled Uniquely Brave! This will hopefully begin the process to turn Uniquely Me into a series, and I am incredibly excited to see where it goes!

We want to take a moment to thank Trace for being our spotlight patient for August and for taking the time to answer our questions.

You can order his book on Amazon and on his website .

You can also check out his Kickstarter campaign here !

Interesting Articles!

Mon, 08 Aug 2016 11:16:00 GMT

Good Morning Friends!

We are always looking for ways to save you time. One of the ways to do that is to be your eyes and ears in the O&P world. Below, I hope you find some of the articles we found for you as interesting to read as we did!

“Shark Tank” Star Robert Herjavec Offers to Buy New Prosthetic Leg for OC Child – A 4-year-old boy from Rancho Santa Margarita captured the hearts of many when ABC7 reported his prosthetic leg was stolen from the beach, including the heart of a famous celebrity who has offered to help him. Click here to read more…

Quadruple Amputee Aimee Copeland Shows How She’s Mastered Cooking – The 28-year-old, who lost her limbs to a flesh-eating bacteria, explains how she has adjusted to her new life. Click here to watch her video …

Boston Marathon Bombing Survivor Helps 5-Year-Old Boy Run Again – A woman who survived the Boston Marathon bombing helped a fellow amputee, five-year-old, Jude Hill, run again. Click here to read more…

Have a wonderful week!

-Infinite Technologies Orthotics and Prosthetics

Technology Spotlight: Surestep SMO

Thu, 21 Jul 2016 14:18:00 GMT

The Surestep SMO has revolutionized orthotic management for children with hypotonia. Through the use of extremely thin, flexible thermoplastic, the Surestep SMO compresses the soft tissues of the foot with its patented design; stabilizing children while still allowing for natural development.

Q. What are some indications that the Surestep might be appropriate for my child/patient?

Pronation
Hypotonia
Triplanar instability in weight bearing
Inability to stand independently
Mild toe-walking
Developmental delay
Delay in acquiring gross motor skills
Poor coordination or balance

Q. Are there any contraindications that this product might not be the right fit for my child/patient?

High muscle tone
Spasticity
Severe toe-walking
Tight heel cords
Tight peroneals

Q. How does my child/patient get an appointment?

Scheduling an appointment at Infinite Technologies is easy. Simply call our office 877-424-7179 .

For more information on the Surestep SMO: click here .

August Support Groups

Wed, 20 Jul 2016 10:45:00 GMT

Good Morning!

Here is a short list of local Stroke and Amputee Support Groups in the area for the month of August. If you would like additional information about these support groups, including times and locations, please feel free to call our office and ask for Kady!

August 3rd : Inova Fair Oaks Hospital, Stroke Support Group , For more information, click here

August 9th: Inova Fairfax Hospital, Stroke Support Group , For more information, click here

August 9th: Georgetown University Hospital, Amputee Support Group , For more information, click here

August 10th: Inova Alexandria Hospital, Stroke Support Group , For more information, click here

August 10th: Inova Loudoun Hospital, Stroke Support Group , For more information, click here

August 18th: HealthSouth Rehabilitation Hospital, Stroke Survivor Group, For more information, click here

Interesting Articles!

Tue, 28 Jun 2016 17:33:00 GMT

Good Morning!

Here at Infinite Technologies Orthotics and Prosthetics, we are always looking for ways to save you time. One of the ways to do that is to be your eyes and ears in the O&P world. Below, I hope you find some of the articles we found for you as interesting to read as we did!

Harvard’s Wyss Institute to Collaberate with ReWalk on Exosuit – The Wyss Institute for Biologically Inspired Engineering at Harvard University has entered into a collaboration with ReWalk Robotics, Yokneam Ilit, Isreal, and Marlborough Massachusetts, to accelerate the development of the institute’s lightweight, wearable soft exosuit technologies for assisting people with lower-limb disabilities, such as patients with multiple sclerosis or those who have suffered strokes. Click here to read more…

Bipedal robot Walks in 3D; May Advance Prosthetic Technology – An unsupported bipedal robot at the University of Michigan can now walk down steep slopes, through a thin layer of snow, and over uneven and unstable ground. The robot’s feedback control algorithms should be able to help other two-legged robots as well as powered prosthetic legs gain similar capabilities. Click here to read more…

Please note that both of the above articles were found at www.oandp.com. Please visit their website for more articles from the O &P field!

Sincerely,

The Infinite Technologies Team

July Support Group Information

Mon, 20 Jun 2016 17:39:00 GMT

Good Afternoon!

Here is a short list of local Stroke and Amputee Support Groups in the area for the month of July. If you would like additional information about these support groups, including times and locations, please feel free to call our office and ask for Kady!

July 6th: Inova Fair Oaks Hospital, Stroke Support Group, For more information, click here

July 12th: Inova Fairfax Hospital, Stroke Support Group, For more information, click here

July 12th: Georgetown University Hospital, Amputee Support Group, For more information, click here

July 13th: Inova Alexandria Hospital, Stroke Support Group, For more information, click here

July 13th: Inova Loudoun Hospital, Stroke Support Group, For more information, click here

July 21st: HealthSouth Rehabilitation Hospital, Stroke Survivor Group, For more information, click here

Technology Spotlight: MyoPro

Sat, 04 Jun 2016 17:41:00 GMT

The MyoPro® is a Myoelectric Arm Orthosis designed to support a weak or deformed arm. The MyoPro can enable individuals to self-initiate and control movements of a partially paralyzed or weakened arm using their own muscle signals. When the user tries to bend their arm, sensors in the brace detect the weak muscle signal, which activates the motor to move the arm in the desired direction. The user is completely controlling their own arm; the brace amplifies their weak muscle signal to help bend and move their arm.

Q. Who is the MyoPro appropriate for?

The MyoPro is applicable to individuals with muscle weakness and neuro-muscular damage from conditions ranging from stroke, Traumatic Brain Injury and Cerebral Palsy to Spinal Cord Injury, ALS and MS. Since there is no electrical stimulation used by the Myopro, patients with pacemakers can use the device as well. The device is designed to assist users in meeting their functional specific goals and is not appropriate for everyone. Contact our office today for a free evaluation if you think the MyoPro is the device for you or one of your patients.

Q. Is the MyoPro available at all Orthotic and Prosthetic facilities?

No, Infinite Technologies Orthotics and Prosthetics is the only provider of the MyoPro in the Greater, Washington DC area.

Q. How do I refer a patient?

Referring a patient to Infinite Technologies Orthotics and Prosthetics is easy. Simply call our office at 877-424-7179.

For more information on the MyoPro, click here .

June Support Group Information

Mon, 23 May 2016 17:09:00 GMT

Good Afternoon!

Here is a short list of local Stroke and Amputee Support Groups in the area for the month of June. If you would like additional information about these support groups, including times and locations, please feel free to call our office and ask for Kady!

June 1st : Inova Fair Oaks Hospital, Stroke Support Group , For more information, click here

June 8th: Inova Alexandria Hospital, Stroke Support Group , For more information, click here

June 8th: Inova Loudoun Hospital, Stroke Support Group , For more information, click here

June 14th: Inova Fairfax Hospital, Stroke Support Group , For more information, click here

June 14th: Georgetown University Hospital, Amputee Support Group , For more information, click here

June 16th: HealthSouth Rehabilitation Hospital, Stroke Survivor Group, For more information, click here

Technology Spotlight: KidCap

Mon, 22 Feb 2016 21:04:00 GMT

Plagiocephaly is a medical condition occurring in infants distinguished by the reshaped, flattened, or deformed appearance of the skull. It develops as a result of constant pressure being placed on one area of the thin and flexible skull of an infant. It can be corrected if treated early, but techniques involving cranial molding, such as the KidCap , often provide the best results.

KidCap is the leader among cranial molding technologies for plagiocephaly treatment through helmet therapy. With proven success since 1999, Infinite Technologies Orthotics and Prosthetics was among the first to gain FDA clearance for its cranial molding helmet as a craniosynostosis and plagiocephaly treatment.

Who is a candidate for KidCap treatment?

Infants with enlargement of one or more cranial quadrants
Infants with head flattening
Infants with visually apparent facial asymmetry
Infants with neck muscle asymmetry

How is KidCap Different from other devices?

Better cranial and facial symmetry as a plagiocephaly therapy outcome
Better ear symmetry
Improved self-image later in life
Reduced risk of jaw related disorders as a side-effect of plagiocephaly treatment
Reduced need of surgical intervention for plagiocephaly and related disorders

Technology Spotlight: RUSH Foot

Wed, 16 Dec 2015 12:41:00 GMT

This month’s technology spotlight focuses on the RUSH Foot. With 4 different designs available, you and your prosthetist will determine which one is the perfect fit for you.

The RUSH foot has a unique sole plate and virtually indestructible, unique glass composite material. It delivers the smoothest transition from heel strike to toe off of any prosthetic foot in the industry.

Benefits:

Static feet made of a glass composite instead of a carbon composite
More flexible than a carbon foot
Ability to withstand more forces than a carbon foot.
Provides more natural rollover without the feeling of dead spots
Provides patient with a high energy return
Provides a more realistic range of motion at the foot/ankle
Can be used on all terrains (snow, mud, sand)
Waterproof (fresh and salt water)
Helps reduce socket issues

Here’s what one of our patients has to say about it:

“Right away, within a couple steps, I could feel a much greater degree of energy return than my previous carbon feet. They are very springy, and that translates into less effort to walk fast and cover longer distances. As time passed, I noticed that my residual limbs and lower back did not ache as much as they normally had with my carbon feet. Honestly, my knee on my BK side has not felt this good in a very long time. Finally, I have more stability walking down hills and ramps. The feet seem to better conform to the surfaces I walk on, improving balance in more challenging situations.” – Tom Ferrante, Satisfied RUSH Foot Bilateral Amputee patient

Interested in trying the RUSH Foot?

Contact our office 1-877-424-7179 to try it out!

KidCap Halloween Costume Contest Winner

Wed, 11 Nov 2015 02:11:00 GMT

Infinite Technologies is excited to announce our 2015 KidCap Halloween Costume Contest winner! Thank you to everyone who sent in pictures! We hope you had a wonderful Halloween!

2015 Kidcap Halloween Costume Contest!

Tue, 06 Oct 2015 14:53:00 GMT

As we enter October, we are excited to be holding our annual KidCap Halloween Costume Contest again (it’s one of our favorite times of the year!)!

Please submit a picture of your precious little one wearing their Halloween costume and helmet (bonus points if helmet is incorporated into the costume!) to Kady by November 2nd at 1:00pm for a chance to win a $25.00 Target gift card! The winner and picture will be posted on our facebook page after the official contest end. If you haven’t liked our Facebook page, click here to do so !

Click here for Official Contest Flyer

Contest Details:

Who can enter: All of our KidCap Kiddo’s!

Contest End: November 2nd at 1:00 pm

PRIZE: $25.00 Target Gift Card!

To Enter: email picture to kady@infinitetech.org no later than the November 2nd!

Technology Spotlight: MyoPro

Fri, 25 Sep 2015 00:13:00 GMT

The MyoPro™, is a Myoelectric Arm Orthosis designed to enable individuals to self-initiate and control movements of a partially paralyzed or weakened arm using their own muscle signals.

Infinite Technologies is the ONLY facility in Virginia to be certified with the MyoPro. When the user tries to bend their arm, sensors in the brace detect the weak muscle signal, which activates the motor to move the arm in the desired direction. The user is completely controlling their own arm; the brace amplifies their weak muscle signal to help bend and move their arm. With the brace, a paralyzed individual, such as one who has suffered a stroke, or other neuromuscular disorder, can perform activities of daily living including feeding, reaching, and lifting.

Who would benefit from the MyoPro?

Any individual who has limited mobility or muscle weakness in the arm due to a neuromuscular disorder such as stroke, MS, ALS and brain & spinal cord injury.

If you think the MyoPro is right for you or someone you know, contact us at 877-424-7179.

Touch Bionics Trip update from the Prosthetists!

Wed, 16 Jul 2014 22:52:00 GMT

A few weeks ago, Infinite Technologies owner and Prosthetist Joe Smith, Prosthetist Nick Covington and Prosthetic Resident Amanda Nigrelli went on a trip to the Touch Bionics Lab in Hilliard, Ohio with one of our patients to learn and become certified in the iLimb and iDigits.

We asked Amanda to give us some inside scoop from the trip. Here is what she had to say:

Day 1

Joe, Nick and I arrived at the Touch Bionics lab with our patients. Myotesting was performed to find appropriate sites for controlling the prosthesis using wrist flexors and wrist extensors. Our patient worked very hard with the occupational therapist to isolate myosites to gain greater control of device. The occupational therapist reviewed the computer software, “Biosim”, with Nick, Joe, our patient and myself.

Next, a silicone glove was made for our patient over a cast of the patient’s limb that was produced from silicone casting in our Arlington office. From that, we created a hard diagnostic socket and trialed placing temporary iDigits appropriately on our patient. With that, a plastic extension was added to create equal limb lengths. Once the device was calibrated, the patient performed occupational therapy fine motor skill tasks such as stacking cups, picking up candy and small coins. This was really neat to watch because our patient picked it up so quickly!

Day 2

When we arrived back to the Touch Bionics Lab, our patient was casted for a North Western style socket by a Touch Bionics Prosthetist. We did this with a goal to achieve better suspension and comfort for our patient, whose number one concern was functionality of the prosthesis. Next, modifications were completed that day by onsite by a prosthetist. A test socket was also pulled and trimmed for patient to trial the next day. While all this was going on, our patient worked with software and completed more tasks working with the occupational therapist.

Day 3

Today, a diagnostic socket was fit to our patient. iDigits were added and the prosthesis was calibrated to our patient through computer software, Biosim. With the diagnostic socket, our patient performed and practiced more occupational therapy tasks and learned more about the software. This software is compatible with iPhone/iPod touch so that we as practioners can use it in the office as well as our patient at home. While our patient was practicing more with the prosthesis, Joe, nick and I had an opportunity to have a more in depth course on software, application of iLimb/iDigits, and any troubleshooting problems that could possibly happen down the line.

After all this, Joe, Nick and I tested out and became certified iLimb/iDigits practitioners.

Overall Experience

We want to thank all the Touch Bionics practitioners, therapists, and staff who were extremely knowledgeable, willing to teach us, and very friendly us. While in Ohio, Joe, Nick, our patient and myself learned, trained, and were provided cutting edge technology in the prosthetic world. The Touch Bionics staff provided an excellent learning environment which cultivated knowledge that will allow us to provide excellent service and technology to even more patients in the future.

Follow Up with the patient: In office definitive fitting

The definitive device was shipped to our Arlington office a week after we returned from Ohio where we were able to do the final fitting for our patient in our own office. The Definitive socket was a North Western style socket with a rigid outer frame and flexible inner frame. This was a perfect fit and our patient required no adjustments at the fitting. With the new prosthesis, our patient completed some of the occupational therapy tasks for comfort and control and was very pleased with the prosthesis. As time goes on, more follow up will be needed with our patient and the patient will continue to come back for any adjustments.

Click this link to watch a video of our patient completing occupational therapy tasks with the definitive prosthesis after final fitting: http://on.fb.me/1mZa08R

For more pictures from the trip, visit here: http://on.fb.me/1qiYkS5

Combo Classic Golf Tournament

Tue, 24 Jun 2014 19:44:00 GMT

The Staff at Infinite Technologies would like to congratulate two very special people!

Alyson Sturm, Infinite Technologies billing specialists and Judi Brush, a Below Knee Amputee patient of Infinite Technologies, teamed up to participate in the Combo Classic Golf Tournament in Clifton, Virginia. They competed against more than two dozen golfers on June 6th at the Twin Lakes Golf Course. The purpose of the Combo Classic Golf Tournament was to pair able-bodied golfers with golfers who have a disability and raise money towards tournament expenses and to help fund the new FCPA Accessible Golf Instructional Program. This program will consist of future clinics geared towards those with physical disabilities and cognitive disabilities. Alyson and Judi were excited to play for such a great cause!

At the end of day one, Alyson and Judi had the lowest score, which resulted in them winning day one of the two day tournament! Pretty impressive considering this was Alyson’s first participation in an official golf tournament! Additionally, Judi made history in this tournament being the first ever women amputee to participate! However, Judi is no stranger to winning and making history. Last summer, she won the 2013 Women’s Eastern Regional Championships and is looking forward to hopefully repeating that title again this year. Judi credits Joe Smith, Director of Prosthetics at Infinite Technologies, for helping her get back on the golf course 4 years ago, and she hasn’t looked back yet! Joe feels very honored to be part Judi’s journey back to the links and will continue making her a prosthesis that will allow her to continue to win tournaments!

Since the tournament, Judi and Alyson have been mentioned in and article written by The Centerville Independent. Click below to read the article and see some more tournament pictures!

See more pictures here: https://www.facebook.com/media/set/?set=a.678603088859753.1073741830.197888923597841&type=1

Read more about Alyson and Judi here: http://centrevilleindependent.com/clifton-hosts-classic-golf-tournament/

Sweating in a Prosthesis

Thu, 20 Jun 2013 21:27:00 GMT

The time has come and it is FINALLY the 1st day of “summer!” However, if you ask me….I would have told you it was summer the first time it turned 95 degrees out there! (Don’t you just love the Washington, DC heat!) In honor of the 1st day of summer, Director of Prosthetics and Co-owner of Infinite Technologies, Joe Smith has provided us with a little advice to help beat the heat while wearing a prosthesis:

1. A light application of baby powder can help absorb excessive sweating. KEY WORD being light…too much just turns into a big ole’ mess!

2. Rubbing women’s non perfume deodorant on your limb before applying your prosthesis helps reduce sweating…. (sorry men…we won’t tell anyone!)

3. A nylon sheath or a thin prosthetic sock worn under your liner will help circulate air under your prosthesis and can wick away the moisture. But remember, it is important that there are no wrinkles, as wrinkles can cause skin breakdown.

4. If you haven’t already, speak to your prosthetist about switching the type of liner you are wearing. It could be possible that your limb reacts differently, depending on which type of gel your liner is made of. (Urethane, Silicone, Mineral Oil)

5. MOST IMPORTANTLY, have your prosthetist check the fit of your prosthesis and liner! Excessive movement can mean an increase in perspiration!

Please feel free to call Infinite Technologies 1-877-424-7179 to speak with one of our expert prosthetists if you have any questions regarding excessive sweating for you or one of your patients.

Stay cool out there!

Sincerely,

Your Infinite Tech Team

Infinite Technologies featured on CNN/CNBC!!

Sun, 19 May 2013 19:19:00 GMT

Infinite Technologies will be featured on CNN and CNBC for our orthotic and prosthetic services between the hours of 4pm-11pm the following dates:

May 23, 2013

May 24, 2013

May 27, 2013

May 28, 2013

We have seen the preview and are excited for it to air on TV for everyone to see! Be on the lookout for it during those hours and let us know what you think!

Attention Physical Therapists!! Now offering CEUs!!

Wed, 24 Apr 2013 14:46:00 GMT

Are you reading this because the letters CEU’s caught your attention? Yeah..we thought so…yet, it gets better…FREE CEUs! Here are the details:

We at Infinite Technologies Orthotics and Prosthetics are excited to announce the Prosthetics for Therapists continuing education course series. The purpose of this series is to educate therapists on various aspects of upper and lower extremity prosthetics and to help strengthen relationships among Infinite Technologies Orthotics and Prosthetics and therapy groups in VA, DC and MD.

Course Series: 1 hour courses

Prosthetics Overview

Transtibial Prosthetics

Transfemoral Prosthetics

Lower extremity Prosthetics Functional Level Predictions and Outcomes Measurement

Continuing Education – Attendees will have the opportunity to earn a total of 5 continuing education hours that are approved by the VA, DC, and MD APTA.

Location- At your facility. No need to travel – we come to you!

Cost – FREE!!

Registration – Simply contact Kady Paradise from Infinite Technologies to schedule a date and time. We prefer either early morning (8 a.m.) or lunch time. However, we do not provide lunch or breakfast.

If you have any questions about our Prosthetics for Therapist series, please contact Kady Paradise at 877-424-7179 or kady@infinitetech.org . We look forward to hearing from you!

April is Limb Loss Awareness Month!

Fri, 05 Apr 2013 02:55:00 GMT

Did you know that everyday, 500 Americans lose a limb….yes, you read that right, 500 Americans! Number a little bigger than you thought? Thinking about what you can do to spread awareness?! GOOD NEWS! April is Limb Loss Awareness Month and show your support by participating in the “Show your Mettle” on April 27th!

The Amputee Coalition of America ( www.amputee-coalition.org – Great site, check it out!) has partnered with WillowWood to help spread the word. WillowWood has pledged to donate $1.00 to EVERY picture updated on the Amputee Coalitions of American Facebook page. So, want to know what you can do? Join the “Show Your Mettle Challenge” by posting a picture on the Amputee Coalition of Americans Facebook page! Here are some details…

You can post up to 4 pictures, one for each of these categories:

Individual
Family, Friends, and Community
Support Groups/Facilities
Workplace

If you get the most likes, you will be recognized on the ACA website and could be issued in in the July/August issue of InMotion Magazine! Excited?! Yeah us too! Now go and get out – Show Your Mettle and help spread the word about Limb Loss!

Infinite Tech starts blogging!

Wed, 03 Apr 2013 18:32:00 GMT

Welcome to our first post in the wild world of blogging!! Here, you will get all the latest news and updates from the company! As a completely patient-oriented company, we rely heavily on what our community thinks. It is our duty to provide optimal service to our patients and we hope that through this latest amenity, we may further that. Not only is the team looking to keep you updated with the latest from us, but we would also love to hear feedback from you! Whether it is updates on our company, tips on wearing our devices, basic new patient questions or concerns or updates on your experience with us! We encourage you to give us feedback at any time by posting your comment or sending us an email!

Features to Look Forward To:

Questions & Answers regarding our services/offerings
Upcoming/current events
Philanthropic opportunities
Office updates
Company-related articles

We hope you stay tuned with us as our company continues to grow throughout the community!!

Infinite Technologies Orthotics and Prosthetics

The Direct Socket: The Science Behind This Innovative New Technology, How It Compares To Traditional Prosthetic Casting, And If It Is Right For You

Benefits of direct socket vs traditional socket fabrication methods

Benefits of direct socket vs traditional socket fabrication methods

Who is a good candidate for the direct socket?

Who is a good candidate for the direct socket?

SDO Vs SPIO

Osseointegration

What is Osseointegration?

What Are the Benefits of Osseointegration?

Am I a Candidate for Osseointegration?

How Will You Know When The Time Comes To Replace Your Device?

Benefits Of A Resting AFO, Aka Stretch Brace

Management of Adolescent Idiopathic Scoliosis

Taking The Next Steps- Your Therapist And Orthotist/Prosthetist Working Towards One Common Goal

Pain in the neck: The need to knows of Cervical/Cervical-Thoracic Orthosis

Microprocessor vs. Non-Microprocessor Prosthetic Feet

What is a Detailed Written Order?

What does ‘Medically Necessary’ Mean?

What does ‘Medically Necessary’ Mean?

What determines what is Medically Necessary?

What if Medicare doesn’t cover a service I think is medically necessary?

What Is A TLSO And What Is It Used For?

Why Physicians Need To Sign Paperwork?

What is Phantom Limb Pain?

What is an SMO and its function?

Copay VS. Deductible? Out of Pocket? What does it all mean?

WHAT’S A COINSURANCE?

DO I ALWAYS HAVE A COPAY?

WHAT IS A DEDUCTIBLE?

WHAT IS THE DIFFERENCE BETWEEN A DEDUCTIBLE AND A COPAY?

WILL MY SECONDARY INSURANCE COVER THE PRIMARY PLAN’S DEDUCTIBLE?

Carbon fiber Vs. Thermoplastic in Prosthetics and Orthotics

July 2017 Newsletter

September Support Groups

Patient Spotlight: Meet Trace!

Interesting Articles!

Good Morning Friends!

Technology Spotlight: Surestep SMO

Q. What are some indications that the Surestep might be appropriate for my child/patient?

Q. Are there any contraindications that this product might not be the right fit for my child/patient?

Q. How does my child/patient get an appointment?

August Support Groups

Good Morning!

Interesting Articles!

Good Morning!

July Support Group Information

Good Afternoon!

Technology Spotlight: MyoPro

June Support Group Information

Good Afternoon!

Technology Spotlight: KidCap

Who is a candidate for KidCap treatment?

How is KidCap Different from other devices?

Technology Spotlight: RUSH Foot

Benefits:

Here’s what one of our patients has to say about it:

KidCap Halloween Costume Contest Winner

2015 Kidcap Halloween Costume Contest!

Contest Details:

Technology Spotlight: MyoPro

The MyoPro™, is a Myoelectric Arm Orthosis designed to enable individuals to self-initiate and control movements of a partially paralyzed or weakened arm using their own muscle signals.

Who would benefit from the MyoPro?

Touch Bionics Trip update from the Prosthetists!

Day 1

Day 2

Day 3

Overall Experience

Follow Up with the patient: In office definitive fitting

﻿

Combo Classic Golf Tournament

The Staff at Infinite Technologies would like to congratulate two very special people!

Sweating in a Prosthesis

Infinite Technologies featured on CNN/CNBC!!

Attention Physical Therapists!! Now offering CEUs!!

April is Limb Loss Awareness Month!

You can post up to 4 pictures, one for each of these categories:

Infinite Tech starts blogging!

Features to Look Forward To: