Intrinsic Adjustments - Machined EVA

This page explains all relevant features on the Intrinsic Adjustments page of LaserCAM Prescribe for Machined EVA prescription.

Overview

Navigation

Click Intrinsic Adjustments from the menu to access this page in LaserCAM Prescribe.

Page Layout

Page Fields

Plantar Fascia Accommodation (PFA)

A Plantar Fascia Accommodation (PFA), sometimes referred to as a Plantar Fascia Groove, is an accommodation at a specified depth (mm) in the top surface of the orthosis shaped according to a Curved, Straight or Scan style selection. 

It is highly recommended that all prescriptions consider the accommodation of the plantar fascia. Not including an accommodation for the plantar fascia can result in patient discomfort.

The specified depth is measured prior to surface smoothing and is subject to minor variability.

Default Value

Minimum Value

Maximum Value

Default Selection

Available Selections

Default Value

Minimum Value

Maximum Value

Default Selection

Available Selections

0mm

0mm

8mm

Curved

Curved

Straight

Scan

Curved

Adjustment Origin

Adjustment Insertion

Adjustment Origin

Adjustment Insertion

Medial calcaneal tubercle

Inline with 1st metatarsal ~10mm proximal to 1st MPJ

Straight

Adjustment Origin

Adjustment Insertion

Adjustment Origin

Adjustment Insertion

Medial calcaneal tubercle

Inline with 1st metatarsal ~10mm proximal to 1st MPJ

Scan

Scan style selection will indicate to technicians that a marking has been made on the plantar fascia prior to 3D scanning, or has been indicated using the Make Drawing tool.

This is the most accurate method of Plantar Fascia Accommodation prescription.

Adjustment Origin

Adjustment Insertion

Adjustment Origin

Adjustment Insertion

As per marking

As per marking

Medial Arch Fill

Medial Arch Fill represents a percentage based adjustment to the height of the orthosis within the area of application.

Default Value

Minimum Value

Maximum Value

Default Value

Minimum Value

Maximum Value

0%

-50%

50%

Area of Application

Positive Percentage

A positive percentage represents an increase in the height of the orthosis in the area of application. For example, if the medial arch height is measured at 30mm then a value of 10% will result in a total height of ~33mm.

In traditional orthosis terms a positive value can be though of as removing plaster from the positive cast.

Negative Percentage

A negative percentage represents a decrease in the height of the orthosis in the area of application. For example, if the medial arch height is measured at 30mm then a value of -10% will result in a total height of ~27mm.

Lateral Arch Fill

Lateral Arch Fill represents a percentage based adjustment to the height of the orthosis within the area of application.

Default Value

Minimum Value

Maximum Value

Default Value

Minimum Value

Maximum Value

0%

-50%

50%

Area of Application

Positive Percentage

A positive percentage represents an increase in the height of the orthosis in the area of application. For example, if the lateral arch height is measured at 10mm then a value of 10% will result in a total height of ~11mm.

Negative Percentage

A negative percentage represents a decrease in the height of the orthosis in the area of application. For example, if the lateral arch height is measured at 10mm then a value of -10% will result in a total height of ~9mm.

Medial RF Posting

Medial RF Posting, sometimes referred to as a Medial Heel Wedge, represents an intrinsic addition of material at a specified angle within the area of application.

Default Value

Minimum Value

Maximum Value

Default Value

Minimum Value

Maximum Value

-20°

20°

Area of Application

Positive Degree

A positive degree will commonly apply a supination moment to the subtalar joint within the area of application. This adjustment will result in an application of force that is medial to a normal subtalar joint axis.

Negative Degree

A negative degree will commonly apply a pronation moment to the subtalar joint within the area of application. This is sometimes requested when a positive degree of Lateral RF Posting is deemed a contraindication due to orthosis fit, or other reasons.

Lateral RF Posting

Lateral RF Posting, sometimes referred to as a Lateral Heel Wedge represents an intrinsic addition of material at a specified angle within the area of application.

Default Value

Minimum Value

Maximum Value

Default Value

Minimum Value

Maximum Value

-20°

20°

Area of Application

Positive Degree

A positive degree will commonly apply a pronation moment to the subtalar joint within the area of application. This adjustment will result in an application of force that is lateral to a normal subtalar joint axis.

Negative Degree

A negative degree will commonly apply a supination moment to the subtalar joint within the area of application. This is sometimes requested when a positive degree of Medial RF Posting is deemed a contraindication due to orthosis fit, or other reasons.

Ramp

Inversion Ramp

An Inversion Ramp is an intrinsically applied medial wedge applied within the area of application.

Default Value

Minimum Value

Maximum Value

Default Selection

Available Selections

Default Value

Minimum Value

Maximum Value

Default Selection

Available Selections

45°

Full Length, Full Width

Full Length, Full Width

Full Length, Half Width

Sulcus Length, Full Width

Sulcus Length, Half Width

3/4 Length, Full Width

3/4 Length, Half Width

Forefoot Only, Full Width

Forefoot Only, Half Width

Area of Application

Eversion Ramp

An Eversion Ramp is an intrinsically applied lateral wedge applied within the area of application.

Default Value

Minimum Value

Maximum Value

Default Selection

Available Selections

Default Value

Minimum Value

Maximum Value

Default Selection

Available Selections

45°

Full Length, Full Width

Full Length, Full Width

Full Length, Half Width

Sulcus Length, Full Width

Sulcus Length, Half Width

3/4 Length, Full Width

3/4 Length, Half Width

Forefoot Only, Full Width

Forefoot Only, Half Width

Area of Application

Heel Cup

The Heel Cup adjustment allows a user to increase or decrease the internal width of the heel, while also having a minor effect on heel cup height.

Default Value

Minimum Value

Maximum Value

Default Value

Minimum Value

Maximum Value

0%

-50%

50%

Area of Application

Positive Percentage

A positive percentage represents a decrease in the internal diameter of the heel cup and an increase in the height of the heel cup within the area of application.

Negative Percentage

A negative percentage represents an increase in the internal diameter of the heel cup and a decrease in the height of the heel cup within the area of application.

Intrinsic Heel Lift

The Intrinsic Heel Lift adjustment applies a lift specified in millimetres within the area of application. The peak thickness is at the most proximal point of the area of application.

Default Value

Minimum Value

Maximum Value

Default Value

Minimum Value

Maximum Value

0mm

-30mm

30mm

Area of Application

Positive Value

A positive value represents an increase in heel height that is tapered from the proximal edge to the distal edge of the area of application.

Negative Value

A negative value represents a decrease in heel height that is tapered from the proximal edge to the distal edge of the area of application.

Metatarsal Wedge

The Metatarsal Wedge adjustment applies a lateral or medial forefoot wedge within the area of application.

Default Value

Minimum Value

Maximum Value

Default Value

Minimum Value

Maximum Value

-45° (medial metatarsal wedge)

45° (lateral metatarsal wedge)

Area of Application

Positive Degree

A positive degree results in a lateral wedge applied within the area of application.

Negative Degree

A negative degree results in a medial wedge applied within the area of application.

Skive

A Skive is an adjustment that is achieved by orientating a flat plane relative to the aligned 3D foot scan during computer-aided design. This plane is orientated in relation to a marked subtalar joint axis, or at a specific angle, and pushed through the 3D foot scan at a specified depth.



Default Value

Minimum Value

Maximum Value



Default Value

Minimum Value

Maximum Value

Depth

0mm

0mm

10mm

Angle (°)

-90° (lateral skive)

90° (medial skive)

There are two methods of prescribing a Skive. Please use the method available to you depending on your 3D scan hardware.

Prescription Variable

STJ Axis Method (Recommended Method)

Depth/Degree Method

Prescription Variable

STJ Axis Method (Recommended Method)

Depth/Degree Method

Angle (°)

Not required

Required

Depth (mm)

Required

Required

3D Scan Type

Colour 3D Scan Only

Any 3D Scan

STJ Axis Method

Recommended Method

The image below shows the orientation of the adjustment relative to the subtalar joint axis marked on the 3D scan (represented by the yellow line).

Using the STJ Axis Method the only variable required is the Skive Depth.

Depth/Degree Method

The Depth/Degree Method allows a user to enter a specific Skive Depth and Skive Angle.

Skive Depth

The Skive Depth directly effects the magnitude of supination or pronation moment applied to the subtalar joint.

Skive Angle

The Skive Angle defines the frontal plane orientation of the skive plane. If the subtalar join axis is medially deviated then the Skive Angle should increase to ensure a supination moment is being applied to the subtalar joint.

Inclination Angle

The Inclination Angle defines the sagittal plane orientation of the skive plane. The default value is set to Maximum Inclination, which is considered generally appropriate. Specific values may be requested.

Default Selection

Available Selections

Default Selection

Available Selections

Maintain Maximum Inclination

Maintain Maximum Inclination

Zero Degree Inclination

Specific Inclination (°)

Maintain Maximum Inclination

The image below shows a Skive with the Maximum Inclination of the skive plane.

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