Information on Central Fabrication of the Perfect Response Orthotic® and the Neuro-IFRAH® PRO KAFO
The Perfect Response Orthotic® (PRO) is a Neuro-IFRAH® Orthotic invented by Waleed Al-Oboudi, as an adjunct to the Neuro-IFRAH® Approach by Waleed Al-Oboudi. The Neuro-IFRAH® Approach is taught throughout the United States and internationally.
This orthotic is loaded with unique features and options to get a response of more normal movement in gait. These features are unmatched in any orthotic.
A unique feature of the PRO is the 2 layer foot bed consisting of a thin pliable layer that is in 4 segments corresponding to the hindfoot, midfoot, and 2 segments devoted to the forefoot. One of the forefoot segments allows for toe extension.
Options for various materials are placed between these two layers to encourage normal foot movements and discourage abnormal or undesired movements. All of this is done through pliable material made in various strengths to define the parameters and assist with movements individualized to the patient’s needs.
Detailed Breakdown of the PRO
- There are three joint setups available:
- Neutral – If active dorsiflexion deficit is mild and slight and hardly detectable, a significant assist is not required. This is for someone who has movement in their ankle toward dorsiflexion, however requires corrections in any/each of the following: hindfoot, midfoot, or forefoot.
- Level 1: If patient has greater than 50% of active ROM toward dorsiflexion
- Level 2: If patient demonstrates no active movement toward dorsiflexion up to 50% active ROM
- There are three joint setups available:
- Another feature is the precise adjustable stabilizing pads at the top of the calcaneous, allowing for optimal alignment of the hindfoot during normal gait.
- The pressure sensitive heel plate allows for a more normal sensory experience during the contact of the heel with the floor. This feature is designed to provide the opportunity for the system of the person to make the proper adjustments throughout the body as the patient increases weight on their foot in normal gait.
- The midfoot section is designed to move toward pronation to a certain degree with weight bearing and return to its normal alignment during non weight bearing.
- This feature is critical for normal foot function during normal gait and only available through this orthosis.
- Toes are set into extension to counteract toe flexion and assist with toe extension which is a critical component of dorsiflexion and foot clearance as well as heel contact in the walking forward component of normal gait.
- Toe extension also allows for contact at the head of the metatarsals, a critical component in certain phases of gait in walking forward, as well as initial landing of the metatarsal heads with the floor in walking backward.
- Optional Eversion/Inversion Assist
- Another unique feature for the PRO is an optional assist for movement of eversion or inversion of the foot.
- This assist is a carbon fiber insert that can incrementally influence the patient’s foot into a more normal foot alignment and discourage abnormal or undesired movements.
Detailed Breakdown of the PRO KAFO
- The PRO KAFO brings all of the features of the Perfect Response Orthotic® with the added/optional knee control component, allowing for the control of a patient’s knee hyperextension.
- The knee section of this brace is easily removable and the angle of knee extension allowed is adjustable.
- These products are currently only available in custom.
- In some cases a slight shoe lift may be needed for the non affected side to account for the material thickness of the brace.
- The recommended shoe is New Balance model 928. This model comes in different widths and has ample space in the toe box, accommodating for the toe lift built into the brace. In most cases the shoe for the affected side is ideally a 4E for extra width and a size and a half to two sizes larger than the shoe on the unaffected side.
Orthotists interested in providing the Perfect Response Orthotic® using KineMedic Concepts, Inc. for fabrication must first sign a license agreement issued by the Neuro-IFRAH® Organization. The Neuro-IFRAH® Organization can be contacted directly by calling (858) 550-1455, or by emailing them at email@example.com. Once that agreement has been signed and returned to the Neuro-IFRAH® Organization, you will be provided an instructional DVD covering the background, specifications, and casting instructions for the Perfect Response Orthotic®. After the video has been viewed and understood, an Account Application will need to be completed and submitted to us (KineMedic Concepts, Inc.) for review.
Once an account is established, our office will contact you about getting started.
SUGGESTED BILLING CODES FOR THE PRO:
SUGGESTED BILLING CODES FOR THE PRO KAFO:
For central fabrication pricing information please contact our office at (909) 337-3449.
After we have contacted you and have set you up as a provider for the Perfect Response Orthotic®, follow the instructions below to place your first order.
Cast your patient according to the specifications in the video you received. Then fill out one of our Perfect Response Orthotic® Order Forms in its entirety. It is important to remember that the standard option will be provided when no option is selected. If the patient was cast in the position outlined in the video and the order is completed with the standard option(s), in most cases, will result in a good fit without a delay. If you would like some small corrections made to your cast please indicate that on your order form. To remind you of the importance of this information, we have highlighted the Cast Correction – Position of Function section. If this section is not completed, we will attempt to contact you in order to clarify your requirements, which most likely will delay your order. We recommend yet do not require a video be provided with the cast noting the dynamics of the patient’s affected ankle/knee/hip during standing and walking. This helps to better inform our staff of the specific needs of the patient. We cannot over-emphasize enough the importance of a cast meeting our specifications. The less modifications and cast correction that is required for a cast to meet our position standards, the better the brace will fit and perform. If a cast is taken and it does not meet the specifications as indicated in your casting video, and if it requires major cast modifications, please recast the patient. Additional charges and a time delay may apply for casts needing major corrections.
A box is provided for you to write in any request for features or options not available on the Order Form. On the bottom right side of the Order Form, indicate any anatomical irregularities and/or measurements that may help us in fabricating the brace, or any other requests for information. You may also call our office at (909) 337-3449 to discuss any questions or concerns, or e-mail us at firstname.lastname@example.org.
Our goal is to deliver a quality brace in a timely manner. Once we receive all the information required to process the order, we will need to have up to 8 business days to complete the fabrication. At completion, the brace will be shipped via UPS 2nd Day Air (except for deliveries to CA, AZ, UT and NV, will will ship via UPS Ground).
Some factors that may cause a delay include:
An order requiring special attention due to unusual patient circumstances
An incomplete Order Form
Poor cast quality
A cast that needs correction
To request a reduced turnaround time, you may request a rush order by calling our office. We will give you an idea of how quickly we may be able to finish the order, and discuss upgrading the shipping to overnight delivery, and what those additional costs will be.
You may call or e-mail our office to check the status of an order.
As a central fabricator, we are able to directly bill your facility. When you complete the Application, specify whether you would like an open account set up, or if you would prefer to pay by credit card, and then provide the information requested.
Orders are shipped via UPS 2nd Day Air, (except for deliveries to CA, AZ, UT and NV, which will ship via UPS Ground). If you wish to arrange overnight delivery, please contact our office.
ADJUSTMENTS AND RETURNS
It is our goal to provide quality service and customer satisfaction. If there is a problem necessitating an adjustment or return, please contact our office immediately, and we will make every effort accommodate your request.
Each PRO is fabricated from an acceptable cast of the patient’s foot, and is guaranteed for fit, materials and workmanship for 90 days beginning 14 days after the date of shipment*. During that period, we will adjust, repair or replace the product if a problem exists. Abuse or undue rough wear and tear will void the warranty. This includes not wearing a shoe over the brace except during therapy times, and/or destruction from outside sources such as heat, cold, impact or undue abrasion beyond normal wear and tear. Patients should communicate with their practitioner about concerns regarding fit or workmanship. This will enhance our ability to resolve any issues you are experiencing as efficiently and quickly as possible.
*the 90 day warranty period is intended to provide ample time for brace fitting and troubleshooting. It is recommended that this fitting occur within 2 weeks following receipt of the brace.
The Neuro-IFRAH® Organization and originator, and inventor Waleed Al-Oboudi does not assume any liability in regards to fabrication and fitting issues between Kinemedic Concepts, orthotists and therapists. The Neuro-IFRAH® Organization recommends that therapists requesting the PRO are Neuro-IFRAH Trained® or Neuro-IFRAH Certified®. The Neuro- IFRAH® Organization and originator, and inventor Waleed Al-Oboudi does not assume any liability for therapist decisions regarding specifications related to the PRO or issues related to design and function of the PRO.