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Shoe Fitting > Measuring and Fitting > Flashcards

Measuring and Fitting Flashcards

1
Q

What five (5) devices are used for Measuring and fitting

A
  1. Brannock device
  2. Fitting Form
  3. Shoe horn
  4. display center
  5. Fitting stool
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2
Q

list ten (10) steps for measuring

A
  1. walk in place to assure a natural foot position when measuring length and width with Brannock device
  2. patient should be wearing socks or stockings while walking in place
  3. align heel all the way back in the Brannock device
  4. measure from heel to longest toe (big toe vs. middle toe)
  5. Align a credit card against edge of toes and measure the next available interval (measured in half intervals, e.g. between 7 and 8 is 7.5) Write it down
  6. Measure from heel to longest arch (metatarsophalangeal joint)
  7. Take midpoint measurement of first two measurements.
  8. Determine patient Width
  9. Repeat same process with other foot
  10. If patient’s two feet are greater than or equal to 1.5 sizes different then you can order a split pair.
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3
Q

Why is it important to help assist a patient in donning and doffing shoes

A
  1. Ensure they are putting them on correctly

2. speeds up process

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4
Q

List four (4) things to check for once a patient is testing a pair of shoes

A
  1. check toe length (3/8 to 1/2 inch length from end of toe to end of shoe)
  2. check width of shoe (metatarsophalangeal joint should be at width of shoe)
  3. heel slippage
  4. balance issues, discomfort
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5
Q

What is the proper name for heat moldable inserts for billing to medicare

A

A5512 Heat Moldable Inserts

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6
Q

List composition of A5512

A
  1. base layer blue/yellow EVA

2. soft accomodative P-cell

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7
Q

What can be used to heat mold an A5512

A
  1. convection oven
  2. heat gun

DO NOT use microwave oven

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8
Q

What is medicare requirement minimum temperature of A5512 heat mold

A

Minimum of 230 F

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9
Q

List twelve (12) steps for heat molding inserts

A
  1. verify size and fit of shoes
  2. Have patient sit forward in chair in a neutral position (allow them to put more weight into the insert)
  3. demonstrate to patient the procedure (e.g. you will heat up the insert and then put foot onto insert while warm to achieve total arch contact)
  4. place insert onto a box top that will not conduct any heat
  5. heat the bottom surface first (the base layer blue/yellow EVA), focusing on forefoot and arch
  6. keep heat gun constantly moving so too much heat isn’ applied to one spot
  7. once bottom surface has been heated, flip it over and repeat process for P-cell surface
  8. make sure patient is wearing socks
  9. place a insert on molding block and then place patient’s foot on the molding block/insert to ensure total arch contact
  10. have patient lean forward to ensure total arch contact
  11. heat mold all 3 pairs at the same time… start heating the next insert
  12. patient should keep their foot on their insert for approximately the same time spent heating initially
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10
Q

What are two signs that an insert has been properly heated

A
  1. leave thumbprint on insert

2. insert start to curl

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11
Q

What is a sign that the insert has been heated too much

A
  1. starting to turn golden brown
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12
Q

What tool is used if total arch contact is not being achieved

A
  1. Scaphoid pad/ arch pad
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13
Q

Why should patient not be barefoot or wearing only nylons while using the foot mold?

A

wearing socks minimizes risk of burn

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14
Q

What was the impetus for developing the scaphoid arch pads

A

medicare has requirements for total arch contact

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15
Q

What are two types of scaphoid arch pads

A

Obtained from Dr. comfort

  1. soft arch pad
  2. hard rubber pad
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16
Q

What is used to affix a scaphoid arch pad to a patient’s heat moldable insert?

A

super glue or rubber cement

17
Q

Which layer is the scaphoid pad place on?

A

the base layer blue/yellow EVA

18
Q

List seven (7) additional pads that can be added to offload certain areas of pressure on patient’s foot

A
  1. adjustable heal lift
  2. sponge heel pad
  3. heel posting
  4. metatarsal pads
  5. metatarsal bars
  6. dancer pads
  7. IPK pads
19
Q

List two billing codes for custom diabetic inserts

A
  1. A5513

2. A5514

20
Q

Describe proper positioning for foam impression casting

A
  1. forward position in chair

2. back, hip, knee and ankle form a 90 degree angle (i.e. subtalar neutral position)

21
Q

should you alter the position of patient’s foot if their alignment is abducted or adducted?

A

No, cast the foam impression without altering position of patient’s foot w/ regards to adduction and abduction

22
Q

Once patient is in proper position, with the foot in subtalar neutral and on the foam impression, what is next step?

A
  1. Cast the heel of the foot by pressing down on the knee and back of foot
  2. Then cast forefoot, ensuring all toes are down
23
Q

Does the patient wear socks or nylons during the foam impression casting?

A

No, patient should be barefoot

24
Q

List four (4) conditions

A
  1. ulcer on plantar surface of 3rd metatarsal: 3rd metatarsal head offload
  2. over 200 lbs: 55 durometer
  3. increased risk of skin breakdown/ulceration: tri-laminate insert
  4. Missing a digit: toe filler
25
Q

List four (4) foot conditions and the adjustment that can be made to help these patients

A
  1. ulcer on plantar surface of 3rd metatarsal: 3rd metatarsal head offload
  2. over 200 lbs: 55 durometer
  3. increased risk of skin breakdown/ulceration: tri-laminate insert
  4. Missing a digit: toe filler
26
Q

Can blue filler inserts be used as the sole insert?

A

No, they should always be accompanied by gel insert, heat moldable A5512, or custom insert.

27
Q

What is the “phrase” to remember if blue filler inserts go on bottom or on top of other inserts?

A

“Blue on the Bottom”

28
Q

What is the $ cost of a split pair order

A

50% surcharge

29
Q

What is a tongue pad used for?

A

Can be affixed to the tongue of the shoe to tighten the fit of the shoe

30
Q

What is a tongue pad used for?

A

Can be affixed to the tongue of the shoe to tighten the fit of the shoe

31
Q

Scenario: patient is experieng heel slippage with a 7.5 W, what is a possible fix that doesn’t involve additional inserts or pads?

A

Bump up to 8 Medium

Shoe Fitting (1 decks)

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