Access Legacy PDF work order. Legacy form will be accepted until Nov 1st.
Legacy form will no longer be accepted.
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Submission Type:
Daily HFN Capacity
{requestedInoffice}{requestedInoffice1217}{requestedInoffice1281}{requestedInoffice1282}
Clinicians can still coordinate special in-office requests by emailing:HFN_Hypercare@hanger.com
TWO STAGE CAST IS REQUIRED
ALIGNMENT CASTING BLOCK:
Toe Ramp Angle:
Please enter a value between 25 cm and 60 cm. You will not be able to proceed otherwise.
i
NEUTRAL is the Tibia perpendicular to the floor based on Heel Height.
Final Forefoot Position:
Set the Forefoot in Degrees* ° of Varus Valgus*
Final Hindfoot Position:
Set the Hindfoot in Degrees* ° of Inversion Eversion*
MANUAL MUSCLE TESTS:Strength
Observational Gait Analysis:
Biomechanical Objectives:
Mild Control: provides minimal resistance to tibial advancement in stance. MMT: DF ≤ 3, PF ≥ 4, KE ≥ 4
Moderate Control: provides mod. resistance to tibial advancement in stance. MMT: DF ≤ 3, PF ≤ 4, KE ≥ 4
Firm Control: provides firm resistance to tibial advancement in stance. MMT: DF ≤ 3, PF ≤ 3, KE ≥ 4
Standard Mods include:
NOTE: No variation in design at this time.