C-Pro Direct ADM User manual

Instructions for Use
Ambulatory Abduction Dorsiexion Mechanism (ADM)
Copyright © 2021 C-Pro Direct Ltd Version 002 January 2021
075_MKT_Day_ADM_Instructions_for_Use_V002
Intended Use
e Ambulatory Abduction Dorsiexion Mechanism (ADM) comprises an ADM device and
ambulatory footwear that has been made or adapted to connect to an ADM. e Ambulatory ADM
may be worn unilaterally or bilaterally by patients with a range of conditions aecting the main joints
and motions of the ankle and foot - specically the sub-talar and tibio-talar joints. Ambulatory ADMs
are suitable for a range of conditions that result in an abnormal (typically supinated) gait. is includes
Clubfoot and some neurological and muscular conditions. Ambulatory ADMs should be used as
directed by a qualied clinician to achieve a specic purpose, such as maintenance of improved foot
position or range of motion and gait improvement.
Device Function and Purpose
Ambulatory ADMs alter the resting foot / ankle position and gait. Gait alterations typically include
reversal of a tendency to supinate (ie., for the foot to turn inwards and downwards). Expected gait
alterations include a lengthening of the stride, prevention of foot-drop, improved heel-strike and
a reduction of inward rotation at the hip and knee. Patients with neurological conditions may also
experience improved balance, endurance and condence. Range of motion improvements may also be
achieved with prolonged consistent use.
Package Contents
An Ambulatory ADM system comprises:
qOne or two ADM devices with a side clip system for attachment to footwear
wFootwear, typically a pair of adapted shoes. Depending on the requirement, one or both items of
footwear will be modied to incorporate an “ADM Socket” which enables attachment of an ADM
device.
eTwo ADM Removal Tools to enable removal of the ADM device from the footwear.
q
e
w
i w p

Detachable ADM
e ADM may be attached and detached from the footwear. It is a matter of personal preference
whether the footwear is donned before or aer attaching the ADM. Some users may nd it more
convenient to leave the ADM permanently attached, others may prefer to detach the ADM from the
footwear aer removal.
Warning: Do not use footwear incorporating an ADM Socket without the ADM attached. This
may result in permanent damage to the ADM Socket rendering the device unusable.
Attaching ADM to Footwear
rCarefully insert the ADM device side clip into the ADM Socket. Note: e ADM mechanism is
positioned laterally, ie. on the outside of the ankle (the photo below is of a le side device).
tPress rmly until two distinct “clicks” are heard and felt as each side of the ADM side clip
engages with the footwear socket.
rt
Detaching ADM from Footwear
yCarefully insert the ADM removal tools into the holes on each side of the footwear until you can
feel the tool engage with the ADM side clip.
uGently push both removal tools and the ADM device should unclip from the footwear
yy
u
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2

3
Fitting the ADM
iFit the footwear as normal with either
the ADM detached or attached to the
footwear. If the ADM is attached then
the leg piece should be positioned to the
side of the leg.
Make sure the footwear laces, straps or
xings rmly secure the footwear to the
patient’s foot. Use the extra lace hole if
available to achieve the most secure t.
oIf appropriate attach the ADM to the
footwear as described at steps 4 and 5.
i
o
aCarefully bring the ADM leg piece into
the tted position and apply the lower
ADM strap to secure the ADM leg piece
to the leg in the required position.
sSecure the ADM top strap and any other
straps.
Conrm ADM is Correctly Positioned on Leg
With the patient’s foot and ankle in a neutral position check the ADM device is correctly positioned
on the leg. A neutral position means the foot is positioned relative to the leg such that there is zero
dorsexion or plantarexion at the tibio-talar joint and zero inversion or eversion at the sub-talar
joint.
qe small arrow on the leg piece should be at the centreline of the leg.
we ADM Connector Bar should be high and close to the limit of its allowable range of motion.
aq
w
s
High
Connector
Bar

M C-Pro Direct Ltd, 7A Enterprise Way, Edenbridge, Kent, TN8 6HF, UK.
PC-Pro Direct Ireland Limited, Unit 3, Block 1, Port Tunnel Business Park, Dublin, Ireland
Tel: [phone] www.c-prodirect.com Email: [email protected]
www.c-prodirect.com
Verication of Function
On rst tting a clinician should observe the patient walking in the ADM and determine that
the device is altering the gait or positioning the foot of the user as intended. If the device is
not performing as intended it should not be used. Oen changes in ADM spring strength
conguration can make signicant changes to how the device impacts on the user.
e simple test illustrated below can be undertaken to conrm the basic function of the ADM on
the patient in a tted condition.
qWith the user relaxed stabilise the leg and press the foot into a position of plantarexion and
inversion.
wRelease the foot and the ADM will move the foot about the patient’s tibio-talar and sub-talar
joints towards the limit of their range of motion.
q w
Warnings and Precautions
• Use only in accordance with these instructions and as directed by your clinician. Patient’s with
atfoot (collapsed foot arches) should use footwear providing arch-support to achieve a neutral
sub-talar position when standing. If required custom insoles should be used.
• Do not use if the patient is experiencing pain, blisters or sores through use of the device or if the
patient’s gait is less satisfactory than without the device. In these circumstances consult your
clinician.
• For general advice and guidance pertaining to tting or functional issues contact C-Pro Direct.
• Do not dis-assemble or tamper with the ADM mechanism. Do not use the ADM if any part is
damaged, not functioning or does not correctly t the patient.
• Clean using warm water and mild detergent, avoid avoid excessive wetting. Do not immerse
products in water and do not put ADM or footwear in a washing machine. With the ADM
detached from the footwear use the ADM Removal Tools and water to rinse mud or dirt from the
ADM socket areas.
• Do not expose any parts to extreme heat or prolonged direct sunlight.
• User’s may engage in mild active play whilst using the ADM, but use during contact sports or
activities such as climbing risks damaging the device.
• Visit www.c-prodirect.com or contact C-Pro Direct for further support and guidance.