OCSI DynaPro Flex Adult Elbow Brace

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• Orthotic Treatment:
  - Upper extremity tone may require the use of Passive Range of Motion (PROM) or NeuroStretch beginning at the shoulder (see the NeuroStretch Instructions) to reduce tone and facilitate muscle inhibition.
  - Use PROM or NeuroStretch to passively stretch the affected joint capsule(s), connective tissue, tendons, and muscles. Avoid a stretch reflex while passively stretching the joint.
  - Slowly and gently use sub-maximal passive stretching to the point of noticeable resistance only (no discomfort). Hold for a minute to allow the extension release of the affected joint.
  - Set the elbow orthotic hinges to provide 5° to 15° of additional extension (extension setting) beyond the point of resistance to stretch (flexion setting).
  - Open the upper and lower cuffs and release the elbow cap straps on the inside (body side) of the device only. The top of the device has a fixed cuff and the bottom cuff will rotate to accommodate upper limb motion from flexion to extension. The device label is always placed on the top cuff for ease in device orientation.
  - Place the orthotic on the arm with the hinge at the midline of the elbow joint. Orient the device slightly above midline during application as the device tends to slip lower during application.
  - Secure the top cuff closure over the back of the bicep.
  - Secure the bottom cuff closure over the back of the forearm.
  - Bring the elbow cap straps up over the top of the orthotic side bars between the side bars and the elbow. Place the adjustable elbow cap straps through the rings and secure the hook on the loop landing pad. The elbow cap of the device should be centered on the elbow cap of the patient.
  - Incrementally tighten all four elbow cap straps to slowly bring the elbow into a stretched (extended) position. The elbow joint should come up into the brace as the elbow cap is secured. [Type text] DynaPro Elbow Orthotic.
  - Palpate the bicep tendon. The tendon should demonstrate extension tension on the tendon. The patient should experience a sensation on the affected joint. No pain or discomfort should be experienced. When the desired extension tension is achieved, the initial application is complete.
  - Check all cuff straps and the elbow cap for pressure. Two fingers should be able to be inserted between the strap and the skin. Loosen straps if necessary.
  - Re-palpate the bicep tendon after 15 to 30 minutes of wear. The tendon should be in a relaxed or state, indicating that relaxed tissue is being stretched by the device. The patient may continue to feel a gentle stretch. No pain or discomfort should ever be present.
  - Determine wearing schedule per therapy evaluation and physicians order.
  - Incrementally increase wearing time per patient tolerance and patient care plan up to a maximum of six hours on per shift. A minimum of three to four hours of wear daily after the adaptation period is recommended for best results.
  - Release and check for skin redness or pressure or patient discomfort every two to three hours at a minimum. Use the Blanch Test to evaluate any red areas. Remove the orthotic device immediately if significant redness or pressure is evident.
  - Upon device removal, closely inspect for skin integrity. Notify the appropriate staff member(s) immediately and document any significant redness or signs of adverse pressure or shear. Discontinue device use until the skin integrity issues are resolved, and the device is modified or the wearing schedule is altered to eliminate potential skin integrity problems.
  - Always follow orthotic device protocols if the patient is transferred to acute care or another healthcare facility. Send the related orthotic care plan and any accessories along with the orthotic device(s) with the patient if the orthotic will be going with the patient.
  - A wearing time adjustment is necessary every time there is a significant disruption in wearing schedule. Device endurance must be reintroduced gradually, and noted in the Patients care plan.
  - Follow manufacturers instructions for care of the orthotic device. Always inspect the device between applications to ensure the soft goods are properly in place, the device settings have not been altered, and the device has not been soiled or would not provide any other risk to the patient prior to application.
  - Check device settings for continued application of the desired amount of extension stretch at least once a month or whenever the patient is not experiencing a gentle stretch sensation post application. Re-adjust the hinges to maintain 5° to 15° of extension beyond the point of resistance to stretch as needed.
• Laundry Instructions:
  - Always remove soft cover from frame before washing
  - Do not machine wash or dry the gel pads
  - Close all hook and loop attachments on soft cover and place in enclosed laundry bag
  - Hand or machine wash, gentle cycle with mild detergent
  - Do not use commercial washer or hot water
  - Do not use bleach or fabric softener
  - Air dry
• Warning:
  - The product requires a physicians order.
  - The product is designed for single patient useonly in order to avoid cross contamination.
  - Any substitution or removal of the products parts voidsthe manufacturers warranty. OCSI/NeuroFlex, Inc. will assume no liability if the above instructionsare not followed.

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