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Amfit32 Orthotic Fabrication System

1. Inside each of these machines there are also a number of sub systems If you encounter a problem while operating either machine you may already have a good idea which system block is at fault Before resorting to the troubleshooting lists make sure that e The system is connected to the AC line that it is turned on and that there is power at the outlet e All cable connections are secure and where applicable screwed into place e All fuses are good The Milling machine has two fuses The Digitizer has none The milling machine fuses are located just above the power switch To remove them you will need a tool a small standard screwdriver works well Insert the tip into the indentation below the fuse drawer and press up and inward The drawer containing the fuses should pop out Replace fuses with the same type and voltage rating Troubleshooting e 95 The Computer 96 e Troubleshooting Computer Operation The computer inside the Amfit system is operating properly if it executes the Amfit program automatically The computer If the Has started booting Screen switches to a full screen display and displays the Windows logo Is probably operating e Windows logo displays correctly e Amfit program starts running and e Amfit introduction window is displayed If not there is a problem with the computer or the display monitor Floppy Diskette Left in Drive A common proble
2. Amfit Orthotic Fabrication System Medical Manual Amfit Inc May 2006 Important Notice Information in this document is subject to change and does not represent a commitment on the part of Amfit Inc The software described in this document is furnished under a license agreement The software may be used or copied only in accordance with the terms of the agreement No part of this manual may be reproduced or transmitted in any form or by any means electronic or mechanical including photocopying and recording for any purpose without the express written permission of Amfit Inc 1982 2006 Amfit Inc Published in the United States Printed in the United States Amfit the Amfit logo Footfax Footfax SL Archcrafter and the Archcrafter logo are registered trademarks of Amfit Inc Microsoft MS DOS Windows and the Windows logo are registered trademarks of Microsoft Corporation Intel 486DX Pentium and Intel Inside are registered trademarks of Intel Corporation Amfit Inc 5408 NE 88th Ave Vancouver WA 98665 PHONE 800 356 FOOT 3668 FAX 360 566 1380 SALES 800 356 3668 x266 TECHNICAL SUPPORT 888 699 2100 CENTRAL FABRICATION 888 356 3668 x254 CLINICAL SUPPORT 800 722 2217 www amfit com Contents Amfit32 Orthotic Fabrication System OVERVIEW e v Contents cont d Ordering Supplies from Amfit 101 lossary Of Terms ccccccccsssssssssseseeee L05 iv
3. SELF Fig 5 Options and Settings Window Options Tab Transfer box In the Options tab area the Transfer box contains several fields where you will need to enter information The first field is the Transfer Phone Number field In this area you will need to enter the destination phone number the phone number where you will be transferring files In the Receive Records Folder field you need to enter a path name This is the folder name and location where you want the files to be stored that are transferred to you In the Default Transfer Mode area you select the mode of transfer that you usually use 14 e SYSTEM OPERATION Amfit32 Orthotic Fabrication System Display Box The Display box allows you to set defaults to the Editor window If you would like to display the 2 D contour after a scan check the Display 2 D contour box If you would you like to view the grid as well check the With Grid option In the Show ruler field you need to decide if you would like to display the ruler If you do want to see the ruler check the Show ruler option If so choose which unit of measurement you would like to see on the ruler Check either the Use Inches or Use Centimeters box If you to want to display the 3 D view in mesh check the Display 3 D Mesh option Settings Tab The Settings tab in Options and Settings window is shown below Options E Settings ix Goie Settings Available Sizes Limits Male Eversion Ramp Bio
4. sitting semi weight bearing or non weight bearing positions The system operator initiates the digital recording of a foot impression using the system s computer controlled front panel buttons The array of sensor pins allows visual and tactile examination of a model of the patient s foot giving the operator an idea of how the finished product will look Because the sensors remain locked in place the operator can see the impression and even run their fingers over the sensors to verify the proper foot position The patient experiences the actual feel and support of the orthotic corrections before fabrication The operator then has the opportunity to edit the contour on the screen The Footfax Digitizer medical software provides unparalleled flexibility to modify the record contour The digitizer can record up to amen s size 17 surface size European size 50 Once the operator is satisfied with the contour including corrections if any the patient data is saved with the push of a button to the computer s hard drive The Mill Carving Station uses CAD CAM production technology to carve custom foot insoles from the digitally recorded foot impressions produced by the Footfax Digitizer This patented process eliminates additional steps that often cause impression distortions Sites that have a complete fabrication system can mill insoles immediately after taking impressions The milling machine is fully self contained and it mill
5. 90 e Communications Amfit32 Orthotic Fabrication System If AutoMerge is enabled the records in the incoming file are immediately merged with the local database and the file is archived in the designated archive directory If AutoMerge is disabled the incoming file is placed in the designated receive directory and the software does nothing further with it To enable or disable AutoMerge open the Configuration panel via the main menu item Windows gt Options amp Settings On the Standard Options panel check or uncheck the box adjacent to Merge Received Records Automatically Be sure to click Apply to confirm the configuration change Amfit CAD CAM Desktop v 5 2 Fig 43 AutoMerge Setup Window Amfit32 Orthotic Fabrication System Communications e 91 Maintenance General The Amfit system is designed for years of service with little attention However some maintenance is recommended After each patient After each use clean the Digitizer with a damp not dripping lint free cloth This ensures that it will be clean for the next patient Daily At the end of each day it is recommended that you do the following 1 GU ee I Every 10 pairs Press Lock Pins to lock the top of the Digitizer Vacuum the Digitizer pins Reset the pins by pressing Reset Then press Pins Up Verify that all the pins are free to move up and down Press Reset to lower the pins again After ten pairs
6. Digitize Client Allows you to send a customer to the Digitize box before the client is scanned Close Client Closes the active client in the user workspace Close All Clients Closes all clients that are in the Amfit Workspace Delete Client Allows you to delete clients from the database Option is available only when there is an active client in the user workspace Delete Insole Allows you to delete an insole under active client The insole must be highlighted for this option to appear View 2D By checking this option you can display the 2 D version of the scanned foot on the right side By unchecking this option only the 3 D version is displayed Lets you display a ruler for measurement on the left side of the 2 D foot Elevation Legend Displays a color legend of pin heights reflected on the scanned insole Pin Grid Places a pin image on the 2 D display allowing you to pinpoint areas from the digitizer Active Editing If checked as soon as shapes or adjustments are made in the workspace they will be reflected in the 2 D display Prints the active insole record View 3D By checking this option you can display the 3 D version of the scanned foot on the right side By unchecking this option only the 2 D version is displayed Show Positive Displays the positive form of the 3 D image on the right side Window E Cascade Allows the Editor windows to sit on top of each other when more than one are open Tile Arranges the op
7. and Heel Lift Ramp commands above Arch Support Heel Cupping Lateral Arch Support and Total Support are summed by the computer This means that if you set Arch Support to 10 and Total Support to 10 the adjustment under the arch will in fact be 20 Medial Heel Wedge A pre defined wedge is placed from the centerline of the foot toward the medial side It runs from the back of the contour to approximately 8mm in front of the low point in the heel It blends in for an additional 8mm further forward The change is specified in degrees Possible range 0 9 degrees Amfit32 Orthotic Fabrication System Editing Adjustments e 63 Table 10 Types of Wedges Lateral Heel Wedge A pre defined wedge is placed from the centerline of the foot towards the lateral side It runs from the back of the contour to approximately 8mm in front of the low point in the heel It blends in for an additional 8mm further forward The change is specified in degrees Possible range 0 9 degrees Sulcus Rise Limit Sets the maximum height of the sulcus or oe I toe crest of the contour above the ball of i the foot The change is specified in millimeters Possible range 0 9 millimeters Note If no sulcus was recorded at the time the foot was digitized this command has no effect This function only limits the height of the sulcus It does not create one if one did not exist This command is useful if a sulcus is recorded but no sulcu
8. amp Diagnostics window is displayed Mill Calibration amp Diagnostics pa Za Fig 37 Mill Calibration amp Diagnostics Window Amfit32 Orthotic Fabrication System Milling e 75 Z Depth Calibration Take the following steps to perform Z depth calibration Table 13 Performing Z Depth Calibration Remove the insole tray and tape the plate of steel over the milling area in the tray Insert the tray into the mill and lock it in place Click Mill Diagnostics on the Milling tab This will open the Mill Calibration and Diagnostics window Click on the New Calibration button You will be asked if you would like to proceed with calibration now Answer Yes When you see no dectected motion accept as a calibration point answer Yes When you see no dectected motion accept as a calibration point answer Yes When you see no dectected motion accept as a calibration point answer Yes When you see no dectected motion accept as a calibration point answer Yes X Y Position Calibration Before performing X Y calibration do the following Remove the insole tray and remove the steel plate Adhere a foam block to the insole plate with the drilled hole directly above the end tip of the hole locating arrow It may be helpful to stick and awl through the hole to locate the hole directly on the arrow This will be used to find the origin for the insole Take the following steps to perf
9. front half of the insole is medium white and brown density The rear half is made of firm material Sizes and Styles Straight vs Curve Molded Straight molded insole blanks are thicker and do not have a precut under the arch Curve molded insole blanks are pre cut under the arch and are designed to minimize secondary sanding Curve molded blanks may not be appropriate for patients with low arches In low arch situations the precut arch of a curve molded blank tends to get weak In extreme cases the grinding head will go entirely through the arch material Table 16 Sizes and Styles of Insole Blanks Women s Sizes Men s Athletic Dress American size 6 17 4 12 4 12 European size 39 50 35 43 35 43 Amfit32 Orthotic Fabrication System Milling e 79 Insole Blank Placement Take the following steps to properly place an insole blank 1 2 Press the release button and remove the insole tray from the mill Place the tray on a horizontal surface Remove the backing from the insole tape and press the blank in place see figure below Stick the insole in place Take care to align the e Heel notch on the insole with the tip of the arrow on the insole tray and e Notch at the toe end of the insole with the centerline Because it is not possible to stick an insole onto the insole tray very well it is a good idea to press the blank FIRMLY in place Re insert the insole tray into th
10. in the Milling window Clean the milling head using a solvent such as lacquer thinner and a wire brush Material temperature should be 80 F 27 C or less Amfit32 Orthotic Fabrication System Troubleshooting e 97 Problem Insoles still tear off Table 18 Solving Milling Machine Problems Possible Cause Dress cut with a wide foot cavous foot and or low arch Action Try pre cutting insole at a thickness of about 6mm Mill blows fuse when a cut is started Debris at milling head Worn out motor brushes Remove insole tray and look for debris at milling head Replace brushes Mill blows fuse during a cut Worn out motor brushes Firm material and a wide foot Replace brushes Try pre cutting insole at a thickness of 8mm Be sure to unplug the unit from wall outlet before attempting this Can t pull tray out of mill A chunk of material is stuck at the milling head Remove tray you may have to pull quite hard and remove debris You may also be able to remove debris by pulling the dust drawer out and accessing the milling area from below 98 e Troubleshooting Amfit32 Orthotic Fabrication System The Digitizer The Digitizer converts the height or elevation of the sensor pins into numbers that the computer uses to define the shape of the bottom of the patient s foot The basic operation of the machine is quite simple 1 Amfi
11. input into a format that can be manipulated by a computer In the Amfit system it refers to the foot scanner A storage media for a computer that can be taken from one computer to another The Amfit system uses 3 5 DSHD diskettes that are formatted for IBM type computers The process of moving an item on the screen Select the item to be moved with the mouse by pressing the left button As you move the mouse the computer re draws a picture of the item This process is called dragging When you release the left button the item assumes its new location Height relative to something else In the Amfit system it refers to the height above the lowest point measured A message displayed on the computer screen indicating that the computer cannot continue to correctly process information For example you would see a message if you entered a letter instead of a number to tell the computer what size insole to produce Amfit32 Orthotic Fabrication System Glossary of Terms e 105 Glossary cont d Eversion Floppy diskette Footfax Hard disk Impression Interactive Inversion Lateral Medial Metatarsal Milling machine Mouse Pentium Prototype RAM Software 106 e Glossary of Terms Inward canting of the foot A storage media for the computer that can be moved from one computer to another The floppy disk drive is the device that reads and writes to the floppy diske
12. last name First name Enter client first name Address Enter client street address City Enter client city address State Province Enter client state or province Zip Enter client zip postal code Phone Enter client phone number Male Select this to cut the area of an Amfit Male insole blank Female Select this to cut the area of an Amfit Female insole blank Thickness Enter the desired minimum insole thickness Insole Size Enter client s insole size Email Enter email address of client Covering Select a topping material for the finished orthosis Density Select the density of the orthosis material Style Choose the style of shoe in which the insole will be fitted 20 e BASICS Amfit32 Orthotic Fabrication System Existing Client To load an existing client click on Record Then either click Open Existing from the menu or click on the head in the toolbar The Select Customer window appears You must enter some of the last name of the customer The computer will use this to search its file Selaci Clare Hame Search Exes Fasi Moser TEEN IATA LI ZII III III AM AIN x Hans Aces Fig 8 Existing Client Window Enter some of the last name and then click on Search The computer will display a selection of names that match the letters entered for the last name Click on the name desired and then click on Open Digitizing The Digitizer Window The screen should now display the Digiti
13. of the toe plate to reach determine whether it is a right or left foot In some cases such as a bad bridge arch a reverse arch or no toe plate used in a session the computer will not be able to make a left right determination In those cases the computer displays the Select Foot window see figure below Click on the correct foot Left or Right and then OK Amfit32 Orthotic Fabrication System DIGITIZE e 43 Menus Files 44 e DIGITIZE Select Foot Select Foot Left Right Cancel Fig 26 Digitizer Needs Information Select Foot Window In other cases if the patient s foot will not be completely down in the heel or forefoot area the computer will warn you that the scan may not be accurate see figure below For more help on correct heel and forefoot positioning see Positioning later in this chapter Digitizer Warning Warning Heel or Forefoot were not on the Digitizer Continue No Fig 27 Digitizer Warning Message Box When the Digitizer window is active the following menus are displayed across the top of the screen Open Database This allows you to select another database For example this is useful when you need to select a database to be sent over phone lines serial cable FTP or by floppy diskette to the Amfit site If you do not use the communication capability of the Amfit system you would not normally use this command The database is normally stored in t
14. to E version Ramp fo to f Female fi to i Auto Pinsup 5 sec Heel Center Style Tenths of men Fig 6 Options and Settings Window Settings Tab Amfit32 Orthotic Fabrication System SYSTEM OPERATION e 15 16 e SYSTEM OPERATION Available Sizes The Available Sizes box allows you to enter default numbers for shoe sizes for both male and female In the example above the range is set for Male sizes 3 to 17 When you create a new male client his shoe size entered in the Customer Information window will have to be between 3 and 17 or an error message will appear This same rule applies for female Limits Like the size box the Limits box allows you to set default thicknesses when you are entering new customers The limits you set here will determine the range you are allowed when you create a new customer If you enter information outside of this range an error message will appear Style Covering and Density Style covering and density are three selections that you will need to make when you are entering a new client However because over time the selections change this area allows you to add and remove selections that are new or no longer available To add a new option type the name of the option you would like to add in the corresponding Add style Add Covering or Add Density box Then click the Insert button This will then fill in or populate the field above it with y
15. with a password or log in 86 e Communications Amfit32 Orthotic Fabrication System Selecting Files to Transfer The communications process is very straightforward You need to tell the computer what you want to send and then tell it how to send it The first part is referred to as selecting records The second part is selecting the mode of communications By Phone By Wire To Folder By FTP Transfer database records To select records for transfer drag them down from the top of the Workspace into the Transfer box at the bottom of the Workspace see figure below gt ti DIGIO00 Public John Wed Oct 12 10 42 03 2005 Right Wed Oct 12 10 20 36 2005 Right Wed Oct 12 10 20 06 2005 Right Wed Oct 12 11 16 11 2005 Left Drag n Drop mN z610 No communications activity Aboit Transfer Receive Records Session Transactions 0 By Phone By Wee C ToFolder ByFTP Destination 1 888 356 3669 Configuration Views Log 4BJSUCIL Fig 41 Transfer Box in the Workspace Simply click on By Phone Then enter the phone number for the central fab facility and click on Send Next you will enter the name of the database and its folder where you want the information to be stored The system will automatically fill in CA Amfitwin Data DatbaseName as the drive and pathname This is correct assuming you are copying to the C drive If you would like to Amfit32 Orthotic Fabri
16. words check for some pins to be all the way down in the heel and the forefoot e Excessive posting of the first met head 42 e DIGITIZE Amfit32 Orthotic Fabrication System 7 Press the Scan 3 on the Digitizer control panel the button button looks like a foot or click on the Scan button in the Digitizer window on the computer screen The Digitizer will now determine the height of all of the sensors in the pin array The process takes about 15 seconds After the computer analyzes the data the Edit window will appear displaying a topographical three dimensional representation of the foot data The green READY light will remain off while the machine is scanning When the green light turns back on 8 Press the Reset 4 on the Digitizer Control Panel or button click on the down arrow button in the Digitizer window on the computer screen The pins will drop and the Digitizer is ready to record the next contour The pins will reset automatically after about two minutes if no keys are touched on the Digitizer If you need to keep the pins locked for a period longer than two minutes simply press the Lock Pins key periodically Digitizer Needs Information Window You may record as many right and left feet as desired Each time you record a foot it displays a new Edit window In most cases the computer is able to determine which foot was digitized The computer looks at the data and the orientation
17. you must clean the dust drawer 1 2 3 4 Amfit32 Orthotic Fabrication System Turn the system power off Pull the dust drawer out from under the milling machine Dump the contents into a garbage can Carefully slide the drawer back into the mill Maintenance e 93 Every 1000 pairs On the mill clean the filters at the rear of the machine Air fans There are two filters in front of the air fans Remove their plastic grilles and vacuum the filters until they are clean Dust drawer The dust drawer filter is located at the lower rear of the machine Remove the filter and vacuum it until it is clean Replace the filter if it is damaged Annual service The Amfit system should be serviced annually contact Amfit Moving the system The Amfit system can be moved using normal care in handling To minimize the risk of damage we recommend using the original shipping containers 94 e Maintenance Amfit32 Orthotic Fabrication System Troubleshooting General This guide is not intended to train anyone to become an experienced Amfit service technician Instead it provides you with a summary of common simple problems and their solutions The troubleshooting process 1 Amfit32 Orthotic Fabrication System The first task when troubleshooting a system is to try to ascertain the system block that is at fault The Amfit System consists of two main systems e The milling machine dust tray e The Digitizer
18. 06 Vancouver WA PIGRI Phone 600 138 3580 Ordered By Order Date Telephone Purchase Order Fax Ship Method _ See O Corana wil mais LPS Groene i ar biari Ship To EMAIL Requires sore corta Litio deu ow bereger Barr MILL SERIAL NUMBER S mcc Hee man pse saria mamar in lininzi cuis well ba enni BS y e A ee dl ae _ I d do dodo i Positive Order Total Fig 44 Amfit Order Form 104 e Ordering Supplies from Amfit Amfit32 Orthotic Fabrication System Glossary of Terms Adjustment Bar graph display CAD CAM Dialog box Digital Digitizer Diskette Drag Elevation Error message A modification to the contour measured by the Digitizer The modification s purpose is to create some positive effect A series of lights to provide a visual indication of a quantity On the Amfit Footfax Digitizer it indicates the amount of support provided by the scanner during casting Computer Aided Design Computer Aided Manufacturing The Amfit computer system is used to design a custom foot insole by first scanning a patient s foot impression and then controlling the process of carving the foot insole A window displayed by the computer when it needs information from the operator or when the computer wants to make the operator aware or something such as an error Any information that is stored or processed in a format that a computer can manipulate A device that converts user
19. 1 Bi noo 1 rele Ul us Aug 10 14 37 46 2004 Richt us Aug 10 14 37 30 2004 Left Recommended Selections ware eee Right Toot Measured SWIOJSJd We 5 3 bartni 51182 51282 51181 51281 51183 can your Left Foot to finish he measuring process Fig 19 Preform Window After Drag n Drop 32 e BASICS Amfit32 Orthotic Fabrication System DIGITIZE Overview The Amfit Contour Digitizer is a precision instrument designed to measure the shape of the bottom of a patient s foot It measures the shape of the patient s foot by raising an array of sensor pins that contact the bottom surface of the foot The computer then determines the height of each of the pins The computer then reconstructs the pin height elevation information and displays the image you see on the screen The Digitizer is shown in the figure below Fig 20 Amfit Digitizer Scanner Amfit32 Orthotic Fabrication System DIGITIZE e 33 Controls The Digitizer s Control Panel is shown in the figure below It consists of four control buttons and the Pins Up Pressure control A bar graph display indicates the amount of pins up pressure Fig 21 Digitizer Control Panel Control Panel Overview The following table explains the Digitizer Control Panel Description Pins Up Raises the sensors pins Lock Pins Locks the sensors pins in place Scan Digitize Scans the sensors pins Reset Lowers th
20. Donor A May 10 16 37 23 Right af Current Hilling Selection Finished Milling Nest to be Milled A 0000 1000 Donor 4 May 1315 43 01 Right Density dual Covering cambria Size mi fe MoeT Thickness E Zi Female Cuts Remaining 0 Add Cuts Diagnostics Fig 16 Milling Window pases When there is more than one pair of foot data records for the patient please be sure that the date and time stamp next to the Left Foot and Right Foot areas of the screen reflect the proper set of contours to cut Amfit32 Orthotic Fabrication System Overview of the Milling Process The milling window provides the Amfit system with your instructions on what you want the milling machine to do It also displays information about the patient s orthosis that the system will produce and how far along the process has progressed The process of milling an orthosis is quite simple see below Table 5 Overview of the Milling Process Step Description 1 Select the proper size blank Select a size that matches the size of foot entered in the New Client window 2 Press the pushbutton on the insole tray cassette handle of the milling machine The catch will flip out and the tray can now be pulled out of the machine Set it down on a table and notice the lines on the tray surface 3 Remove the protective backing from the insole tape and place it on the insole tray 4 Now press the blank
21. TALLATION e 11 12 e INSTALLATION Amfit32 Orthotic Fabrication System SYSTEM OPERATION General The Amfit System is computerized While this may seem like stating the obvious it does mean that there are certain aspects to the operation of the system that may be new to you Manual Conventions The following standards are used throughout this manual for clarity Text that the operator needs to type into the computer will be LIKE THIS Text that the computer displays on the screen will be either a picture of the screen or Like this The manual frequently makes reference to parts of the computer s keyboard display and mouse pointing device That text will be Like this The first occurrence of a word that is in the Glossary will be Like this Amfit32 Orthotic Fabrication System SYSTEM OPERATION e 13 Options and Settings Options Tab The Options tab in Options and Settings window is shown below Options aing Ti Transis Phone Humber Transfer Pretec Traralm Indi Piacere Record Folder EMMATWINDATAS Receta Aitchet Foldei EMMA TWIN ARDY ARICHY Fs Deia Trarafer Mode By Prani lus Fiotrotece SEL Fan Win By wire Wire COM Port 7 Menge Fiscerved Record To Folder diutomaticalli By FTP Tea FTP Corrector M Diny E Display 30 beh E Displap 2 0 Camme f Show Aike F Display Grapher Manu D Wih Gii EE Lino nchis I Digfize on Cheni Cisation Lee Cenlimatori Piom Slocked SKU
22. ases the original foot and replaces it with the one on the screen Answering no adds a new foot record to the client s file Closes the open insole record Printer Setup Allows you to choose a printer that is connected to the system and print out a patient s scanned image Open Database Allows you to select a database This is used to retrieve e Client records on a floppy disk e Records that had been transferred by phone to this site Import Records Allows you to import records from some other location and add to the main database such as a floppy disk Convert Old Records Allows you to convert 3x 16 bit records to 5x 32 bit records Closes the Amfit program I Displays the top bar where the Print option can be found Displays the bottom bar displaying status of the equipment Records See Create New Opens the Customer Information window allowing you to enter a new client into the database Open Existing Opens the Select Client window so that you can select a client already in the database Edit Client Allows you to change customer information in the Customer Information window This option is only displayed when a client is active in the user workspace Edit Insole Allows you to make changes to a foot that has already been scanned This option is only displayed when there is an active insole in the user workspace Amfit32 Orthotic Fabrication System Editing Adjustments e 69 Table 12 Edit Window Menus Sub Menus
23. basic styles of insole blanks are available Table 21 Styles of Insole Blanks Pre Cut All Style Arch Sizes Density Notes Straight molded No Yes Soft medium firm Extra material for low and dual density 1 arches and large Men s and 2 corrections Curve molded Yes Yes Soft medium firm and dual density Straight molded No Yes Soft medium firm Extra material for low and dual density arches and large corrections Athletic curve Yes Yes Soft medium firm Will fit into most Women s molded and dual density women s casual and athletic shoes Dress curve Yes Yes Medium and firm Will fit into most molded women s dress shoes and pumps Arch area is pre cut to minimize secondary sanding Cover Materials The following cover materials are available Blue Cambrelle Brown Cambrelle Black Cambrell Dryz Black Leatherette Tan Suede e Micro Cell Puff NBS Plastizote Poron Plastizote Smoke Navy ETC Blue Spenco Black Spenco Blue Leather Black Leather Black X Static For more questions on top covers please contact the Blanks Order Process Department at Amfit Inc Patterns A complete set of insole patterns is included with each system Extra sets may be ordered at 245 00 set Amfit32 Orthotic Fabrication System Ordering Supplies from Amfit e 103 Please fill out and fax to Natalya Sova at 360 566 1380 AMEIT Blanks Order Form workomere 00 400 KE 28th Siroo Bldg D4
24. bump under your thumb This bump is the outside of the talus As the foot moves from inside to outside and back to inside there is a point where you can t feel either bump or you feel them equally on both sides This is neutral position By keeping your thumb or finger on the inside point of the foot as the impression is being recorded you will be able to detect if the foot is moving out of neutral If the foot does move you must start over again instructing the patient not to move the foot Neutral may also be determined by aligning the Achilles tendon vertically at a 90 angle to the top of the Digitizer Amfit32 Orthotic Fabrication System DIGITIZE e 47 Weight Bearing 48 e DIGITIZE Why Neutral Position By taking the impression in a neutral position this provides support for the foot in a position that is optimal for balance and control of the foot and skeletal structure Neutral position allows normal movements of the foot during activity without predisposing it to an excess of any of those movements In fact providing the balance and control at the start should help prevent excessive movements associated with injury The foot may be digitized in this neutral position when it is under full partial or non weight bearing The contour recorded by the digitizer will change depending on the amount of weight placed on that foot This can be a great advantage By standing on the Digitizer with even weight on both
25. cation System Communications e 87 copy the database to a floppy diskette simply erase what is in the box and type A Data DatabaseName Send Customer Records Command Overview By Phone When By Phone is checked the computer will send files to another system via modem When By Wire is checked the computer sends files via a serial cable between the two systems When To Folder is selected it sends the To Folder new database to a specified folder You must enter a user defined name in the text box after C When By FTP is selected it sends the By FTP new database to Amfit s FTP site which will then be received by the central fabrication department By Wire Phone Number When By Phone is checked the system sends files to the number entered here The computer automatically remembers the last number dialed Drive Path Name Enter the name of the database to be written to the folder here The system automatically displays C as the drive Send Records Start the transfer Abort Transfer Abort the process Table 17 Performing Operations in Select Records Delete an individual Right click on the record you would like to delete from the transfer portion record of the workspace Then choose Remove Insole Delete multiple Right click on a record in the transfer portion of the workspace Then records choose Remove All Insoles 88 e Communications Amfit32 Orthotic Fabrication System Table 17 Performing Operati
26. ck The mill has one safety interlock that is connected to the insole tray It prevents the machine from operating without an insole tray The interlock will also abort the milling process if the tray comes loose or an attempt is made to remove the tray during a cut This interlock is active and will not allow you to remove the insole tray unless the Amfit software is running and it determines that the mill is in a state where it is appropriate to open the tray Make sure the insole tray is in place and the latch is locked Solving Milling Machine Problems The following table lists possible problems causes and actions you can take to resolve the problem Table 18 Solving Milling Machine Problems Possible Cause Insole tray not in machine or not all the way in the machine Worn cut motor brushes Action Secure insole tray Change cut motor brushes Computer says X Y Z not home Usually caused by an obstruction in the transports Check the insole tray and inside the milling area for pieces of insole material that may block operation of the system Insole blanks tear off of the insole tray Poorly adhered blank Incorrect size specified in the Milling window Adhesive stuck in milling head Material too warm Insole must be secured to the insole tray before milling If the machine tears off an insole blank check to see if any adhesive is stuck in the milling head Enter the correct size
27. contour that has been saved on the system The Edit window and Workspace are shown below AW CADAN Dose n 0 fe xe pod Soy Poy imow DO a Li O 10 08 doses Pary pre ez 4 Wet ary dei 14084114 IOR Ltt Pri Mime 13 16 08 D SOT Lf rn 17 25 39 tt Fig 31 Edit Window and Workspace Amfit32 Orthotic Fabrication System Editing Adjustments e 55 Edit Window Overview The following table explains the elements of the Edit window Table 7 Edit Window Elements 2D Display Shows a topographical representation of the two dimensional current foot contour All editing takes place in this display Section Displays Displays a length and width profile of the contour to the right and below the two dimensional display respectively When the arrow is anywhere on the two dimensional display of the foot and you click on the mouse it forces a plot of the length and width profiles of the contour at that point Ruler Displays a ruler in inches or centimeters on the left side of the two dimensional display 3D Display Displays a rendering computer generated three dimensional visualization of the corrected insole All corrections entered on the two dimensional display are incorporated into the display 56 e Editing Adjustments Amfit32 Orthotic Fabrication System Controlling the Two Dimensional Display The 2D Display shows a topographical representation of the current foot contour All ed
28. create a new patient file This is where you enter the text based information about this client that will be stored in the computer Click on Records and select Create New The following Customer Information window will be displayed allowing you to enter new client information New Client The Customer Information window shown below is where you will enter information for each patient Customer Information Last Name Fig 7 Customer Information Window The following table provides an overview of the information the computer needs All items are mandatory After one line is filled in use the TAB key to move to the next line You can also use the mouse to move the arrow to the spot where you would like to enter information and press the left button on the mouse If you make a mistake while typing in an area simply use the backspace key The backspace key is located above the ENTER key If you notice an error in an earlier entry use the mouse to move the arrow on top of the entry to correct it at the location of the error Now use the backspace key and correct the error You can also move back one line by typing SHIFT TAB Information must be entered in a way that makes sense If you enter a letter for the insole size an error message will appear When you are done click OK Amfit32 Orthotic Fabrication System BASICS e 19 Table 4 Customer Information Window Overview of Entries Last name Enter the client s
29. depends upon the number of corrections made to the contour in the editing window It will range from 5 seconds to 30 seconds or more Amfit32 Orthotic Fabrication System Milling e 83 84 e Milling Amfit32 Orthotic Fabrication System Communications Overview Telephone Transfer Serial Cable Transfer File Transfer The Amfit Windows based program allows you to easily transfer patient files from one Amfit system to another This can be accomplished in one of the following ways The two systems are connected via an ordinary telephone line This is the best mode of communication when there is a central milling site and Footfaxes in the field It is also the mode that allows Amfit to provide back up milling capacity for milling machines in the field The two systems need a serial cable optional that connects them together This is the best mode of operation for two systems located at one site that need to share information The system copies the patient files to a folder on your PC including network folders and floppy disks The file can then be loaded onto any other system that runs the Amfit software Amfit32 Orthotic Fabrication System Communications e 85 FTP Transfer Gient FTP we This is the language used for file transfer pr from computer to computer across the M et Internet An anonymous FTP is a file z LJ transfer between locations that does not EAE e require users to identify themselves
30. ding Insert the power plug securely into the wall socket Verify that your wall socket is grounded in North America this means a three plug type socket Static electricity ESD Providing a solid ground power connection is essential to prevent Static electricity and electro static discharge ESD which may disrupt the system Installation site power Do not connect other high power consuming equipment such as copy circuit machines or microwave ovens to the same circuit as the Amfit system Footfax Digitizer and Milling Machine This will reduce the possibility of blowing a fuse or activating a circuit breaker in your building when milling This power requirement is much less critical for a Digitizer only site No multiple power Do not connect other equipment to the same socket If an extension connections cord not recommended is absolutely necessary do not connect other equipment to the same extension cord Power cord care and Do not step on or set anything on the power cord Be sure that the hazards power cord is not in a position where it would be hazardous Extension cords Amfit does not recommend using extension cords However if an extension cord is absolutely necessary use a minimum of a 16 3 not Not recommended to exceed 8 meters 25 feet in length 4 e INSTALLATION Amfit32 Orthotic Fabrication System Power Requirements Table 1 Milling Machine and Digitizer Power Requirements Milling Machin
31. e North American models Export models 110 120 VAC 60Hz 1200W 220 240 VAC 50 60Hz 1200W Digitizer North American models Export models Equipment Checklist 110 120 VAC 60Hz 450W 220 240 VAC 50 60Hz 450W The Amfit system contains the following equipment Please check your shipment upon receipt to make sure that all parts are included Table 2 Digitizer Equipment List Main units e e SL Digitizer unit DC power supply Calibration plate Toe plate Computer amp Software e Notebook Dell Amfit Software 5 1 Medical Accessories e Floor stand OR travel case optional Medical DVD U S only Foot adjustment package wedges Shoe Patterns Male Female athletic Female dress Kits samples Met pad kit Top cover samples Manuals System user manual Prescribing Guidelines manual U S only Cables Amfit32 Orthotic Fabrication System Digitizer parallel interface cable 25 foot telephone cable Null modem cable SL power cord INSTALLATION e 5 Table 3 Milling Machine Equipment List Main units e Milling machine unit e Flat screen LCD monitor e USB keyboard e USB trackball mouse e Calibration plate e Insole tray Accessories e Support for monitor keyboard e Floor stand dust bin e Spare fuses Kits Samples e Sample blank package Manuals Videos e System user manual e Medical DVD U S only e Prescribing Guidelines manua
32. e Double check that you have chosen the correct size blanks and desired topping material Carefully position and firmly adhere insole in the insole tray Define the cut in the mill window After milling is complete finish the insoles by covering them with a topping material QU 0074 LA Transmit client data to the central milling site pp a Prepare list of records to transmit b Establish connection with milling site c Transfer client data A Quick Run Through Turning the System ON For sites with a complete system turn on the Footfax and laptop the power switch is at the center rear and turn on the Milling machine The power switch is on the front panel If the milling machine s does not power on check to see if the red emergency stop button is depressed If it is turn it turn until it pops out If the power light is on but the monitor does not come on turn the monitor on as well After a few seconds the computer inside the mill and or the Footfax laptop should beep and the monitor will start to display the start up sequence of the computer The computer will perform a self test on the scanner and the mill and display the Windows desktop To start running the Amfit for Windows application double click on the Amfit icon on the desktop 18 e BASICS Amfit32 Orthotic Fabrication System After the machines are booted up and the Amfit program is running the most common action at this point is to
33. e OVERVIEW Amfit32 Orthotic Fabrication System Contents cont d List of Figures Figure Description Page Figure Description Page List of Tables Table Description Page Table Description Page able 1 Milling Machine and Digitizer Power Milling able 4 Customer Information Window Fable 20 Amfit Orthotic Blanks Table 21 Amfit32 Orthotic Fabrication System OVERVIEW e v vi e OVERVIEW Amfit32 Orthotic Fabrication System OVERVIEW General CAD CAM Computer Aided The Amfit computer controlled custom insole fabrication system Design Computer Aided uses electronic scanning digitizing and CAD CAM production Manufacturing technology to carve custom foot insoles from digitally recorded foot impressions The system consists of a foot digitizer and a compact milling machine both computer controlled See Figure 1 below Fig 1 The Amfit System Amfit32 Orthotic Fabrication System OVERVIEW e 1 Introduction The Amfit CAD CAM fabrication system is a patented state of the art system that uses electronic scanning digitizing and CAD CAM production technology to carve custom foot insoles The system consists of the following equipment Footfax SL Contact Digitizer Mill Carving Station 2 e OVERVIEW The Footfax SL Contact Digitizer uses electronic scanning or digitizing to digitally record foot impressions Foot impressions are derived using standing weight bearing
34. e Quiet operation The dust stand captures the particles of material that have been machined off of the insole blank Features e Easy one step cleaning e Docks to the underside of the mill e Built in dust container AMFIT MILLING MACHINE DUST ane Sii Fig 3 Dust Stand Amfit32 Orthotic Fabrication System Uncrating the System Unpacking the Digitizer Set the SL Digitizer shipping carton upright it s the box with the 20XX model number Open the shipping carton and carefully remove the white accessory box on top of the foam Remove both sides of the foam covers and lift the SL Digitizer out of the shipping carton This requires two people The shipping carton also contains a separate box that includes the system notebook computer with accessories Also part of the shipment is the SL Digitizer floor stand which has two separate boxes The floor stand consists of two parts the floor stand itself and the handrail To assemble remove the handrail and floor stand from their separate boxes Four screws located in the Floor Stand box are required to attach the handrail to the floor stand The handrail when installed bends toward the front of the SL Digitizer Slide the handrail into the holes at the top rear of the floor stand Insert the screws from the rear to secure the handrail to the floor stand To line up the screw holes you may have to maneuver the upright Be careful not to cr
35. e milling machine Flip the lever down to lock it in place It is good practice to tug on the handle to check that it is secure If the drawer comes loose during a milling operation the mill will stop automatically However the insole will probably be unusable 80 e Milling Fig 39 Amfit Insole Cassette Amfit32 Orthotic Fabrication System Controlling the Milling Process Click on the mill icon on the bottom of the workspace The Mill window will appear Mill Window The Mill window controls the operation of the milling machine It displays status information and has a number of controls to tell the mill what work is to be performed The Mill window is shown below 8 Waiting to be Milled 1 QO00 t000 Donor A May 13 15 49 01 Right 0000 4000 Donor A May 10 16 37 23 Right Cri Current Milling Selection Finished Milling Nest to be Milled F OO00 t000 Donor A May 1315 49 01 Right Density dual Covering cambria sz FM Thickness E 4 mm Female Cuts Remaining O Add Cuts Diagnostics Fig 40 Mill Window nd vr Tui Hh nf di I TO Mil Positive Amfit32 Orthotic Fabrication System Milling e 81 Command Overview The following table gives an overview of the command fields Waiting to Reference Displays patient files that are in the be Milled queue to be milled R Current eference Displays which foot is being milled Millin
36. e sensors pins Pins Up pressure Adjusts the upward force on the sensors pins Pressure gauge Bar graph Indicates current amount of upward force on the sensors pins Ready light Indicates that the scanner is ready to accept a command 34 e DIGITIZE Amfit32 Orthotic Fabrication System The Pins Up Pressure knob allows you to vary the amount of pressure used to raise the pins Slide it up to increase the support or slide it down to reduce it This function can be quite helpful for positioning and inducing an arch in a patient with flat feet The bar graph pressure gauge display indicates the relative amount of support The normal setting is approximately 1 2 full scale In other words the bar graph reading should be near the 1 2 full circle mark If you select a Pins Up Pressure setting that is too high the bar graph display will flash If this happens slide the Pins Up Pressure knob down until the pressure gauge displays normally Toe Plate The primary purpose of the toe plate is to keep the toes from getting pushed up by the slight pressure while the sensor pins are raised It also allows you to control the amount of sulcus that is recorded while the Digitizer is taking the impression The toe plate is reversible you must slide it into the Digitizer properly for the foot being digitized The shape of the toe plate is such that it is always obvious which way it should be inserted The edge of the toe plate tha
37. e to manufacturing or workmanship errors we will repair or replace them at our option All claims must be made within 30 days Amfit will issue credit Amfit will not issue credit For blanks that are destroyed due to machine failure For blanks that were improperly recorded poorly adhered in the milling machine or otherwise destroyed or defective due to operator error Amfit Supplies Orthotic Blanks Amfit orthotic blanks are available in the following densities hardness Table 20 Amfit Orthotic Blanks Density Description Comments Soft Shore A durometer of less than 30 Ideal for diabetic patients Material is blue in color Medium Shore A durometer of between 30 Ideal for most patients Provides control and 45 with comfort Firm Shore A durometer greater than 55 Provides maximum control Dual Density 1 Most of the blank is medium density with a horse shoe of firm material around the heel Provides extra control in the heel while still maintaining a high degree of comfort There is a premium for the dual density material Dual Density 2 Men s only Most of the blank is medium density with a firm material in the heel Provides extra control in the heel while still maintaining a high degree of comfort There is a premium for the dual density material 102 e Ordering Supplies from Amfit Amfit32 Orthotic Fabrication System Blank Styles The following
38. e you should have a good idea about what you want to achieve in the insole before positioning the patient Have the patient remove their socks Although this is not absolutely necessary it will result in better detail This is especially true in the sulcus or toe crest area Slide the heel all the way back Amfit32 Orthotic Fabrication System DIGITIZE e 41 Fig 25 Positioning the Patient s Heel Things to consider when placing a foot on the Digitizer e Check for a centered forefoot and a neutral position For specific positioning information see Positioning later in this chapter e Slide the toe plate back into its proper position 1 Place the foot Have the patient slide their foot either one fully back into the heel guide 2 Press the Pins Up 1 on the Digitizer Control Panel or click button on the Pins Up button in the Digitizer window on the computer screen Wait for the pins to rise fully 3 Press the Lock Pins 2 on the Digitizer Control Panel or click button on the Lock Pins button in the Digitizer window on the computer screen It takes 3 5 seconds for the pins to lock 4 Remove the The sensors now form a prototype of the patient s foot orthosis that will be produced from this impression 5 Inspect the contour 6 Edit Enter Enter comments before pressing Scan Comments Check for e Heel and forefoot centered e Heel and forefoot contact to the Digitizer top plate In other
39. ea inside the shape all at one elevation positive or negative This is similar in appearance to a table The following describes how to use the Bump tool 1 Click on the Bump button it looks like an eye The button Amfit32 Orthotic Fabrication System Editing Adjustments e 67 68 e Editing Adjustments becomes indented sinks and its outline fades Now using the mouse move the arrow into the two dimensional view of the foot Position the arrow on one corner of the proposed wedge Press the left mouse button The computer will draw a black square at the first point These black squares are called control points Now move the arrow to the next corner of the wedge Press the left mouse button The computer will once again draw a square at the point defined In addition the computer draws a line between this point and the previous point Continue defining points until the last point is defined To close the shape connect the last point with the first point double click on the second to last point on the wedge Amfit32 Orthotic Fabrication System Menus When the Edit window is active the following menus are available across the top of the screen Table 12 Edit Window Menus Sub Menus Save Forces a save to archive of this foot If there has been a previous save for this client on this right or left foot the system will ask if you would like to overwrite the existing records Answering yes er
40. ed shape with a slope in The following describes how to use the Wedge tool 1 Click on the Wedge button it looks like a wedge viewed from one end The button becomes indented sinks and its outline fades 2 Using the mouse move the arrow into the two dimensional view of the foot Position the arrow on any corner of the proposed wedge Press the left mouse button The computer draws a black square at the first point These black squares are called control points 3 Now move the arrow to the next corner of the wedge Press the left mouse button The computer will once again draw a square at the point defined In addition the computer draws a line between this point and the previous point Continue defining points until the last point is defined 4 To close the shape connect the last point with the first point double click on the second to last point on the wedge 5 The operator must define the e Direction of the slope forefoot heel medial or lateral e Angle of the correction Slope The side of the wedge where the altitude will be e A forefoot wedge will be highest at the toe end of the wedge e A heel wedge will be highest at the heel end e A medial wedge will be highest on the medial arch side of the foot e A lateral wedge will be highest on the lateral inside of the foot Angle Defined in degrees The valid range is 0 9 degrees Bump Tool Use the Bump Tool to place a user defined shape with an ar
41. ee Fig 30 Heel Wedge Placement 52 e DIGITIZE Amfit32 Orthotic Fabrication System Recording a Plaster Cast A plaster cast is recorded just like a foot except that you must approximate the neutral position without the benefit of having the patient 1 2 3 Amfit32 Orthotic Fabrication System To ensure that no plaster chips get into the top of the Digitizer it is highly recommended that you place the cast in a plastic bag If chips of plaster get into the digitizer this could result in sticky pins Place the plaster cast all the way back in the heel guide position the toe plate and press Pins Up Since a plaster cast is a solid you will need to take care when using the toe plate Be sure that the ball of the foot is resting on the top plate of the digitizer You may have to move the toe plate forward from its optimal position to accomplish this This may entail grinding the insole in the forefoot somewhat Press Lock Remove the cast and press Scan DIGITIZE e 53 54 e DIGITIZE Amfit32 Orthotic Fabrication System Editing Adjustments General The Amfit Windows based software enables the operator to interactively edit the contour on the computer screen This gives you unprecedented flexibility to modify the digitized foot contour The Edit window appears automatically each time a foot is digitized It can also be opened upon command to display any foot
42. egend Window 58 e Editing Adjustments Amfit32 Orthotic Fabrication System Controlling the Three Dimensional Display The 3D Display shows a rendering or computer generated visualization of the corrected insole All corrections that have been entered in the two dimensional display are incorporated into the three dimensional display Any change to the settings of the three dimensional display will force the computer to regenerate the three dimensional display Viewpoint The viewpoint or the direction the computer uses to determine which side of the contour to display is controlled by a click of the mouse To rotate the image simply grab the display by clicking on the left mouse button while dragging it in the direction you would like it to rotate The features of the display are controlled by the View 3d drop down menu To view these options position the arrow on View 3d in the title bar at the top of the screen and press the left button on the mouse The menu bar will drop down Elements Window The following table explains the 3D Display Elements window Table 9 3 D Display Elements 3D Display Enables and disables the 3 D display To make the 3 D display active place the cursor on top of 3D Display and press the left mouse button a check mark appears To turn it off do the same thing this time the check mark goes away Show Negative Controls the appearance of the three Positive dime
43. ened Editor windows horizontally or vertically horizontally vertically depending on what you choose Will attempt to re size all the re sizeable windows on the screen and display as much information as possible about each one at the same time If many Edit windows are open at one time this command may take a while to re display the entire screen 70 e Editing Adjustments Amfit32 Orthotic Fabrication System Table 12 Edit Window Menus Sub Menus Arranges minimized insole icons into order by date time Options amp Settings Displays the Options and Settings window Contents Calls up Amfit Help system About Displays a splash screen displaying version and date information Amfit32 Orthotic Fabrication System Editing Adjustments e 71 Milling Overview The Amfit milling machine cuts precision custom insoles from the data recorded by the Amfit Footfax Digitizer see figure below Fig 35 Amfit Milling Machine Amfit32 Orthotic Fabrication System Milling e 73 The Milling Process These are the only steps required to mill Amfit insoles 1 Load a patient file 2 Edit the contour and make computer adjustments if required 3 Select the proper insole blanks and secure one of them to the insole tray Place the insole tray in the milling machine and lock it in place Drag n drop the patient s foot record down into the mill portion of the Amfit workspace 6 Define the foot left or right minimum t
44. feet a full weight bearing contour is recorded By limiting the weight on the foot and especially the heel you can achieve a contour with more aggressive heel cupping The heel can actually be recorded slightly above the top plate of the Digitizer The computer will automatically lower the heel to produce the expected insole thickness Amfit32 Orthotic Fabrication System Mechanical Adjustments and Positioning Mechanical corrections are adjustments to the foot that hold the foot in a corrected position while the impression is being recorded The following wedges are included with every Footfax Digitizer Table 6 Mechanical Adjustments Kit Large wedge One each 3 5 and 8 degrees The large wedge is usually used to address pronation or supination in the heel area Three angles are provided to allow you to select the required adjustment for the current patient Forefoot wedge One each 5 degrees Used to post the forefoot Metatarsal Pad One 8mm pair each Small and Medium The metatarsal pad is used behind the ball of the foot to relieve the metatarsal heads Two sizes are provided Amfit32 Orthotic Fabrication System DIGITIZE e 49 Placing a Mechanical Adjustment Using a mechanical adjustment to correct a foot s placement on the Digitizer is the same regardless of the adjustment 1 50 e DIGITIZE The patient stands on the Digitizer and the operator presses the Pins Up key on the unit Wait for
45. g Selection Finished Reference Displays which feet files have completed Milling the milling process Insole Size Control Displays the current patient s default insole size This must be the size of the blank that you will actually be milling This number may be changed at milling time If changed it will not change the default insole size entered under client information Male Control Informs the mill that a male insole blank is in the insole tray Female Control Informs the mill that a female insole blank is in the insole tray Thickness Control Allows you to manually set the minimum insole thickness Mill Control Instructs the mill to carve a positive out Positive of the insole selected GO Control Instructs the mill to start milling the blank that has been loaded in the insole tray Play button Stop Control Halts the milling process It is normal for the computer to sometimes respond slowly to this button at some places during the cut process Stop button Cuts Reference Displays the number of cuts remaining on Remaining the milling machine before more need to be added Add Cuts Control Allows you to add cuts to the Amfit system after a blank order 82 e Milling Amfit32 Orthotic Fabrication System Diagnostics Control Diagnostic tool mostly used by Amfit Technical Support The length of time it takes between the time you click on GO and when the milling starts will vary It
46. he amfitwin data directory Using the mouse select the proper directory and double click on the database to be loaded If you are attempting to load data from a floppy diskette do the following 1 Place the diskette in the floppy drive 2 Click the down arrow under Drives and select a 3 After the File Name list updates select the desired database Amfit32 Orthotic Fabrication System Files on a diskette reside in the a data directory Double click on the data directory to see databases available on the floppy Always remember to reselect the c amfitwin data amfdb dtc database again before removing the floppy from the diskette drive Open Database rome Ca Files of topa Database Fies eta Cancel M ipen at pead onky Fig 28 Open Database Window Records Create New Use this window to enter a new client Open Existing Use to select an existing client record Edit Client Displays a window identical to the New Client window Use this to edit the patient information Digitize Client Sends the current client down to the digitize portion of the workspace so that the client can be scanned Close Client Closes the current client that is open and highlighted in the workspace Delete Client Deletes the client from the open database Help Contents Calls up the Amfit help system About Amfit Displays the date and version of the current Amfit software Amfit32 Orthotic Fabrication System DIGITIZE e 45 P
47. hickness and whether you want a positive or negative of the contour GO When the milling process is finished remove the insole from the insole tray Vacuum the tray and the insole 9 Finish off the insole by applying a topping material to the insole 10 Repeat steps 3 through 9 for the other foot Enabling the Mill The milling machine has an odometer feature that will disable the mill after a certain number of insole cuts Each time you order insole blanks from Amfit Inc you will receive an email with an alpha numeric code you will need to enter into your system The code will unlock your mill for a specified number of cuts The number of insoles ordered will determine that number To use the code start up the Amfit program and then click on the Mill tab in the lower portion of the Workspace On the Mill tab there will be a button named Add Cuts Click on Add Cuts to display the Install Cuts window see below After you have entered the code into your system click the Install button See the following dialog box 74 e Milling Amfit32 Orthotic Fabrication System Ineta Gute Enter the Installation key and click Install FS Install Fig 36 Install Cuts Dialog Box This code will only work in the mill whose serial number is show on the label The code can only be used once Calibrating the Mill Start by clicking on the Diagnotics button in the lower portion of the Mill tab The Mill Calibration
48. iting takes place on this display Table 8 2 D Display Elements View 2D If checked this option displays the 2 D version of the scanned foot on the right side By unchecking this option only the 3 D version will be shown Ruler Lets you display a ruler on the left side of the 2 D foot for measurement Enables disables and controls the scale or the ruler display at the left of the two dimensional display A check to the left of Ruler indicates that the ruler is currently displayed To turn on the ruler using the cursor move the arrow on top of the Ruler command Press the left mouse button To turn the ruler off do the same thing this time the check mark goes away When the arrow is on top of this command a sub menu of additional commands is displayed Note Ruler settings only have an effect when the two dimensional display is turned on Use Inches Moving the arrow on top of this command and pressing the left mouse button will set the ruler to display inches If the ruler was already displaying inches this command has no effect Use Centimeters Moving the arrow on top of this command and pressing the left mouse button will set the ruler to display centimeters If the ruler was already displaying centimeters this command has no effect Elevation Legend This option allows you to drag the cursor over the 2 D foot to see pin elevation during a scan Pin Grid Enables and disables the grid The grid displays an over
49. k Up a number of times until the Z in mm returns to the number you previously noted Click in the check box next to Motor On Off The cut motor will turn off Recheck the cutting head location If the center of the cutting head is exactly on the drilled hole check on Set Origin If not repeat steps 10 through 14 until they match Exit the Mill Calibration and Diagnostics window and restart the Amfit32 program Amfit32 Orthotic Fabrication System Milling e 77 Insoles The Amfit pre molded insole blank has been designed for quick easy insole fabrication The insole has many intrinsic features see figure below General Five basic types of insoles are available for the Amfit System and they are available in a wide variety of sizes and three pattern styles In addition special blanks are available for producing positive forms A REFERENCE LINES ASSIST WHEN TRIMMING INSOLE BLANK SIZE 10W 11 7 ee eee 2402 a si amp o ae Fe HN tU A UN M N 0 W SA DOTS LINE UP WITH 7 j PIN LOCATIONS ON DIGITIZER Fig 38 Amfit Insole Blank 78 Milling Amfit32 Orthotic Fabrication System Insole Types Table 15 Types of Insole Blanks Soh i Medium Whi Fi ow Dual density Style 1 Most of the insole is medium density white and brown However the heel cup is made of firm material This insole provides superior control with added comfort Dual density Style 2 The
50. l U S only Cables e 25 foot telephone cable e Monitor AC power cord e Mill AC power cord Operations Software Amfit s easy to use software Amfit s Foot Orthosis design software operates in a familiar Windows based environment offering a wide array of features and functionality in a fully self contained workspace environment A few of the software features are listed below e Full Windows XP compatibility e High Speed 3 D viewing e Drag n drop of all user defined adjustments e Easy management of client s foot records e Multi modal data transfer e Easy management of milling functions 6 e INSTALLATION Amfit32 Orthotic Fabrication System Footfax SL Digitizer Scanner TOE PLATE SENSOR ARRAY CONTROL PANEL The Footfax SL Digitizer Scanner is a computer controlled foot measuring instrument Features e Computer precise measurements e Easily transported e Adjustable sensor pressure e Operator controlled positioning of the foot HEEL GUIDE PRESSURE GAUGE Fig 2 The Amfit Footfax SL Scanner Amfit32 Orthotic Fabrication System INSTALLATION e 7 Amfit Milling Machine Dust Stand 8 e INSTALLATION The Amfit milling machine is a computer controlled insole fabricating machine Features e High speed low maintenance milling head e Three axis transport e Removable insole tray e Dust particle control system patented e Ability to mill a range of densities of Amfit material
51. lay of black dots corresponding to the sensor locations on the Digitizer This feature can be an invaluable aid in placing adjustments on the foot 1 You can use a transfer medium such as lipstick to highlight a spot on the foot 2 Then place the foot on the digitizer or an insole The transfer medium will indicate the desired spot Amfit32 Orthotic Fabrication System Editing Adjustments e 57 Table 8 2 D Display Elements 3 You can now use the grid to locate this area on the 2 D display A check to the left of Pin Grid indicates that the grid is currently displayed Pin Grid is initially turned off no check mark To turn on the grid using the cursor move the arrow on top of the Pin Grid command Press the left mouse button To turn the grid off do the same thing this time the check mark goes away Note Pin Grid settings have an effect if the two dimensional display is turned on Elevation Legend Each color in the two dimensional display represents a range of elevation Use this command to display the heights represented by the colors To use move the arrow on top of Elevation Legend under the 2 D Display option and press the left mouse button The Elevation Legend window will be displayed see next figure Millimeters o gt D M 15 0 n 19 0 o co 22 5 SS oOo N is uw 28 5 Click an Elevation or Color to customize Apply i Fig 32 Elevation L
52. m occurs with computers if you turn them on with a floppy disk in the drive at the side of the mill or laptop If this is the case the computer attempts to read the software on the floppy disk before reading the software on the hard drive This produces unpredictable results Check to make sure that there is no disk in the floppy drive Ungraceful Database Shutdown If the computer is turned off while accessing a database on a floppy diskette the program will attempt to properly close the database when the system is once again turned on Note This could happen if the fuse blew while milling the computer crashes because of a power failure etc If the system was turned off in this state take these steps When the Do this Windows logo appears Insert the diskette containing the on the display database that was being accessed during the unexpected shutdown System is up and e Select the database you wish to use running e Continue normally Amfit32 Orthotic Fabrication System The Milling Machine Problem Computer says Reposition tray or door active cut has been cancelled The milling machine is a three axis transport mechanism with a milling motor attached to the Z in and out axis The insoles are adhered to the removable insole tray with double sided tape If you slide the tray into the machine and all is well the mill takes care of the rest Milling Machine Safety Interlo
53. nsional display and what the image looks like Move the arrow on top of this command with the mouse and press the left button Show Positive Displays an image that resembles the bottom of the foot Amfit32 Orthotic Fabrication System Editing Adjustments e 59 Table 9 3 D Display Elements Show Negative Displays an image that resembles a machined insole blank Depending upon the image currently displayed the command line in the menu changes from Show Positive to Show Negative and back again Moving the arrow on top of this command and pressing the left mouse button turns on the indicated display mode Initially set to Show Negative Adjustments Window Using the Adjustments Window 1 Click on the Adjustments tab located in the middle section of the Amfit Windows based workspace The Adjustments window appears see below Thickness o mm Heel Lift o mm Sulcus Rise 0 mm Size 0 se Lateral Arch 10 Total 0 Medial Arch 0 4 Heel Cup 0 X Lateral Heel o deg Invert o deg Medial Heel o deg Evert o deg Apply Squid SquUaUAsNipYy 350019 Fig 33 Adjustments Window 60 e Editing Adjustments Amfit32 Orthotic Fabrication System 2 Using the mouse position the arrow on the screen in the text area after the adjustment you would like to change Then press the left button on the mouse and type in the desired adjustment 3 If more than one adjustment is re
54. ons in Select Records Add individual Click on the picture of the head above the Workspace The Select records Customer window will appear Enter information about the customer s name and click on Open The customer will now appear with their digitized feet in the Workspace Drag n drop the feet you would like to transfer into the transfer box in the lower portion of the Workspace Amfit32 Orthotic Fabrication System Communications e 89 Receive database records Click on the method of file transfer phone or wire and then click Receive Records The system is now ready to receive a file via the mode you selected You cannot receive information via phone and wire at the same time If the mode selected is BY PHONE the computer will monitor the phone line connected to the WALL jack on the computer I O panel Every phone call will be answered automatically A dedicated phone line is highly recommended Rad 33240 j i No communications activity nd Re Abort Transfer Session Transactions 0 ByPhone By Wire ToFolder By FTP Destination I 888 356 3669 Configuration View Log SUC JaJsUCdl Fig 42 Receive Files Setup Window To abort the receive record process click on Receive Records again Use AutoMerge When the Amfit32 Software is placed in Receive mode an incoming file is handled in one of two ways depending on the AutoMerge configuration
55. onto the tray e The line at the heel should line up with the end of the arrow on the insole tray e The notch at the toe end of the insole blank should line up with the lengthwise line on the insole tray 5 Press the blank firmly onto the tray Take extra care with this step If the blank comes loose during milling it will usually need to be discarded a waste of material and time 6 Now slide the tray back into the milling machine and press the flip latch down until it locks 7 On the milling window of the computer screen select left or right as appropriate and click the Play button see below Amfit32 Orthotic Fabrication System BASICS e 29 Preforms Below is the Preform window This window is located in your Amfit Workspace on the third tab down To use the Preform function follow the directions below Customer Selection oo hy 3 vw se x V g o 3 Fig 17 Preform Window 1 First select a client from your database 2 Drag n drop each foot for which you would like a preform into the bottom preform box 30 e BASICS Amfit32 Orthotic Fabrication System Tue Aug 10 14 07 46 2004 Right 3 Tue Aug 10 14 07 30 2004 Left SULIOJAIA AFi5URAL 3821216 Fig 18 Preform Window Drag n Drop 3 After the items have been dropped into the Preform box the following will appear see next figure Amfit32 Orthotic Fabrication System BASICS e 3
56. orm X Y calibration Table 14 Performing X Y Calibration In the Number of Steps box enter 100 Click on Left until X in mm indicates approximately 60mm Click on Back until Y in mm indicates Smm Note the number next to Z in mm It should be approximately 33mm 76 e Milling Amfit32 Orthotic Fabrication System Table 14 Performing X Y Calibration Click in the check box next to Motor On Off The mill motor will turn on Click on Down After a number of clicks you should hear the milling head start to cut into the foam block Click on Up a number of times until the Z in mm returns to the number you noted above Click in the check box next to Motor On Off The motor will turn off Wait until the motor stops before opening the tray door 10 11 12 13 14 15 16 Pull the insole tray out of the machine Note the difference in location between the hole drilled in the foam and the hole made by the mill head Click on Set Origin to save current calibration even if it is not correct Click Yes when asked to save Click on the X Left Right and or Y Back Front buttons to correct the milling head position Left moves the head upward Back moves it toward the toe area Reinsert the tray and click in the check box next to Motor On Off The milling motor will turn on Click Down a number of times until you hear the milling head start to cut into the foam block Clic
57. ositioning Positioning Overview 46 e DIGITIZE The top quality orthotic insole that the Amfit system produces is only as good as the positioning of the patient Positioning refers to the controlled placement of the foot on the Digitizer Positioning can be as simple as e Placing the foot back against the heel guide e Centering the forefoot e Holding the foot in neutral For patients who need more of a correction you can add a wide variety of intrinsic or built in mechanical corrections to the basic contour The basics for positioning are the same regardless of the corrections required They include 1 Manipulate the foot to a neutral position see Neutral Position later in this chapter 2 Press Pins Up on the Digitizer This raises the pins around the foot 3 Press Lock Pins The patient s foot can now be removed If you wish to digitize the contour at this time the machine will record a quality neutral positioned insole Mechanical Adjustments If mechanical adjustments are required as well you need to also perform steps 4 8 A mechanical adjustment as opposed to a computer or software adjustment is an adjustment that modifies the shape of the digitized anatomy In practice this involves placing a particular shape such as a metatarsal pad under the patient s foot when it is being digitized Mechanical adjustments are covered in detail later in this chapter 4 Determine the location fo
58. oss thread the screws and firmly tighten the screws Place the completed floor stand in the desired location Remove the foam panels from the sides of the SL Digitizer inside the floor stand Do not connect the cables at this time Amfit32 Orthotic Fabrication System INSTALLATION e 9 Unpacking the Mill Making Connections 10 e INSTALLATION There are two 2 shipping pallets that contain the milling machine system The first box is the mill itself which is the smaller of the two boxes Cut the two plastic straps on the outside of the cardboard box and lift gently to remove it from the pallet Please note that an AC power cord and the calibration plate are attached to the exterior of the mill Remove and set them aside Next remove the shipping wrap from the two brown accessory boxes located on top of the mill stand Set the boxes aside One box contains the keyboard mouse monitor and other mill accessories The second box contains a sample set of insole blanks Remove the outer cardboard box from the mill stand and remove the protective foam end caps The dust collection drawer is located inside the mill stand Notice that the mill stand and the milling machine are designed to dock together Take care to ensure they both mate securely Be careful when making connections All connectors must seat fully and be screwed in place Be careful not to bend pins while plugging in cables Unpack the mill acce
59. our new option To remove an option use the drop down box to select the option you want to delete When the option is in the box use the corresponding Remove button to delete it from the list When you are finished making changes to the Options and Settings page click Apply to save changes and exit If however you do not wish to save any changes you have made click Cancel to exit without saving changes Amfit32 Orthotic Fabrication System BASICS Operational Overview This section describes the entire process involved in recording digitizing or scanning Amfit computer aided orthotics It is assumed that the steps outlined in the Installation chapter have been completed This section first walks you through the steps required and then covers the specifics of patient interaction and positioning The following steps are involved in fabricating Amfit computerized insoles 1 Greet the client and explain the process and the time involved Create the patient file Digitize or scan the patient s corrected foot a Position the patient If needed use mechanical adjustments to aid in proper positioning b Scan the contour c Examine the contour d Edit the contour optional e Repeat for other foot Amfit32 Orthotic Fabrication System BASICS e 17 Machine the insole blanks or else go to step 5 below a Select proper insole blanks along with a topping material for the customer Not
60. proper position front rear e Be careful not to place the toe plate too far toward the heel The toe plate should never be under the ball of the foot Placing the toe plate that far to the rear may produce an insole with a bad horizontal ridge under the metatarsal heads What about a toe box filler The Amfit system can produce a toe box filler to allow patients with an amputated forefoot or other similar foot deformity to wear normal shoes In this case record the patient s foot without a toe plate The toe plate s shape is used by the Amfit program to determine which foot left or right is being digitized When no toe plate is used as in a toe box filler the computer will ask which foot is being digitized The operator simply answers left or right as appropriate Keep in mind The sulcus can be removed at any time by using software adjustments However while a sulcus can be synthesized the original sulcus ridge can never be put back if it was not recorded in the first place When in doubt place the toe plate edge just in front of the sulcus Amfit32 Orthotic Fabrication System Scanning a Foot The Digitize Window It is assumed that a patient record has been created or an existing record has been loaded and that the operator is in the Amfit Windows based program If you have not already done so read the previous Chapter Basics and create load a record for this patient From
61. quired simply move the arrow to the next text area and press the left mouse button again Type in the desired adjustment 4 Continue until you have entered all adjustments 5 Click on Apply when you are done Overview of Wedges The following table gives an overview of the various wedges Table 10 Types of Wedges n Inversion Ramp A full length wedge Builds up the medial J side of the insole See Glossary for definition of inversion Possible range 0 9 degrees Eversion Ramp A full length wedge Builds up the lateral side of the insole See Glossary for definition of eversion Possible range 0 9 degrees T Thickness Sets the minimum insole thickness The minimum thickness is the thinnest the insole will be at the lowest areas These are areas measured by the Digitizer This is typically under the ball of the foot the toes and heel Possible range 0 15mm Amfit32 Orthotic Fabrication System Editing Adjustments e 61 Table 10 Types of Wedges Arch Support Allows you to reduce or increase the amount of support under the arch area of the current contour The change is specified by a percentage Possible range 30 to 30 Example If an area under the arch measures 20mm and the Arch Support is set to 10 the mill cuts that area at 22mm above the minimum insole thickness as set by the Thickness command above Lateral Arch Support Allows you to reduce or increase the amo
62. r fabricating facility customize the insole SJUSWWOD Fig 13 Comments Portion of the Workspace Below is the Adjustment tab of the Workspace This window allows you to customize the insole by adjusting Metrics Support and Wedging Metrics Thickness fo mm Heel Lift fo 4 mm Sulcus Rise 0 mm Size 0 Support Lateral Arch 0 Total fo Medial Arch 0 Heel Cup 0 sjusuisnip y Wedaing deg Lateral Heel o Invert 0 Medial Heel o Evert 0 Fig 14 Adjustment Portion of the Workspace z 26 e BASICS Amfit32 Orthotic Fabrication System The figure below shows the Shapes tab of the Workspace This window allows you to create certain shapes for adjustments that are used often and then save them within the software These shapes are used to make adjustments to the insole as well gt 23 Bizarro New Shape p New Shape 0 New Shape 1 Fig 15 Shapes Tab of the Workspace The following is the process for editing 1 Select an adjustment 2 Place the adjustment by drag n dropping to the desired location on the foot 3 Define its parameters Amfit32 Orthotic Fabrication System BASICS e 27 Milling 28 e BASICS The Mill Window Click on the Mill tab at the bottom of the screen The Mill control panel window will appear see next figure SE Waiting to be Milled 0000 4000 Donor A May 13 15 49 01 Right 4 0000 000
63. r screen that contains or groups related elements in order to organize unrelated tasks Windows can also allow you to dialog with the computer The screen can display many frames at once often with one on top of the other Amfit32 Orthotic Fabrication System Glossary of Terms e 107
64. r the correction 5 Place the pad or wedge in the proper location on the top of the Digitizer 6 Replace the foot 7 Press Pins Up on the Digitizer Raise the pins through the pad or wedge and press Lock 8 Digitize the contour After the scan is complete the computer displays the impression Amfit32 Orthotic Fabrication System Neutral Position Do it again Repeat for the other foot If for any reason the contour is less than perfect simply re digitize the foot in question The foot impression is typically taken with the foot in a neutral position What is Neutral Position Neutral Position means that the foot is neither pronated turned in nor supinated turned out The joint that determines neutral position is the subtalar joint Neutral is really the relationship of the talus the bone at the bottom of the tibia and fibula and above the calcaneus heel bone to the rest of the foot Therefore the way you find neutral position is by feeling the head of the talus How do I find Neutral Position Place your e Thumb just in front of the bump on the outside of your leg lateral malleolus and e Your index finger in front and below the bump on the inside of the lower leg medial malleolus As the patient turns their foot inwards pronates you should feel a bump under your finger This is the inner head of the talus As the patient turns their foot outwards supinates you should feel a
65. rs will use only one database the one that comes with the system as shipped from the factory The ability to manage databases allows you to segregate groups of clients This could for instance be useful to group patients who are referred from the same doctor Comments There is a Comments tab to allow you to enter miscellaneous information about the current patient Some examples are patient indications special fabrication instructions for the person who actually produces the orthosis or any other information that you may want to save with the patient s contour Making Entries To enter text into the comments area use the mouse to click on the Comments tab in the middle portion of your screen Amfit32 Orthotic Fabrication System Operation Calibration To calibrate the digitizer take the following steps 1 Start by choosing Diagnostics on the Digitizer tab in the Workspace The following window appears Digitizer Calibration amp Diagnostics Calibration Procedure amp Diagnostics Hardware Setup and Tests Up Scan Array 10 PSE senso e Origin Verify Bottom _ Oin Helk I Auto Cycle Status Serial Number 8600 Autocycle Count Model Number 2050 On Bottom Pin Discrepencies 0 Step Count Pin Diagnostics True Levels Up Calibration Table True Levels Down Deviations Fig 24 Digitizer Calibration and Diagnostics Window 2 Click on the Calibrate b
66. ry The area that the computer uses to manipulate data and run programs while the computer is operating All information that is stored in RAM is lost when the computer is turned off This is one of the reasons why computers have hard disks to store information hard disks store information even when the computer is off A computer program or data that a computer can process Amfit32 Orthotic Fabrication System Glossary cont d Sulcus The area between the ball of the foot and the toes where the system will measure a slight elevation Sum The result of adding one or more numbers together Support Refers to the difference in the amount of elevation relative to the original casting For example if elevation is modified and raised upward by 10 the height at that point on the orthosis will be 10 higher than the original casting SVGA Super Video Graphics Array The latest in high resolution computer display adapters for IBM type personal computers An SVGA card is the computer card that the computer uses to communicate to the display monitor Trackball A pointing device much like a mouse It is operated by rolling a ball to move the arrow on the screen to the desired location Trackballs have three pick buttons You use the left one to select and or move items Wedge Angular raised area In the Amfit system it refers to an angular adjustment to the contour Window A frame displayed on the compute
67. s an insole in approximately 8 10 minutes Total time depends on the insole size and material density that is being fabricated The mill carving station cuts men insole sizes 3 17 To understand how digital data is transferred between both Amfit Systems see the Communications section of this manual Amfit32 Orthotic Fabrication System INSTALLATION This Manual This manual is a combination installation guide and operator s manual Topics covered include Installation of the system e Selecting the proper location for the system e Unpacking e Connecting the components Operation of the system e Creating a patient file e Positioning the foot e Scanning a foot e Editing the contour e Milling the insole blank e Maintenance Finishing the insoles Troubleshooting Ordering Amfit supplies Amfit32 Orthotic Fabrication System INSTALLATION e 3 Installation Considerations The Amfit System is designed for easy installation and will function anywhere where there is adequate AC electrical power Keep in mind that you will need access to the Digitizer from all sides to observe the patient s feet from various views The system MUST be properly grounded for safe and reliable operation The milling machine and the monitor display keyboard require a flat tabletop surface for stability See the following Safety Notes and Power Requirements sections for site requirement guidelines Safety Notes Groun
68. s is actually desired Runners do not typically like support in this area Shape Library Overview The Shapes library gives you the ability to save a shape generated in the Amfit system It can then be applied to any foot data record 64 e Editing Adjustments Amfit32 Orthotic Fabrication System Bizarro New Shape 2 f New Shape 0 New Shape 1 Fig 34 Shapes Library Window Right Click Menu Preview Shape The right click menu shown at left has the following possible Insert Shape selections Rename Shape e Preview Shape e Rename Shape Delete Shape from Library e Insert Shape e Delete Shape from Library Table 11 Right Click Menu Options Preview Shape Allows you to see what the foot will look like with the following adjustment however it doesn t actually insert it When you choose Preview it will change the contour of the foot However as soon as you click off of the shape the foot will return to its previous contour contour without adjustment Insert Shape Actually inserts the shape onto the foot in its most appropriate area for adjustment Rename Shape Turns the name of the shape into a text box and allows you to type whatever name you decide is appropriate for the shape Amfit32 Orthotic Fabrication System Editing Adjustments e 65 Table 11 Right Click Menu Options Delete Shape from Choosing Delete Shape from Library will Library do exactly that It permanently deletes
69. ssory box It contains cables a sheet metal monitor keyboard support and keyboard trackball Place the monitor trackball support on top of the milling machine Unpack the display monitor and place it on top of the monitor trackball support on the milling machine Place the keyboard in front of the display Plug the keyboard cable into the connector provided on the milling machine see figure It must be properly oriented with the notch toward the rear of the milling machine Connect the monitor s computer interface cable to the I O panel see the following figure There is only one connector with 15 pins that is the right size Connect the monitor power cord to an AC outlet Make sure that the Footfax power switch is turned off Connect the interface cable that came with the Footfax to the connector on the rear of the laptop There is only one place that it will fit Secure the cable Amfit32 Orthotic Fabrication System by screwing it in place Connect the power cord from the Footfax to an AC outlet Press the button on the side of the heel guide and remove the calibration dust plate Then insert the toe plate in its place Make sure the power switch on the milling machine is turned off Connect the milling machine to an AC outlet using the power cord provided Refer to figure below to review your connections Pe OL MILL SIDE PANEL WALL OLTLET Fig 4 Connection Schematic Amfit32 Orthotic Fabrication System INS
70. t Press the up arrow button on the keypad of the Footfax s Control Panel see the following figure or using the mouse click on the Pins Up button in the Digitizer window The sensors will start to rise When the pins are fully up press the Lock Pins button second button from the top Wait at least three seconds Then remove the foot and select Scan third button from the top The computer will calculate the image data and display an Edit window This takes about 15 seconds Amfit32 Orthotic Fabrication System BASICS e 23 Fig 11 Digitizer Control Panel 24 e BASICS Amfit32 Orthotic Fabrication System Editing The Amfit software enables you to interactively edit the contour on the computer screen This provides unprecedented flexibility to modify the digitized foot contour The Edit window appears automatically each time a foot is digitized The window can also be opened upon command to display all foot contours you have saved on the system The Edit window is shown in the following figure awl De Yer poas Dosey OME ae go oe El 10054 doves Pasy Tum May 17 23 lt 23 2008 rift Wet da dt 144114 DOOR Lat Pu Mer 13 16 08 de 207 coli porse Fig 12 Edit Window Amfit32 Orthotic Fabrication System BASICS e 25 The Comments portion of the Workspace is shown below This window is designed to let you write in certain information about the customer that will help Amfit or anothe
71. t goes underneath the toes should roughly approximate the shape of the sulcus of that foot If this is not the case slide the toe plate out and reverse it see figure below N Fig 22 Toe Plate Orientation Amfit32 Orthotic Fabrication System DIGITIZE e 35 Positioning the Toe Plate 36 e DIGITIZE What is the proper position for the Toe Plate In brief if a sulcus ridge is desired the toe plate is placed just forward of the sulcus If no sulcus ridge is desired slide the toe plate back to the forward edge of the ball of the foot There are times when this may not apply If the patient has no toes or has some other forefoot deformity it would probably be good to slide the toe plate to a position further toward the heel Another situation where you might slide the toe plate further toward the heel is if the patient is an athlete who may not want a sulcus Generally you slide the toe plate back toward the heel so that the edge of the toe plate is just forward of the ball of the foot If you want the system to record elevation in the toe crest or sulcus area slide the plate so that the rear edge is just posterior to the toe s bottom pad area where it is touching the top plate of the scanner Keep these things in mind while positioning the toe plate e Is the toe plate inserted in the correct direction into the Digitizer for the foot currently being digitized e Is the toe plate in the
72. t32 Orthotic Fabrication System When activated the green Ready light illuminates on the control panel When the Pins Up button is pressed the system provides air to the gauge on the control panel and the bladder located under the sensor pin array This raises the pins Next when the Lock button is pressed it sends air pressure to an array of tubes between the rows of pins to lock the pins in place When the Scan digitize button is pressed the scanner system measures the elevation of each of the 576 pins During this process the system also pumps the air out of the bladder This way when the Reset key is pressed e Allof the pins drop almost instantly and e The unit is ready for the next impression The computer then analyzes the pin height data to determine e Was the left right foot digitized e Is the foot centered e Is the foot too far forward e Was the foot level front rear on the digitizer Troubleshooting e 99 Problem Pins don t rise or they rise slowly Solving Digitizer Problems The following table lists possible problems causes and actions you can take to resolve a problem Table 19 Solving Digitizer Problems Possible Cause Pins Up pressure is set too low Action Increase Pins Up pressure to mid range on the bar display Some pins stay up after the Reset is pressed Dust or dirt is in the top of system Some slightly sticky pins are normal They should drop with a slight
73. that shape from the library Pre Made Shapes At the bottom of the Shape tab are the following pre made shapes e Bump tool e Pad tool e Wedge tool These shapes are the most popular Pad Tool Use the Pad Tool to place a user defined shape with an area inside the shape all at one elevation positive or negative This is similar in appearance to a mesa The following describes how to use the Pad tool 1 Click on the Pad button it looks like a bump with a flat top The button becomes indented sinks and its outline fades 2 Using the mouse move the arrow into the two dimensional view of the foot Position the arrow at any point on the perimeter of the proposed pad Press the left mouse button The computer will draw a black square at the first point These black squares are called control points 3 Now move the arrow to the next point on the perimeter Press the left mouse button The computer will once again draw a square at the point defined In addition the computer draws a line between this point and the previous point Continue defining points until the last point is defined To close the shape connect the last point with the first point double click on the second to last point on the perimeter Wedge Tool 66 e Editing Adjustments Amfit32 Orthotic Fabrication System one of four directions medial lateral forefoot or heel at any reasonable angle Use the Wedge Tool to place a user defin
74. the Amfit32 Workspace use the mouse to click on the Digitizer tab see below and the Digitize window will appear Drag n drop the client that you would like to digitize down from the Client box into the Digitize Window The Digitizer window is shown in the figure below It shows the current patient name and there are buttons on the window that operate exactly the same as the ones on the digitizer Digitizing Selection Donor amp Gi Male Size 11 ID 0000 1000 t AN Pins Up i Center Heel D 2 Lock Pins 182141610 J wel E Diagnostics t Scan J y Reset IB RUGAN Fig 23 Digitizer Window Amfit32 Orthotic Fabrication System DIGITIZE e 37 Digitize Window Overview 38 e DIGITIZE The following table explains the elements in the Digitizer window shown in the previous figure Name Description Digitizing Selection Displays the current patient information Diagnostics This is a diagnostics tool used in house only by Amfit s technical representatives Control buttons The four control buttons function the same Pins Up Lock Pins as the buttons on the Digitizer s control Scan Reset panel Center Heel When checked will automatically center the patient s heel Data The Amfit system is able to maintain a number of databases A database is a collection of patient records A database is analogous to a file cabinet that contains many similar items Many Amfit system operato
75. the pins to rise fully and press the Lock Pins key Have the patient remove their foot from the Digitizer Place the mechanical adjustment on the top of the Digitizer at the location where the adjustment should be made Have the patient place their foot onto the top of the Digitizer again Be careful to position the foot back in exactly the same location where it was in previously Press Pins Up once again The pins will now rise up through the mechanical pad or wedge and contact the foot Press Lock Pins Have the patient remove their foot from the Digitizer Inspect the contour Make sure that the pins have risen fully through the mechanical adjustment If the contour is acceptable press Scan It is often helpful to use some sort of transfer medium such as lipstick to assist in locating the proper point for a correction Place a dot on the bottom of the foot and have the patient stand on an insole or the top of the Digitizer itself The dot will transfer to the proper location Amfit32 Orthotic Fabrication System Metatarsal Pad Placement See figure below for suggested placement of the metatarsal pad Fig 29 Metatarsal Pad Placement Amfit32 Orthotic Fabrication System DIGITIZE e 51 Large Wedge Placement See figure below for suggested placement of the heel wedge This illustration addresses pronation O00 0000 soco00s 0009200 00000090 dd000090 eevecc
76. touch Frequent vacuuming of the top of the Digitizer will minimize this problem Pins don t lock 100 e Troubleshooting Response delay The computer normally looks at the control panel switches four times a second Press the switch long enough so that the computer detects the switch The computer will look at the control panel less often when milling or printing and digitizing at the same time Amfit32 Orthotic Fabrication System Ordering Supplies from Amfit Placing an Amfit Order Now that you are an Amfit customer you will be purchasing supplies for your new Amfit system Available Materials A wide variety of materials are available from Amfit to serve your customer needs Contacting Amfit Orders can be placed by Fax 1 360 566 1380 Phone 1 800 356 FOOT toll free 1 800 356 3668 Shipments We usually ship your order within 48 hours of receipt To speed processing of your order please use the Amfit order form located at the end of this section Amfit Credit Policy Amfit customers in good standing receive net 30 terms Amfit32 Orthotic Fabrication System Ordering Supplies from Amfit e 101 Returns Credit If Amfit has made an error in an order shipped the wrong item we will accept a return and ship out the correct item If Amfit shipped short on an item we will either issue credit for the item or ship out the shorted material s If materials are defective du
77. tte The trademarked name of the Amfit digitizer scanner which is a device for measuring the shape of the bottom of a patient s foot A large capacity computer storage device The one used in the Amfit System has a capacity of at least 80 million characters of text It is where it stores patient files The contour that is produced by the Amfit digitizer scanner Type of computer program that allows you to manipulate an image on the screen and see the effect of the change Outward canting of the foot The outside non arch side of the foot The arch side of the foot Refers to the ball of the foot A computer controlled grinding machine that carves the top surface of a foam block to produce an orthosis The surface it produces is a result of all of its recorded contours and adjustments A pointing device used by the operator of a computer to move an arrow around the screen to indicate what tasks you want the computer to perform A mouse has at least two buttons on it You use the left button to tell the computer that the arrow is over the task you want to perform At that time you press the left button This is called clicking on a task The Pentium computer is the eighth generation of computer from Intel and is the fastest processor of its type currently available Pentium is a registered trademark of Intel Corporation A look alike to the real thing Random Access Memo
78. unt of support under the lateral arch area of the current contour The change is specified by a percentage Possible range 30 to 30 Example If an area under the lateral arch measures 10mm and the Arch Support is set to 10 the mill cuts that area at 11mm above the minimum insole thickness as set by the Thickness command above Total Support Allows you to reduce or increase the amount of support across the entire area of the current contour The change is specified by a percentage Possible range 30 to 30 Example If an area under the foot measures at 20mm and the Total Support is set to 10 the mill cuts that area at 22mm above the minimum insole thickness as set by the Thickness command 62 e Editing Adjustments Amfit32 Orthotic Fabrication System Table 10 Types of Wedges Heel Lift Ramp A linear ramp that runs from the ball of the foot to the heel It will increase the minimum thickness under the heel This is typically used for additional cushioning under the heel or to allow for a leg length discrepancy Heel Cupping Allows you to reduce or increase the amount of support around the heel area of the current contour The change is specified by a percentage Possible range 30 to 30 Example If an area around the heel measures at 20mm and the Heel Cupping is set to 10 the mill cuts that area at 22mm above the minimum insole thickness and the heel lift as set by the Thickness
79. utton This will start the Digitizer calibration process This process takes approximately three minutes to complete You will be asked several questions To begin the process click Yes see below Calibration Procedure LI Run step by step instruction for calibration Amfit32 Orthotic Fabrication System DIGITIZE e 39 3 Once you see the pins rising out of the pin box click OK see below 5 Now the pins should be completely lowered back into the pin box If so click OK see below Calibration Procedure x e 1 Verify that the pins have reset i Cancel 6 Place the clear plastic calibration plate over the pin holes and click OK see below Calibration Procedure La 1 Insure that the calibration plate is in position E Cancel 40 e DIGITIZE Amfit32 Orthotic Fabrication System 7 Make sure the pressure adjuster is about half way up Then click OK Calibration Procedure i Set Compressor pressure to 2 3 above zero Verify that the pins have risen to the calibration plate Cancel 8 Press OK to exit calibration and start digitizing Calibration Procedure A Calibration Complete General The Amfit Footfax Digitizer is an interactive system This means that it responds to the operator s actions The Digitizer is a highly flexible tool that gives you exceptional latitude when positioning casting a patient s foot Patient evaluation is important By this tim
80. zer window which is a control panel used to operate the Footfax Digitizer The window is shown in the following figure It closely resembles the control keypad on the Footfax itself Amfit32 Orthotic Fabrication System BASICS e 21 Digitizing Selection Ci Donor 4 Male Size 11 ID 0000 000 t AN Pins Up W Center Heel 2 Lock Pins Wy Jeziubig Diagnostics Diagnostics a Fig 9 Digitizer Window The window displays the four control buttons for the Footfax The top of the window shows the current client s name and other information You can have the system automatically center the heel by clicking on Center Heel Scanning Place a foot right or left on the top of the scanner Position the heel in the center of the heel guide Then slide the toe plate back so that the edge of the plate is under the toes The toe plate may have to be removed turned around and re inserted Its shape makes proper orientation obvious see next figure 22 e BASICS Amfit32 Orthotic Fabrication System Where do I put the Toe Plate Slide the toe plate back toward the heel so that the edge of the toe plate is just forward of the ball of the foot If you want the system to record elevation in the toe crest or sulcus area slide the plate so that the rear edge is just posterior to the toe s bottom pad area touching the top plate of the scanner Fig 10 Toe Plate Placemen

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