North Coast Progress Plus Pronation/Supination Turnbuckle Orthosis Instructions Instruction Manual

US Patient # 6179799

Pronation/Supination Orthosis

Progress™-PLUS

Elbow Component Hand Component

Distal white plastic
piece with
metal screw

Threaded rod

Indications:

Use for static or static-progressive positioning of the forearm to maintain
or improve rotational motion that has been reduced by contractures from
neurological disorders, muscle hypertonicity, or orthopedic conditions.
Recommended for serial splinting to increase ROM or postoperatively
to limit or prevent forearm motion. Infinite adjustability allows the
forearm to be held statically in any position between full supination
and pronation.

Description:

The Progressu-PLUS Pronation/Supination Orthosis is comprised of:

•Elbowcomponent

•Handcomponent

Instructions:

Pronation

Supination

Figure 1 Figure 2

Distal white

Palmar hole

Middle hole

Dorsal hole

1. Set up the hand component for the desired resting position.
The component comes assembled to allow almost full range of motion.

Check the location of the distal white plastic piece on the hand compo­nent. If end-range supination or pronation is desired, relocate the white
plastic piece to the hole location as indicated in Figure 1. Do not over­tighten the set-screw inside the hand component. This piece should
be able to rotate slightly.

Setting Options Desired Resting Position

1. Plastic piece in the middle hole Preset, for most range of motion

2. Plastic piece in the palmar hole For supination > 75°

3. Plastic piece in the dorsal hole For pronation > 75°

plastic piece

2. Attach the hand component to the elbow component.
Remove the white nut, metal nut and washer from the end of the

screw on the hand piece. Do not remove the spacer sleeve from the
screw. Place the end of the screw into the hole of the threaded rod that
extends from the elbow component. Rescrew the nuts and washer into
place. (Figure 2).

White nut

Threaded rod

Spacer sleeve

Metal nut

Washer
Distal white
plastic piece

Tiburon Medical Enterprises, Inc.
915 Industrial Way
San Jacinto, CA 92582 – U.S.A.

Medica Surgical Innovations Limited
Moorgate Street
Blackburn
BB2 4PB Lancs – UK

3. Apply the hand component to the hand.

•Place the hand component around
the wrist with the opening on the

Velcror Y-Strap Tab

ulnar side of the hand and the con­toured section over the palmar arch.
Use a heat gun to soften and trim the
Kydexr shell for slight changes in fit.

•Wrap the distal strap through the
web space and around the hand.
The sticky back hook pieces can be

Figure 3

relocated a few times for optimal strap placement. Secure the wrist
strap using the D-ring. To shorten the strap, remove the Velcror
Y-Strap Tab (Figure 3) from its end, cut the strap and return the strap
end between the two hook pieces of the tab.

4. Apply the elbow component to the anterior arm (Figure 5).

•Turn the large thumb
screws in the adjust­ment hardware so
that the screw ends

Threaded rod
hardware

White
nut

are positioned clear
of the threaded rod
hardware.

•Move thewhitenuts

to both ends on the
threaded rod, away

Thumb screws

Figure 5

from the hardware.

•Place the elbowcomponenton the anterior arm with the orthosis

bend in alignment with the elbow crease. The elbow is held fixed
at approximately 60° flexion. Fasten the three elbow straps around
the arm using the corresponding D-rings. Adjust the neoprene pads
(attached by Velcror hook) on the straps for optimum comfort.

5. Achieve the desired forearm position.

•To rotate the forearm into position,
turn the large thumb screws in oppo-

Pronation

site directions until both screws are
against the adjustment hardware. The
thumb screw that protrudes out can
be removed if not needed for rod sta­bility later.

For Pronation: the proximal thumb

screw is screwed farther into the
adjustment hardware (Figure 6).

(6a)

Spacer sleeve/rod should be pushing
from the dorsal side (Figure 6a).

For Supination: the distal thumb

screw is screwed farther into the
adjustment hardware (Figure 7).
Spacer sleeve/rod should be pushing
from the palmar side (Figure 7a).

Supination

Figure 6

•To adjust the length between the
elbow and hand component, move
the two white plastic nuts located
on the threaded rod. Slide the rod
forward or backward until the hand
component is in good alignment.
Lightly tighten the two nuts against
the adjustment hardware when fin­ished. (Figure 5) If a shorter distance
is needed, the distal white nut can

(7a)

be removed from the rod. The rod
will need to be removed from the
hardware in order to do this. Note: A
shorter rod distance is needed when

Figure 7

the hand is in a neutral position versus a longer distance when the
hand is at the end range.

© 2015 North Coast Medical, Inc., www.ncmedical.com

Gilroy,CA95020 REV14040i_0915

Manufactured for: North Coast Medical, Inc.

5. Achieve the desired forearm position. (Continued)

•To adjustthealignment/tilt of the

hand component, loosen and slide
the metal screw side-to-side in

Figure 8

metal screw

the slot of the hand component’s
distal white plastic piece. Tighten the
white nut on the end of the metal
screw when finished. (Figure 8)

6. Refasten the straps and adjust the neoprene pads for a better fit.

•Trim the straps and pads if needed
(see Figure 3 for tips on trimming
straps). Neoprene pads should fit
next to (not over) the liner edges.
(Figure 9)

Figure 9

7. Continued static progressive positioning.

Make minor adjustments as needed

to increase range and maintain a com­fortable fit. Try the following steps
during each positional change to
achieve desired results:

• To gain greater forearm rotation,
adjust the large thumb screws.

• To set the appropriate distance
between the hand and the elbow
components, adjust the threaded
rod position.

• For better alignment of the hand
to the elbow component, slide the
metal screw side-to-side in the distal
white plastic piece.

Greater
than 80°
Supination

Figure 10

• To progress into the desired range of pronation or supination, move
the distal white plastic piece to another hole on the hand component
(see settings in Figure 1). (Figure 10) Note: Washers, spacer sleeve,
and nuts may need to be repositioned or removed to achieve proper fit.

Wear and Care Instructions:

Initially wear the orthosis for one hour on and one hour off. Increase the
wear time as necessary based on the medical condition. Note any poten­tial pressure areas and adjust the fit accordingly. Repeatedly adjust the
thumb screws to provide static progressive changes over time. A medical
professional should fit the orthosis.

The orthosis can be surface-cleaned using mild soap and water. The elbow
component liner can be hand washed and air dried.

Ordering Information:

Elbow Component
Left Right

NC14040-1 NC14040-2 Small
NC14040-3 NC14040-4 Medium
NC14040-5 NC14040-6 Large

Hand Component
Left Right

NC14041-1 NC14041-2 Small
NC14041-3 NC14041-4 Medium
NC14041-5 NC14041-6 Large

Replacement Elbow Liner
NC14040-12L Small
NC14040-34L Medium
NC14040-56L Large

To be used under the

guidance of a qualified

medical professional.