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Intended Use
Dorsi Ramp is a physiotherapy device to help children to stretch
their Achilles tendons, and gastrocnemius and gastrosoleus
(Calf) muscles. Using Dorsi Ramp applies a passive weight
bearing stretch to the Achilles tendon and Calf muscles. This
type of stretch is often recommended for children suffering from a
range of medical conditions where tendon tightness and muscle
contracture is affecting the ability to dorsiflex the foot and is
possibly leading to an abnormal gait. Examples of conditions
where Dorsi Ramp may be applicable include:
• Neurological conditions such as Cerebral Palsy
• Congenital conditions such as Congenital Talipes Equino Varus
(Clubfoot)
• Idiopathic conditions, most commonly Idiopathic Toe Walking
• Recovery from trauma and tendonopathy
• Various neuropathies and myopathies
Dorsi Ramp is for use by children able to stand upright and
plantigrade (i.e. with their feet flat to the ground) from 18 months
of age to not more than 10 years of age and weighing no greater
than 63.6kg (140 pounds).
How to Use
To achieve a passive weight bearing stretch to the Achilles
tendons and Calf muscles place Dorsi Ramp on a solid level
surface, select the correct slope angle and stand upright as
directed (
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Changing the Slope Angle
Select the most appropriate slope angle, which can be 10, 15 or
20 degrees. To switch between 10 and 20 degree slope angles
pick up Dorsi Ramp and turn it upside down. When lifting Dorsi
Ramp hold from each end to avoid trapping fingers. The slope
angle is clearly indicated. The 15 degree position is achieved
by positioning the Dorsi Ramp with the 20 degree slope facing
upwards and placing the orange coloured insert on top (
Choosing the Correct Slope Angle
Carefully monitor the child to determine the most appropriate
angle. Do not use Dorsi Ramp at slope angles that cause
discomfort to the child. Excessive stretching can lead to Calf and
tendon strains or tears.
A child will be coping well with a slope angle if they can stand on
Dorsi Ramp with a normal looking, straight and upright posture
for 2 minutes without signs of discomfort. If the child needs
to push their bottom out, raise their heels or shows signs of
discomfort the slope angle is too high and should be reduced. If
the child is not comfortable with the 10 degree slope angle then
do not use Dorsi Ramp.
Start with the lowest slope angle and aim to progress to greater
angles over a period of weeks, months or even years as
appropriate to the user's condition. When the slope angle is
increased monitor the child carefully for signs of discomfort; start
with short duration stretches before building up to longer ones.
There may be days or periods when a child's ability to dorsiflex
reduces. This is normal in fast growing children. If the child
shows signs of not coping with the slope angle then reduce it.
Frequency and Duration of Stretches
Daily use is recommended. Ideally stretches should last for at
least two (2) minutes, but not longer than 30 minutes. Stretches
for as little as 30 seconds may still be beneficial. If possible
encourage use several times per day.
Correct Foot Position and Posture
The child should stand on the ramp with their heels close to the
lowest corner of the slope. The feet can be pointing directly
forward or angled outwards as the slope angle is constant in all
positions (
2
).
Should Shoes be Worn When Using Dorsi Ramp?
Children who overpronate or are flatfooted should use Dorsi
Ramp with footwear that provides support for the longitudinal
foot arch. Ideally such footwear should include custom orthotics.
Children who do not overpronate or who tend to supinate (such
as children with clubfoot) can use Dorsi Ramp in just socks
®
GB Instructions for Use
or bare feet. Shoes, slippers or sandals can always be used if
preferred (
Encouraging Children to Use Dorsi Ramp
The greatest benefits will be achieved with regular daily use –
even for relatively short periods of time.
Persuading young children to engage in regular physiotherapy
is not easy. It is best to incorporate the use of Dorsi Ramp
into everyday activities and to create incentives and positive
associations with its use. Try to avoid situations that lead to
negative associations as these will lead to resistance. The best
examples of use are when the child is so distracted by what
they are doing that they become unaware they are undergoing
physiotherapy. Here are some examples:-
Daily Teeth Cleaning: Dorsi Ramp can be placed in front of the
bathroom sink and used during the morning and evening teeth
cleaning routine. Dorsi Ramp acts as a step, which helps young
children comfortably reach the sink. Try using a kitchen timer and
insist the child brushes their teeth for 2 minutes each morning and
evening (
4
Computer Games: Incentivise children to use Dorsi Ramp by
allowing extra time on computer games or other fun activities (
Kitchen worktops: Dorsi Ramp acts as a step helping children to
comfortably reach the worktop to help out in the kitchen (
Storage and Cleaning
Do not store in direct sunlight. Store at temperatures between
5 and 30 degrees Centigrade. Do not stack items on top of the
Dorsi Ramp. Plastics will yellow in time, this is normal. Clean
the unit using a damp cloth only, do not use bleach, solvents or
abrasive cleaning pads. Do not use polish.
).
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Warnings and Precautions
Use only as directed in this guide. Stand only on the sloping
surfaces. Do not stand on edges as product may tilt or tip over. If
in doubt about how or whether to use Dorsi Ramp please consult
a qualified medical practitioner with knowledge of the user's
condition. Do not use ramp at slope angles that cause discomfort
to the child. Not for use by children less than 18 months of age
or unable to stand upright with plantigrade feet. Not to be used
by children over 10 years of age or weighing greater than 63.5Kg
(140 pounds). Children using Dorsi Ramp must be supervised
by an appropriate adult carer at all times. When lifting Dorsi
Ramp hold from each end to avoid trapping fingers. Do not drop
the Dorsi Ramp. Do not use if damaged or cracked. If in doubt
inspect Dorsi Ramp for signs of damage. The Dorsi Ramp is not a
toy and should not be used as such. Do not use outdoors.
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