phone - 805-687-7508, fax - 805-687-6251
email - info@nobbeorthopedics.com




WALKAIDE SCREENING QUESTIONNAIRE

I have a pacemaker or severe cardiac disease. 6 points
I have a history of seizures 5 points
I often lose my balance and fall several times a day or week 5 points
I am pregnant or expecting to become pregnant. 5 points
I have significant contractures (i.e. extreme muscle tightness) at the ankle, knee and/or hip 5 points
I have discussed the possibility of using functional electrical stimulation with my physician and was told it was not indicated because of other medical conditions. 5 points
I do little to no walking. I only stand to transfer from the bed to a chair or the chair to the toilet. 4 points
I have been diagnosed with foot drop by my doctor. 0 points
My foot drop is related to a stroke, brain injury, multiple sclerosis, incomplete spinal cord injury, cerebral palsy or other neurological condition. 0 points
I am unable to lift my foot effectively during walking, which forces me to drag the foot or engage in a high-stepping gait. 0 points
I occasionally stumble because my foot does not always lift up at the correct time during walking. 0 points
I have discussed the possibility of using functional electrical stimulation for waling with my physician and they support my interest. 0 points
Walking with my current orthopedic devices (AFOs, canes, walkers, etc.) is very tiring, requiring me to rest often or not participate in many activities 0 points
If your score is 4 or LESS, the WalkAide may be right for you............TOTAL _______
   
The WalkAide has been cleared for market by the FDA and is effective for some people with certain types of physical limitations
Insurance companies presently do not cover the cost of this new medical technology.
•You can also learn more about the WalkAide by visiting the WalkAide web site at www.walkaide.com

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