custom molded orthotics

BACKGROUND: Excessive foot pronation is a causal mechanisms described in relation to injuries of the lower extremities. Evidence to support an effective treatment is insufficient. OBJECTIVE: To investigate the effect of exercise and custom-made insoles to patients with excessive pronation and chronic pain conditions in the foot at short and long term follow-up. METHODS: Single blinded Randomized Controlled Trial with 80 subjects randomized: (1) Standard Intervention, (2) Insole, (3) Exercise, and (4) Insole+Exercise...

BACKGROUND: The aim of this case study was to identify the effect of a powered stance control knee ankle foot orthosis on the kinematics and temporospatial parameters of walking by a person with poliomyelitis when compared to a knee ankle foot orthosis. CASE DESCRIPTION AND METHODS: A knee ankle foot orthosis was initially manufactured by incorporating drop lock knee joints and custom molded ankle foot orthoses and fitted to a person with poliomyelitis. The orthosis was then adapted by adding electrically activated powered knee joints to provide knee extension torque during stance and also flexion torque in swing phase...

STUDY DESIGN: A gross anatomic and motion analysis study in cadavers. OBJECTIVE: Assess spinal motion in a cadaveric spinal fracture model and investigate the ability of external orthoses to control this motion. SUMMARY OF BACKGROUND DATA: External orthoses are frequently prescribed for patients who have experienced burst fracture of the thoracolumbar spine. Despite the substantial expense involved, there is little data confirming their value...

BACKGROUND AND AIM: Sport is associated with risk of injury and re-injury. A rehabilitative sport-related orthosis could protect the injured site and help in the earlier return of athlete to the match. This technical note aims to describe a potential high-prescribed face orthosis to protect/prevent a sport-related injury. TECHNIQUE: Face-protective orthosis should be custom molded from negative impression of the injured athlete's face. It is lightweight and structured as a one-piece rigid plastic shell that is secured in place with three elastic straps...

BACKGROUND: Plantar ulcers pose a frequent serious complication in the neuropathic foot. Previous studies suggested that ulcer initiation occurs within the plantar soft tissue rather than on the plantar surface. This study investigated the effectiveness of different shaped silicone insoles on the reduction of both plantar soft tissue strain and pressure. The authors have found no previous experimental studies on the effectiveness of insole shape on reducing plantar soft tissue strain during standing...

BACKGROUND: The most common method of customizing shoe insoles to the shape and surface of the foot is to heat and then mold the materials. The effect of heating on the mechanical properties of these materials is unknown. METHODS: The properties of individual and common combinations of insole materials were tested before and after heating. Individual materials tested were soft Plastazote (SP), medium Plastazote (MP), Puff (F), and Nickelplast (N); combinations of materials that were tested were SP + F and MP + F, each with and without Poron (P)...

Midfoot Charcot collapse commonly occurs through the tarsometatarsal and/or midtarsal joints, which creates the characteristic "rocker bottom" deformity. Intramedullary metatarsal fixation spanning the tarsus into the talus and/or calcaneus is a recently developed method for addressing unstable midfoot Charcot deformity. The intramedullary foot fixation technique has various advantages when addressing midfoot Charcot deformity in the neuropathic patient. These advantages include anatomical realignment, minimally invasive fixation technique, formal multiple joint fusion, adjacent joint fixation beyond the level of Charcot collapse, rigid interosseus fixation, and preservation of foot length...

OBJECTIVE: The purpose of the study was to collect preliminary data to address methodological considerations that may impact subject-specific reactions to foot orthotics during running. METHODS: Six endurance-trained recreational runners recruited from a chiropractic college campus wore their preferred running shoes and then inserted either their custom-made orthotics during 1 testing session or their shoe-fitted insoles during the other testing session. Comfort perception was measured for each footwear condition...

OBJECTIVE: The aim of this study was to identify the effect of induced knee flexion during gait on the kinematics and temporal-spatial parameters during walking by a patient with spinal cord injury (SCI) through the application of an isocentric reciprocating gait orthosis (IRGO) with a powered knee mechanism. METHODS: Two orthoses were considered and evaluated for an ISCI subject with a T8 level of injury. An IRGO was initially manufactured by incorporating drop lock knee joints and was fabricated with custom molded AFOs to block ankle motion...

BACKGROUND: Historically, the orthotic treatment in progressive myopathic scoliosis has not been as effective as expected. The purpose of this study was to investigate the effect of a spinal orthosis on scoliotic curve correction, alignment of altered posture and cardio-respiratory functions. CASE DESCRIPTION AND METHODS: An 11 year-old girl diagnosed with myopathy was fitted with a custom molded thoraco-lumbo-sacral orthosis to enhance the sitting ability. The cardio-respiratory tests were performed by a COSMED K4 b(2); metabolic analyzer...

The purpose of this research was to determine the effects of footwear comfort perception on the gain of the gastrocnemius H-reflex response during single leg balance tasks. Subjects performed single leg balance tasks while wearing aerobic sneakers with two different pairs of shoe insoles that were subjectively rated for comfort using a reliable 150 mm visual analog scale. The primary outcome was the consistency of decreasing the gain of the gastrocnemius H-reflex with increasing balance task complexity as a function of footwear comfort perception...

BACKGROUND: Custom molded insoles with metatarsal supports are used to redistribute excessive loading under the metatarsal heads in patients with metatarsalgia. However, these pressure reductions are usually insufficient for the rheumatoid foot with painful deformed metatarsal heads. We developed an effective insole made by sequential foam padding under successive walking impression. METHODS: Seventeen consecutive rheumatoid arthritic outpatients with metatarsal pain participated in this repeated measures study of 7-mm flat Ethylene Vinyl Acetate, custom molded and dynamic impression insoles...

Prompted by repeated pathology reports of fibromas at the origin of the plantar fascia after fasciectomy for chronic plantar heel pain, this study examines the incidence of proximal plantar fibroma. A retrospective study of 101 pathology specimens from 97 patients with the preoperative diagnosis of recalcitrant plantar fasciitis was performed. Patients ranged in age from 36 to 82, and included 30 males and 67 females. The specimens consisted of medial and central bands of the fascia obtained from transverse plantar fasciectomies...

PURPOSE: The study's purpose was to determine the effect of foot orthoses on neuromuscular control and the aerobic cost of running. METHODS: Twelve recreational athletes ran for 1 h on a treadmill at a constant velocity (i.e., 10% higher than their first ventilatory threshold) with and without custom-molded foot orthoses, in a counterbalanced order. Surface EMG activity of five lower limb muscles, together with oxygen consumption and HR, was recorded at 8-min intervals, starting after 2 min, during the run...

BACKGROUND: A non-articulated plantarflexion resist ankle foot orthosis (AFO), commonly known as a posterior leaf spring AFO, is indicated for patients with motor impairment to the dorsiflexors. The AFO is often custom molded to a patient's lower limb anatomy and fabricated from polypropylene. There are no established guidelines for fabricating this type of AFO with predetermined stiffness of the ankle region for normal walking speeds. Therefore an AFO may not meet the biomechanical needs of the patient...

STUDY DESIGN: Prospective cohort study. OBJECTIVE: To quantify which 3 common lumbar orthoses of varying rigidity restrict both full, active range of motion (ROM) and functional ROM required for activities of daily living (ADL). SUMMARY OF BACKGROUND DATA: Spinal orthoses are implemented to restrict lumbar motion. Despite widespread prevalence of lumbar bracing, the efficacy of these appliances for immobilizing the spine has not been definitively established...

Prompted by repeated pathology reports of fibromas at the origin of the plantar fascia after fasciectomy for chronic plantar heel pain, this study examined the incidence of proximal plantar fibroma. A retrospective study of 100 pathology specimens from 97 patients with the preoperative diagnosis of recalcitrant plantar fasciitis was performed. Patients ranged in age from 36 to 82, and included 31 males and 66 females. The specimens consisted of medial and central bands of the fascia obtained from transverse plantar fasciectomies...

Treating patients with custom foot orthoses for common pathologies is a rewarding experience when the proper steps are taken during foot casting and custom-orthosis prescription writing. This article describes successful methods for orthoses casting and prescription writing for custom-molded orthoses for Achilles tendonitis, pes planus, hallux limitus, plantar fasciitis/heel spurs, lateral ankle instability, metatarsalgia, and pes cavus. In addition, a summary of orthotic laboratory instructions for each pathology-designed custom orthosis is provided, which should be considered by orthotic laboratories...

STUDY DESIGN: Experimental laboratory study supplemented by a case series. OBJECTIVES: (1) To assess the effect of a 4-week intervention with a full-length insert on functional outcomes in patients with midfoot arthritis; (2) to examine the effect of the custom molded three-quarter-length (3Q) and full-length (FL) carbon graphite insert on plantar loading in patients with midfoot arthritis. BACKGROUND: Given the coexistence of pain and lower-arched foot alignment in patients with midfoot arthritis, arch-restoring orthotic devices such as the 3Q insert are frequently recommended...

BACKGROUND: A scientific study was conducted to evaluate the effects of non-custom-molded (over-the-counter) foot orthoses. METHODS: Several parameters were examined, including foot, knee, hip, and back pain; balance; and reduction in flexible deformities, such as hammer toes and hallux valgus. Wherever possible, objective measurements were used, including measurements of shifts in center of pressure to assess balance and changes in bone position examined on radiographs...