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custom orthotics

Pedro H T Q de Almeida, Joy C MacDermid, Tatiana Barcelos Pontes, Clarissa Cardoso Dos Santos-Couto-Paz, Licia Maria H da Mota, João Paulo C Matheus
STUDY DESIGN: Cross-sectional descriptive study. INTRODUCTION: Osteoarthritis (OA) is the most prevalent musculoskeletal disease in the adult and older adult populations. The use of orthoses to stabilize the thumb's articular complex is one of the most common conservative management strategies. Despite substantial research about this topic, there is insufficient evidence about the optimal use of orthoses to inform clinical practice, contributing to practice variations within and across health professionals...
October 19, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Amir A Zadpoor, Jos Malda
The introduction of additive manufacturing (AM), often referred to as three-dimensional (3D) printing, has initiated what some believe to be a manufacturing revolution, and has expedited the development of the field of biofabrication. Moreover, recent advances in AM have facilitated further development of patient-specific healthcare solutions. Customization of many healthcare products and services, such as implants, drug delivery devices, medical instruments, prosthetics, and in vitro models, would have been extremely challenging-if not impossible-without AM technologies...
September 8, 2016: Annals of Biomedical Engineering
Elisa S Arch, Bretta L Fylstra
The large, late-stance energy generated by the ankle is believed to be critical during gait. However, the distal foot absorbs/dissipates a considerable amount of energy during the same phase. Thus, the energy generated by the combined ankle-foot system is more modest, which raises questions regarding the necessity of such a large ankle power and the interplay between foot and ankle energetics. This study aimed to evaluate our conservation of energy hypothesis, which predicted if distal foot energy absorption/dissipation was reduced, less energy would be generated at the ankle and thus the same combined ankle-foot energetics would be achieved...
September 6, 2016: Journal of Applied Biomechanics
Gabriele Baronio, Sami Harran, Alberto Signoroni
The possibility to realize highly customized orthoses is receiving boost thanks to the widespread diffusion of low-cost 3D printing technologies. However, rapid prototyping (RP) with 3D printers is only the final stage of patient personalized orthotics processes. A reverse engineering (RE) process is in fact essential before RP, to digitize the 3D anatomy of interest and to process the obtained surface with suitable modeling software, in order to produce the virtual solid model of the orthosis to be printed...
2016: Applied Bionics and Biomechanics
Evgenia Manousaki, Tomasz Czuba, Gunnar Hägglund, Louise Mattsson, Hanneke Andriesse
Relapse after successful initial correction of idiopathic clubfoot with the Ponseti method is often related to poor compliance with the foot abduction orthosis (FAO). The aim of this study was to evaluate treatment with custom-made dynamic orthoses. Twenty children with idiopathic clubfoot (30feet) who had been treated with dynamic orthoses after the correction phase according to the Ponseti casting technique were evaluated. Relapse rates during orthotic treatment were registered. A Vicon gait analysis system was used to measure gait parameters at the age of seven years...
August 7, 2016: Gait & Posture
Lisa Heuch, Judith Streak Gomersall
BACKGROUND: The incidence of foot ulceration related to diabetes is increasing. Many foot care professionals recommend offloading measures as part of management strategies for modulating excess pressure to prevent development of diabetic foot ulcers (DFUs). These measures may include padding, insoles/orthotic devices and footwear. There is a lack of evidence-based guidance on the effectiveness of the different offloading options for preventing primary ulceration in those with diabetes...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
Andrew J Sheean, David J Tennent, Johnny G Owens, Jason M Wilken, Joseph R Hsu, Daniel J Stinner
BACKGROUND: Fractures of the distal tibia, ankle, and foot sustained through a high-energy mechanism can be extremely debilitating, and ankle and/or subtalar fusion may be indicated if the limb is deemed salvageable. Functional outcomes among this population are often poor. The purposes of this study were to evaluate the effect of an advanced rehabilitation program combined with the use of a custom ankle-foot orthosis for patients with ankle or subtalar fusion on selected physical performance measures and patient-derived outcome measures and to determine if the response to treatment was predicated upon the type of fusion...
August 11, 2016: Foot & Ankle International
Daniel Harte
This author provides instruction regarding an alternative, simple, and custom-made orthotic device to manage the mallet finger that may stay in place more securely while also allowing for proximal interphalangeal joint flexion during the healing of the terminal tendon. - KristinValdes, OTD, OT, CHT, Practice Forum Editor, Journal of Hand Therapy.
July 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Joanne O'Connor, Dorothy McCaughan, Catriona McDaid, Alison Booth, Debra Fayter, Roccio Rodriguez-Lopez, Roy Bowers, Lisa Dyson, Cynthia P Iglesias, Simon Lalor, Rory J O'Connor, Margaret Phillips, Gita Ramdharry
BACKGROUND: Patients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee-ankle-foot orthoses (KAFOs). OBJECTIVES: To assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs. METHODS: Qualitative study of views of orthoses users - a qualitative in-depth interview study was undertaken...
July 2016: Health Technology Assessment: HTA
P Faglin, É Nectoux, A Belkhou, P Guerreschi, V Duquennoy-Martinot
Anterior chest wall deformity are mostly represented by pectus excavatum, which is a depression of the chondrosternal plastron from the 3rd to the 7th pairs of the costal cartilages, then by pectus carinatum which conversely represents a protrusion of this plastron. The major esthetic and psychosocial impact is not to be demonstrated anymore whereas the cardiopulmonary functional impact remains still highly debated. Regarding the management, curative surgical techniques such as Wurtz's sub-perichondrial simplified sternochondroplasty or Nuss' minimaly invasive technique are opposed to palliative filling technique such as customized silicone implant, lipostructure and flaps...
July 13, 2016: Annales de Chirurgie Plastique et Esthétique
W T Lo, D P Wong, K L Yick, S P Ng, J Yip
BACKGROUND: Turning during locomotion involves considerable changes of the body's center of mass and reduced stability, as well as lower limb kinematics and kinetics. However, many previous studies have been carried out to evaluate the effectiveness and applications of orthotic insoles as well as different types of orthotic materials in various clinical symptoms, which are focused primarily on straight line walking. Hence, the influence of custom-made insoles with the use of advanced three-dimensional spacer fabrics on biomechanics parameters in terms of plantar pressure distribution and lower limb electromyography during turning movement was studied...
2016: Journal of Foot and Ankle Research
Rob Grieve, Shea Palmer
OBJECTIVES: To identify how United Kingdom (UK) physiotherapists currently diagnose, assess and manage plantar fasciitis in routine practice. DESIGN: Online questionnaire survey. PARTICIPANTS: Practising physiotherapists across the UK who treat patients with plantar fasciitis. METHODS: Physiotherapists were approached via 'interactive Chartered Society of Physiotherapy (CSP)' online networks and an email database of clinical educators in South West England...
February 12, 2016: Physiotherapy
Sheree E Hurn, Bill T Vicenzino, Michelle D Smith
BACKGROUND: Patients with hallux valgus (HV) frequently present to podiatrists for non-surgical management, with a wide range of concerns including pain, footwear difficulty and quality of life impacts. There is little research evidence guiding podiatrists' clinical decisions surrounding non-surgical management of HV. Thus practitioners rely largely upon clinical experience and expert opinion. This survey was conducted to determine whether a consensus exists among Australian podiatrists regarding non-surgical treatment of HV, and secondly to explore common presenting concerns and physical examination findings associated with HV...
2016: Journal of Foot and Ankle Research
Silvio Tocco, Alessio Pedrazzini, Francesco Pogliacomi
Proximal interphalangeal joint (PIPj) flexion contractures are a common clinical problem seen by hand therapists and orthopaedic surgeons after various types of injury to the finger. Conservative treatment is preferable over surgery but a variety of pre-fabricated and custom-made orthoses have been proposed in the literature. The aim of the present paper is to share our 15 year experience in treating PIPj flexion contractures using 2 different custom-fabricated orthoses and the exercise regimen used to preserve maximal PIPj passive and active extension obtained through the orthotic intervention...
2016: Acta Bio-medica: Atenei Parmensis
Sandra L Winkler, Sergio Romero, Emily Prather, Marisa Ramroop, Emmy Slaibe, Matthew Christensen
Some people without independent mobility are candidates for powered mobility but are unable to use a traditional power wheelchair joystick. This proof-of-concept study tested and further developed an innovative method of driving power wheelchairs for people whose impairments prevent them from operating commercial wheelchair controls. Our concept, Self-referenced Personal Orthotic Omni-purpose Control Interface (SPOOCI), is distinguished by referencing the control sensor not to the wheelchair frame but instead to the adjacent proximal lower-extremity segment via a custom-formed orthosis...
March 2016: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Iskander S Al-Githmi
BACKGROUND: Pectus carinatum is a congenital chest wall deformity characterized by protrusion of the sternum and adjacent costal cartilages. Multiple treatment options are available for correction of pectus carinatum. OBJECTIVE: We report our initial experience with first-line treatment using a custom fitted dynamic compression orthosis. DESIGN: Prospective evaluation of all patients seen between November 2013 and December 2014. SETTING: University hospital...
January 2016: Annals of Saudi Medicine
Rebecca D Lewis, Paul Wright, Laine H McCarthy
CLINICAL QUESTION: In adults with acute plantar fasciitis whose symptoms have not been relieved with the conventional regimen of NSAIDS, stretching and lifestyle modification, do the addition of orthotics (prefabricated or custom fitted) reduce pain and improve function compared with other non-surgical treatments (manipulative chiropractic, physical therapy and/or heel steroid injections)? ANSWER: Yes. Studies have shown that orthotics, both prefabricated and custom fitted, reduce pain and improve function in adults with acute plantar fasciitis with few risks or side effects...
December 2015: Journal of the Oklahoma State Medical Association
John R Fisk, Sharon DeMuth, James Campbell, Thomas DiBello, Alberto Esquenazi, Robert S Lin, Bryan Malas, Francis X McGuigan, Thomas F Fise
OBJECTIVES: This article establishes needed guidelines for determining orthotic prescriber authority, documenting medical necessity, and ensuring continuity of care for patients needing orthoses. It also identifies "off-the-shelf" (OTS) devices that can safely and appropriately be delivered to patients without professional adjustment as well as those that cannot. METHODS: A multidisciplinary task force made up of experts in orthopedics and physical medicine physicians, along with therapists and certified orthotists, applied a consensus approach to answer key questions: (i) When can a device be safely, effectively delivered to the patient OTS without professional guidance or education, and which caregivers have a role in that decision? (ii) What documentation is appropriate for physicians and other caregivers to determine medical necessity? (iii) What documentation/communication ensures continuity of care among physicians, therapists, and orthotists? RESULTS: Guidelines developed for consideration of OTS orthoses include accepting documentation from collaborating caregivers, including therapists and orthotists; keeping that documentation as part of the patient's total medical record for clinical, medical necessity determinations and reimbursement purposes; and using the physician's prescription for the device as the key determinant of whether a device is delivered OTS or as a custom-fitted device...
February 2016: Military Medicine
Gillian L Hatfield, Christopher K Cochrane, Judit Takacs, Natasha M Krowchuk, Ryan Chang, Rana S Hinman, Michael A Hunt
UNLABELLED: This study compared immediate changes in knee and ankle/subtalar biomechanics with lateral wedge orthotics with and without custom arch support in people with knee osteoarthritis and flat feet. Twenty-six participants with radiographic evidence of medial knee osteoarthritis (22 females; age 64.0 years [SD 8.0 years], BMI 27.2 kg/m(2) [4.2]) and flat feet (median foot posture index = + 5) underwent three-dimensional gait analysis for three conditions: Control (no orthotic), lateral wedge, and lateral wedge plus arch support...
September 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Hong-Jae Lee, Kil-Byung Lim, JeeHyun Yoo, Sung-Won Yoon, Hyun-Ju Yun, Tae-Ho Jeong
OBJECTIVE: To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. METHOD: A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation...
December 2015: Annals of Rehabilitation Medicine
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