custom orthotics

Syndrome of the Trephined (SoT) is a frequently misunderstood and underdiagnosed outcome of decompressive craniectomy, especially in cases of trauma. The pressure gradient between atmospheric pressure and the sub-atmospheric intracranial pressure results in a sinking of the scalp overlying the craniectomy site. This gradually compresses the underlying brain parenchyma. This parenchymal compression can disrupt normal autoregulation and subsequent metabolism, yielding symptoms ranging from headaches, dizziness, altered behavior to changes in sensation, and difficulty with ambulation, coordination, and activities of daily living...

Background  Kienbock's disease is primarily seen in young adult males but has been recognized in skeletally immature populations as well. Traditional treatment strategies recommend operative treatment but high remodeling potential in children may allow conservative management. Case Description  We present the case of a 7-year-old female with 2 months of atraumatic right wrist pain who was found to have edematous signal change within the lunate on wrist magnetic resonance imaging (MRI) consistent with Kienbock's disease...

The orthotic insole is a device that is placed between the bottom of the foot and the sole of the shoe. It bears the body weight and directly influences the biomechanics of the foot and the body. These insoles are used to minimize the stress by reducing plantar pressure between support points hence minimizing the pressure. Such customized insoles have usually been produced by either handmade or subtractive methods. Fused deposition modeling (FDM) has opened innovative ways for the manufacture of orthotic insoles...

INTRODUCTION: Hallux valgus (HV) is one of the most prevalent forefoot deformities, and its frequency increases with age, reaching nearly 23% in adulthood (females are usually more affected). Studies on customised insoles and orthoses for HV showed inconclusive results. There is no consensus in literature regarding the ideal insole or length of use for pain relief or functional improvement in individuals with HV. This study will assess the effects of a customised insole with retrocapital bar associated with an infracapital bar of the first metatarsal on pain and function of individuals with symptomatic HV...

A misshaped pinna, caused by extrinsic pressures such as birth canal extrusion or incorrect position, is typically one of congenital auricular deformities in newborns. As an approach to this deformity, surgery is a routine option, but it may lead to uncomfortable outcomes traumatically and aesthetically. Commercial ear mold orthosis with uniform size has achieved an effect of non-surgical orthotic treatment, but it is not applicable among all newborns in terms of the auricle morphologies. This research was to employ the CAD and 3D printing technology to develop a novel customized orthosis for congenital auricular deformities...

INTRODUCTION: Chronic ankle instability (CAI) is a disorder that occurs after one or more acute ankle sprains and is characterised by persistent symptoms which include episodes of ''giving way'' a sensation of instability, recurrent ankle sprains, and functional deficits. Despite of effective treatment strategies a comprehensive approach is needed that can break this continuum of disability and improve the postural control. A systematic review with meta-analysis assessing the effectiveness of interventions targeting plantar cutaneous receptors for improving postural control in individuals with chronic ankle instability...

BACKGROUND: Pediatric flexible flat foot (PFFF) is often associated with pain along the medial longitudinal arch and potential disability. There are several conservative treatment options for PFFF, ranging from intrinsic muscle exercises to orthosis, including University of California Biomechanics Laboratory (UCBL) and custom-made semi-rigid insoles. OBJECTIVES: To investigate and compare the effect of UCBL and custom-made semi-rigid insoles on pedobarographic and radiologic parameters in PFFF...

Custom foot orthoses are used to treat a variety of foot pathologies. However, orthotic production requires significant hands-on fabrication time and expertise to produce orthoses that are both comfortable and effective. This paper introduces a novel 3D printed orthosis and fabrication method that utilizes custom architectures to produce variable-hardness regions. These novel orthoses are compared to traditionally fabricated orthoses during a 2-week user comfort study. Twenty (n = 20) male volunteers underwent orthotic fitting for both traditional and 3D-printed foot orthoses prior to engaging in treadmill walking trials and 2 weeks of wear...

3D printing for custom prosthetic finger fabrication can have better fit and comfort than non-custom off-the-shelf ones while reducing fabrication labor time. The purpose of this case study was (1) to design and fabricate custom prosthetic fingers using 3D-printed molds for the treatment of partial finger amputation; (2) to evaluate patient satisfaction of the custom prosthetic fingers fabricated using 3D-printed molds and compare them to the custom prosthetic fingers fabricated through a conventional method of molding using plaster casts...

BACKGROUND: Additive manufacturing enables to print patient-specific Foot Orthotics (FOs). In FOs featuring lattice structures, the variation of the cell's dimensions provides a locally variable stiffness to meet the therapeutic needs of each patient. In an optimization problem, however, using explicit Finite Element (FE) simulation of lattice FOs with converged 3D elements is computationally prohibitive. This paper presents a framework to efficiently optimize the cell's dimensions of a honeycomb lattice FO for flat foot condition...

Adolescent idiopathic scoliosis is a 3D spinal deformity and mostly affects children in the age group of 10-16 years. Bracing is the most widely recommended nonoperative treatment modality for scoliosis in children. Scoliosis brace fabrication techniques have continuously evolved and currently use traditional plaster casting, computer-aided design (CAD) and computer-aided manufacturing (CAM), or 3D printing. This is a mini narrative literature review. The objective of our study is to conduct a narrative review of traditional, CAD-CAM and 3D printed brace manufacture...

Foot-drop is one of the most diagnosed and physically limiting symptoms persons with multiple sclerosis (pwMS) experience. Clinicians prescribe ankle-foot orthosis (AFO) and functional electrical stimulation (FES) devices to help alleviate the effects of foot drop, but it is unclear how their clinical and functional gait improvements compare given the user's level of disability, type of multiple sclerosis, walking environment, or desired physical activity. The research questions explored were what is the current state of AFO and FES research for pwMS? What are the prevailing research trends? What definitive clinical and functional device comparisons exist for pwMS? eight databases were systematically searched for relevant literature published between 2009 and 2021...

Isolated frontosphenoidal craniosynostosis is extremely rare, due to which diagnosis can be challenging. All the isolated cases reported have been treated by open surgical technique. We present a unique case report of an infant with an isolated frontosphenoidal synostosis corrected by a novel endoscopic surgical technique. The patient was a 5-month-old boy with worsening abnormal head shape indicating progressive right frontal bossing, left orbital displacement, and right occipital plagiocephaly. Computed tomography scan confirmed the diagnosis of left isolated frontosphenoidal craniosynostosis...

Recent scientific evidence supports the idea that foot plantar stimulation increases the functional connectivity of brain regions involved in visuo-spatial and sensory-motor integration. In this before-after, non-randomised intervention study we assessed the change in several gait and postural parameters using inertial sensor measurements after acute plantar stimulation using custom 3D-printed insoles. The pilot study was performed on 22 institutionalised, older individuals with a high comorbidity burden who either walked autonomously or with the help of a cane...

Knee orthoses can potentially reduce muscular activities of the quadriceps. The aim of this study was to investigate the effect of a custom flexion-resist and extension-assist knee orthosis on electromyographic activities of quadriceps during lateral stepping (step-up and step-down). Flexion resistance and extension assistance mechanisms were set by a pair of linear springs built into the orthotic knee joints. Electromyography (EMG) signals were collected from rectus femoris (RF), vastus medialis obliquus (VMO), and vastus lateralis (VL) during lateral step-up and lateral step-down activities in 7 healthy young adults...

A complexity of factors, from health and technology innovations to policy redesign to achieve consumer-directed care, are impacting traditional roles for Australian allied health practitioners (AHPs). This pilot study considers roles for AHPs in relation to assistive technology (AT) interventions. Articulating 'who does what' may serve a number of purposes including de-professionalization of the discourse; better utilization of support networks and workforces; and alignment with contemporary policy. Yet, a suitable framework to assist with collaborative AT implementation between relevant stakeholders was not identified within the existing literature...

Diabetic individuals with peripheral neuropathy are at risk for the development of foot ulcers due to musculoskeletal abnormalities and abnormal loading in the gait cycle leading to elevated plantar pressures. To prevent diabetic foot ulcers, practitioners should regularly screen patients for the presence of neuropathy as well as neuroarthropathies and prescribe the appropriate shoes and orthotics based on the best available clinical evidence. Although not widely available, there is potential for data-driven customization of orthotics and shoe wear based on plantar pressure data to prevent the development of diabetic foot ulcers more effectively, and ultimately prevent lower limb amputations...

People with lower limb impairment can participate in activities such as running with the use of a passive-dynamic ankle-foot orthosis (PD-AFO). Specifically, the Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a PD-AFO design that includes a carbon-fiber strut, which attaches posteriorly to a custom-fabricated tibial cuff and foot plate and acts in parallel with the impaired biological ankle joint to control sagittal and mediolateral motion, while allowing elastic energy storage and return during the stance phase of running...

BACKGROUND: Genu varus (GV) is a common deformity characterized by leg bending, which seriously threatens human health. At present, there is no definite conclusion to explain the cause of genu varus. The purpose of this study is to systematically review and meta-analysis the effectiveness and scientific basis of the clinical efficacy of customized orthopedic insoles on genu varus and hope to provide a reference for future research in this field. METHODS: The following electronic databases will be searched from inception to January 2022: Pubmed, Cochrane Library, MEDLINE, EMBASE, Web of Science, Weipu, Wanfang Data, and CNKI...

BACKGROUND: Following transtibial amputation, a custom-built socket is the most common interface between the prosthesis and residual limb. Desire from both prosthetists and prosthesis users for improved socket fitting processes have been well documented. However, there is currently limited information available about prosthetists' experiences of how prosthetic manufacturing workflow can contribute to socket fit problems. OBJECTIVES: This study aims to determine how socket fit problems are currently detected and managed by prosthetists and to identify challenges, management strategies, and opportunities for workflow and technological innovation during prosthesis manufacture and socket fitting...