Custom foot orthotics

BACKGROUND: In children with unilateral spastic cerebral palsy (USCP), ankle-foot orthoses (AFOs) are widely used to correct common gait deviations such as a drop-foot pattern. Most studies on this topic have investigated specific time points while omitting other parts of the gait cycle. OBJECTIVES: This study investigated the separate effects of prefabricated carbon fiber AFOs and custom-made hinged AFOs compared with barefoot walking in children with USCP with a drop-foot gait pattern using statistical parametric mapping...

INTRODUCTION: Custom insoles are a routine treatment for many foot pathologies, and the use of computer-aided design and computer-aided manufacturing (CAD/CAM) is well established within clinical practice in the UK. The method of foot shape capture used to produce insoles varies throughout orthotic services. This trial aims to investigate the effectiveness of two common shape-capture techniques on patient-reported outcomes in people who require insoles for a foot or ankle pathology. METHODS AND ANALYSIS: This double-blinded randomised controlled trial will involve two intervention groups recruited from a National Health Service orthotic service...

Background: Corrective shoe insoles are prescribed for a range of foot deformities and are typically designed based on a subjective assessment limiting personalization and potentially leading to sub optimal treatment outcomes. The incorporation of in silico techniques in the design and customization of insoles may improve personalized correction and hence insole efficiency. Methods: We developed an in silico workflow for insole design and customization using a combination of measured motion capture, inverse musculoskeletal modelling as well as forward simulation approaches to predict the kinematic response to specific insole designs...

The finite element (FE) foot model can help estimate pathomechanics and improve the customized foot orthoses design. However, the procedure of developing FE models can be time-consuming and costly. This study aimed to develop a subject-specific scaled foot modelling workflow for the foot orthoses design based on the scanned foot surface data. Six participants (twelve feet) were collected for the foot finite element modelling. The subject-specific surface-based finite element model (SFEM) was established by incorporating the scanned foot surface and scaled foot bone geometries...

BACKGROUND: A link between pronated feet (PF) and chronic low back pain (CLBP) has been reported in the literature. However, physical interventions (PI) like physiotherapy and orthotics mainly target the lower back, neglecting the broader biomechanical impacts of PF that affect the feet, ankles, and overall posture. Currently, there is a lack of comprehensive meta-analyses or systematic reviews on this subject. OBJECTIVES: This systematic review with a meta-analysis aimed to evaluate the effects of PI on pain and disability in patients having CLBP with PF...

BACKGROUND: Ankle-foot orthoses (AFOs) are orthopaedic devices often prescribed to treat foot drop. For patients who are not satisfied with off-the-shelf solutions, custom AFOs personalized to the patient's lower limb anatomy are required. Dynamic AFOs provide stability while allowing for physiological ankle mobility in the stance phase of walking. RESEARCH QUESTION: Can a morphology-based dynamic custom AFO made of fiberglass-reinforced polyamide restore a quasi-normal gait pattern and improve comfort in patients with foot drop? METHODS: In this pilot study, the legs and feet of ten foot drop patients (age=64...

BACKGROUND: Ankle-foot orthoses (AFOs) are a type of assistive device that can improve the walking ability of individuals with neurological disorders. Adjusting stiffness is a common way to customize settings according to individuals' impairment. OBJECTIVE: This study aims to design a variable-stiffness AFO by stiffness module and characterize the AFO stiffness range to provide subject-specific settings for the users. METHODS: We modeled AFO using bending beams with varying fulcrum positions to adjust the stiffness...

This study proposes a 3D printed, custom insole using an architectural lattice structure infill targeting diabetic patients at risk of foot ulcers. An analysis of five lattice configurations: Fluorite, Kelvin, Octet, Isotruss unit cells, and Truncated Octahedron was conducted to identify the most effective insole infill for plantar pressure and weight redistribution. The Kelvin lattice demonstrated minimal stiffness, suggesting its superiority in balancing plantar pressure and weight. Such lattice-structured insoles offer enhanced foot support and cushioning, crucial for ulcer-prone individuals...

Millions of Americans wear ankle-foot orthotic devices for protection, pain relief, and deformity correction. Inquiries about off-the-shelf and custom devices are a common reason for evaluation with a foot and ankle surgeon or general orthopaedic surgeon. Despite limited high-quality evidence for their use, these devices can have a notable clinical impact on physical function. An up-to-date understanding of orthotic device options and their appropriate use in managing musculoskeletal pathologies applies to all orthopaedic providers...

BACKGROUND: Ankle-foot orthoses (AFOs) are widely used to restore mobility and reduce pain in individuals with lower extremity pain and disability. The use of a carbon fiber custom dynamic orthosis (CDO) with integrated physical training and psychosocial intervention has been shown to improve outcomes in a military setting, but civilian data are limited. OBJECTIVES: To use existing clinical data to evaluate the initial effectiveness of an integrated CDO and rehabilitative program and identify baseline characteristics that impact patient response to the intervention...

The management of tibial pilon fractures is challenging and often leads to complications and limitations in ankle function. The study aims to investigate myotonometric parameters and muscle strength of ankle muscles, as well as gait pattern and balance among patients following surgical treatment of pilon fractures. The randomized controlled study will analyze the differences between the patients who will follow a 3-month physical exercise program and will wear customized foot orthoses (i.e., customized orthotic arch support insoles) versus patients who will attend only the physical exercise program...

The abnormal plantar pressure of flatfoot patients is a common condition. The main objective of the present study was to investigate the effect of custom-molded insole on the plantar pain of flatfoot METHODS: 105 patients (representing 174 feet) participated in evaluating a custom-made orthotic insole from June 2018 to March 2019. The height of the navicular tubercle (HNT) and the deflection angle of calcaneus (DAC) in flatfoot patients after using orthotic insoles for 6 months were recorded by X-ray imaging and scanning measurements...

BACKGROUND: Medial cuneiform dorsal opening wedge (Cotton) osteotomy is often used for treating forefoot varus in patients undergoing surgery for stage II posterior tibialis tendon dysfunction. The goal of this study was to examine the radiographic outcomes of Cotton osteotomy with bioactive glass wedge to assess for both maintenance of correction and clinical results and complications. We hypothesized that bioactive glass wedges would maintain correction of the osteotomy with low complication rates...

BACKGROUND: Individuals with Hereditary Motor and Sensory Neuropathy (HMSN) are commonly provided with orthopedic footwear to improve gait. Although orthopedic footwear has shown to improve walking speed and spatiotemporal parameters, its effect on gait adaptability has not been established. RESEARCH QUESTION: What is the effect of orthopedic footwear on gait adaptability in individuals with HMSN? METHODS: Fifteen individuals with HMSN performed a precision stepping task on an instrumented treadmill projecting visual targets, while wearing either custom-made orthopedic or standardized footwear (i...

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...

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...

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...