(1) Ministry Of Defence Primary Health Care
(2) Faculty of Health, Staffordshire University.
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In clinical practice, it is common for casted and non-casted foot orthoses to be prescribed. Since there are differences between these orthoses in terms of manufacturing protocols a subject with the same prescription, could end up with radically different looking insoles dependent on the technique used. The main objective of this exploratory study was to compare the kinematic effect of three 3 different methods of orthotic production using the same prescription for the same individual.
Materials and methods
2 male and 7 female participants aged 19–38 years (mean 26 years) volunteered to participate in this study. The individuals attended for orthoses prescription and returned 5 weeks later for fitting and kinematic analysis. Kinematic data on tibial rotation and heel eversion was compared for 3 different orthoses (a CAD/CAM laboratory device, a traditional plaster cast protocol device and a chair-side pre-moulded shell insole adapted in clinic) which were made using the same prescription. The degree of rear foot motion and tibial rotation during treadmill walking was recorded for three test devices against a control shoe using an electromagnetic tracking device.
For heel eversion (Y axis) significant differences were noted across groups from the control (P=0.05), but there was no significant difference between computer aided design orthoses (CAD) and traditional lab cast orthoses (TRAD). There were no significant differences across groups for dynamic tibial rotation (Z axis). Based on the data gathered in this study, modified chair-side orthoses (MCSO) produced the largest difference in heel eversion within the group of participants in this study.
MCSO produced the largest change in heel eversion. The results suggest that CAD and TRAD insoles produced by using the same negative cast have a similar effect.