Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Custom Made Orthotic Devices No Better than Off the Shelf

27.07.2004


A study published in the July issue of the American Orthopaedic Foot and Ankle Society’s journal, Foot and Ankle International, found no significant difference in the incidence of stress fractures, ankle sprains or other foot problems between the users of expensive custom made foot orthoses and those who used prefabricated orthotic devices.



Foot orthoses are devices worn within shoes that allow the foot to function better. They are usually prescribed to treat specific existing foot conditions, or are used in an attempt to prevent the development of a musculoskeletal problem. Foot orthoses may be fabricated from soft or semi-rigid materials, or a combination of both.

In the study, researchers dispensed foot orthoses among four groups of Israeli infantry recruits to determine how shoe orthoses fabrication affects user comfort and the incidence of overuse injuries in a normal physically active healthy young male population. Recruits were blinded in the study as to whether they trained in custom orthoses or prefabricated orthoses. Both were made of identical materials. Group 1 consisted of 227 recruits given soft custom orthoses. Group 2 consisted of 224 recruits given soft prefabricated orthoses. Group 3 consisted of 215 recruits given semi rigid biomechanical orthoses. Group 4 consisted of 208 recruits given prefabricated semi rigid orthoses, (the study of group 3 and 4 was done at a separate Army base).


The researchers found no statistical difference in foot problems among the groups. However, the recruits did seem to find the semi-rigid orthoses (both custom and prefabricated) to be more comfortable than the soft orthoses (both custom and prefabridcated) and thus were more likely to wear the orthoses throughout the study.

“The findings of this study suggest that if an orthosis is being dispensed as prophylaxis in a physically active population, and not designed to treat a specific biomechanical abnormality, then there is little economic justification for prescribing semi rigid biomechanical orthoses,” said Charles Milgrom, M.D., chief investigator in the study. “Their cost is high without advantages in comfort, patient acceptance, and reduction in the incidence of stress fractures, ankle sprains, and foot problems.

All recruits in the study were issued standard army infantry boots. During 14 weeks of basic training, the recruits were reviewed every three weeks in the field by two orthopaedists. Recruits were monitored for symptoms related to their feet, stress fracture, and ankle sprains. At the end of basic training, recruits were asked to evaluate, on a scale of 1–4, the comfort of their orthoses. Full clinical follow-up was available for 204 out of 227 (89.9%) recruits who trained in soft custom orthoses, for 213 out of 224 (95%) recruits who trained in soft prefabricated orthoses, for 180 out of 215 (83.7%) recruits who trained in semi rigid biomechanical orthoses, and for 172 out of 208 (82.7%) recruits who trained in semi rigid prefabricated orthoses. There was no statistically significant difference between the incidence of stress fractures, ankle sprains, or foot problems according to the type of orthoses that recruits used.

The orthoses comfort scores for recruits who finished basic training in their assigned orthoses were statistically lower for the semi rigid biomechanical and semi rigid prefabricated orthoses than for the custom soft and soft prefabricated orthoses This shows that the orthoses comfort scores for both recruits who finished the study training in their assigned orthoses as well as recruits who discontinued their use because of dissatisfaction were the lowest for the soft prefabricated orthoses.

Subject height and weight were not found to have a statistically significant relationship with orthoses comfort scores. Recruits with high arch feet were more likely to discontinue use of soft prefabricated orthoses than those with average or low arches. This relationship was not found for the other orthoses types used in the study.

All subjects were young healthy males doing infantry training. The orthoses used in the study encompass the major types prescribed by orthopaedists and podiatrists. The orthoses were worn within high-top leather army shoes with a flat inner last and were given universally to the population, without regard to the presence or absence of foot pathology.

The cost of the orthoses used in the study varied. The semi rigid biomechanical orthoses were the most expensive, costing four times that of the soft prefabricated orthoses, almost three times that of soft custom orthoses, and twice that of the semi rigid prefabricated orthoses.

| newswise
Further information:
http://www.aofas.org

More articles from Studies and Analyses:

nachricht A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg

nachricht Urbanization to convert 300,000 km2 of prime croplands
27.12.2016 | Mercator Research Institute on Global Commons and Climate Change (MCC) gGmbH

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>