Fred Holtkamp, Trudi Sonderkamp, Yvonne van Zaalen
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A systematic review of the explicit knowledge used and evidence base in the process of design and fabrication of orthopedic footwear
BACKGROUND: The design and manufacturing of effective foot orthoses is a complex multidisciplinary problem involving biomedical and gait pattern aspects, technical material and geometric design elements as well as psychological and social contexts. This complexity contributes to the current trial-and-error and experience-based orthopedic footwear practice in which a major part of the expertise is implicit. This hampers knowledge transfer, reproducibility and innovation. OBJECTIVE/METHODS: A systematic review of literature has been performed to find evidence of explicit knowledge, quantitative guidelines and design motivations of pedorthists. RESULTS: 17 studies have been included. No consensus is found on which measurable parameters ensure proper foot and ankle functioning. Parameters suggested are: neutral foot positioning and control of rearfoot motion, maximum arch, but also tibial internal/external rotation as well as a three point force system. Also studies evaluating foot orthoses centering on the diagnosis or orthosis type find no clear guidelines for treatment or for measuring the effectiveness. CONCLUSIONS: A gap in the translation from diagnosis to a specific, customized and quantified effective orthosis design is identified. Suggested solutions are both top-down, fitting of patient data in simulations, as well as bottom-up, quantifying current practices of pedorthists in order to develop new practical guidelines and evidence-based procedures.
期刊介绍:
Technology and Disability communicates knowledge about the field of assistive technology devices and services, within the context of the lives of end users - persons with disabilities and their family members. While the topics are technical in nature, the articles are written for broad comprehension despite the reader"s education or training. Technology and Disability"s contents cover research and development efforts, education and training programs, service and policy activities and consumer experiences. - The term Technology refers to assistive devices and services. - The term Disability refers to both permanent and temporary functional limitations experienced by people of any age within any circumstance.