{"title":"使用计算机辅助设计和制造足部矫形器：矫形服务在英国的横断面研究。","authors":"Laura Barr, Jim Richards, Graham J Chapman","doi":"10.1002/jfa2.70031","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify how computer aided design and manufacture (CAD/CAM) technologies are currently being used for insole production by UK orthotic services in the National Health Service (NHS), including any variation in the specific processes and identify barriers to implementation.</p><p><strong>Design: </strong>A cross-sectional study was undertaken using freedom of information requests sent to all 214 NHS Trusts and Health Boards (HBs) across the UK. The request comprised 22 questions relating to CAD/CAM for insole production by UK NHS orthotic services during the 2021/22 financial year.</p><p><strong>Outcome measures: </strong>Analysis was undertaken and presented in terms of response rate to individual questions. Where free text responses were provided, thematic analysis was conducted.</p><p><strong>Results: </strong>Responses were received from 186 (86.9%) Trusts/HBs, those who did not have an orthotic service were excluded, and 131 responses were included in the final analysis. 70.5% (91/129) of Trusts/HBs used CAD/CAM to manufacture bespoke insoles. The most common workflow associated with CAD/CAM insole production was foot-shape capture with a foam box impression cast (86.8% (79/91)); casts transported to another site (90.8% (79/87)); foam boxes scanned into a CAD/CAM system (81.6% (71/87)); insoles designed by a technician (73.6% (67/91)) and insole produced with reduction milling (59.1% (SD 37.92)). The greatest barriers to the use of CAD/CAM were those of equipment costs and staff experience and training.</p><p><strong>Conclusions: </strong>UK orthotic services have widely adopted CAD/CAM insole production, but fully-digital workflow is uncommon. Hybrid-digital workflow involves physical casts and their transportation, generating waste and impacting sustainability. Further research is required to understand how hybrid-digital and fully-digital workflow affect patient treatment outcomes, costs and sustainability. Barriers to CAD/CAM including costs and staff training which should be considered alongside the growing body of research around CAD/CAM technologies.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 1","pages":"e70031"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798744/pdf/","citationCount":"0","resultStr":"{\"title\":\"The use of computer-aided design and manufacture for foot orthoses: A cross-sectional study of orthotic services in the UK.\",\"authors\":\"Laura Barr, Jim Richards, Graham J Chapman\",\"doi\":\"10.1002/jfa2.70031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to identify how computer aided design and manufacture (CAD/CAM) technologies are currently being used for insole production by UK orthotic services in the National Health Service (NHS), including any variation in the specific processes and identify barriers to implementation.</p><p><strong>Design: </strong>A cross-sectional study was undertaken using freedom of information requests sent to all 214 NHS Trusts and Health Boards (HBs) across the UK. The request comprised 22 questions relating to CAD/CAM for insole production by UK NHS orthotic services during the 2021/22 financial year.</p><p><strong>Outcome measures: </strong>Analysis was undertaken and presented in terms of response rate to individual questions. Where free text responses were provided, thematic analysis was conducted.</p><p><strong>Results: </strong>Responses were received from 186 (86.9%) Trusts/HBs, those who did not have an orthotic service were excluded, and 131 responses were included in the final analysis. 70.5% (91/129) of Trusts/HBs used CAD/CAM to manufacture bespoke insoles. The most common workflow associated with CAD/CAM insole production was foot-shape capture with a foam box impression cast (86.8% (79/91)); casts transported to another site (90.8% (79/87)); foam boxes scanned into a CAD/CAM system (81.6% (71/87)); insoles designed by a technician (73.6% (67/91)) and insole produced with reduction milling (59.1% (SD 37.92)). The greatest barriers to the use of CAD/CAM were those of equipment costs and staff experience and training.</p><p><strong>Conclusions: </strong>UK orthotic services have widely adopted CAD/CAM insole production, but fully-digital workflow is uncommon. Hybrid-digital workflow involves physical casts and their transportation, generating waste and impacting sustainability. Further research is required to understand how hybrid-digital and fully-digital workflow affect patient treatment outcomes, costs and sustainability. Barriers to CAD/CAM including costs and staff training which should be considered alongside the growing body of research around CAD/CAM technologies.</p>\",\"PeriodicalId\":49164,\"journal\":{\"name\":\"Journal of Foot and Ankle Research\",\"volume\":\"18 1\",\"pages\":\"e70031\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798744/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Foot and Ankle Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jfa2.70031\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Foot and Ankle Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jfa2.70031","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The use of computer-aided design and manufacture for foot orthoses: A cross-sectional study of orthotic services in the UK.
Objective: This study aimed to identify how computer aided design and manufacture (CAD/CAM) technologies are currently being used for insole production by UK orthotic services in the National Health Service (NHS), including any variation in the specific processes and identify barriers to implementation.
Design: A cross-sectional study was undertaken using freedom of information requests sent to all 214 NHS Trusts and Health Boards (HBs) across the UK. The request comprised 22 questions relating to CAD/CAM for insole production by UK NHS orthotic services during the 2021/22 financial year.
Outcome measures: Analysis was undertaken and presented in terms of response rate to individual questions. Where free text responses were provided, thematic analysis was conducted.
Results: Responses were received from 186 (86.9%) Trusts/HBs, those who did not have an orthotic service were excluded, and 131 responses were included in the final analysis. 70.5% (91/129) of Trusts/HBs used CAD/CAM to manufacture bespoke insoles. The most common workflow associated with CAD/CAM insole production was foot-shape capture with a foam box impression cast (86.8% (79/91)); casts transported to another site (90.8% (79/87)); foam boxes scanned into a CAD/CAM system (81.6% (71/87)); insoles designed by a technician (73.6% (67/91)) and insole produced with reduction milling (59.1% (SD 37.92)). The greatest barriers to the use of CAD/CAM were those of equipment costs and staff experience and training.
Conclusions: UK orthotic services have widely adopted CAD/CAM insole production, but fully-digital workflow is uncommon. Hybrid-digital workflow involves physical casts and their transportation, generating waste and impacting sustainability. Further research is required to understand how hybrid-digital and fully-digital workflow affect patient treatment outcomes, costs and sustainability. Barriers to CAD/CAM including costs and staff training which should be considered alongside the growing body of research around CAD/CAM technologies.
期刊介绍：
Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders.
Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care.
The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care.
The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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