By definition, an orthosis is a device that is used to protect, support, or improve function of parts of the body that move. In the field of podiatric orthopedics, the terms orthoses and orthotics are used to describe a wide range of devices that are placed inside the shoe…
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The three basic types of foot orthoses are pre-fabricated, customized, and custom-molded. A pre-fabricated orthosis is one that is mass-produced and is intended to be dispensed to the user without modification. Pre-fabricated orthoses are usually designed to provide either increased support or shock absorption for a specific area of the foot, such as an arch support or heel cushion. They may also provide cushioning to the entire foot, as is the case with the use of a full insole.
A customized orthosis usually consists of a pre-fabricated base component that is modified in some way, such as adding a metatarsal pad or heel lift. A custom-molded orthosis is one made from a model of the patient's foot made from some form of three-dimensional impression-taking procedure. These devices are used for patients with more severe or complicated foot problems. They are commonly composed of a shell, the layer of material next to the foot and in total contact with the foot, and posting material, filling the space between the shell and the shoe. Custom orthoses can be further modified by adding materials to the top of the shell to either redistribute pressure or provide cushioning.
Foot orthoses are often described as being either accommodative or functional. An accommodative orthosis is designed primarily to accommodate a rigid foot or foot deformity, or one that is a risk, while a functional orthosis is designed to realign a more flexible foot by providing joint stability and support. In reality, most orthoses offer some degree of both accommodative and functional properties. In general, foot orthoses are designed to accomplish one or more of the following:
1) Reduce shock,
2) Reduce shear,
3) Relieve areas of excessive plantar pressure,
4) Stabilize and support the joints of the foot,
5) Limit motion of joints. (Caselli, 2004).
Orthoses or orthotic devices are medically-prescribed shoe inserts that are designed to improve foot function and reduce mechanical stress. The American Podiatric Medical Association categorizes them as follows: those that intend to change foot function, those that are protective in nature and those that combine functional control and protection. Some of the materials used in these devices offer excellent shock absorption and compression set resistance, while others are noted for support and moldability. Whatever the offering, these materials are often used in combination for a better functioning orthosis. Depending on the condition of the foot, they can be constructed of one or more layers with two- or three-layer constructions most often selected by medical practitioners.
These materials are offered in a wide range of formulations, densities, thicknesses, colors and weights. Some are measured in durometer, a guide to determine a material's softness in relation to other materials. Distributors buy these specialty materials from manufacturers like Rogers Corp, Rogers, CT, and, in turn, sell them to fabricators which include podiatric laboratories, podiatrists, orthotists, pedorthists and physical therapists, among others
Certain biomechanical foot deformities such as ligamentous laxity, neurologic deficits or supinated foot types which function with an inverted heel, make some people more susceptible to inversion sprains. Valmassy (1996) also states that those with an uncompensated
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