Affiliations: [a] Fontys University of Allied Health Professions, Eindhoven, The Netherlands | [b] Sonderkamp Research, Eindhoven, The Netherlands | [c] The Hague University of Applied Sciences, The Hague, The Netherlands
Correspondence:
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Corresponding author: F. Holtkamp, Fontys University of Allied Health Professions, Rachelsmolen 1, 5612 MA, Eindhoven, The Netherlands. Tel.: +31 6 51942732; E-mail: f.holtkamp@fontys.nl.
Abstract: 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.
