Foot orthotics are functional devices designed to correct and optimize foot function. Amongst various treatment options available for pes planus, custom foot orthoses are currently recognised as the gold standard of treatment. Anecdotal evidence suggests that most practising podiatrists in South Africa are prescribing and manufacturing traditional handmade orthotics compared to CAD/CAM orthotics for pes planus deformity. This advanced technology is costly in South Africa and is limited by the suppliers as most suppliers are abroad. A critical drawback of CAD/CAM systems is that they are generally expensive given the small group of specialized podiatrists they are aimed at.
Studies have been undertaken abroad to determine the variations of orthotics produced by traditional methods and advanced technology. However, until this study, there have been no studies in South Africa that have investigated the efficacy of handmade orthotics compared to CAD/CAM orthotics. This study used a cross-sectional, experimental design. The aim was to compare the differences in the realignment of pes planus between traditional handmade foot orthotics and Computer-Aided fabricated orthotics.
This study had a sample of 50 participants diagnosed with functional pes planus. The researcher measured Navicular drop (N.D) in millimetres (mm), which had provided the degree of malalignment in each foot. Thereafter, each participant had a pair of handmade and CAD/CAM orthotics manufactured. N.D was then re-measured for each participant standing on their pair of handmade and CAD/CAM devices.
In the results of this study, in 80% (40/50) of participants handmade orthoses had successively realigned both feet, which meant that N.D values were realigned to normal values for both the left and the right foot. However, amongst 20% (10/50), participants had N.D values that remained abnormal, meaning that for 20% of the participants, the orthoses failed to realign both feet. In fact, of these 10 participants, 6/10 (12%) participants had both their feet remain misaligned, which meant these orthoses failed to correct both feet. In 3/10 (6%), participants had their left foot realigned to normal N.D values, but their right foot remained in abnormal N.D values
(misaligned). Lastly, 1/10 (2%) of the participants had both their feet overcorrected, meaning that the orthoses had changed both feet in a completely different position/ pathology.
The findings indicated for CAD/CAM orthotics were precise compared to handmade orthotics. This novel approach of manufacturing orthotics would be accurate in achieving normal N.D. limits, and that realignment would be achieved significantly. The findings show that 100% of participants (50/50) had N.D. within normal limits achieved by CAD/CAM orthotics for both feet. In fact, the realignment achieved by CAD devices was better than handmade devices. It was noted that none of the participants' feet remained in abnormal N.D limits, nor were any feet overcorrected.
Click to expand...