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Laser scanners

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Robertisaacs, Apr 4, 2014.

  1. Members do not see these Ads. Sign Up.
    Firstly, hello again everyone. I've missed you.

    I've recently been enjoying the Northern Ireland conference, and was interested to see a new (to me) laser scanner.

    These things have been commonplace for a few years now and the technology seems to be moving somewhat. What are people's thoughts about using these scanners to capture the foot? Aside from the obvious logistical advantage of hitting send on a laptop over boxing up a cast, what are you views on the pros and cons, and have they changed since laser foot scanning was introduced? Do you use one? And if not, what would inspire you to?
  2. Boots n all

    Boots n all Well-Known Member

    And we missed you too Robert.

    Firstly the captured image is great for record keeping and even better for sharing with refers and insurance companies "Why do they need custom?" With the report/quote goes the attached image and measurements captured by the scanner.

    It allows for very accurate assessment and comparison of any changes since the last scan, you have evidence to support your position.

    You can show the client what the areas of concern are and why you are taking such action within the prescription.

    And finally for us the workshop is so much cleaner with less plaster dust and we can turn out so more units than before.

    There a number of things other than capturing the foot image that seem to be a reflection of having a scanner from the patient perspective.

    Clean, tidy and very quick, then there is the wow factor, it shows you are investing in the future and that your clinic is more advanced than the clinic down the road, never underestimate that in a market place where you want to be sure of getting your share of the business.

    Separate question; Are these open faced scanners legal? Do they meet OHS laws?
    It was suggested to me recently that the laser are not allowed to be "in-view" by the eye whilst in operation?
  3. Hey dave.

    Interesting that you should mention the open face scanners. The one I saw most recently, wasn't. It had a sort of hood.


    Not the clearest image. I'll prod the rep and see if he can offer a better one.

    My big concern with laser is that what you are getting is essentially a 3d image of the foot in its relaxed position. Generally I want an "image" (or cast) of the foot in a manipulated position. For eg with the forefoot pronated or the windlass engaged.

    Of course one can overcome this by casting the foot in foam or similar then scanning the foam. But still.

    One of the fights I think we will lose in biomechanics is the idea that an insole is or needs to be foot shaped. The "laser revolution" seems to have done nothing to combat that.
  4. Griff

    Griff Moderator

    Hey Rob

    I think laser scanners are the future (with respect to the speed/ease of capture and storage of files etc) but share your concerns regarding their use and how this may shape thought processes. I find myself manipulating the foot of every cast I take now (can't remember the last time I used STJ "neutral" as a reference point) and when I have used a scanner [open face sharpe shape] I found this much trickier to do. I have no experience with one designed as you show in your picture but I suspect it would be almost impossible?
  5. CraigT

    CraigT Well-Known Member

    Hi Ian
    I regularly manipulate the foot during a scan- very similar result to a suspension cast and of course much faster and cleaner (I can wear dark coloured pants again)... we have the iQube from Delcam.
  6. CraigT

    CraigT Well-Known Member

    See comment for Ian above.
    You also need to look at the software that is used to then modify the scan... or in most cases what the lab does to the scan afterwards.
    The comment regarding whether the orthosis is foot shaped or not i understand, but a true custom orthosis should be based on the shape of the foot and should not be any compromise in fit or function. In this aspect a laser scanner should be embraced over faux scanners using pressure maps for designing orthotic geometry...
  7. Ian Drakard

    Ian Drakard Active Member

    That will depend on the classification of the laser. Simply put it is based on the power and wavelength of the laser. If it is more powerful there is obviously more potential for eye damage. Also if the wavelength is outside of the visible range, there is a danger that the normal reflex when you have a bright light pointed at your eye doesn't happen. There is no reason I know why an open faced scanner that uses a laser would fall in to these groups- every one I've seen has been low power and visible spectrum.
  8. Griff

    Griff Moderator

    I suspected there may have been a learning curve to it. I've not used the iQube before. How does it differ to the sharpe shape?
  9. Paul Bowles

    Paul Bowles Well-Known Member

    We also manipulate our scans when we take them - same as we used to when we cast.
  10. Phil Wells

    Phil Wells Active Member

    Hi Ian and Robert

    If you want to have a go with a couple of types of scanner feel free to call down to my new place in Croydon. I have an I-Qube and am just getting a Sense ( http://cubify.com/Products/Sense ) non-laser scanner.
    The Sense or Playstation Kinect based system is very cheap and accurate enough - bit of checking to confirm this but all looks good so far. Ian Drakard has done a lot of work with this technology and knows how good it is - any comments Ian D?


  11. Griff

    Griff Moderator

    I'll take you up on that offer Phil. My sister lives in the Reigate area so next time I'm down that way I'll call in.
  12. RobinP

    RobinP Well-Known Member

    In an ideal envronment, with no time pressure, with the software to manipulate shape after scanning and the time to do so, in addition to facitilies nearby enough that can manufacture same day or deliver the next day(assuming the requirement was there), I think scanning has to be the way forward.

    However, I, and I'm sure many other practitioners do not work under these circumstances. As such, a foam box is inexpensive, modifiable after seeing the patient with their foot still in front of me. I can influence shape and force application as I take the impression and takes very little time. I hope, after that, the lab has little to do. Are the results as good as the process above - possibly not in terms of finished product but shouldn't make too much difference to outcomes?

    It makes very little difference to me if it takes 5 days to get an orthosis back from the lab or 1 day - I probably won't see the patient again for a least 2 weeks anyway. I guess it depends on the circumstances of your clinical setting.

    Doesn't stop me wanting a scanner and the software, however. I can but wish. My birthday is not long passed and I got some cinema tickets instead of an iQube. so, wait for another year then.
  13. Phil Wells

    Phil Wells Active Member

    Let me know in advance as I am only down here 2 days a week - I'm a Northern lad and they speak funny down here!
  14. Ian Drakard

    Ian Drakard Active Member

    The Sense is based around the primesense hardware, which is what I'm using currently most of the time (but with a very useful handle). Presumably the results are the same. The scan accuracy is pretty good, certainly in excess of what's required for orthotic design, but to achieve this you have to take a dynamic scan (ie move scanner like a video camera around object). This means you can capture whatever depth is required, but unless you are part octopus means manipulating the foot at same time is difficult.

    Quite often I'll therefore end up casting/foam boxing and scanning this.
  15. Interesting comments. One of my employers (I have several these days) has the delcam scanners and they've proved a bit of a headache. We don't seem to be able to capture the posterior heel very well. Spoke to delcam and their suggestion was to very gently touch the heel to the glass and have the foot at about 30 degrees, so the forefoot is hanging free in the air. This robs me of the base plane. Never had that problem with the old sharpshape scanner.

    Well I got one and it's been the gift that keeps on taking :eek:

    I'm with you on the pressure map scanners. Not sure about the "true custom" thing though.

    I mean first off, you have the definition of "based upon". That could mean almost anything. A freelan with a bit of felt on it is based on the shape of the foot.

    Devils advocate question 1.
    Why must a true custom insole be based on a 3d capture of the foot?

    Devils advocate question 2.

    Consider two insoles.
    One is a "root classic" based on a foot cast in stjn and forefoot and rear foot varus / valgus angles applied to the device. As such the patient gets the same prescription whether the pathology is a medial ligament sprain, a lateral ligament strain or a fnhl.

    The other is based on a standard arch shape, no casts. However the clinician can requested higher / lower arch, any combination of wedges, skives, cloughy wedges, pf grooves, kinetic wedges, grindoffs etc as they please.

    Is the first really a custom and the second not? I mean with standard lab practice you don't really even know what arch shape you're getting anyway by the time the lab has applied "cast correction"
  16. Paul Bowles

    Paul Bowles Well-Known Member

    I can take a 3D scan in under 2mins - I dont have to do any modification to it if I dont want to, just fill out the prescription for the patient and then deal with the lab like I would with normal plaster or foam impression. The scans are kept on my computer and backed up forever. I can re-make from these scans. The scanners are ultra portable.

    Also the scanner with an additional software suite does wound tracking and analysis as well - all non contact.

    the "right" circumstances? What better circumstances do you need?
  17. brekin

    brekin Active Member

    The real benefit will be when laser scanning is combined with 3D printing. All the ingredients are there except really the software, though the software orthotic labs use (anyone knows what they are?) would probably work. Be really great to edit your own orthoses on the computer before printing.

    Imagine scanning the foot and then sending to your own 3D printer (currently around $2,500) and printing the orthoses within a couple of hours. Will be very interesting in five years time and I would be a little concerned if I was a lab. It could be common place for podiatrists to be self sufficient as their own lab in a short space of time.
  18. Paul Bowles

    Paul Bowles Well-Known Member

    Not quite true the software is there and you can download it FREE from places like CADCAM orthotics in Australia - the problem is with 3D printers the materials arent there yet and who wants to wait "hours" to print an orthotic???
  19. CraigT

    CraigT Well-Known Member

    I am referring to a capture of the foot- whether it be scanned or cast. I assume that a freelan is an OTC orthosis and you are saying that you can modify its shape to be close to the same as a patient by adding felt??

    Part of this is obviously my opinion based on my experience.
    You can indeed create a device that may be the same shape and size of a of an orthosis that is made from a 3D capture without a 3D capture... but why would you? Cost? If that is what the patient is paying for, then this is fine...

    Lab practice is more the issue here.
    I would argue that a true bespoke custom orthosis is your second device applied to the 3D capture of the foot so as it takes into consideration the large amount of anatomical variation that exists. Feet come in all sorts of shapes and sizes and it frustrates me when I do not see this reflected in a supposed custom bespoke orthosis. Does this matter? Not necessarily... but people should get what they are paying for.
  20. Boots n all

    Boots n all Well-Known Member

    Robert if you cant place your hand in the scanner to manipulate the foot into the position you want, why not make a little EVA wedge to place under the distal hallux or where ever you want, to manipulate the foot?
  21. Paul Bowles

    Paul Bowles Well-Known Member

    ...because technically you aren't after a weight bearing image of the foot in the majority of functional orthotic cases....
  22. Lucy Best

    Lucy Best Member

    Question for Ian Drakard please: I like the idea of scanning the foam box or cast. Which UK companies make the orthotic insoles from a scan like this?
    I have an artec scanner (I use it for scanning babies heads for plagiocephaly helmets). I experimented with scanning a foot with me holding the foot in the position I want with one hand at the same time holding and moving the scanner around with the other hand, but my arms aren't long enough to do this. It would work if I had an assistant but I don't have one.
  23. joejared

    joejared Active Member

    On this topic, I've been asked by a member of Podiatry Arenda to make OreTek compatible with a 3D printer, which I am seriously considering. However, and stateside, there are already many manufacturing labs capable of producing orthotics much more efficiently than a 3D printer could. My own equipment has a single shift capacity of 2000 pairs per month, as do many of my client/server sites, which is a substantially higher bang for buck than a $2500.00 3D printer would deliver, even if it were 1/4 of the cost, which is about what happens when I decide to build something.

    A 3D printer fits into the cooperative business model that I intend to expand on, and not just in podiatry. My first goal, however, other than a quick conversion to a 3D model, would be to add a new type to OreTek, a DIE part for injection mouding, as well as my own design of an injection molding system. My reasoning is simple. If a prefab device comes from an OreTek lab, I want it to be separate from the normal prescription devices such that there is never a doubt whether a device is prescription or prefab. Way too many labs in our industry blur that distinction.
  24. I know for a fact that salts techstep would. They're moderately awesome. Never been disappointed with them.
  25. Ian Drakard

    Ian Drakard Active Member

    Hi Lucy, almost all the large (and quite a few smaller) labs will accept scans now Salts included, so you should be able to choose on whether they can produce what you're after. I think the artec software exports open file formats so shouldn't be a problem with any of them.

    If you have design software most will also offer variable pricing depending on what level of finishing you need, but you often have to ask for this.
  26. mr t

    mr t Member

    This is correct nearly all the lasers used for this purpose are class one and that is it is in the visible light spectrum and the blink reflex will make you look away. There are 7 basic classes of lasers with class one being ok but it would be advisable not to look at the laser at all and to advise your patients the same. Most barcode scanners are class one as well. You will find they are usually red and below1 mw in power. If your an aircraft enthusiast you will notice all military a/c have a golden coloured canopy which is quite dark. This is to attenuate laser light as it was discovered you didn't need high powered lasers to shoot down an a/c all you needed to do was blind the pilot.
  27. mr t

    mr t Member

    I'm going to weigh into this discussion to see if I can help but first wish to declare my hand. I have worked with lasers for years in various jobs as a repair technician. These days I own and run a lab. It has always been CNC based. And out of need I have built my own laser scanners and software to make orthotics . When I started, I didn’t have the choices in software and hardware we have today. But I’m glad I continued on with it as it better suits the requirements of my customer base better than anything else I have reviewed over the years.
    There are also a lot of things going on which I don't agree with. I understand why things have developed the way they have because I developed my own software. So hopefully I can help people choose a little better and enhance podiatry overall.

    Firstly a laser scanner is a misnomer, they are photographic scanners with a laser light source. It sounds more technical than it is. The other basic type is a structured light scanner or white light scanner. These usually project a shadow pattern of some sort on the foot. The other thing to consider is weight bearing or non-weight bearing. And there are a myriad of those on the market both mechanical and photographic. Suffice to say “whatever your poison.” But I will share my experiences over the years with you and what I have observed.
    I have had both weight bearing and non-weight bearing scanners available to me. I have lent the semi/weight bearing scanners to my customer base. They all returned it as they did not get the clinical outcomes compared to taking a non-weight bearing casts. And all without exception returned to messy plaster casting. Some of my larger customers have set their own labs up with systems that included weight or semi weight bearing scanners. It has always being interesting to hear the comments from their staff when they are forced to use a system based on the company’s investment and not their clinical outcomes. Behind the bosses ear they let their dissatisfaction rip. I have had them leave and set up their own employment and return to my lab. Or if they work part time somewhere else they prefer to use my lab and not the other system. The overall conclusion is non-weight bearing is the way to go.

    This leads to the next system which I will touch on which is foam boxes. Well, they fall into the same category as weight bearing scanners and the people who mostly use them do so for convenience and not for good outcomes. All the good podiatrists I know that use my lab will not use foam boxes. Please view this as an observation and not an opinion. Over the years I have had many discussions with pods over foam boxes and the general consensus is, they do not work as well, because it is capturing a compensated foot which captures the foot in the condition that lead the patient through your door in the first place as opposed to capturing a foot in the uncompensated position. If this was generally the best method to cast a foot then why are the majority of casts taken suspended and not “Stand up while this is drying.” When I ask people do they do this they say no because it wouldn’t work. Well then why is it going to work on a piece of glass or a foam box?

    Now when choosing a system the important things to remember is to be careful with your capital expenditure. Try and chose scanners, software and milling systems that are not what I term a closed loop system. I.E. a system that locks you into their mill or software or scanner that means you can only use their complete system and often raw materials which are expensive. And if you don’t like them or the closed loop system the lab is using. You are stuck and either have to walk away with a cupboard full of equipment you can no longer use. (I know many podiatrists in this situation.) Often equipment is given for free hoping to lock you in. There are several scanners you can purchase which do not lock you into a lab. The same with milling machines. In my opinion it is better to purchase one with local support and these days they are quite cheap. Aus$12,000 should set you up with a good scanner and milling system. And then you can chose the software.

    Now scanners:

    Let’s just agree for the sake of this article that we are going to settle on non-weight bearing scanners where we can set the foot up and position it how we need to. This will give us two types to consider. The First is a laser line generated scanner that has a mechanical sweep. These will give us a correct length of scan but you need to be close to the surface as the depth of field is very finite. Now most people tend to use these semi weight bearing because it is easier and, if we accept the principle that the method is inferior to the suspended cast technique, then they can be difficult to use. Generally they produce a good scan but are not cheap. You need to make sure that your bisection is also perpendicular to the scanning surface. Because when casts are sent to me all the measurements are based on that bisection and the more accurate the lab is with this the greater the chance that the orthotic is going to do what you want it to do. The second type of scanner is the structured light scanner and there are several versions of this. Laser light and White light. The white light based scanners are the more popular. These work by casting a shadow on the surface and can be very hit and miss as to their accuracy. (Read past articles on this forum.) These days you can purchase one for US$800 and if used correctly are very accurate.

    Now I will be very critical of some of the orthotic labs out there that do not use these scanners correctly. I cannot, from a scan, work out where the bisection is, and if I can’t, then neither can your lab. If they tell you they can, you have being had, so find another lab. The manufacturers of these scanners recommend you use a black background to trim out the non-foot parts of the scan. Now, if you do this and you are using a structured light scanner that casts a shadow, how can it see the shadow on a black back ground? This is why they distort around the edges. We teach people to use a shield around the foot that the camera can see. This gives you a greater depth of field to work with but requires you to trim it better. Also the resulting scans are often not to scale. You need to be able to verify the validity of the scan by having some known points to measure from. I get people to give me the distance from the heel to the first mpj and if it is not correct I recalibrate the scan before I create the orthotic from it. In open architecture, as opposed to closed loop, the industry seems to have settled on STL formatted files. This limits you to files that you cannot quantify. I use VRML files, this is also an open architecture file format but it allows you to overlay a picture of the foot on the 3d image. With this I can see on the screen the foot deformities that the podiatrist wants to address and the measurement marks they have placed on the foot which I can use in order to recalibrate the scans if need be.

    In conclusion. Scanners in general if used properly work much better and are more accurate. Once you can take a scan without thinking you will be able to measure, scan both feet and fill the script in under ten minutes, have a record on your computer and send to the lab with no mess. As opposed to the cleaning up boxing and sending the casts to the lab. It is a great cost and time saver. I will be happy to answer any questions on this subject.
  28. i-man

    i-man Member

    If you don't use the STJ neutral position of the foot as the reference point, what consistent, repeatable reference point do you use?
  29. mr t

    mr t Member

    a guy called stephen osborne is setting up a lab and he can scan in foam boxes. or you can send him the scans.
    if you would like his details let me know
  30. Griff

    Griff Moderator

    Is the STJ neutral position a consistent repeatable reference point...?
  31. joejared

    joejared Active Member

    You're effectively scanning a marshmallow, especially in the forefoot. The rearfoot is more repeatable. From a lab perspective, the shape of the forefoot (flatness), determines whether we treat it as a biofoam like device, or a non-weight bearing plaster cast. The labs can work with it either way, but consistency not just in stj neutral, but force applied to the forefoot helps make for a more reliable end product.
  32. Ignoring the STJ neutral thing and all the questions regarding repeatability in placing the foot into this position. The thread here is titled "laser scanners": I take a scan of the foot and manufacture a pair of successful foot orthoses... I have a digital record of the scan and a digital record of the foot orthoses manufactured... why do I need a repeatable technique to position the foot for scanning when I can use the same digital data obtained from the initial scan and successful orthoses, again and again? Just thinking...
  33. javier

    javier Senior Member

    I attach a 3D scan from a foam box using a depth scan (Asus Xtion) and Skanect. Other options for 3D scanning software here

    Sketchfab link (for 3D viewing): https://skfb.ly/yJEO

    Attached Files:

  34. Phil Wells

    Phil Wells Active Member

    Dear all

    Just to throw a technical cat amongst the pigeons, I am now seeing reasonable 3d image capture being produced by camera phones! Without giving too much away, a piece of very clever hosted software can take video images and convert it into to accurate 3d files.
    This will negate the need for any type of hardware and will work well on anything - maybe another 12 months before it becomes fully available but it does look a a 'goer'!

  35. javier

    javier Senior Member

    It is available now with 123D Catch from Autodesk, although it is quite tricky and you will need another software for editing the mesh and scale it to real mesures (such as Meshlab)

    Good news, plenty of Open Source software is available now for 3D scanning. Bad news, it is difficult to edit resulting meshes.
  36. Phil Wells

    Phil Wells Active Member

    123d Catch is ok but as you say just not quite there yet.
    The new stuff I have seen is doing all the meshing behind the scenes without the need for user input and rendering the image over the top as a colour obj file. Should be open source with maybe a click per use fee structure - again like Autodesk.
  37. mr t

    mr t Member

    Hi Simon I don't quite understand what you are saying Are you saying with a digital scan you don't need to position the foot like you would a suspended cast, if you were doing plaster. So, therefore you don't. You just take a picture of the foot in frees space as it sits. how do you position your foot too scan now?
  38. This question was asked:
    Which pre-supposes that STJ neutral position of the foot is a consistent, repeatable reference position. In reality the repeatability of STJ neutral has been shown to be not so good.

    So the question becomes: why does a position of capture need to be repeatable? Historically this was because labs couldn't store casts indefinitely due to the physical space the casts took up. So if a patient wanted a repeat pair of orthoses a couple of years down the line, the practitioner would need to attempt to match the shape of the foot captured in the original cast and hope that the lab could add the same amount of plaster in the same places. Again, this was pretty unlikely, but at least there was a semblance of pretence.

    Digital scans on the other hand do not need to be repeated for repeat manufacture of successful foot orthoses because scans only take up virtual space on a computer. In theory they can be stored indefinitely and used time and again. Therefore the position the foot was originally captured in does not need to be repeatable since it only ever needs to be done once.

    Ulitmately the position chosen to scan the foot in is the individual practitioners choice, and should be based around an understanding of the patient's diagnosis and the inter-relationship between the surface geometry of the orthoses and the reaction forces likely to occur in response to such geometry at the foot orthosis-interface. But the point was that whatever that position is, it doesn't need to be repeatable because when using a digital scan one should only ever need to capture the foot once for a successful foot orthosis.

    Now, we've got a couple of new posters in this thread i-man and mr-t, it would be nice if you could introduce yourselves and give your real names to the bottom of your posts. That way people like will be more likely to respond to your posts.
  39. Mr. T.....you mean Laurence Tureaud?:rolleyes:
  40. I-man??

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