There are so many choices available out on the market, and more Podiatrists are using this option instead of custom made. A Yorkshire based NHS trust predominantly use prefab insoles (variety of different kinds) in comparison to custom made.
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So I have been thinking what do we all like about prefabricated types?
What would make an ideal prefab insole?
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Seems I maybe a bit grumpy today, -
There is really no such thing as the ideal prefabricated orthotic. It doesn't matter what type of orthotic it is as they are all orthotics. As Mike said, it is a lot more to do with which prescription variables do the most effective job at reducing the pathological loading forces on the injured anatomical structure. For example, this maybe in the form of stretches, footwear modifications/recommendations, prefabricated orthotics, custom orthotics... etc
It really doesn't matter what you choose as long as you can design a Tx regime to reduce the damaging forces.
Regards
Daniel -
The ideal prefabricated foot orthoses will have the design features that can deliverer all of the prescription variables needed for each patient. In other words, there is not one that I know of that can do that, which is why I tend to use 3 different ones, some glue, some eva and a grinder to get most of the design features that are needed.
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I see what you are driving at Kursch.
We all agree that the prescription variable that delivers the reduction in the tissue stress is the important element. What you are really asking is what would be the best vehicle to offer you the greatest choice of variables. You can't have an all encompassing prefab, but what will make it appropriate to the largest cross section of the population?
How would we construct a prefab that was generic enough in shape to be close enough to match a large cross section of the population(debate ofver the importance of orthosis conguency to the foot aside)
What are the most important prescription variables that the prefab can offer?
How many variables can be offered withoutmaking the structural integrity of the device an issue?
EVA/PU/polprop? Which gives the best scope for customisation of the shell?
Is it better to have pre made additions that can be stuck on with double sided tape or is it better to just have a flat base with square edge to adhere additions to?
Looking at the current prefabs, I would have to say that the Interpod control tech flex with the new cover is a pretty good all rounder. It covers a lot of bases. The danger is that, in offrering soemthing with a massive variablity of additions and prescription variables, you run the risk of making the cost of the device high enough that a library style semi bespoke device becomes a better option eg Salts performer Range at £40 approx per pair
More questions than answers -
I agree with the comments of the above posts. In addition, I think for the Podiatrist in private practice that the prefab should be high quality yet inexpensive and only sold to Podiatrists for price control. It does not look good when your patient is paying more for a product in the office only to find it much cheaper with a google search.
I also like the EVA wedges that you can cut and stick on the bottom of prefabs and patients like that your modifying their prefabs for their particular problem.
Steven -
any thoughts about d3o in an insole?
Last edited by a moderator: Sep 22, 2016 -
I want some d3o just to play with let alone put into an orthotic;)
Interesting idea though. I suppose it would depend how much force it took for the material to react as to how it would work within an orthosis. Or rather if the reaction to force was on a sliding scale of force input = increase in the molecular activity causing the material to increase in stiffness -
Elastohydrodynamic.....I have used similar materials a long time ago but it was called "P.Q" liquid polymer. A part " A" and "B" are mixed together to get the required durometer. The nice thing was that you could play with different mixes for different areas of the foot in the same insole if one was technically savvy.
Bad part was the materials prior to set were quite toxic. -
Non-newtonian polymer. Has been done.;)
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Q) Who would be the ideal wife
A) My one, the one made for me. -
Although Kelly Rowland would be a good all round compromise if you had to pin me down to an off the shelf one size fits all wife :D
Last edited: Sep 23, 2011 -
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I know, just imagine custard filled shoes - comfortable and delicious
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I've used allsorts (but not liquorice) but always come back to Vasyli - However, at the moment I am using Talar Made Architec EVA, they are not posted at all but come with separate adhesive medial posting and heel lifts. They also come in two densities, they can be used and cut and ground (grinded) in all types of imaginative ways but at least you can start from a base line non posted position unlike many OTC that have medial posting built in. National Orthotics also do a similar EVA product but only 3/4 length but what is useful about them is that they have a medial skive designed in to them and come in 3 densities and they are very cheap, I would recommend both of them as an excellent product and probably very useful for quick turnover and maximum effect in the NHS clinic.
Dave Smith -
When the going gets tough, go back to basics - advice from Colonel Herman Potter - got to be good advice. At the end of the day, common things are common and rare things are rare. Since rearfoot varus (are we allowed to call it that these days?) is more common than all else put together, at the of the day, the prefab insole would be posted at the hindfoot by about 4' inversion, have an arch support, be made of eva and be machine washable. Easy really. One size does not fit all, but it goes a long way towards it. Rob
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Luv Dave -
Last edited by a moderator: Sep 22, 2016
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If this is how insoles work and if the reaction to material like d30 has a higher viscosity when more force is applied to it... my question is....if you have a insole with a forefoot valgus wedge.. and d3o (or some dilitant) acting as the support under the calc-cuboid, a supinator would apply more force towards that area causing the d3o to act with a higher viscosity which would act as a the support reversing the forefoot valgus wedge effect of a more lateral CoP and ultimately compensating the supination. However, a pronator would not apply as much force to the calc-cuboid area during mid stance leaving it at a low viscosity (no support) causing the forefoot valgus wedge shift the CoP laterally compensating for pronation.
would this work? please dont get too complex -
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whats the equation for rate of loading?
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Karrimor are using D30 in trainers - didn't know this
http://www.sportsdirect.com/karrimor-d30-mens-trail-running-shoes-213005?colcode=21300516
Attractive in lime green
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