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I am an R.N. who attended the Pedorthic program at Temple Univ. in Phily so I have newly learned knowledge of concepts and vocabulary but will need an explanation that I can follow. As I understand it, there appears to be mostly 2 ways to cast people. The first is non weight bearing with the foot positioned in the neutral position and the great toe dorsiflexed to improve contact with the first metatarsal and the ground. The other is partially weight bearing into a foam box where the foot can also be positioned in a type of neutral position that captures the heel and forefoot positioning in the cast itself.
Now a non weight bearing foot does not stay compact when one weight bears so pressure spots from the orthotic can appear as hot spots or tightness as the foot wants to spread or do other motion in mid stance leading to discomfort wearing the orthosis since a non weight bearing casting has captured a position where the foot is not in motion. A orthotic casted from a foam box impression can suffer from a lowered arch which can lead to more pronation but I understand that one can carve the arch back to be higher if you know the client has a significant collapsing arch.
So, why is the non weight bearing casting seem to be the preferred method when midstance is where most people start to have their biomechanical problem and a partial weight bearing cast would seem to be the way to capture and correct that?
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