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Silva R, Silva B, Fernandes C, Morouço P, Alves N, Veloso A. A Review on 3D Scanners Studies for Producing Customized Orthoses. Sensors (Basel) 2024; 24:1373. [PMID: 38474907 DOI: 10.3390/s24051373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024]
Abstract
When a limb suffers a fracture, rupture, or dislocation, it is traditionally immobilized with plaster. This may induce discomfort in the patient, as well as excessive itching and sweating, which creates the growth of bacteria, leading to an unhygienic environment and difficulty in keeping the injury clean during treatment. Furthermore, if the plaster remains for a long period, it may cause lesions in the joints and ligaments. To overcome all of these disadvantages, orthoses have emerged as important medical devices to help patients in rehabilitation, as well as for self-care of deficiencies in clinics and daily life. Traditionally, these devices are produced manually, which is a time-consuming and error-prone method. From another point of view, it is possible to use imageology (X-ray or computed tomography) to scan the human body; a process that may help orthoses manufacturing but which induces radiation to the patient. To overcome this great disadvantage, several types of 3D scanners, without any kind of radiation, have emerged. This article describes the use of various types of scanners capable of digitizing the human body to produce custom orthoses. Studies have shown that photogrammetry is the most used and most suitable 3D scanner for the acquisition of the human body in 3D. With this evolution of technology, it is possible to decrease the scanning time and it will be possible to introduce this technology into clinical environment.
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Affiliation(s)
- Rui Silva
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, 1499-002 Lisbon, Portugal
- CDRSP, Polytechnic University of Leiria, 2430-028 Marinha Grande, Portugal
| | - Bruna Silva
- CDRSP, Polytechnic University of Leiria, 2430-028 Marinha Grande, Portugal
| | | | - Pedro Morouço
- ESECS, Polytechnic University of Leiria, 2411 Leiria, Portugal
- CIDESD, Research Center in Sports Sciences, Health Sciences and Human Development, 6201-001 Covilhã, Portugal
| | - Nuno Alves
- CDRSP, Polytechnic University of Leiria, 2430-028 Marinha Grande, Portugal
| | - António Veloso
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, 1499-002 Lisbon, Portugal
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Demeco A, Foresti R, Frizziero A, Daracchi N, Renzi F, Rovellini M, Salerno A, Martini C, Pelizzari L, Costantino C. The Upper Limb Orthosis in the Rehabilitation of Stroke Patients: The Role of 3D Printing. Bioengineering (Basel) 2023; 10:1256. [PMID: 38002380 PMCID: PMC10669460 DOI: 10.3390/bioengineering10111256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Stroke represents the third cause of long-term disability in the world. About 80% of stroke patients have an impairment of bio-motor functions and over half fail to regain arm functionality, resulting in motor movement control disorder with serious loss in terms of social independence. Therefore, rehabilitation plays a key role in the reduction of patient disabilities, and 3D printing (3DP) has showed interesting improvements in related fields, thanks to the possibility to produce customized, eco-sustainable and cost-effective orthoses. This study investigated the clinical use of 3DP orthosis in rehabilitation compared to the traditional ones, focusing on the correlation between 3DP technology, therapy and outcomes. We screened 138 articles from PubMed, Scopus and Web of Science, selecting the 10 articles fulfilling the inclusion criteria, which were subsequently examined for the systematic review. The results showed that 3DP provides substantial advantages in terms of upper limb orthosis designed on the patient's needs. Moreover, seven research activities used biodegradable/recyclable materials, underlining the great potential of validated 3DP solutions in a clinical rehabilitation setting. The aim of this study was to highlight how 3DP could overcome the limitations of standard medical devices in order to support clinicians, bioengineers and innovation managers during the implementation of Healthcare 4.0.
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Affiliation(s)
- Andrea Demeco
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Ruben Foresti
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
- Center of Excellence for Toxicological Research (CERT), University of Parma, 43126 Parma, Italy
- Italian National Research Council, Institute of Materials for Electronics and Magnetism (CNR-IMEM), 43124 Parma, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Nicola Daracchi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Francesco Renzi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Margherita Rovellini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Antonello Salerno
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Chiara Martini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Laura Pelizzari
- AUSL Piacenza, Neurorehabilitation and Spinal Unit, Department of Rehabilitative Medicine, 29121 Piacenza, Italy;
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
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Lewin M, Price C, Nester C. Can a shoe-mounted IMU identify the effects of orthotics in ways comparable to gait laboratory measurements? J Foot Ankle Res 2023; 16:54. [PMID: 37670403 PMCID: PMC10478350 DOI: 10.1186/s13047-023-00654-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Footwear and orthotic research has traditionally been conducted within laboratories. With increasing prevalence of wearable sensors for foot and ankle biomechanics measurement, transitioning experiments into the real-world is realistic. However wearable systems must effectively detect the direction and magnitude of response to interventions to be considered for future usage. METHODS RunScribe IMU was used simultaneously with motion capture, accelerometers, and force plates during straight-line walking. Three orthotics (A, B, C) were used to change lower limb biomechanics from a control (SHOE) including: Ground reaction force (GRF) loading rate (A), pronation excursion (A and B), maximum pronation velocity (A and B), and impact shock (C) to test whether RunScribe detected effects consistent with laboratory measurements. Sensitivity was evaluated by assessing: 1. Significant differences (t-test) and effect sizes (Cohen's d) between measurement systems for the same orthotic, 2. Statistical significance (t-test and ANOVA) and effect size (Cohen's d & f) for orthotic effect across measurement systems 3. Direction of orthotic effect across measurement systems. RESULTS GRF loading rate (SHOE: p = 0.138 d = 0.403, A: p = 0.541 d = 0.165), impact shock (SHOE: p = 0.177 d = 0.405, C: p = 0.668 d = 0.132), pronation excursion (A: p = 0.623 d = 0.10, B: p = 0.986 d = 0.00) did not significantly differ between measurement systems with low effect size. Significant differences and high effect sizes existed between systems in the control condition for pronation excursion (p = 0.005 d = 0.68), and all conditions for pronation velocity (SHOE: p < 0.001 d = 1.24, A: p = 0.001 p = 1.21, B: p = 0.050 d = 0.64). RunScribe (RS) and Laboratory (LM) recorded the same significant effect of orthotic but inconsistent effect sizes for GRF loading rate (LM: p = 0.020 d = 0.54, RS: p = 0.042 d = 0.27), pronation excursion (LM: p < 0.001 f = 0.31, RS: p = 0.042 f = 0.15), and non-significant effect of orthotic for impact shock (LM: p = 0.182 d = 0.08, RS: p = 0.457 d = 0.24). Statistical significance was different between systems for effect of orthotic on pronation velocity (LM: p = 0.010 f = 0.18, RS: p = 0.093 f = 0.25). RunScribe and Laboratory agreed on the direction of change of the biomechanics variables for 69% (GRF loading rate), 40%-70% (pronation excursion), 47%-65% (pronation velocity), and 58% (impact shock) of participants. CONCLUSION The RunScribe shows sensitivity to orthotic effect consistent with the laboratory at the group level for GRF loading rate, pronation excursion, and impact shock during walking. There were however large discrepancies between measurements in individuals. Application of the RunScribe for group analysis may be appropriate, however implementation of RunScribe for individual assessment and those including pronation may lead to erroneous interpretation.
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Affiliation(s)
- Max Lewin
- School of Health and Society, University of Salford, Manchester, UK.
- Scholl's Wellness Company, Hull, UK.
| | - Carina Price
- School of Health and Society, University of Salford, Manchester, UK
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Walker KJ, Przestrzelski BT, Kaluf B, Driggers NH, Ballard WD, Pruett TC, Hoeffner SL, DesJardins JD. Novel 3D-printed foot orthoses with variable hardness: A comfort comparison to traditional orthoses. Med Eng Phys 2023; 115:103978. [PMID: 37120178 DOI: 10.1016/j.medengphy.2023.103978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 03/12/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
Custom foot orthoses are used to treat a variety of foot pathologies. However, orthotic production requires significant hands-on fabrication time and expertise to produce orthoses that are both comfortable and effective. This paper introduces a novel 3D printed orthosis and fabrication method that utilizes custom architectures to produce variable-hardness regions. These novel orthoses are compared to traditionally fabricated orthoses during a 2-week user comfort study. Twenty (n = 20) male volunteers underwent orthotic fitting for both traditional and 3D-printed foot orthoses prior to engaging in treadmill walking trials and 2 weeks of wear. Each participant undertook a regional comfort, acceptance, and comparison analysis of the orthoses at three time points throughout the study (0, 1, and 2 weeks). Both the 3D-printed and the traditionally fabricated foot orthoses demonstrated statistically significant increases in comfort when compared to the factory fabricated shoe insert. Additionally, the two orthosis groups were not significantly different from each other in comfort rankings both regionally and overall at any time point. The similar comfort achieved by the 3D-printed orthosis to the traditionally fabricated orthosis after 7 days and 14 days emphasizes the potential of the future use of the more reproducible and adaptable 3D-printed orthosis manufacturing methodology.
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Affiliation(s)
- Kyle J Walker
- Clemson University, Department of Bioengineering, 301 Rhodes Hall, Clemson, SC 29634, United States
| | - Breanne T Przestrzelski
- Clemson University, Department of Bioengineering, 301 Rhodes Hall, Clemson, SC 29634, United States
| | - Brian Kaluf
- Ottobock North America, 3820 Great Lakes Dr, Salt Lake City, UT 84120, United States
| | - Nikki H Driggers
- Carolina Orthotics & Prosthetics - Ottobock Care, 1455 Harden Street Extension, Columbia, SC 29201, United States
| | - W Daniel Ballard
- Upstate Pedorthic Services, 24 Parkway Commons Way, Greer, SC 29650, United States
| | - Timothy C Pruett
- Clemson University, Department of Bioengineering, 301 Rhodes Hall, Clemson, SC 29634, United States
| | - Steve L Hoeffner
- Clemson University, Department of Bioengineering, 301 Rhodes Hall, Clemson, SC 29634, United States
| | - John D DesJardins
- Clemson University, Department of Bioengineering, 301 Rhodes Hall, Clemson, SC 29634, United States.
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Zhang X, Vanwanseele B. Immediate effects of forefoot wedges on multi-segment foot kinematics during jogging in recreational runners with a symptomatic pronated foot. Front Physiol 2023; 13:1064240. [PMID: 36699670 PMCID: PMC9868581 DOI: 10.3389/fphys.2022.1064240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Foot orthoses (FOs) have been used to alter lower limb kinematics and kinetics in pronated feet. A clear relationship between FOs' features, e.g., the amount of wedging and support, and the corresponding biomechanical responses is vital for the design and prescription of FOs. In this study, we sought to determine if changing the level of the forefoot wedge would cause a linear response in the multi-segment foot kinematics during jogging, and if this effect would be enhanced by an arch support. Methods: Ten pairs of 3D printed FOs with five levels of forefoot wedges and two levels of arch supports were tested on 12 recreational runners with a symptomatic pronated foot. Multi-segment foot kinematic data during jogging was measured using the Oxford Foot Model. Two-way ANOVAs were performed to examine the main effect of the forefoot wedge and arch support, as well as their interaction on peak joint angles. Statistical parametric mapping and paired-t tests were used to identify differences in the foot kinematic traces and the joint range of motion (ROM) between each FO and the control, respectively. Results: Linear main effects for the forefoot wedge level were found in the forefoot peak dorsiflexion, eversion and rearfoot peak dorsiflexion of jogging. FOs with a medial forefoot wedge caused an average of 2.5° reduction of the forefoot peak abduction during jogging. Furthermore, forefoot wedges showed an opposite effect on the sagittal ROM of the forefoot and rearfoot. Adding an arch support did not improve the kinematic performance of a forefoot wedge during jogging. Conclusion: This study highlights a linear dose-response effect of a forefoot wedge on forefoot kinematics during jogging, and suggests using a medial forefoot wedge as an anti-pronator component for controlling forefoot motion of a pronated foot.
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Affiliation(s)
- Xianyi Zhang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China,Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China,*Correspondence: Xianyi Zhang,
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Zhang X, Yang F, Zhao K, Vanwanseele B. Symptomatic and asymptomatic pronated feet show differences in the forefoot abduction motion during jogging, but not in the arch deformation. Sports Biomech 2022:1-12. [PMID: 35959794 DOI: 10.1080/14763141.2022.2109506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
Pronated feet have been associated with higher risks of running-related overuse injuries than neutral feet. However, it remains unclear why some pronated feet develop running-related injuries, while others do not. This study aimed to examine the differences in foot kinematics during jogging among individuals with symptomatic pronated feet (SP), asymptomatic pronated feet (AP) and asymptomatic neutral feet (AN). Thirty-nine recreational runners were recruited and classified into the SP, AP and AN groups. Statistical parametric mapping (SPM) and ANOVA were used to identify kinematic differences among three groups. The SPM results showed that the SP had larger forefoot abduction than the AN and AP during jogging, while three groups had similar rearfoot eversion during jogging. Both the AP and SP had larger forefoot sagittal range of motion (ROM) (mean difference = 3.5 and 4.8 deg, respectively) and smaller rearfoot sagittal ROM (mean difference = 5.0 and 3.5 deg, respectively) than the AN. Forefoot abduction during jogging may have the potential to identify pronated feet at greater risk of injury. Pronated feet, symptomatic or not, have comparable large forefoot sagittal ROM, i.e., arch deformation, compared to neutral feet. The findings could have implications for the injury aetiology and intervention strategies for SP.
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Affiliation(s)
- Xianyi Zhang
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Fan Yang
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company Limited, Beijing, China
- Department of Physical Education and Research, China University of Mining and Technology-Beijing, Beijing, China
- School of Sports Science, Lingnan Normal University, Guangdong, China
| | - Kaidi Zhao
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Benedicte Vanwanseele
- Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven, Leuven, Belgium
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Abstract
This systematic review aimed to evaluate custom-made 3D printed insoles for people with flatfeet. PubMed, Embase, ISI web of knowledge, ProQuest, Scopus, and Cochrane databases, were searched from inception until January 2022. The quality assessment of included studies was performed through the Downs and Black checklist. A narrative analysis was performed since a meta-analysis could not be conducted. Ten studies including 225 subjects with flexible flatfeet were chosen for final evaluation. Although the evidence from selected literature was generally weak, using insoles with 3D printing technology may positively affect pain (comfort score) and foot function, with no significant change in vertical loading rate during walking or running. There were discrepancies among studies for plantar pressures, center of pressure trajectories, 3D ankle joint kinematics and kinetics of gait while wearing these insoles. Dose-response effects of medial posting on 3D printed insoles suggested beneficial effects on lower limb gait biomechanics in people with flatfeet. There was insufficient evidence to conclude the comparison between 3D printed insoles and other types of insoles. In conclusion, using a 3D printed insole may improve comfort score and foot function in people with flatfeet.
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Affiliation(s)
- Aliyeh Daryabor
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Hassan Saeedi
- School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Samuel M Lyons
- Motion Analysis and Sports Performance Lab, Department of Orthopedic Sports Medicine, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Noriaki Maeda
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sedighe Sadat Naimi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ho M, Nguyen J, Heales L, Stanton R, Kong PW, Kean C. The biomechanical effects of 3D printed and traditionally made foot orthoses in individuals with unilateral plantar fasciopathy and flat feet. Gait Posture 2022; 96:257-264. [PMID: 35709609 DOI: 10.1016/j.gaitpost.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot orthoses (FOs) are used to manage foot pathologies such as plantar fasciopathy. 3D printed custom-made FOs are increasingly being manufactured. Although these 3D-printed FOs look like traditionally heat-moulded FOs, there are few studies comparing FOs made using these two different manufacturing processes. RESEARCH QUESTION How effective are 3D-printed FOs (3D-Print) compared to traditionally-made (Traditional) or no FOs (Control), in changing biomechanical parameters of flat-footed individuals with unilateral plantar fasciopathy? METHODS Thirteen participants with unilateral plantar fasciopathy walked with shoes under three conditions: Control, 3D-print, and Traditional. 2 × 3 repeated measures analysis of variance (ANOVAs) with Bonferroni post-hoc tests were used to compare discrete kinematic and kinetic variables between limbs and conditions. Waveform analyses were also conducted using statistical parametric mapping (SPM). RESULTS There was a significant condition main effect for arch height drop (p = 0.01; ηp2 =0.54). There was 0.87 mm (95% CI [-1.84, -0.20]) less arch height drop in 3D-print compared to Traditional. The SPM analyses revealed condition main effects on ankle moment (p < 0.001) and ankle power (p < 0.001). There were significant differences between control condition and both 3D-print and Traditional conditions. For ankle moment and power, there were no differences between 3D-print and Traditional conditions. SIGNIFICANCE 3D-printed FOs are more effective in reducing arch height drop, whist both FOs lowered ankle plantarflexion moment and power compared to no FOs. The results support the use of 3D-printed FOs as being equally effective as traditionally-made FOs in changing lower limb biomechanics for a population of flat-footed individuals with unilateral plantar fasciopathy.
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Affiliation(s)
- Malia Ho
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Julie Nguyen
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Luke Heales
- Department of Physiotherapy, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Robert Stanton
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity Australia, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Pui W Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore.
| | - Crystal Kean
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity Australia, Bruce Highway, North Rockhampton, QLD 4701, Australia.
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Brognara L, Fantini M, Morellato K, Graziani G, Baldini N, Cauli O. Foot Orthosis and Sensorized House Slipper by 3D Printing. Materials (Basel) 2022; 15:ma15124064. [PMID: 35744123 PMCID: PMC9231166 DOI: 10.3390/ma15124064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND In clinical practice, specific customization is needed to address foot pathology, which must be disease and patient-specific. To date, the traditional methods for manufacturing custom functional Foot Orthoses (FO) are based on plaster casting and manual manufacturing, hence orthotic therapy depends entirely on the skills and expertise of individual practitioners. This makes the procedures difficult to standardize and replicate, as well as expensive, time-consuming and material-wasting, as well as difficult to standardize and replicate. 3D printing offers new perspectives in the development of patient-specific orthoses, as it permits addressing all the limitations of currently available technologies, but has been so far scarcely explored for the podiatric field, so many aspects remain unmet, especially for what regards customization, which requires the definition of a protocol that entails all stages from patient scanning to manufacturing. METHODS A feasibility study was carried out involving interdisciplinary cooperation between industrial engineers and podiatrists. To that end: (i) For patient-specific data acquisition, 3D scanning of the foot is compared to traditional casting. (ii) a modelling GD workflow is first created to design a process permitting easy creations of customized shapes, enabling the end user (the podiatrist) to interactively customize the orthoses. Then, (iii) a comparison is made between different printing materials, in order to reproduce the same mechanical behavior shown by standard orthoses. To do this, the mechanical properties of standard materials (Polycarbonate sheets), cut and hand-shaped, are compared with four groups of 3D printed samples: poly(ethylene glycol) (PETG), poly(acrylonitrile-butadiene.styrene) (ABS), polycarbonate (PC) and poly(lactic acid) (PLA) obtained by Fused Filament Fabrication (FFF). RESULTS Differences found between the foot plaster model obtained with the plaster slipper cast in a neutral position and the model of the real foot obtained with 3D scanning in the same position can be ascribed to the non-stationarity of the patient during the acquisition process, and were limited by a locking system with which no substantial differences in the almost entire sole of the foot scan were observed. CONCLUSIONS Using the designed GD workflow, podiatrists with limited CAD skills can easily design and interactively customize foot orthoses to adapt them to the patients' clinical needs. 3D printing enables the complex shape of the orthoses to be reproduced easily and quickly. Compared to Polycarbonate sheets (gold standard), all the printed materials were less deformable and reached lower yield stress for comparable deformation. No modifications in any of the materials as a result of printing process were observed.
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Affiliation(s)
- Lorenzo Brognara
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy;
| | | | - Kavin Morellato
- Department of Industrial Engineering, Alma Mater Studiorum, University of Bologna, Via Terracini 28, 40131 Bologna, Italy;
| | - Gabriela Graziani
- Laboratory of Nanobiotechnology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
| | - Nicola Baldini
- Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
| | - Omar Cauli
- Nursing Department, University of Valencia, Avda Menendez Pelayo 19, 46010 Valencia, Spain
- Frailty Research Organizad Group, University of Valencia, Avda Menendez Pelayo 19, 46010 Valencia, Spain
- Correspondence:
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Xu Y, Li X, Chang Y, Wang Y, Che L, Shi G, Niu X, Wang H, Li X, He Y, Pei B, Wei G, Signoroni A. Design of Personalized Cervical Fixation Orthosis Based on 3D Printing Technology. Appl Bionics Biomech 2022; 2022:1-8. [PMID: 35535322 PMCID: PMC9078801 DOI: 10.1155/2022/8243128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
The movement of the cervical spine should be restricted throughout the rehabilitation phase after it has been injured. Cervical orthosis is commonly utilized in clinical settings to guarantee cervical spine stability. However, to date, the investigations are limited to patient-specific cervical fixation orthoses. This study provides a new idea for making personalized orthoses. The CT data of the patient's cervical spine were collected, then mimics were used for reconstructing the skin of the cervical spine, the Geomagic Studio was used for surface fitting, the Inspire Studio was used for structural topology optimization, redundant structures were removed, the resulting orthotics were postprocessed, and finally, it was printed with a 3D printer. No signs of pain or discomfort were observed during the wearing. The cervical spine range of motion in flexion, extension, lateral flexion, and rotation is all less than 8° after using the device. Low cost, quick manufacturing time, high precision, attractive appearance, lightweight structure, waterproof design, and practical customized orthotics for patients are all advantages of 3D printing technology in the field of orthopedics. Many possible benefits of using 3D printing to build new orthotics include unique design, stiffness, weight optimization, and improved biomechanical performance, comfort, and fit. Personalized orthotics may be designed and manufactured utilizing 3D printing technology.
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Ho M, Nguyen J, Talbot K, Heales L, Kean C, Kong PW, Stanton R. Immediate comfort perception of 3D-printed foot orthoses in individuals with unilateral heel pain. Prosthet Orthot Int 2022; 46:31-36. [PMID: 35179521 PMCID: PMC8865620 DOI: 10.1097/pxr.0000000000000068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/06/2021] [Accepted: 08/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Custom-made foot orthoses (FOs) play an integral part in managing foot disorders. Traditional FO fabrication is time-consuming and labor intensive. Three-dimensional (3D) printed FOs save time and cost compared with the traditional manufacturing process. To date, the differences in dimensions and comfort perception of these orthoses have not been compared in a pathological population. OBJECTIVE Compare the dimensions between 3D-printed and traditionally made FOs and comfort perception between 3D-printed, traditionally made, and no FOs in individuals with flatfeet and unilateral heel pain. STUDY DESIGN Within-subject single-blinded randomized crossover study design. METHODS Thirteen participants had custom-made FOs using 3D-printing and traditional processes. Orthotic lengths, widths, arch heights, and heel cup heights were compared. Participants performed walking trials under three conditions: (1) no orthoses, (2) 3D-printed orthoses, and (3) traditionally made orthoses. Comfort perception was recorded. Orthotic dimensions were compared using paired t tests, and comfort perception were compared using one-way multiple analysis of variance and Bonferroni post hoc tests. RESULTS Three-dimensional-printed orthoses were wider, have higher arch heights, and heel cup heights compared with traditionally made FOs (medium to large effect sizes). There was a difference in comfort perception between the three orthotic conditions, F(12,62) = 1.99, P = 0.04; Wilk Λ = 0.521, ηp2= 0.279. Post hoc tests show that there is no difference in comfort perception between the 3D-printed and traditionally made FOs. Both FOs were significantly more comfortable than no orthoses. CONCLUSIONS Three-dimensional printing seems to be a viable alternative orthotic fabrication option. Future studies should compare the biomechanical effects of 3D-printed and traditionally made FOs.
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Affiliation(s)
- Malia Ho
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
| | - Julie Nguyen
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
| | - Kerwin Talbot
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
| | - Luke Heales
- Department of Physiotheraphy, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, QLD Australia
| | - Crystal Kean
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
| | - Pui W. Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Robert Stanton
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
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Cheng KW, Peng Y, Chen TLW, Zhang G, Cheung JCW, Lam WK, Wong DWC, Zhang M. A Three-Dimensional Printed Foot Orthosis for Flexible Flatfoot: An Exploratory Biomechanical Study on Arch Support Reinforcement and Undercut. Materials (Basel) 2021; 14:5297. [PMID: 34576526 PMCID: PMC8469370 DOI: 10.3390/ma14185297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 11/18/2022]
Abstract
The advancement of 3D printing and scanning technology enables the digitalization and customization of foot orthosis with better accuracy. However, customized insoles require rectification to direct control and/or correct foot deformity, particularly flatfoot. In this exploratory study, we aimed at two design rectification features (arch stiffness and arch height) using three sets of customized 3D-printed arch support insoles (R+U+, R+U-, and R-U+). The arch support stiffness could be with or without reinforcement (R+/-) and the arch height may or may not have an additional elevation, undercutting (U+/-), which were compared to the control (no insole). Ten collegiate participants (four males and six females) with flexible flatfoot were recruited for gait analysis on foot kinematics, vertical ground reaction force, and plantar pressure parameters. A randomized crossover trial was conducted on the four conditions and analyzed using the Friedman test with pairwise Wilcoxon signed-rank test. Compared to the control, there were significant increases in peak ankle dorsiflexion and peak pressure at the medial midfoot region, accompanied by a significant reduction in peak pressure at the hindfoot region for the insole conditions. In addition, the insoles tended to control hindfoot eversion and forefoot abduction though the effects were not significant. An insole with stronger support features (R+U+) did not necessarily produce more favorable outcomes, probably due to over-cutting or impingement. The outcome of this study provides additional data to assist the design rectification process. Future studies should consider a larger sample size with stratified flatfoot features and covariating ankle flexibility while incorporating more design features, particularly medial insole postings.
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Affiliation(s)
- Ka-Wing Cheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou 510000, China;
- Department of Kinesiology, Shenyang Sport University, Shenyang 110102, China
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing 101111, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
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Andrés-Cano P, Calvo-Haro J, Fillat-Gomà F, Andrés-Cano I, Perez-Mañanes R. Role of the orthopaedic surgeon in 3D printing: current applications and legal issues for a personalized medicine. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021. [DOI: 10.1016/j.recote.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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14
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Andrés-Cano P, Calvo-Haro JA, Fillat-Gomà F, Andrés-Cano I, Perez-Mañanes R. Role of the orthopaedic surgeon in 3D printing: current applications and legal issues for a personalized medicine. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 65:138-151. [PMID: 33298378 DOI: 10.1016/j.recot.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/14/2020] [Indexed: 12/16/2022] Open
Abstract
3D printing (I3D) is an additive manufacturing technology with a growing interest in medicine and especially in the specialty of orthopaedic surgery and traumatology. There are numerous applications that add value to the personalised treatment of patients: advanced preoperative planning, surgeries with specific tools for each patient, customised orthotic treatments, personalised implants or prostheses and innovative development in the field of bone and cartilage tissue engineering. This paper provides an update on the role that the orthopaedic surgeon and traumatologist plays as a user and prescriber of this technology and a review of the stages required for the correct integration of I3D into the hospital care flow, from the necessary resources to the current legal recommendations.
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Affiliation(s)
- P Andrés-Cano
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - J A Calvo-Haro
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, Madrid, España; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - F Fillat-Gomà
- Unidad de Planificación Quirúrgica 3D, Departamento de Cirugía Ortopédica y Traumatología, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - I Andrés-Cano
- Departamento de Radiodiagnóstico Hospital Universitario Puerta del Mar, Cádiz, España
| | - R Perez-Mañanes
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, Madrid, España; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Barrios-Muriel J, Romero-Sánchez F, Alonso-Sánchez FJ, Salgado DR. Advances in Orthotic and Prosthetic Manufacturing: A Technology Review. Materials (Basel) 2020; 13:E295. [PMID: 31936429 PMCID: PMC7013385 DOI: 10.3390/ma13020295] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 01/16/2023]
Abstract
In this work, the recent advances for rapid prototyping in the orthoprosthetic industry are presented. Specifically, the manufacturing process of orthoprosthetic aids are analysed, as thier use is widely extended in orthopedic surgery. These devices are devoted to either correct posture or movement (orthosis) or to substitute a body segment (prosthesis) while maintaining functionality. The manufacturing process is traditionally mainly hand-crafted: The subject's morphology is taken by means of plaster molds, and the manufacture is performed individually, by adjusting the prototype over the subject. This industry has incorporated computer aided design (CAD), computed aided engineering (CAE) and computed aided manufacturing (CAM) tools; however, the true revolution is the result of the application of rapid prototyping technologies (RPT). Techniques such as fused deposition modelling (FDM), selective laser sintering (SLS), laminated object manufacturing (LOM), and 3D printing (3DP) are some examples of the available methodologies in the manufacturing industry that, step by step, are being included in the rehabilitation engineering market-an engineering field with growth and prospects in the coming years. In this work we analyse different methodologies for additive manufacturing along with the principal methods for collecting 3D body shapes and their application in the manufacturing of functional devices for rehabilitation purposes such as splints, ankle-foot orthoses, or arm prostheses.
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