A Comparison of Two Different Methods to Produce Ankle Foot Orthoses

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Orthotic Biomechanical Solutions 2010

 

Casts for ankle foot orthoses (AFO) have been rectified using plaster of Paris models for many years. It is however very difficult to precisely add plaster build-ups and the finished casts are often discarded due to their bulk. The use of Computer aided design (CAD) may be able to resolve these issues.

However there are some issues to be considered before adopting CAD. Can the process provide an accurate way of producing a good fit and can it accurately correct a cast that has unwanted plantarflexion and/or forefoot mal-alignment? To resolve these questions a study was devised to compare the production of orthoses by standard rectification and with CAD.

One Clinician took 10 STS sock casts of 10 asymptomatic individuals. Each Subject was cast on a pitch board with 10 degree of plantarflexion and 5 degrees of forfoot varus. The STS socks were then scanned into the Vorum Cad system and the shapes were then rectified and corrected. The STS casts were then put into standard plaster manufacture process. The casts and polyurethane shapes produced by the two methods of rectification were then used to manufacture an AFO for each subject.

The finish, fit and comfort of each orthoses were graded from one to five by the Orthotist and by the subject for each AFO.
The conventionally produced AFO scored higher in the finish of plastic surface and for comfort whilst sitting. However the CAD orthoses fitted closer across the metatarsals, Malleoli, and the top of the calf section.

Overall the CAD AFOs scored higher than standard manufactured orthoses. This was mainly due to the fit of the orthoses and improved accuracy of the cast corrections. AFOs produced by CAD may well be a viable alternative for the Orthotist to enable them to produce accurate orthoses for their patients.

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