FFO Casts/Impression Boxes - How accurate is this data capture method?

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Orthotic Biomechanical Solutions 2010

 

It has been widely accepted that foot impressions or casts to produce functional foot orthoses are normally taken in sub talar joint neutral position. This does give some level of standardisation between practitioners in how they cast and describe their patients to other practitioners and technicians. It is also claimed that an orthoses made in this way would be more effective in assisting the foot to work in a more efficient way and would be more comfortable to wear. Identifying sub talar joint neutral can be difficult to achieve in practice, as the relationship between the navicular and talus needs to be identified before a plaster or by foam impression is taken.

A previous study comparing the results of multiple casts of the same subject showed variation in the foot position achieved. 1 In a different study comparing foam impression techniques there was also a large variation between practitioners and even the same practitioner could not achieve a repeatable result2. Considering the difficulties in producing accurate sub talar joint neutral casts it is likely that some moulds or casts will arrive at a fabrication sites in a none corrected position. This will have an adverse effect upon the technician’s ability to produce an accurate and effective foot orthoses. The technician will then be faced with making decisions about the suitability of the cast to manufacture an orthoses from.

Foot casts taken in pronation, supination and in a neutral position all affect the foot differently. They particularly change the pressure patterns and alignment of the foot in stance phase. If the impact of these changes in foot position can be understood then the technician can make appropriate choices in deciding what to do with the casts and impressions that come through the door every day.

A good understanding of what the effect of sub talar joint position has upon the effectiveness of an orthoses is important to both the orthotist and technician if an effective solution for the patient is to be found.

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