30: Orthotic Scanning - Feilmeier

Question 1

EBM Casting Criteria

Answer 1

• The foot image must be captured in a NWB, STJ neutral position
• The posterior heel must be captured to allow frontal plane correction of the orthosis (FF:RF balancing)
• The foot image must obtain a precise 3D representation of the foot’s plantar aspect
• The 1st ray should be plantarflexed to the end of its range of motion during casting

Question 2

what is a major complaint of SWB foam?

Answer 2

artificial increase in varus

Question 3

why should the 1st ray be plantarflexed to the end of its range of motion during casting ?

Answer 3

to allow the sliding motion of the 1st MPJ (ginglymoarthroidial joint)

• allows for maximal Dorsiflexion

Question 4

what decreases plantar fascia strain?

Answer 4

• Decreased with lateral forefoot wedge - Increased with medial forefoot wedge - Rearfoot wedges had no significant effect

Question 5

techniques that do not meet EBM criteria

Answer 5

foam box (SWB leads to dorsiflexion of first ray)

contact digitation (does not capture psoterior heel, SWB leads to dorsiflexion of 1st ray)

pressure plates/ mats (does not allow NWB, WB dorsiflexes 1st ray plantarflexion, does not capture posterior heel, does not capture 3D image of foot)

Question 6

techniques that CAN meet EBM criteria

Answer 6

plaster casts

STS sock

Laser Scanning

Infrared Scanning

Question 7

Ideal Scanner Functionality

Answer 7

• meets all EBM criteria
• allows use of all prescription variables
• cost and time efficient
• high degree of reliability
• strong support infrastructure
• intuitive software