The performance and durability of a successful orthotic device depend largely on the orthotic design and the manufacturing technique used in fabrication.
Attention needs to be paid to each aspect in the manufacture of such orthotics, with regard to the heel cup, the shoe type and the top covers used.
A shallow heel cup is necessary to avoid the spread of the heel counter, which could cause the patient’s heel to come out of the shoe during gait.
Medium heel cups work for most patients without special shoe types whereas deep heel cups are useful for overpronated feet that require extra support through the arch.
Patients with insensate feet such as diabetics, would require wider shells to accommodate their feet and to prevent potential rubbing at the orthotic margins.
Tight/constricting shoes would require a narrow shell width in order to avoid spreading the shoe or seeing the orthotic edge profile against the walls of the shoe.
For the best biomechanical efficiency, athletic and walking-type shoes are recommended for use with the orthotics, as they offer the added advantage of built-in construction details for pronation control.
The choice of top cover is also a crucial decision that affects overall comfort, volume of the orthotic, relative friction against the foot and cutout options for pressure relief.
The advantages of using a full length top cover involve a uniform orthotic surface from heel to toes, with limited chances for the orthotic to slide around in the shoe.
However, such a top cover can take up too much volume in the shoe and can lead to crowding of toes in the toe box, limiting its use in most types of shoes.
The most versatile of all top covers is the met head length, which can be used in many kinds of footwear with minimal footwear integration issues.
But it is important to note that the met head length is best suited for those who do not require extra shock absorption or many cutout options.
MASS4D® orthotics attempt to support the motion of the foot before any pathological movement occurs, in order to prevent the onset of excessive structural collapse.
This is the reason for the success of MASS4D® orthotic in active rehabilitation programmes and for treating lower extremity biomechanical faults.
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Severe haemophilia involves spontaneous bleeding within the musculoskeletal system and mucosal or cerebral hemorrhages at an early age. Hemophilic arthropathy is a long-term, debilitating consequence of repeated haemarthrosis in patients suffering from haemophilia.