The Physical Examination Dictates The Manufacturing Process

The long-term biomechanical benefits of using custom made orthotics make its manufacturing and design key factors in achieving successful functional outcomes in the treatment of several lower-limb pathologies.

For an orthotic intervention to be included in an active rehabilitation program, a host of information about the patient’s biomechanical profile needs to be considered first.

These details can be collected only through an extensive assessment of the patient’s foot and gait analysis, which helps in gaining a better insight into dynamic function and identifying the source of the pathomechanics.

The patient’s surgical and medical history need to be taken into consideration to gather information on any previous injuries, medications or allergies that could be contributing to the progress of the condition.

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A physical examination of the foot and ankle complex follows next, with an emphasis on the patient’s gait pattern, standing posture and shoe wear pattern. 

The shape of the foot must be examined thoroughly to determine which metatarsal and metatarsal phalangeal joint take on the maximum load, and to spot any deformities of the toe.

The medial longitudinal arch is an important determinant of functionality in the foot as it plays a critical role in sustaining the weight of the body and distributing the majority of the shock to the foot during physical activities.

High or low arches can be identified by inspecting the medial arch in both weightbearing and nonweightbearing positions. This helps in determining the dispersion of the forces of impact loading of the foot.

A normal gait is characterised by the ability of the foot to support body weight without collapsing, to maintain balance during the single support phase and to advance in the swing leg phase.

Any deviations from the normal gait pattern induces altered joint motion and indicates a postural abnormality that needs to be corrected.

MASS4D® advocates the use of gait reference casting to attain a precise impression of the foot in its corrected posture that is ideal to the patient’s anatomy. This replicates the foot’s structure and highlights any fibrous tissue mass or bony developments as well.

For this purpose, a semi-weight bearing impression of the foot is created by mimicking the patient’s healthy stance-phase gait in a specialised foam box.

The MASS4D® proprietary calibration process is at the centre of the manufacturing process. This creates a unique product that is individualised for each patient’s specific needs and anatomy.

By correlating the patient’s body weight, forefoot flexibility and activity levels into every foot orthotic, the specialised calibration process at MASS4D® blends strength and flexibility into every orthotic to create the ideal support for each person.

In terms of orthotic design, the heel cup, the shell width and the top cover all become important considerations in the treatment of individual pathologies of the lower limbs.

The shell is the most important part of the orthotic as it is responsible for properly positioning the calcaneus and supporting the foot in maximal supination through gait. Shell width is determined by foot size, foot condition and shoe selection.

The choice of top cover affects overall comfort, orthotic volume, cutout options for pressure relief and relative friction against the foot.

The BiLam cushion top, for instance, has been created for use with patients suffering from insensate foot symptoms that are most commonly associated with diabetes.

The final MASS4D® orthotic provides long-term symptomatic relief from various musculoskeletal conditions and provides the perfect balance of functional movement to meet each patient's rehabilitative needs.

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