Investigating the Effect of Semi-Hard Medical Insoles Made with CAD-CAM Technology on Balance and Pressure Caused by Flexible Flatfoot in the Ages of 12 to 40 Years: Systematic Review

Document Type : Review Articles

Authors
Elahe Heidari 1
Tahmoures Tahmasbi 2
Shahin Mojiri 3
1 MSc Student, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 Lecturer, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
3 PhD Student, Department of Medical Information, School of Management, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jrrs.2023.41605.1029
Abstract
Introduction: Flexible flatfoot causes pain in higher joints and disturbs the pressure distribution of soles in affected people. In this study, we aimed to determine the effect of three-dimensional (3D)-printed insoles and computer-aided design/computer-aided manufacturing (CAD/CAM) in reducing pressure and pain in people with flexible flatfoot.
Materials and Methods: The present study was designed as a systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An extensive search was conducted in the most important databases including PubMed, Web of Science, Embase, Cochrane, and Scopus. The methodological quality of the included studies was evaluated through Downs and Black's checklist. A form was also designed to extract the most important findings of the studies based on the research objectives, and finally the results of the studies were evaluated.
Results: In the electronic search, 19 articles that met the inclusion criteria were published between 2003 and 2022. Insoles that used 3D-design technology and CAD/CAM might have a positive effect on pain and function and distribution of foot pressure in patients with flat feet during the period of patient investigation. But there was no reliable evidence due to the examination of different outcomes and the small number of studies in this regard.
Conclusion: Although the use of 3D insoles and CAD/CAM played a role in reducing pressure and pain and increasing the comfort of patients with flexible flatfoot, the evidence in this field is insufficient and requires more studies.
Keywords
Foot orthosis
Flatfoot
Pes planus
CAD/CAM
3D-printed insole
Subjects
  1. Cavanagh PR, Rodgers MM. The arch index: A useful measure from footprints. J Biomech 1987; 20(5): 547-51.
  2. Mo S, Leung SHS, Chan ZYS, Sze LKY, Mok KM, Yung PSH, et al. The biomechanical difference between running with traditional and 3D printed orthoses. J Sports Sci 2019; 37(19): 2191-7.
  3. Tsung BY, Zhang M, Mak AF, Wong MW. Effectiveness of insoles on plantar pressure redistribution. J Rehabil Res Dev 2004; 41(6A): 767-74.
  4. Paiehdar S, Saeedi H, Ahmadi A, Kamali M, Mohammadi M. The comparison of the immediate effect of 3 functional, UCBL and modified UCBL foot orthotics impact on dynamic balance in subjects with flexible flatfoot. J Rehab 2014; 14(4): 66-73. [In Persian].
  5. Nawoczenski DA, Ludewig PM. Electromyographic effects of foot orthotics on selected lower extremity muscles during running. Arch Phys Med Rehabil 1999; 80(5): 540-4.
  6. Hessert MJ, Vyas M, Leach J, Hu K, Lipsitz LA, Novak V. Foot pressure distribution during walking in young and old adults. BMC Geriatr 2005; 5: 8.
  7. Khodaei B, Saeedi H, Jalali M, Farzadi M, Norouzi E. Comparison of plantar pressure distribution in CAD-CAM and prefabricated foot orthoses in patients with flexible flatfeet. Foot (Edinb ) 2017; 33: 76-80.
  8. Dars S, Uden H, Banwell HA, Kumar S. The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update. PLoS One 2018; 13(2): e0193060.
  9. Daryabor A, Kobayashi T, Saeedi H, Lyons SM, Maeda N, Naimi SS. Effect of 3D printed insoles for people with flatfeet: A systematic review. Assist Technol 2023; 35(2): 169-79.
  10. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998; 52(6): 377-84.
  11. Subramanian SK, Caramba SM, Hernandez OL, Morgan QT, Cross MK, Hirschhauser CS. Is the Downs and Black scale a better tool to appraise the quality of the studies using virtual rehabilitation for post-stroke upper limb rehabilitation? Proceedings of the 2019 International Conference on Virtual Rehabilitation (ICVR); 2019 July 21-24; Tel Aviv, Israel.
  12. Erdemir A, Saucerman JJ, Lemmon D, Loppnow B, Turso B, Ulbrecht JS, et al. Local plantar pressure relief in therapeutic footwear: Design guidelines from finite element models. J Biomech 2005; 38(9): 1798-806.
  13. Ciobanu O. [The use of CAD/CAM and rapid fabrication technologies in prosthesis and orthotics manufacturing]. Rev Med Chir Soc Med Nat Iasi 2012; 116(2): 642-8.
  14. Liu X, Rizza R, Valin S, Al-Ramahi J, Lyon R, Thometz J. Fluoroscopy and dynamic pressure-based foot orthoses for children with flatfoot. J Prosthet Orthot 2019; 31(2): 145-51.
  15. Ilavarasi K. Effectiveness of 3D foot scanner designed and fabricated customized foot insole in the management of children with flat foot. Komarapalayam, india: JKK Muniraja Medical Research Foundation; 2018.
  16. Bok SK, Kim BO, Lim JH, Ahn SY. Effects of custom-made rigid foot orthosis on pes planus in children over 6 years old. Ann Rehabil Med 2014; 38(3): 369-75.
  17. Bok SK, Lee H, Kim BO, Ahn S, Song Y, Park I. The effect of different foot orthosis inverted angles on plantar pressure in children with flexible flatfeet. PLoS One 2016; 11(7): e0159831.
  18. Yildiz K, Medetalibeyoglu F, Kaymaz I, Ulusoy GR. Triad of foot deformities and its conservative treatment: With a 3D customized insole. Proc Inst Mech Eng H 2021; 235(7): 780-91.
  19. D'Amico M, Kinel E, Roncoletta P, Gnaldi A, Ceppitelli C, Belli F, et al. Data-driven CAD-CAM vs traditional total contact custom insoles: A novel quantitative-statistical framework for the evaluation of insoles offloading performance in diabetic foot. PLoS One 2021; 16(3): e0247915.
  20. Jin H, Xu R, Wang J. The effects of short-term wearing of customized 3d printed single-sided lateral wedge insoles on lower limbs in healthy males: A randomized controlled trial. Med Sci Monit 2019; 25: 7720-7.
  21. Balsdon MER, Dombroski CE. Custom-made foot orthoses with and without heel plugs and their effect on plantar pressures during treadmill walking. Prosthet Orthot Int 2022; 46(4): e357-e361.
  22. Jandova S, Mendricky R. Benefits of 3D printed and customized anatomical footwear insoles for plantar pressure distribution. 3D Print Addit Manuf 2022; 9(6): 547-56.
  23. Telfer S, Abbott M, Steultjens M, Rafferty D, Woodburn J. Dose-response effects of customised foot orthoses on lower limb muscle activity and plantar pressures in pronated foot type. Gait Posture 2013; 38(3): 443-9.
  24. Joo JY. Effects of customized 3D-printed insoles on the kinematics of flat-footed walking and running. Korean Journal of Applied Biomechanics 2018; 28(4): 237-44.
  25. de Melo Lopes Martinho Malaquias T, Solten JV, Jonkers I, De Groote F. A combined multibody and plantar pressure approach to estimate and predict foot kinematics applied to 3D-printed insoles [PhD Thesis]. Leuven, Belgium: Katholieke Universiteit Leuven; 2019.
  26. Xu R, Wang Z, Ren Z, Ma T, Jia Z, Fang S, et al. comparative study of the effects of customized 3d printed insole and prefabricated insole on plantar pressure and comfort in patients with symptomatic flatfoot. Med Sci Monit 2019; 25: 3510-9.
  27. Cherni Y, Desmyttere G, Hajizadeh M, Bleau J, Mercier C, Begon M. Effect of 3D printed foot orthoses stiffness on muscle activity and plantar pressures in individuals with flexible flatfeet: A statistical non-parametric mapping study. Clin Biomech (Bristol, Avon) 2022; 92: 105553.
  28. Ho M, Nguyen J, Heales L, Stanton R, Kong PW, Kean C. The biomechanical effects of 3D printed and traditionally made foot orthoses in individuals with unilateral plantar fasciopathy and flat feet. Gait Posture 2022; 96: 257-64.
  29. Hu CW, Nguyen CT, Holbling D, Pang TY, Baca A, Dabnichki P. A novel 3D printed personalised insole for improvement of flat foot arch compression and recoil  preliminary study. Proc Inst Mech Eng Pt L J Mater Des Appl 2022; 237(2): 329-42.
  30. Cheng KW, Peng Y, Chen TL, Zhang G, Cheung JC, Lam WK, et al. A Three-dimensional printed foot orthosis for flexible flatfoot: an exploratory biomechanical study on arch support reinforcement and undercut. Materials (Basel) 2021; 14(18): 5297.
  31. Stolwijk NM, Louwerens JW, Nienhuis B, Duysens J, Keijsers NL. Plantar pressure with and without custom insoles in patients with common foot complaints. Foot Ankle Int 2011; 32(1): 57-65.
  32. Su S, Mo Z, Guo J, Fan Y. The effect of arch height and material hardness of personalized insole on correction and tissues of flatfoot. J Healthc Eng 2017; 2017: 8614341.
  33. Wang Y, Jiang W, Gan Y, Yu Y, Dai K. Clinical observation of 3D printing technology in insoles for flexible flatfoot patients. J Shanghai Jiaotong Univ 2021; 26(3): 398-403.
  34. Kim, Young-Kwan and Joo, Ji-Yong. Effects of custom-made 3d printed insoles for flat-foot people on gait parameters: A preliminary study. ISBS Proceedings Archive 2017; 35(1): 223.
  35. Desmyttere G, Hajizadeh M, Bleau J, Begon M. Effect of foot orthosis design on lower limb joint kinematics and kinetics during walking in flexible pes planovalgus: A systematic review and meta-analysis. Clin Biomech (Bristol, Avon) 2018; 59: 117-29.
  36. Yurt Y, Sener G, Yakut Y. The effect of different foot orthoses on pain and health related quality of life in painful flexible flat foot: A randomized controlled trial. Eur J Phys Rehabil Med 2019; 55(1): 95-102.
  37. Haris F, Liau BY, Jan YK, Akbari VB, Primanda Y, Lin KH, et al. A review of the plantar pressure distribution effects from insole materials and at different walking speeds. Appl Sci 2021; 11(24): 11851.
  38. Anggoro PW, Bawono B, Jamari J, Tauviqirrahman M, Bayuseno AP. Advanced design and manufacturing of custom orthotics insoles based on hybrid Taguchi-response surface method. Heliyon 2021; 7(3): e06481.
  39. Girard O, Morin JB, Ryu JH, Van AK. Custom foot orthoses improve performance, but do not modify the biomechanical manifestation of fatigue, during repeated treadmill sprints. Eur J Appl Physiol 2020; 120(9): 2037-45.
  40. Cheung RT, Chung RC, Ng GY. Efficacies of different external controls for excessive foot pronation: A meta-analysis. Br J Sports Med 2011; 45(9): 743-51.
  41. Hamblen DL, Simpson H. Adams's outline of orthopaedics. Edinburgh, UK: Elsevier Health Sciences; 2009.
  42. Bowen TR, Miller F, Castagno P, Richards J, Lipton G. A method of dynamic foot-pressure measurement for the evaluation of pediatric orthopaedic foot deformities. J Pediatr Orthop 1998; 18(6): 789-93.
  43. Zhai JN, Wang J, Qiu YS. Plantar pressure differences among adults with mild flexible flatfoot, severe flexible flatfoot and normal foot when walking on level surface, walking upstairs and downstairs. J Phys Ther Sci 2017; 29(4): 641-6.
  44. Lee SW, Choi JH, Kwon HJ, Song KS. Effect of pressure based customized 3-dimensional printing insole in pediatric flexible flat foot patients. J Korean Foot Ankle Soc 2020; 24(3): 113-9.
  45. Moon D, Jung J. Effect of incorporating short-foot exercises in the balance rehabilitation of flat foot: A randomized controlled trial. Healthcare (Basel) 2021; 9(10): 1358.
  46. Bidari S, Kamyab M, Ghandhari H, Komeili A. Efficacy of computer-aided design and manufacturing versus computer-aided design and finite element modeling technologies in brace management of idiopathic scoliosis: A narrative review. Asian Spine J 2021; 15(2): 271-82.
  47. Ploner M, Lee MC, Wiech K, Bingel U, Tracey I. Prestimulus functional connectivity determines pain perception in humans. Proc Natl Acad Sci USA 2010; 107(1): 355-60.
Journal of Research in Rehabilitation Sciences
Volume 18, Issue 1
2022
Pages 1-11

Article View 42,289
PDF Download 35,614