what-when-how
In Depth Tutorials and Information
3
choose the right design and materials. As there is an extricable relationship
between the foot, the orthoses and the footwear that contains the two,
footwear design and usage has a direct impact on the potential for the foot
orthoses to be effective. The following chapters will provide the clinician
with the knowledge and understanding that is required if we are to achieve
the right combination of orthoses and footwear. Further to this, an under-
standing of the role of footwear as being more than protection is required
if we, as clinicians, are to understand the impact of what we consider as
an intervention and, from the patient's perspective, an item of clothing that
is visible and can define who they are. This view of footwear has become
established over centuries, therefore the next chapter gives a brief outline
of the evolution of footwear design and purpose.
review questions
Reflection
1.
Can I provide a rationale for the benefits and limitations of bespoke
versus off-the-shelf orthoses?
2.
Do I understand the principle objectives of orthotic therapy?
Self-assessed questions
1.
In what conditions is it desirable to control excessive pronation?
2.
What percentage reduction in pronation is generally considered
appropriate?
3.
Describe the design of what is considered to be the most effective
foot orthosis in reducing plantar pressure.
4.
Why is the flex line of a full-length orthosis important in gait?
5.
What type of device is useful in managing the symptoms associated
with medial compartment osteoarthritis of the knee?
6.
Describe the type and purpose of an orthosis for someone with early
RA.
7.
For which two main groups of patients with diabetes should foot
orthoses be considered as part of the management of preventing
foot ulceration?
references
Albert S, Rinoie C 1994 Effect of custom orthotics on plantar pressure
distribution on the pronated diabetic foot. The Journal of Foot & Ankle
Surgery 33(6):598-604.
