Versus Shoes

The following report on completed research articles, in whole or in part under a grant ACFAOM. Thank you to all those whose voluntary contributions to the Fund for Research ACFAOM make the grants possible. Comparing Negative Casting Techniques: Foam versus plaster of Paris Richard Berent, DPM, FACFAOM Introduction: This study was undertaken to determine if there was a difference in clinical outcomes associated with the type of technique used in the negative mold manufacturing Functional foot orthoses. Practitioners who are in favor of block foam casting argue that technology is cleaner, faster, more efficient and equally reliable method to produce functional foot orthoses compared to the technique of plaster of Paris. On the other hand, a number of practitioners have argued that the technique of the foam is less because the foam is unable to capture the shape of the foot with the subtalar joint neutral position and the midtarsal joint maximum pronation, thus leading to a lower leg orthosis that are less effective in reducing symptoms in patients. Materials and Methods: A total of 38 patients were included in the study. All patients had symptoms associated with lower extremity lower extremity function abnormality as determined by the assessment of gait. At the initial visit, each patient signed a consent form and completed the upper part of the data sheet which includes both personal information and the amount of pain at each end (patients were asked to circle the amount of pain on a scale of 0-10, with 0 being no pain and 10 being the worst pain ever felt). At the end of all papers, both feet of each patient were sunk by the technique of semi-weight bearing foam block and plaster in the supine position does not bear the weight of the method of Paris. The two sets of shots were sent to a professional lab with a prescription orthotic orthotic shell filled with a medium amount of arch bridge, the average depth of heel, the normal width of orthotics (at the border lateral fifth metatarsal bisection of the first metatarsal shaft) and a thickness of polypropylene, which behaves in a semi-rigid behavior for the weight of said patient. A laboratory technician was instructed to randomly select one of two pairs of rolls of negatives and keep track of which casts were used without the knowledge of the principal investigator. In this way, a double-blind study was therefore established that neither the PI nor the patient knew which casts were used to construct foot orthotics. Approximately 2-3 weeks after casting, the patient was given a pair of functional foot orthotics and asked to walk for a minimum of 10 minutes to assess the level of comfort of the orthosis. Each participant was asked to use one of four descriptive terms (very comfortable, comfortable, somewhat uncomfortable or very uncomfortable) to describe the comfort level of 5 different regions on each orthosis corresponding foot to the heel area, medial arch, lateral arch, middle of the brace and the distal edge. Patients were then sent home with standard break-in instructions for the functional foot orthotics and returned to the clinic at intervals of 2 weeks and 4 weeks post-dispensal orthotics. Each follow-up visit, patients were asked to complete a data sheet to measure the level of symptoms and level of comfort of the orthosis. The data was then compiled and saved in a spreadsheet and the completion of the study, the laboratory technician was contacted to identify patients belonged to group study, foam box or plaster of Paris casting technique. Results: Data were compiled and the two study groups separated by casting technique. An independent investigator (non-podiatrist) was contacted and asked to analyze the data to answer the following questions: 1. Is it the negative mold technique.