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Comparative Study of the Effects of Customized 3D printed insole and Prefabricated Insole on Plantar Pressure and Comfort in Patients with Symptomatic Flatfoot

Rui Xu, Zhonghan Wang, Zhenxiao Ren, Tingjian Ma, Zhe Jia, Shuyan Fang, Hui Jin

(Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland))

Med Sci Monit 2019; 25:3510-3519

DOI: 10.12659/MSM.916975

Published: 2019-05-12

BACKGROUND: There are many shortcomings in traditional prefabricated rehabilitation insoles for symptomatic flatfoot patients. This study investigated the effects of customized 3-dimensional (3D) printed insoles on pressure and comfort of the plantar foot in symptomatic flatfoot patients.
MATERIAL AND METHODS: Eighty patients with bilateral flatfoot participated in this study. At week 0, patients were randomly assigned into 1 of 2 groups. In the control group, the patients wore standardize shoes with prefabricated insoles; and in the experimental group the patients wore standardize shoes and customized insoles. The Footscan® system recorded peak pressure, peak force, and peak contact area in 10 areas of the sole at weeks 0 and at week 8. Patients used visual analogue scale scores at week 0 and at week 8 to assess overall comfort of insoles.
RESULTS: At week 0, compared with the control group, the peak pressure in the metatarsal was significantly lower in the experimental group (P<0.05) while the peak pressure in the mid-foot was significantly higher than the control group (P<0.05). At week 8, in the experimental group, the peak pressures in the mid-foot were significantly higher than the control group (P<0.05). The comfort scores (measured by pain scale) reported by the experimental group were significantly lower than those reported by the control group (P<0.05).
CONCLUSIONS: Customized 3D printed insoles reduced the pressure on the metatarsals by distributed it over the mid-foot area, thus reduced the damage from symptomatic flatfoot. Customized 3D printed insoles were more effective than prefabricated insoles and offered better comfort for patients with symptomatic flatfoot.

Keywords: Flatfoot, foot orthoses, Imaging, Three-Dimensional, Physical and Rehabilitation Medicine