After the medical condition of the patient has become clear, orthosis intervention can be started. The first step in intervention is making a diagnosis with respect to foot problems. The diagnosis should include not only dysfunctions of the motoric system but also neuropsychological and social problems of the patient. Intervention also involves a laborious learning process for these patients. Patients are often unprepared and do not originally possess an optimal attitude for learning.
Learning to use orthosis and cope with disabilities is often an essential part of intervention. In many cases this includes learning to cope with remaining pain and motion functions. The main purpose is to gain more independence and mobility in the activities of daily life. In the course of deformation, the foot has undergone a drastic change. This has significant consequences for the multifunctional role of the foot. In addition, the foot is one of the most complex motion systems of the human body.
Its large mobility does not contribute to the stability of the joints. The stabilization is for the most part performed by muscle activity. In the case in which the muscles that bear the weight of the body have lost their function, deformations occur that then results in the pain and loss of control. In these cases particular orthosis should be used. Orthotic devices exist in many different forms. They are providing specific biomechanical characteristics to help patients perform effectively.
Hence these devices can play an important role in improving functionality or performance, keeping from injury, and reducing pain. Orthotic interventions can include lightweight bracing, casting, orthopedic shoes, and assistive devices for ambulation (Mccabe 69). Human movement commonly involves continual loading at the foot-floor interface. This results in force transmission through the human feet and toward the upper extremities. Proper orthosis attenuates these impact forces and protects the musculoskeletal system from potential deformation worsening and injury.
The past three decades have witnessed the production and clinical use (for example, as a therapy device) of a comparatively inexpensive foot orthosis that can be placed into the standard shoes of the patients with motor delays to improve their balance and functional capacities. The general term that is used to describe an orthotic device is minimum controlled dynamic foot orthosis. An example of dynamic foot orthosis is presented in Figure 1.
The features of this dynamic foot orthosis include, a) a relatively small in extent layer of plastic on the bottom of thick foam (material that is like aliplast) contoured and shaped to fit the sole of the foot, b) device with low-density polyethylene, and c) adaptable at the toe, semi-flexible at the arch, and stiff around the heel. Other features are an arch support, a metatarsal head depression, heel cup, and toe lifting for toes 2 (Case-Smith 115). Orthotic devices are designed to make the feet more comfortable, reduce stress on the foot, or improve not normal or anomalous walking pattern.
An orthotic device could be a clinically successful approach to a foot problem, a preventive method to avoid problems, or a useful help after foot surgery. Conclusion In summary, the clinical investigations analyzed in the paper strongly suggest that orthoses are clinically successful podiatric intervention and can be used as a highly effective first-line treatment of many foot diseases. Once the biomechanical deformations of the lower extremity kinetic chain are addressed with orthotic devices and pain levels or discomfort decrease, then different exercises and sport-specific training can be begun.
This will reduce pain and improve dynamic patellar muscular functioning. It is the indication of the investigators of these studies that the success of the orthosis first-line treatment of athletes/patients with foot diseases will be directly proportional to the accuracy of the primary evaluation of the doctor and the quality and consistency of the orthosis made available. The discussed clinical investigations are informative, but additional studies are needed in this area by larger research centers with a greater volume of the patients.
The information presented in the studies calls for a larger research center to perform a prospective study complete with biomechanical video results to make clear the role of orthosis as a first-line treatment for foot diseases. From the researchers’ point of view, the limited number of participants in these studies prevents definitive conclusions. Prosthetic-Orthotic firms have their timetable in improving and marketing orthotic devices, but podiatric clinicians and researchers should have a timetable that is well planned and irrefutable in determining the proper application of those orthotic devices.
For orthotic devices, podiatric clinicians and researchers still have work remaining on their agenda.
References
Case-Smith, Jane. (2001). Occupational Therapy for Children. Mosby: St. Louis, MO. Mccabe, Paul T. (2002). Contemporary Ergonomics 2002. Taylor & Francis: London. Meadows, Michelle. (2006). “Taking Care of Your Feet. ” FDA Consumer. Vol. 40 (2). Michaud, Thomas (1993). Foot Orthoses and Other Forms of Conservative Foot Care.