This section aims to promote digital skills in 2 main areas:
– Improving the communication between foot health practitioner and patients
– Improving the adoption of digital tools that enhance foot therapeutic insole practice.
Improving communication between foot health practitioner and patients with the use of digital communication interventions
With the population’s increased use of technologies, patients are increasingly requiring the use of digital health solutions. However, while these digital health solutions has a great potential to improve healthcare cost-effectiveness, their implementation intopractice has proven to be difficult. Thus the literature suggested that some effort should be made to implement these solutions into practice.
The objective of this section is to promote the implementation of digital health solutions in foot health practice. In this perspective we (1) identified two common challenges in foot health practice and (2) illustrate how digital health solutions can realistically address these challenges. This part should be considered as a starting point which will need to be updated over time to incorporate new evidence and technologies.
Improving the adoption of digital tools that enhance foot therapeutic insole practice
This part aims to highlight how the latest technological advances have enabled the latest advances in the FO design and manufacturing process. The use of digital technology is important and relevant to foot healthcare practice where there is an increasing drive to provide flexible digital solutions to healthcare problems. We consider that there is a need for improved skills and training in the development and application of foot orthotic practice requiring the use of digital technologies. However, this work does not pretend to the superiority of one manufacturing process over another, since more than one manufacturing process may be appropriate. Wathever the technology, we believe that the use of foot orthoses can be considered as appropriate when it creates value for the patient.
Orthoses were used during much of recorded history. During the 20th century, the evolution of industrial manufacturing processes has significantly influenced the way FO have been made. In the 1930s, the development of the thermoforming process significantly influenced the innovation in the field of FO. In 1958, Root was one of first to experiment the vacuum forming techniques with thermoplastics and his Root Functional orthoses theory has been followed by other FOs such as the UC-BL, the Blake Inverted Orthosis and the medial heel skive. In the 1980’s, the subtractive manufacturing technique was introduced in the FO field, approximately 30 years after the first commercial numerical-control programming system had been developed. Once more, the development of a manufacturing technique significantly influenced the innovation in the FO field. To date, the most recent manufacturing method which has been implemented in the FO field is the additive manufacturing (AM). It is recognised that the digital manufacturing process provides a lot of opportunities such as a potentially increased accuracy of the product manufactured and the ability to better embrace the concept of dosage response modelling. However, the potential of the digital manufacturing process has not yet been sufficiently explored in the field of orthotics which could be explained by the fact that some barriers to its proper implementation persist.
Numerous techniques have been developed to capture the geometry of an object. These technologies make it possible to scan the geometry of a foot in order to design a FO with an upper surface geometry which corresponds to the plantar surface of the foot. This part illustrates those techniques and synthesizes scientific evidence on this topic.
From a general point of view, the term design is defined as the action of making or drawing plans for something which in this case is a FO model. When designing a FO, the pursued effect of the treatment should be considered simultaneously with the manufacturing constraints (constraints related to the manufacturing process itself, and to the materials usable with this manufacturing process).
With this perspective in mind, it seems logic that the emergence of new manufacturing techniques have allowed the design of products with new properties and also gave birth to new ways of designing a product which have then been applied into the world of orthotics . These innovations have brought promising opportunities in particular to improve the understanding of the effect of FO geometric features on biomechanical variables. This part illustrates these opportunities and also gives a critical appraisal.