The SHIFT Project 15 - Foot Orthotic Prescriptions: From Geometry to Force
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The SHIFT Project 15 - Foot Orthotic Prescriptions: From Geometry to Force
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This podcast discusses a shift in foot orthotic therapy from kinematic devices based on geometry, to a device based solely on GRF modulation. The presenters argue that traditional focus on joint alignment and motion control fails to address the true cause of pathology, which is excessive tissue stress due to improper load distribution and management. Instead of using geometric features like arch supports to control motion, the proposed kinetic insole -- based on the concepts of contact mechanics -- utilizes regional stiffness mapping to directly alter ground reaction forces and joint moments. By manipulating material compliance rather than trying to change foot position, clinicians can more precisely and simply modulate how the foot accepts load during gait. This framework emphasizes testable mechanical goals and in-shoe pressure measurements, if available, to ensure orthotic interventions effectively reduce load on symptomatic tissues.