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Orthopaedic Modular System for a systematic diagnosis and treatment of foot and related musculoskeletal deformities

An EU-funded team has developed a smart system for diagnosis and correction of foot and posture problems using powerful algorithms to recommend fully customised insoles and orthotics.

Some 200 million people within the European Union suffer from pain due to foot problems that can extend to the hips and spine. The number will rise sharply with aging populations and decreased physical activity. Now the EU-funded OrmoSys team has developed a smart system for diagnosis, design and manufacturing of fully customised insoles and corrective footwear for such problems.

“It is an extra diagnostic tool for doctors, nurses, physiotherapists and others to use for treatment and therapy planning and they also use it for obtaining a description for orthopaedic supplies,” says OrmoSys project coordinator Mr Fatmir Langmeier, a mastercraftsman in orthotics with years of experience in his own company in Bavaria, Germany.

“Most insoles are poorly designed because they use only static measurements. But orthotics are needed for moving, walking and running,” he says, stressing that OrmoSys takes into account whole-body dynamic movements.

“We used the accumulated data from over 20 000 patients over the past 15 years of diagnosing and treating people with foot problems – we have very good documentation within the company – and used this data to create the algorithms,” he says.

“The OrmoSys algorithms calculate over 40 000 insole variations derived from a single patient,” Langmeier explains. Based on these algorithms the system produces a diagnostic report, including information for modular lasts and varieties of cushioning for the manufacture of personalised orthotics, and recommends corrective exercises.

It even recommends insoles for particular sports. “Each and every sport has its own design,” he says.

Whole body system

With EU funding, the system was expanded from analysing feet and foot movements to the correction of musculoskeletal problems involving the knees, hips and spine, up to the neck. Measurements from electronic foot pressure pads using hundreds of sensors, from 3D biomechanical imaging of the limbs and from a special sensor worn as a belt to determine hip movements and rotation together detect gait problems and divergence between the left and right side of the body that require correction.

With the additional data, the Ormosys algorithms were expanded by around 65 %, for better-designed orthotics and insoles. “We found that if we included data on the upper body, such as hip-alignment data, we could improve the algorithms to get a much better orthotic for hip and back pain,” Langmeier says. These can be used for stroke patients with hemiplegia or paralysis of one side of the body and for patients with spastic problems.

The system was also expanded to children’s orthotics and to diabetics patients needing soft foot bedding to protect the feet from developing pressure sores or ulcerations that lead to infections.

Improved customised manufacturing

OrmoSys insoles are manufactured using a modular foot last system on which the customised insole is moulded. The process was streamlined to reduce the unit cost of personalised insoles, including developing parts of the diabetic footpad that can be 3D-printed and reducing the cooling time of the materials moulded on lasts.

The combined analysis and manufacturing system is being marketed worldwide. In the Czech Republic it is used for the Olympic team’s orthotics, in the US for the biathlon team and golf professionals. It can even be used for corrective flip flops.

The combined system, which has benefited some 20 000 patients so far, includes training under ‘OrmoSys Academy 4.0’ to enable less skilled operators to use the system.

Reference source: Orthopaedic Modular System for a systematic diagnosis and treatment of foot and related musculoskeletal deformities

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