The Analysis and Applications of Dynamic Impression Insole
Condition: Metatarsalgia
MeSH terms: Metatarsalgia
Study type: Interventional
Phase: Early Phase 1

Summary: 
      The aim of the study was to investigate the effectiveness of dynamic impression insoles on
      plantar pressure and pain reduction. A dynamic impression insole was made by sequential
      padding with Plastazote and P-cell under daily walking compression. The pain levels and
      plantar pressure with the use of dynamic impression insole were assessed and compared with
      7-mm Ethylene Vinyl Acetate (EVA) control, 9-mm uncompressed Plastazote and custom molded
      insoles. Plantar pressure was measured by a Pedar-X mobile system, and pain level was
      assessed using a Visual Analog Scales.
    

Detailed description: 
      Toe deformities may cause prominence of the metatarsal heads (MTH) and distal displacement of
      fat-pad cushion beneath the MTH, resulting in the metatarsal pain. Foot pain frequently leads
      to limitation of activities of daily life and deterioration of life quality. Foot orthoses
      have been commonly used in clinical practice to reduce plantar pressure and subsequent pain.
      However, the therapeutic efficacies of custom molded insoles with a metatarsal support vary
      widely with their designs and materials. We designed a simple and effective method that a
      dynamic impression insole was made by sequential padding of foams with different
      compressibility under successive dynamic impression in daily walking. A piece of metatarsal
      pad and arch support made of EVA was attached to the bottom of impressed insole just proximal
      to the first, second, and third MTH according to the foot impression. Fifty participants with
      metatarsal pain were recruited from the podiatry outpatient clinic of Taipei Veteran General
      Hospital. The plantar pressure measurements were carried out under a comfortable and stable
      walking speed preferred by the participants one month after the dynamic impression and custom
      molded insoles were well fabricated. All pressure data were processed with the Novel-Win
      Multimask analysis software. The purposes of this study were to investigate the biomechanics
      of dynamic impression insole in plantar pressure and pain reduction.
    

Intervention name(s): Dynamic impression insole; Custom molded insole; 9-mm uncompressed Plastazote; 7-mm Ethylene Vinyl Acetate (EVA)
Intervention type(s): Procedure; Procedure; Procedure; Procedure
Intervention description(s): We sequentially padded (1)a 6.5-mm thick P-cell (21 Shore A hardness, Acor orthopedic Inc. Cleveland, Ohio, USA), and (2)a piece of metatarsal pad and arch support made of Ethylene Vinyl Acetate (EVA) (40 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany) to the bottom of the impressed 9-mm thick plastazote (15 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany) with double-sided adhesive tape in the forefoot region and just proximal to the first, second, and third metatarsal head region. We additionally padded a 2-mm thick Multiform (30 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany) on the top of the impressed insole with double-sided adhesive tape.; The custom molded insole was made by sequentially padded Multiform (30 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany), P-cell (21 Shore A hardness, Acor orthopedic Inc. Cleveland, Ohio, USA), Ethylene Vinyl Acetate (EVA)(40 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany), and cork (50 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany) on the positive plaster cast impressed by an impression box while holding the subtalar joint at a neutral position.; We used 9-mm flat Plastazote(15 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany) as an insole; We used 7-mm flat Ethylene Vinyl Acetate (EVA) (40 Shore A hardness, Schein orthopadie service KG. Remscheid, Germany) as an insole
Intervention MeSH terms: Ethylene
Allocation: Non-Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: plantar pressure; metatarsalgia; insole