Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland).
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
Med Sci Monit. 2019 Feb 21;25:1392-1400. doi: 10.12659/MSM.915045.
BACKGROUND Traditional ankle-foot orthoses (AFOs) are not effective in treating plantar fasciitis, while customized 3-dimensional (3D) printed ankle-foot orthoses are effective in treating many ankle-foot diseases. This study investigated the effects of customized 3D printed AFOs on biomechanics and comfort of the plantar foot in plantar fasciitis. MATERIAL AND METHODS Sixty patients with bilateral plantar fasciitis aged 31-60 years participated in this study. At week 0, patients were randomly assigned into 2 groups: the control group consisting of those wearing separate shoes with prefabricated AFOs; and the experimental group consisting of those wearing a separate shoe and customized 3D-printed AFO. The Footscan® system recorded maximum pressure, maximum strength, and contact area of patients' hallux, toes 2-5, first to fifth metatarsal, midfoot, lateral heel, and midfoot heel at weeks 0 and 8. Patients used visual analogue scale scores at weeks 0 and 8 to assess overall comfort of foot orthosis, to determine the credibility and comfort of both orthopedic insole conditions. RESULTS At week 0, in the experimental group, peak pressure in the hallux and first metatarsal area was significantly higher than the control group (P<0.05), while mid-heel and lateral heel peak pressures were significantly lower than the control group (P<0.05). After 8 weeks, all groups reported more comfort compared with the same group in week 0 (P<0.05). The comfort scores reported by the experimental group were significantly lower than those of the control group (P<0.05). CONCLUSIONS This study supports the efficiency of customized 3D printing AFO for reducing damage associated with plantar lesions and improving comfort in patients with plantar fasciitis compared with prefabricated AFO. Customized AFO is useful in the treatment of plantar fasciitis compared with prefabricated AFOs.
传统的踝足矫形器（AFO）在治疗足底筋膜炎方面效果不佳，而定制的三维（3D）打印踝足矫形器在治疗许多踝足疾病方面效果显著。本研究旨在探讨定制 3D 打印 AFO 对足底筋膜炎患者足底部生物力学和舒适度的影响。
本研究纳入了 60 名年龄在 31-60 岁之间的双侧足底筋膜炎患者。在第 0 周时，患者被随机分为两组：对照组患者穿着带有预制 AFO 的单独鞋子；实验组患者穿着单独的鞋子和定制的 3D 打印 AFO。Footscan®系统记录了患者第 1 跖骨、脚趾 2-5、第 1-5 跖骨、中足、外足跟和中足跟的最大压力、最大强度和接触面积，分别在第 0 周和第 8 周进行。患者在第 0 周和第 8 周使用视觉模拟评分法（VAS）评估足矫形器的整体舒适度，以确定两种矫形鞋垫的可信度和舒适度。
在第 0 周时，实验组患者的第 1 跖骨和第 1 跖骨区域的峰值压力明显高于对照组（P<0.05），而中足跟和外足跟的峰值压力明显低于对照组（P<0.05）。8 周后，与同组第 0 周相比，所有组的舒适度均有所提高（P<0.05）。实验组的舒适度评分明显低于对照组（P<0.05）。
与预制 AFO 相比，定制 3D 打印 AFO 可减少与足底病变相关的损伤，并提高足底筋膜炎患者的舒适度，本研究支持其有效性。与预制 AFO 相比，定制 AFO 可有效治疗足底筋膜炎。
