Orthotists currently use a range of weight bearing conditions when casting or scanning a patient's limb during the Ankle foot orthosis (AFO) fitting process. This variability in clinical practice is the result of differing opinions regarding the best method for fitting, and a limited understanding of how weight bearing affects the resulting geometry. Few studies have been performed to determine the effect of weight bearing on resulting geometry, or the consistency of the geometry obtained. In this study we seek to evaluate the effect of foot loading on lower limb geometry and the consistency of measurements using low-cost 3D scanning technology, with implications for fitting AFOs.
Two groups of subjects will be recruited for this study. The first group (Group 1) will consist of healthy, able-bodied individuals with no history of lower extremity trauma. The second group (Group 2) will consist of individuals with unilateral, below-knee functional deficits that require an AFO for daily activities (e.g. fracture, muscle and/or nerve injury, ankle arthritis, or peripheral neurologic disease). We will obtain a brief medical history to identify major medical conditions or prior injuries that could influence limb geometry and lead to reliance on an AFO for Group 2 participants. A 3D representation of each participant's lower limb geometry will be obtained using a Structure Core scanner (Occipital, Inc.), which uses an infrared structured light projector to construct a 3D image of an object. The scanner is connected to an iPad; to operate the scanner, the user rotates the iPad camera around the desired object. In seconds, the entire geometry is digitally reconstructed. Measurements will be evaluated using digital imaging analysis software (Standard Cyborg, Inc.). The different conditions being tested are full weight bearing, partial weight bearing, and non-weight bearing. The effect of limb loading on multiple measures of limb geometry will be evaluated. Limb measurements will include 1) width of the metatarsal heads, 2) width of the calcaneus, 3) foot length, 4) foot height, 5) arch height, 6) medial-lateral width between ankle malleoli, 7) minimum circumference above the ankle malleoli, 8) maximum calf circumference , 9) medial-lateral width of the knee condyles 10) anterior-posterior width at mid patellar tendon, 11) distance from bottom of foot to tibial tubercle.
Study Type
OBSERVATIONAL
A 3D representation of each participant's lower limb geometry will be obtained using a Structure Sensor scanner (Occipital, Inc.) which uses an infrared structured light projector to construct a 3D image of an object. The scanner is connected to an iPad; to operate the user rotates the iPad camera around the desired object. In seconds, the entire geometry is digitally reconstructed.
University of Iowa
Iowa City, Iowa, United States
Width of the metatarsal heads
Distance from the medial aspect of the first metatarsal head to the lateral aspect of the fifth metatarsal head.
Time frame: Less than 2 days
Width of the calcaneus
Distance from the medial aspect of calcaneus parallel to lateral aspect of calcaneus.
Time frame: Less than 2 days
Foot length
Distance from the most posterior aspect of calcaneus to the most anterior toe (1st or 2nd).
Time frame: Less than 2 days
Foot height
Distance from the most superior point on the foot distal to the tibialis anterior insertion.
Time frame: Less than 2 days
Arch height
Dorsum height at 50% foot length.
Time frame: Less than 2 days
Medial-lateral ankle malleoli width
Distance from the lateral malleolus to the medial malleolus.
Time frame: Less than 2 days
Minimum ankle circumference
Minimum ankle circumference above the ankle malleoli. Must be less than 10 cm proximal to the ankle malleoli.
Time frame: Less than 2 days
Maximum calf circumference
Maximum calf circumference greater that 5 cm distal to the knee condyles.
Time frame: Less than 2 days
Width of the knee condyles
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Distance from the medial condyle to the lateral condyle.
Time frame: Less than 2 days
Anterior-posterior width at patella
Distance from mid patellar tendon to a parallel point most posterior on the back of the knee.
Time frame: Less than 2 days
Tibial tubercle height
Distance from the floor to tibial tubercle.
Time frame: Less than 2 days