3 minIn the first post of this series, we detailed what is 3D printing. In this new article, we will have a look at the scientific advancements and proofs of the use and benefits of 3D printing in orthotics field.
It has been shown that 3D printing techniques can be efficiently used to produce personalized casts or orthotics for various purposes, e.g., orthopedic cast design (Kelly et al., 2015), functionality-aware mechanism retargeting (Zhang et al., 2017a) as well as rapid prototyping (Li and Tanaka, 2018).
Research focus in this area has particularly been on foot and ankle-foot orthoses because of their large quantity of prescriptions and/or revenue and their needs for patient-specific design (Jin et al., 2015). Several studies have shown that FO and AFO are at least as effectiveness as traditional customized orthotics concerning pain and gait and running modifications (Salles and Gyi, 2013; Creylman et al., 2013; Dombroski et al., 2014; Mo et al., 2019). Even if the 3D printed devices are “just” as effective as the traditional one, the scientific studies revealed that the comfort and the aesthetics of these 3D printed devices are better (Salles et Gyi., 2013; Zhang et al., 2017b; Xu et al., 2019; Mo et al., 2019). This is an essential point when it is known that it is two major reasons for the non-compliance to assistive devices (Squyer et al., 2013; Yu et al., 2016).
These benefits are seen on the traditional way to assess assistive devices; however, 3D printing offers new opportunities (e.g. new materials with better energy storage and return properties), which are not possible or very difficult to implement with traditional fabrication (Vasiliauskaite et al., 2019). Thus, 3D printing allows to approach fabrication by taking sustainability, ventilation, comfort sensitivity, and weight as their objectives, by employing lattice patterns or Voronoi tessellations (Lin et al., 2016; Li and Tanaka, 2018; Zhang et al., 2017b). However, 3D printing gives even more flexibility because one recent study has looked at taking shape deformation while another one to have split insoles (Rao et al., 2019; Ganesan and Ranganathan, 2018). In the first one, the researchers propose a framework for generating 3D printed personal casts that consistently fit and adapt to the shape deformation caused by swelling and allow to use a single cast made from a flexible layer design throughout the whole healing process. In the second study, the researchers identified the anthropometry and biomechanical parameter to split up the foot area in zones to assign different material properties when the 3D printed insole is printed.
While these high-level customizations imply a complex design, the processed to make these designs taking all these constraints into account can be completely automatized (Paterson, 2013; Ganesan and Ranganathan, 2018; Rao et al., 2019; Savov et al., 2019).
Finally, 3D printing can also improve the use of orthotics in rehabilitation by facilitating the monitoring or the implementation of an active part in the orthosis by making the orthosis lightweight (Telfer et al., 2014; Hook et al., 2014; Antonelli et al., 2019). Thus, some scientific studies have already embedded temperature sensors to give feedback to the clinicians about patients’ behavior or inertial measurement unit (IMU) giving feedback to the clinicians and the patients about the movement, which can help the rehabilitation. Active orthosis could be useful in some cases like foot drop. These active orthosis needs actuators or other engineering process to make it active, so orthosis must fit with this part and should be lightweight also and 3D printing is the perfect tool to achieve these goals (Adiputra et al., 2019; Laubscher, 2017; Antonelli et al., 2019).
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