3D printing and orthotics: scientific advancements

August 30, 2023
3 min

In 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.

Image from Rao, 2019

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).

At TechMed 3D, we are specialized in 3D human body scanning, but we are always up to date in the fields related to it. Thus, feel free to contact us if you need any help in your different projects involving 3D human body scanning.

References

Kelly S., Paterson A. & Bibb R.J. (2015) A review of wrist splint designs for additive manufacture. In: Proceedings of 2015 14th Rapid Design, Prototyping and Manufacture Conference (RDPM 14). Loughborough, Great Britain.

Li J. & Tanaka H. (2018) Rapid customization system for 3d-printed splint using programmable modeling technique – a practical approach. 3D Printing in Medicine. 4(1):5.

Zhang R., et al. (2017a) Functionality-aware retargeting of mechanisms to 3d shapes. ACM Transactions on Graphics. 36:1–13.

Jin Y., et al. (2015) Additive manufacturing of custom orthoses and prostheses – A review. Procedia CIRP. 36:199-204.

Salles A.S. & Gyi D.E. (2013) An evaluation of personalized insoles developed using additive manufacturing. Journal of Sports Sciences. 31(4):442-450.

Creylman V., et al. (2013) Gait assessment during the initial fitting of customized selective laser sintering ankle foot orthoses in subjects with drop foot. Prosthetics Orthotics International. 37(2):132-8.

Dombroski C.E., Balsdon M.E., Froats A. (2014) The use of a low-cost 3D scanning and printing tool in the manufacture of custom-made foot orthoses: a preliminary study. BMC Research Notes. 7:443.

Mo S., et al. (2019) The biomechanical difference between running with traditional and 3D printed orthoses. Journal of Sports Sciences. 37(19):2191-2197

Xu R., et al. (2019) Effect of 3D printing individualized ankle-foot orthosis on plantar biomechanics. Medical Science Monitor, 25: 1392-1400.

Zhang, X., et al. (2017b). Thermal-comfort design of personalized casts. In: Proceedings of the 30th Annual ACM Symposium on User Interface Software and Technology. ACM, New York, NY, USA. 243–254.

Squyer E., et al. (2013) Unloader knee braces for osteoarthritis: do patients actually wear them? Clinical Orthopaedics and Related Research. 471(6):1982-91.

Yu S.P., et al. (2016) Effectiveness of knee bracing in osteoarthritis: pragmatic trial in a multidisciplinary clinic. International Journal of Rheumatic Diseases. 19:279–286.

Vasiliauskaite E., et al. (2019) A study on the efficacy of AFO stiffness prescriptions. Disability and Rehabilitation: Assistive Technology.

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Rao C., et al. (2019) Consistently fitting orthopedic casts. Computer Aided Geometric Design. 71:130-141.

Ganesan S. & Ranganathan R. (2018) Design and development of customised split insole using additive manufacturing technique. International Journal of Rapid Manufacturing (IJRAPIDM). 7(4)

Paterson A. (2013) Digitisation of the splinting process: exploration and evaluation of a computer aided design approach to support additive manufacture [Thesis]. Leicestershire: Loughboroufh University.

Savov I., et al. (2019) Research and Development of Methods and Tools for Rapid Digital Simulation and Design of Personalized Orthoses. In: Zahariev E., Cuadrado J. (eds) IUTAM Symposium on Intelligent Multibody Systems – Dynamics, Control, Simulation. IUTAM Bookseries. Vol 33. Springer, Cham

Telfer S., et al. (2014) Personalized foot orthoses with embedded temperature sensing: Proof of concept and relationship with activity. Medical Engineering & Physics. 36(1):9-15.

Hook J., et al. (2014) Making 3D Printed Objects Interactive Using Wireless Accelerometers. In: CHI ’14 extended abstracts on human factors in computing systems, ACM. pp 1435-1440.

Antonelli M.G., et al. (2019) Additive Manufacturing Applications on Flexible Actuators for Active Orthoses and Medical Devices. Journal of Healthcare Engineering. 2019: 5659801.

Adiputra, D., et al. (2019) A Review on the Control of the Mechanical Properties of Ankle Foot Orthosis for Gait Assistance. Actuators. 8(1), 10.

Laubscher C.A., Farris R.J. & Sawicki J.T. (2017) Design and preliminary evaluation of a powered pediatric lower limb orthosis. Proceedings of the ASME 2017 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. Cleveland, Ohio, USA




Image1 from: Barrios-Muriel J., Romero-Sánchez F.; Alonso-Sánchez F.J., Rodríguez Salgado D. (2020) Advances in Orthotic and Prosthetic Manufacturing: A Technology Review. Materials. 13(2):295

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