Biomechanical Assessment and Orthotic Prescription
Orthotic and Prescription Insole
History and Examination
Firstly, extract relevant history from the patient regarding their current presenting complaints. The following would be taken into consideration:
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occupation
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lifestyle
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sporting and recreation activities
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regular footwear
Medical Background
Surgeries, fractures, strains and sprains
Footwear Assessment
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Observation of their current shoes observing heel counter, midsole, upper, sole)
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suitability for purpose
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suitable for accommodation of orthoses
Full Postural Assessment
Assess standing position of the entire body for alignment and symmetry, flexibility and strength combined with functional movements. Then, more specifically look at the feet. Are the feet standing in a good position or do they look to be standing in one of the following:
Pronated foot
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arches rolled in
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internal tibial and femoral rotation
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genu valgum
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anterior pelvic tilt
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increased lordosis
![Image](/images/2020/11/12/grapic-image-1.png)
Supinated Foot
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arches rolled out
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genu varum
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posterior pelvic tilt
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external tibial and femoral rotation
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flat back
![Image](/images/2020/11/12/grapic-image-2.png)
Foot Posture
Observations and palpation skills are key to assess whether the feet are positioned in a good functional position or if they are pronated/supinated. Palpating the rearfoot ankle bone (talus) and determine if they are positioned more towards the inside (medial) or outside (lateral). If neither is present, the patient is standing in their neutral position.
Supinated Position (Pes Cavus)
arches rolled out
arches
heels turned in (inverted)
sometimes clawed toes
Neutral Position
Arches not raised or flattened
The heels are normally slightly turned in (inverted)
Pronated Position (Pes Planus)
arches rolled in
arches flattened
heels turned outwards (everted) or straight
Hallux Valgus is likely present (Big toe pushes towards 2nd toe)
![Image](/images/2020/11/12/grapic-image-3.jpg)
Gait Analysis
![Image](/images/2020/11/12/grapic-image-4.jpg)
Assessment
![Image](/images/2020/11/12/grapic-image-5.jpg)
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