72yo male diagnosed with bilateral neuropathic arthropathy with significant resultant foot deformity. Comorbidities of Diabetes Myelitis Type II, peripheral neuropathy, chronic diabetes related foot ulceration, and previous lower limb osteomyelitis. Client has also suffered previous transient ischemic attack and seizures resulting in weakness in Left body and sensory issues impacting balance. Plantar pressure reading: Max kPa of 737 on left foot and 656 on right foot.
Client fitted with bilateral custom-made orthopaedic boots produced on 3D-foot lasts. The footwear feature bilateral integrated rigid hindfoot bracing and polyphasic rockers to stabilise foot and ankle, reduce ground reaction forces, and compensate for limited ankle range of motion. Bilateral medial zippers are fitted on the uppers to allow independent don/doffing of the footwear. Bilateral custom-moulded foot orthoses are fitted in the footwear to accommodate the foot deformity, with the use of targeted poron offloading at peak plantar pressure areas, and a plastazote top cover to reduce shearing forces on the plantar foot.
Client successfully stands and walks in his custom footwear and orthoses with improvements in gait pattern and overall balance. Ground reaction forces have decreased, and plantar pressure forces are reduced to max kPa 136 on left and
164 on right, both under the DFA guideline of <200 kPa.