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OK, need to keep this simple, as I know the answers will not be, so best not to drag it out!
Laser foot scanning for orthoses manufacture vs casting:
Which is best and why?!
My view, basically, depends on the scanner, depends on the lab it's attached to or is capable of making orthoses from laser images, but not sure whether scanning is better than casting from a precision point of view?
Loads of threads on here about this already and well worth reading through them. The general consensus is that laser scanning is more repeatable, but as we don't know what the 'ideal' position is that could mean it gets it wrong consistently (or right consistently of course).
Nic also to throw a 3rd into the discussion. There is cast scanning. ie taking the cast in what ever position you want then scan to manufactor the device. Might be the best of both worlds. I was hoping to discuss this with couple of people in England today but some Volcano in Iceland got in the way.
I did a search on here for laser scanning, but nothing came up that related to it, so, I apologise - we'll start to look through the posts suggested!
However, I am already using a lab that scans the casts we send to them and we're really happy with our orthoses, but, locally, there are clinics starting to use scanners (although they are through TOG apparently, so we're not too worried about that), and sometimes you just start to wonder whether you are falling behind technologically?
I did a search on here for laser scanning, but nothing came up that related to it, so, I apologise - we'll start to look through the posts suggested!
However, I am already using a lab that scans the casts we send to them and we're really happy with our orthoses, but, locally, there are clinics starting to use scanners (although they are through TOG apparently, so we're not too worried about that), and sometimes you just start to wonder whether you are falling behind technologically?
I'll look at the posts anyway!
Thanks!
Nic,
As I'm sure you know TOG is a bit different (2D information - not 3D scanning like the Sharpe Shape scanner for example). In my experience people using the TOG system are usually less knowledgeable/confident in what they are doing. Certainly no threat to you in theory - but those pesky patients do love pretty pictures unfortunately!
Yes, that's what I thought, but when you look at the guys website, he says he has a 3D as well as a 2D scanner, so can TOG do orthoses from both types of scan?
Which leads to the more important question of scanning really, which labs support scanned information being sent to them instead of casts and are there any limitations to the orthoses they produce from the scanned images? If not, then why isn't everyone doing it, because the whole issue with capturing the right position of the foot is the same for scanning as it is for casting, surely?
For instance, Ian, do you use a scanner? If not, why not and what about the technology would have to change to convince you to use it?
Yes, that's what I thought, but when you look at the guys website, he says he has a 3D as well as a 2D scanner, so can TOG do orthoses from both types of scan? Or he may have a TOG system AND a seperate 3D sytem? (seems unlikely though).
Which leads to the more important question of scanning really, which labs support scanned information being sent to them instead of casts and are there any limitations to the orthoses they produce from the scanned images? If not, then why isn't everyone doing it, because the whole issue with capturing the right position of the foot is the same for scanning as it is for casting, surely?
For instance, Ian, do you use a scanner? If not, why not and what about the technology would have to change to convince you to use it?
Nic
Nic,
As far as I am aware TOG do not do a 3D scanner. A more likely scenario is that the person's website is misleading (and not necessarily intentionally on his part).
You may want to read the threads on here on negative model production because that is what we are really talking about here. Some methods are quicker - some are cheaper - some have more of a wow factor but they all essentially do the same thing and we do not necessarily know which is 'superior' with respect to negative model capture or orthoses produced.
I do not use a scanner no. I did use a 3D one for a time, and found it to be a lot quicker (is this always a good thing if you charge for your time?) and certainly noticed the patients seemed more impressed by it. It was also lovely to be able to just email the data to the lab immediately and not have to faff with posting off POP casts etc. What I didn't like was that it tied me to one lab (I use 3 different ones now) and that if they 'give' you the scanner for free there are usually targets which need to be met and that is not how I roll. I also didnt feel I could manipulate the foot position as easy as I can with POP (e.g plantarflex the 1st Ray etc)
Just my thoughts you understand - I'm sure someone else may think differently. Rob Issacs did a decent comparison of the negative capture methods in a recent Pod Now (assuming you are in the UK?)
Rob Issacs did a decent comparison of the negative capture methods in a recent Pod Now (assuming you are in the UK?)
Quote:
I somehow seem to have missed the article in Pod Now, but will back track and have a look at it!
Ah, I think that that is a FUTURE Pod Now. Remember you get the pre release version because you are special .
If memory serves it will be the NEXT issue with the casting techniques (May, should be out in the next week or so I think.) June is a commentry on Barefoot running written mostly by our own Ian Griffiths (no photos, he's sold the rights to OK magazine) and july will be on the arguments for and against taking measurements as part of biomechanical assessments.
The article is a bit longer than my usual, but can be summarised as followed.
"Whatever works"
Seriously, so far as being left behind in concerned, don't be. A machine which goes ping may be impressive to the GU but all it can do is capture a shape. If you can capture the same shape in plaster, foam, wet sand, hot wax, Amfit, by direct moulding or however then it won't make a better orthotic.
There is no magic to this. The object of all casting methods is to capture the shape we want. The method which does this consistently and conveniently for you is the best method... for you.
To use an analogy, I drive a family saloon car. My friend drives a 2 seater sports car. Both get us from A to B in a similar amount of time. He can't get 2 kiddie seats, 2 kiddies, 1 buggy, 1 changing bag, 234 soft toys, 1 dom case, 10 casting boxes, 1 Lock box, and a box of wheat crunchies in his, I can't get away from the lights as fast in mine. Which is better? It depends HOW you wish to get from A to B.
In My Option the machine that goes ping and when the systems are there to capture a 3D foot shape at a price that people can afford will be the norm.
Although the 1st step maybe to capture the foot shape. The use of computer added and CAD systems will make for a faster turn around, more specific device and give greater control to the Person who prescribes the device ( the next question is if this is a good thing or not for another thread perhaps).
With this systems there will be less waste, faster turn around, less middle-person handelling. The problem is that it requires more from the prescriber which maybe an issue maybe not.
I´m still looking but the technology is at what I can work not quite there and the cost is quite high. I´m hoping time will increase one and decrease the other.
The use of computer added and CAD systems will make for a faster turn around, more specific device and give greater control to the Person who prescribes the device ( the next question is if this is a good thing or not for another thread perhaps).
With this systems there will be less waste, faster turn around, less middle-person handelling. The problem is that it requires more from the prescriber which maybe an issue maybe not.
Don't be so sure. There is an awful lot of waste when an orthosis is milled from a block of material.
The use of computer added and CAD systems will make for a faster turn around, more specific device and give greater control to the Person who prescribes the device ( the next question is if this is a good thing or not for another thread perhaps).
Oooooooo. Is greater clinician control a good thing? Now THERE is a question with far reaching consequences!! Are outcomes improved or damaged by the "homogenising" which goes on at the lab?
Oooooooo. Is greater clinician control a good thing? Now THERE is a question with far reaching consequences!! Are outcomes improved or damaged by the "homogenising" which goes on at the lab?
BIG thread.
Too right. Firstly, can anyone point to a study of clinical outcomes in which custom devices performed better in reducing pathological symptoms than prefabricated devices... Josh Burns?
Oooooooo. Is greater clinician control a good thing? Now THERE is a question with far reaching consequences!! Are outcomes improved or damaged by the "homogenising" which goes on at the lab?
BIG thread.
Quote:
Originally Posted by Simon Spooner
Too right. Firstly, can anyone point to a study of clinical outcomes in which custom devices performed better in reducing pathological symptoms than prefabricated devices... Josh Burns?
New thread for the question "is greater clianican control in orthotic manufactor a good thing ? over Here
There is a new laser scanner on the block, which will scan feet, weight bearing, semi weight bearing and weight off. It will also scan deep foam boxes and casts. The good thing about this one is the fact it goes part way around the foot. therefore not just the widest point.
Firstly I am aligned with a lab that does Scanning
In the end like casting it depends on the quality of the cast and the scan.
If the scanner is an bed scanner the podiatrist need to ensure the heel is not touching the glass as the heel on the finished job will tend to flat and this will translate to a flat heel on the orthosis,
My experience is the non weight bearing scanners give the best scans.
There is a criteria to do this and only Experienced sellers of the product will be able to put the Podiatrist on the right track.
We scan casts however we grind and the cast to give a result and a good heel scan. Most Scanner are with accurate to .625mm.
Some of the cad cam software to design the Orthosis is based on 2D scanners and the results are of poor quality. If you are thinking of using scanning technology thoroughly investigate the results you hope to achieve.
Hope that was not too long.Rosso
Quote:
Originally Posted by nicpod1
OK, need to keep this simple, as I know the answers will not be, so best not to drag it out!
Laser foot scanning for orthoses manufacture vs casting:
Which is best and why?!
My view, basically, depends on the scanner, depends on the lab it's attached to or is capable of making orthoses from laser images, but not sure whether scanning is better than casting from a precision point of view?
OK, need to keep this simple, as I know the answers will not be, so best not to drag it out!
Laser foot scanning for orthoses manufacture vs casting:
Which is best and why?!
My view, basically, depends on the scanner, depends on the lab it's attached to or is capable of making orthoses from laser images, but not sure whether scanning is better than casting from a precision point of view?
Opinions would be gratefully received!
Let's break this into specific segments, specifically, data acquisition, design, and manufacture.
Capturing a data from plaster is more repeatable, only because it captures a moment of time from the foot. It doesn't make it right, but it is an object that can provide repeatable results. Capturing data from the foot directly, sounds nice, but it also depends on the characteristics of the casting method. Perhaps the most subjective portion of the scan is the forefoot, except in pathologically rigid cases. A non-weight bearing scan is probably as close as one can get to replacing plaster, but slightly less repeatable than plaster. Applying any amount of force particularly to the forefoot generally leaves it to the orthotic designer to interpret forefoot expansion as comparable between plaster (non-weight bearing) and biofoam casting (semi-weight bearing), whereas the rearfoot is typically less of an issue.
The laboratories that read scans in my network learn to interpret the level of expansion based on the red areas of the scan, which imply contact with the window, and react accordingly. Whatever method of casting the practitioner uses, consistency is helpful.
As for design and manufacturing capabilities, at least one competitor started without any form of data acquisition and laboratories sold devices from that system as a prescription device. Another competitor obviously used the data in a limited fashion, as evidenced by a consistent longitudinal arch peak position. Any cadcam system for orthotic manufacturing should have a flexibility to support any level of fill, or no fill what-so-ever, and should be able to mimic or closely approximate the original surface.
You'll have to pardon my ignorance about scanning - whatever type
- and jumping in now.
I've had a look every so often and have not been able to work out how you can read a reference - for example a rearfooit reference into a scan.
I have seen feet that have large rigid forefoot eversion alignment balanced from a scan as if the problem was the opposite and had a large rearfoot inversion correction built in. It looks as though the balance on the scan was read off the distorted heel fat pad. I also see this done with casted devices so that is a prescriber error. Nevertheless, the shape floating in space doesn't have the references I want.
Yes, that's what I thought, but when you look at the guys website, he says he has a 3D as well as a 2D scanner, so can TOG do orthoses from both types of scan?
Which web site would that be then ???
Quote:
Yes, that's what I thought, but when you look at the guys website, he says he has a 3D as well as a 2D scanner, so can TOG do orthoses from both types of scan? Or he may have a TOG system AND a seperate 3D sytem? (seems unlikely though).
Ian
Quote:
As far as I am aware TOG do not do a 3D scanner. A more likely scenario is that the person's website is misleading (and not necessarily intentionally on his part).
Shame on you
If it is my web site that is being referred to here it most definatly is NOT misleading in any way, as I do have and use BOTH types of scanner the Sharpe Shape is linked to the lab I get the majority of my orthoses from and the Pressure mat is now used mainly to assist me in gait analysis and yes to give the patient the pretty pictures it produces and to educate and help the patient understand what the problems are.
Why ? Just add's more strings to my bow and choice in application.
TOG will scan casts if you send the cast in to them I believe.
Whether that makes you lacking in technology Nicpod I don't know but it's never a good idea to generalise on systems: or practitioners
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
I was not aware of who nicpod was talking about nor had I seen the website she was referring to - was just going on what information she gave. She referred to a 3D tog system which is what I based my answer on (I even referred to the sharpe shape being 3D in one of my posts).
I get the feeling I may have stumbled into a more 'personal' debate by accident - I was trying to be objective about the differences between methods. No offense meant to anyone - but no apologies either as I stand by the comments I made based on the info I had at the time
I do have and use BOTH types of scanner the Sharpe Shape is linked to the lab I get the majority of my orthoses from and the Pressure mat is now used mainly to assist me in gait analysis and yes to give the patient the pretty pictures it produces and to educate and help the patient understand what the problems are.
Why ? Just add's more strings to my bow and choice in application.
TOG will scan casts if you send the cast in to them I believe.
Whether that makes you lacking in technology Nicpod I don't know but it's never a good idea to generalise on systems: or practitioners
Mutter mutter sulk sulk, you with all your scanners and toys and machines-which-go-ping, mutter mutter.
And you MAY have a better microscope for dermatology than me but I had one FIRST. So ner. And I have a notched stick! Where's your notched stick eh Harland?
Bloody old experienced Pods with their fancy city ways.
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
I was simply making the point it is not necessarily "misleading"or "unlikely"
AND
Whats more you have just earned a 2 shot cut on your stated handicap !!!
Cheers Fella
D
Fair point - perhaps I dived in a bit quick there. But let's be clear - defaming someone elses website is not how I roll. I'll be more careful next time.
I was recently informed that the highest handicap available is 28 (is that right?). If so feel free to penalise me 2 shots. I'm playing off 27
Fair point - perhaps I dived in a bit quick there. But let's be clear - defaming someone elses website is not how I roll. I'll be more careful next time.
Lighten up fella it may not have been my website anyway no worries, I think we are all aware of your intentions and roll
Quote:
I was recently informed that the highest handicap available is 28 (is that right?). If so feel free to penalise me 2 shots. I'm playing off 27
Ahh yes that was before winter rules were lifted, maximum in the summer is 14 which makes you off 10 SO you give me 4 shots
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
Laser scanning vs casting: Yes or No!
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