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The AcuStep DPRO™ Fabrication Process
An Outcomes Based Integrated Approach to Foot Orthotic Fabrication


Step 1- The Measurement


The first step is to acquire measurement data in properly fitted footwear using the AcuStep Direct Pressure Redistribution Orthotic (DPRO™) system. In a matter of minutes, a leading-edge patented pressure sensor along the entire plantar foot records in-shoe foot pressures during normal gait (standing, walking, running). The completed measurement data files are emailed to AcuStep.



Step 2- Shape Generation/Milling


Shape Generation Software- Computer software analyzes the recorded data to identify excessive pressure points. The resulting orthotic shape is a mathematical function of measurement data and a set of numeric parameters, including thickness factors, to control orthotic topography. Initial Shape Generation includes two phases, the Internal Phase and the Operator Phase. Diagnostic features in the shape generation software assist the operator throughout the orthotic fabrication process.

Initial Phase– This phase begins with generation of a Composite Pressure Distribution Pattern and is displayed as an isometric image representing the digital pressure shape of the plantar foot. This results in a precise 3D shape of the plantar foot.


Operator Phase - In this phase AcuStep allows the traditional “extrinsic” properties of orthotic fabrication to be inserted before the orthotic is milled to speed the fitting process. Traditionally this is done after the orthotic is fabricated. The software diagnostic features allows the operator to move a graphic curser through each isometric view to examine detailed conditions and modify parameter values such as heel and forefoot thickness; arch position, length and height; heel cupping; rear and forefoot posting and metatarsal pressure redistribution.

        


Milling- Once Shape Generation is complete, a computer file containing control data for the CNC machine is produced. The base orthotic layer is milled from a one inch thick closed cell foam product with a Shore A durometer of 50 or greater. It has been selected to resist “compression set” and “bottoming out” – key characteristics of good foot orthotic material design.

The base layer is CNC milled on the top side to redistribute peak pressures. The bottom and periphery is milled to conform to the shoe last. This helps to assure that the final base layer shape more precisely redistributes peak vertical and shear pressures and fits within the shoe – “the first time”.

The top layer is selected based on the intended use and manually applied to complete the fabrication process for the full contact orthotic. For the Pressure Pro DM Orthotic, 3/16 inch plastizote Shore A 35 durometer or higher is used. The finished DPRO orthotic may have an undulating top surface. This is not due to wear but rather due to a direct CNC-milled corrective response to the individual’s in-shoe pressures (including peak vertical and shear).



Step 3- Orthotic Fit/Post-Fit Analysis


Over time the shape of the plantar foot changes based on unprotected peak plantar pressures. Visible changes can include calluses, blisters and even foot ulcers. Internal changes can include bony stress injuries and plantar heel maladies. Reversal or improvement can occur with the appropriate peak pressure management. Proper footwear may be all that is required. However, many times the DPRO orthotic is needed to redistribute damaging peak pressures – especially in the diabetic insensate foot.

Once the DPRO orthotic is fitted, a repeat in-shoe pressure analysis can be done to confirm fit within the first week and over months. We have repeatedly demonstrated reduction in foot complaints and harmful peak pressures. This is unprecedented documentation for the diabetic “at risk” foot, the “high demand” athlete and others with foot pain demanding a solution. No other orthotic system provides this level of documentation and sets a new high standard for care.





The AcuStep DPRO system is a practical, cost effective tool for footwear and orthotic analysis, orthotic design and fabrication and diabetic foot ulcer prevention management.









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