This application is a National Stage Application of International Application Number PCT/EP2018/051569, filed Jan. 23, 2018; which claims priority to German Patent Application No. 10 2017 201 885.2, filed Feb. 7, 2017.
A problem of modern civilized societies is that the deformation of people's feet is increasing. The deformation of the feet can in turn cause postural defects, which can lead to significant health complaints in the long term. It has been found that at least 90% of all humans have healthy feet at birth, while at least 60% of all humans have structurally and/or functionally damaged feet as adults.
In primitive societies, in contrast, in which regular use of shoes is the exception, foot deformations are much rarer. Healthy feet are essentially maintained for longer.
The increased foot deformation in people in civilized societies results inter alia from walking on hard ground and from separation of the feet from their natural perception of the surroundings, which in particular leads to weakening of the feet. In this case, a distinction is made in principle between structural damage of the feet and functional damage of the feet. Structural damage is for example pes equinovarus and pes calcaneus, serious toe deformities such as Hallux valgus and hammer toe, i.e. damage to the foot itself. The proportion of structurally damaged feet has also increased in civilized societies, on account of the problems described above. A functional disorder of the foot, in contrast, is understood to be a dysfunction of the foot such as unhealthy rolling behaviour or impaired statics. In this case, impaired statics of this kind can in particular lead to bad posture of the person, as a result of which further muscular problems or joint or spinal problems may be caused. Examples for this are splayfoot and in particular also talipes valgus and pes planus. These disorders, too, have increased significantly.
Against this background, the object of the invention is that of providing an improved orthopaedic footbed by means of which the above-described problems can be solved in a cost-effective manner and as far as possible for the population as a whole. Furthermore, a cost-effective method for providing an orthopaedic footbed for the population as a whole is intended to be provided.
According to the basic concept of the invention, it is proposed, according to claim 1, that the foot contact surface of the footbed should be formed by a planar base surface having a plurality of pimples that are arranged in accordance with a distribution that is optimized for podiatry.
Commercially available shoes are generally provided with a footbed having a foot contact surface, the foot contact surface being purposely adapted to the foot shape. In particular, the foot contact surface is raised in the region of the foot arch, for example by what is known as a truss pad, such that said foot arch is supported, in particular irrespective of whether or not the foot has a structural and/or functional disorder. This causes the load on the foot to be reduced, with the result that the strength and shape of the foot can in turn be permanently weakened.
The invention takes an entirely different approach in comparison. Specifically, according to the invention the foot contact surface of the footbed is formed by a planar base surface, the foot thus rests on a deliberately planar foot contact surface, and is thus deliberately stressed and loaded, such that the foot is strengthened by the regular loading, as a result of which, in turn, the likelihood of structural and/or functional disorders of the foot is reduced. In this case, the solution according to the invention follows the example of primitive societies where people walk barefoot and thus do not walk on a foot contact surface that is purposely adapted to the sole of the foot. The proposed orthopaedic footbed essentially makes it possible to combine shoes used in modern civilized societies with loading of the foot that approximates that of walking barefoot, by means of the planar base surface in the shoe. The proposed footbed is also referred to as a standard footbed. A base surface having slight unevenness, such as elevations, is also understood to be a planar base surface, which unevenness may be due to long use, uneven ground, or manufacturing inaccuracies.
It is furthermore proposed that the base surface should comprise a plurality of pimples which are arranged in a distribution that is optimized for podiatry. A distribution of this kind may for example be a distribution in accordance with the anatomical distribution, projected in the foot contact surface, of the bony parts, and/or the distribution, projected in the foot contact surface, of the pathways comprising the lymphs and/or the nerves and/or the vessels, of a human foot that is resting on the foot contact surface. As a result, the pimples purposely form stimulation points for the sole of the foot which are arranged in accordance with the bony parts and/or the pathways of the foot. Pathways are assigned to the bony parts, which pathways are similar, with minor variations, in all humans, and can be considered a universal basic arrangement resulting from evolution. The basic arrangement of the course of the pathways is thus a representation of the bony parts of the foot. The proposed arrangement of the pimples in accordance with the bony parts and/or the pathways deliberately stimulates the human biotensegrity system. In this case, the proposed distribution of the pimples is defined with respect to the bony parts and/or the pathways of a foot contact surface in a foot that comes into contact in a normal position or in a pre-determined orientation and position, such that the pimples on the foot contact surface are associated with pre-determined zones of the sole of the foot or of the bony parts and/or the pathways of a foot resting on the foot contact surface.
The biotensegrity system is an important scientifically accepted fundamental principle of the human body, and describes an underlying tension system or a self-regulating stabilizing system in the human body. The term “biotensegrity”, or in general also “tensegrity” is a compound coinage of the words “tension” and “integrity”. According to the principle of the tensegrity concept, the ligaments and fasciae correspond to fixed tensile ligaments in the medical field, while the bones correspond to the fixed thrust pieces of the model. These are supplemented by the dynamic stabilizers of the system, i.e. the muscles which impart the pretension of the system. The pretension generated by the muscles determines the reaction of the tensegrity system to loads that arise. Under biological loading and everyday conditions, the stability of the entire system depends on the dynamic stabilizers. The greater the pretension in the bond, the more stable the system. Too low a pretension results in the system giving way and in posture problems, while too great a pretension in turn causes restriction of mobility and other undesired medical after-effects such as tennis elbow and other instances of orthopaedic enthesitis or foot deformities such as pes cavus. In the case of a skeleton that is still growing, this incorrect organization of the forces leads to scoliosis, postural abnormalities, foot deformities and other anatomical states that develop adversely in later life. Since, in humans, muscle tension is lowered in sleep, in contrast with some animals, humans are unable to stand up when asleep. If the structure, e.g. the thrust parts, the geometry and the biomechanics, is impaired, this leads to the tensile parts no longer being able to be pretensioned by the dynamic tensioning means, formed by the muscles, in such a way as to form an inherently stable system. If a structural disorder, such as cerebral palsy, is present, this can often be remedied only by mechanistical measures or by means of an operation. In this case, the balancing and symmetry-defining pretension of the system is not provided, owing to central neurological damage, meaning that malalignments of the joints may result. If the dynamic tensile ligaments (tendons and fasciae) are too weak, such as in the case of a connective tissue disease, the healthy dynamic tensioning muscle likewise cannot pretension the biotensegrity system to a stable system. In both these cases of structural disorder, the proposed orthopaedic footbed is a compensation and training aid for the remaining function of the biotensegrity system that is present and can be developed. Complex treatment that is based on this understanding thus always also involves equalization of the tension in the dynamic portions of the system, i.e. the muscles in the human system. Humans themselves can generally achieve this by an improvement in the sensory system, in that the correct muscle tension is generated by means of matching to centrally stored target values, it being possible for the improvement in the sensory system to be further promoted by muscular stamina training and targeted relaxation and stretching of shortened structures, and strengthening of structures that are too weak. The proposed footbed helps in all aspects of this scientific basis.
The distribution of the pimples corresponds to the anatomical distribution of the bony parts or the pathways of the human foot, and thus also to the distribution of the sensory fields in the sole of the foot. In this case, they in particular follow the distribution of the bony parts in the heel, the tarsus and the transition region between the tarsus and the metatarsus, and in particular in the metatarsal tendon region. As a result, the stimulation points of the sole of the foot are stimulated in a specific manner and sequence in the case of the physiological rolling pattern of walking. The sequence of the stimulation leads to perception in the person's brain, which is coded in a particular manner and leads to reflex-based adjustment of posture and gait.
The human biotensegrity system further comprises a plurality of chambers in which individual cells up to entire organs are arranged in each case, in a scaled manner. In this case, irrespective of the size thereof, each chamber is subjected to pressure changes on account of the movement, muscle power and body weight. The cyclical movement of a person while walking results in a temporally coded pressure change in the foot, i.e. initially a pressure increase in the heel, then a pressure increase in the tarsus region, followed by a pressure increase from the metatarsus region as far as the toes, until the foot leaves the ground in order to prepare for the next step. This pressure wave which extends cyclically through the foot is the main pump for all the fluids of the foot, both venous and lymphatic. In contrast to human blood, which is pumped arterially from the heart to the foot, the lymphatic and venous fluid is not moved by the heart, but instead this function is essentially performed by the foot. Accordingly, the foot could also be understood as the heart or as a pump for the low-pressure system of the veins and the lymphatic vessels. This pump is activated or stimulated by the proposed distribution of the pimples, and the biotensegrity system is essentially strengthened thereby. This function can also be referred to as a “heart of feet function”.
It is furthermore proposed that the pimples be arranged, in a zone of the foot contact surface on which a foot comes into contact by a front ball of the foot, in five rows, corresponding to the orientation of the bony parts that form the five toes and/or along the pathways assigned thereto. The pimples thus extend in five rows along the bone structures of the foot that form the toes and the metatarsus bones, proceeding from the metatarsus as far as the tips of the toes or the last bone member of the toes, and thus stimulate, in a targeted manner, the stimulation points arranged on the bony parts or the pathways of the toes. In this case it is assumed that the foot comes into contact with the footbed in the intended normal orientation, which necessarily results when the shoe is put on, when the footbed is arranged in the shoe. This applies in principle for the entire application, when the footbed is described with respect to a foot that is in contact therewith.
Furthermore, the pimples are preferably arranged in a circular manner in a zone of the foot contact surface on which a heel of a foot comes into contact. The pimples that are arranged in an imaginary circle cause the foot to be stimulated in a uniform manner, in the region of the heel, the arrangement of the pimples in the heel region more preferably being formed by a circle of pimples comprising further, uniformly distributed pimples that are arranged within the circle. This produces a specific stimulation effect which results in a specific movement vector.
It is furthermore proposed that the pimples be arranged, in a zone of the foot contact surface on which a midfoot region of a foot comes into contact, in at least two lines that diverge towards the inside of the foot contact surface. In this case, the inside of the foot contact surface is the side of the foot contact surface which is assigned to the inside of a foot resting thereon, the inside of the foot in turn being the side of the foot which is adjacent to the respective other foot of a person in normal standing posture of the person. In principle, the spacings of the stimulation points in the longitudinal direction of the sole of the foot increase from the outside of the foot to the inside, which is taken into account in the solution according to the invention by the pimples on the foot contact surface that are arranged in divergent lines.
It is furthermore proposed that the spacings between the pimples reduce, in the longitudinal direction of the foot contact surface, proceeding from a zone of the foot contact surface on which a midfoot region of a foot comes into contact, to a front and/or rear face of the foot contact surface. The pimple density on the foot contact surface thus increases from the midfoot to the front and rear side of the foot contact surface, resulting in particular in stimulation of the stimulation zones of the sole of the foot in the region of the zones of the sole of the foot that come into contact on the front and rear face of the foot contact surface, which zones are of particular importance for the biotensegrity system and the effect described above.
It is furthermore proposed that the pimples be of an identical height. The pimples can preferably be of an identical height at least in the new state, in order that the upper faces thereof make up a planar base surface, or in order that they raise a planar base surface by an identical amount. The entire sole of the foot is thus used as a sensory surface, in order to change the biological perception of symmetry, posture, muscle tension, weight distribution and positioning in space, by means of targeted sensory impulses to the entire sole of the foot, such that the person using the footbed experiences an effect that improves posture and gait. However, if stimulation of the foot is useful or advantageous only in a designated region, it would also be conceivable to provide the pimples only in defined portions of the base surface or to emphasize said pimples in specified regions on which the region of the foot to be stimulated comes into contact.
In this case, the pimples can preferably be of a height of from 2 to 3 mm with respect to the foot contact surface, and have a diameter of from 3 to 5 mm, which has been found to be sufficient for bringing about the sensory stimulation effect. In special cases, however, deviations from this standard are expedient.
It is furthermore proposed that it be possible for the diameter of the pimples to be dependent on the shoe size. In this case, the pimples are preferably of smaller diameters and heights in smaller shoe sizes, i.e. for children, than in larger shoes for adults.
It is furthermore proposed that the foot contact surface may comprise at least one functional zone which is raised or depressed relative to the base surface and/or has a greater or lesser hardness than the footbed in the remaining portion. The functional zone makes it possible for the footbed to be individually adapted to a structural and/or functional disorder of the foot, it being possible for the functional zone to be formed only by local raising or depressing, while the remainder of the base surface is formed unchanged as a planar surface.
In this case, the footbed can also have a greater hardness in the region of the functional zone and/or can preferably be formed so as to have a greater hardness by means of a group of pimples of a different hardness with respect to the remaining pimples. The proposed developments make it possible for the stimulation effect, which is intended to be achieved by the pimples or the footbed, to be further intensified locally, in regions of the sole of the foot coming into contact therewith which are defined by the position of the functional zones.
In this case, if necessary, in order to fulfil the purpose thereof, the functional zone may be raised or depressed by 3 to 5 mm, preferably by 4 mm, relative to the base surface. In this case, the functional zones can transition in a harmonious manner, having corresponding radii, into the base surface and continuously rise or lower.
In particular, the functional zone may be formed by a talipes valgus correction surface which is raised relative to the base surface and is arranged in a zone of the foot contact surface on which the foot comes into contact by the inside of the front ball of the foot and the inside of the foot arch. The talipes valgus correction surface protrudes upwards from the base surface and supports the foot on the inside, such that the person's tendency to bend the knees in towards one another is counteracted.
Furthermore, the functional zone may also be formed by a statics correction surface which is raised relative to the base surface and is arranged in a zone of the foot contact surface on which a heel of the foot comes into contact, such that the person's foot is slightly raised at the heel and the foot statics is corrected. It is thus possible to bring about static leg length compensation.
According to a further preferred embodiment, the functional zone is formed by a pes cavus correction surface which is raised relative to the base surface and is arranged in a zone of the foot contact surface on which the entire width of the front foot part of the foot comes into contact. In this case, the pes cavus correction surface can preferably be combined with the statics correction surface, in order to counteract the tendency for pes cavus, because the foot is thereby slightly raised both in the front region and in the region of the heel.
Furthermore, the functional zone may also be formed by a calcaneal spur correction surface which is depressed relative to the base surface and is arranged in a zone of the foot contact surface on which the foot comes into contact by a central portion of the heel thereof and/or by a central portion of the foot arch, as a result of which the load on the foot is purposely relieved in the region of a calcaneal spur.
Furthermore, the functional zone may preferably be formed by a portion which is raised relative to the base surface and is of a lesser hardness than the base surface, which portion is arranged in a zone of the foot contact surface on which a foot comes into contact, on an inside, by a midfoot region that is arranged between a heel and a ball of the foot. The proposed functional zone of the orthopaedic footbed makes it possible for the pumping system of the lymphatic and venous fluids in the human body, referred to in the invention as the “heart of feet function”, to be stimulated and intensified. Raising the functional zone, and the lower hardness thereof in the described portion of the foot contact surface means that the stimulation points are stimulated in a targeted manner in this region, the shape of the described functional zone not being purposely adapted to the shape of the foot arch, in contrast with the truss pads known in the prior art, but is instead only raised, since the task of said functional zone is not to support the sole of the foot but instead only to build up pressure more intensively in this region. For this purpose, it is sufficient, for example, for the functional zone to be raised by a constant height in this portion, in contrast with the truss pad.
If present, an anatomical leg length inequality can also take place by means of adapting the material thickness of the orthopaedic footbed on the shortened side. In this case, the material thickness is adapted or increased in particular by adapting the thickness of the base layer located below the stimulation zone.
In this case, the functional zones and the base surface are each formed by uniform, pre-defined, person-independent surfaces, and the various orthopaedic footbeds are formed as a range, having different foot contact surfaces, by means of combining the base surface with different functional zones. The base surface and the functional zones for the different shoe sizes are first designed in a person-independent manner, and are combined to form the foot contact surface of an orthopaedic footbed for a specific foot type. In this case, a different combination of the base surface and the functional zones, or even just using the base surface alone, makes it possible to manufacture different orthopaedic footbeds, having different foot contact surfaces, in a range in large numbers, which footbeds can then be used for different people having different structural problems and/or functional disorders of the feet. Since the footbeds are not manufactured in a person-specific manner, but rather in a range in very large numbers, the production costs and the marketing costs can be significantly reduced by means of the proposed orthopaedic footbed and the method for manufacturing the footbed. Overall, the orthopaedic footbeds can thus be manufactured in a cost-effective manner, for a large number of people, as a result of which it is possible to achieve a significant contribution to improving the health of a large number of people from very wide population strata and in all age groups.
In this case, the footbed can alternatively be formed by a main body onto which the base surface and/or the functional zones are moulded or out of which they are worked. The main body may be a foam block for example, into which both the base surface and the functional zones are for example cut. Alternatively, manufacture in a 3D printing process, a spray process or a sintering process would also be conceivable. Furthermore, the footbed can also be manufactured from different layers of different materials having different properties, in particular different strengths, the layer thicknesses and strengths of which can in turn vary over the foot contact surface, in order to achieve the desired effect that is described in the application.
If the footbed is manufactured from a main body, the functional zones can either be worked into the base surface after manufacture of the base surface, if said functional zones are depressed, or, if they are raised, can already be taken into account during manufacture of the base surface.
Furthermore, in order to achieve the object, a method for providing a footbed that is adapted with respect to a structural and/or functional disorder of a person's foot is proposed, in which method a plurality of different footbeds of a defined size are provided, which footbeds in each case comprise different, modularly assembled, foot contact surfaces, the modular foot contact surfaces of the different footbeds being formed by one of the following pre-defined, person-independent surfaces: a planar base surface or a combination of a planar base surface and a person-independent functional zone that is adapted to a structural and/or functional disorder of the foot, the person being examined for the presence of a structural and/or functional disorder of the foot and, if no structural and/or functional disorder of the foot is present, a footbed of a person-dependent size and comprising a foot contact surface formed by a planar base surface is selected, and, if a structural and/or functional disorder is present, a footbed of a person-dependent size and comprising a foot contact surface formed by a combination of a planar base surface and at least one functional zone is selected.
The footbeds are prefabricated in large numbers and are stored on-site, for example in a shoe shop, a physiotherapy or osteopathy practice, a podiatry practice, a medical practice, a sports shop, a trekking shop, a fitness centre, or a tai-chi training centre, etc. The person is then visually assessed, e.g. by a correspondingly professionally qualified specialist, for the presence of structural and/or functional disorders of the foot, it also being possible, alternatively or in addition, for suitable sensor means, such as pressure-sensitive sensor plates, on which the person stands, to be used as aids. If, in this case, no structural and/or functional disorder of the foot is identified, a footbed comprising a simple, planar base surface is selected, which footbed can also be referred to as a standard footbed. If, in contrast, a structural and/or functional disorder is identified, a footbed that is provided specifically for the structural and/or functional disorder, as a result of the individual functional zone(s), is selected, in a corresponding shoe size.
The invention will be explained in the following, on the basis of preferred embodiments and with reference to the accompanying figures, in which:
The reference signs 1 to 56 in each case denote an individual pimple 5 on the orthopaedic footbed 1, and therefore the distribution of the reference signs 1 to 56 corresponds to the distribution of the pimples 5 on the foot contact surface 3. In the basic arrangement thereof, the distribution of the pimples 5 corresponds to the arrangement of the essential bony parts 100 of the bone structure of the foot 16 and the pathways 200 extending thereon, in the projection in the foot contact surface 3 of the orthopaedic footbed 1, as can be easily identified by way of a comparison of
In the basic structure thereof, the foot 16 which can be seen in a view from below in
In the rear zone of the foot contact surface 3, on which the heel 102 of the foot 16 comes into contact, the pimples 5 are arranged in a circular manner in an imaginary ring, which can be seen from the reference signs 41 to 52. Four further pimples 5, having reference signs 53 to 56, are arranged in the centre of the imaginary ring, in as uniform a distribution as possible and in a square, having identical spacings in the longitudinal direction and transversely to the longitudinal direction of the foot contact surface 3. As a result, at the start of the rolling movement the foot 16 is uniformly stimulated in the stimulation zones of the heel 102, as a result of which the pumping process described at the outset is initiated. In this case, the stimulation signals triggered in the stimulation zones generate corresponding signals, in the person's brain, for pressure change in the associated chambers of the cells or the organs of the person, as a result of which the segmented nervous system and the organs are deliberately vitalized.
During the further rolling movement, a midfoot region 103 of the person's foot 16 rolls on the foot contact surface 3, and in this case rolls over a zone of the foot contact surface 3 in which the pimples 5 are arranged in two imaginary lines that extend transversely to the longitudinal direction of the foot contact surface 3 and diverge towards the inside 105 of the foot contact surface 3, according to reference signs 40 to 36 and 35 to 31. The divergent orientation of the lines means that the spacings of the pimples 5 in the longitudinal direction of the foot contact surface 3 are greater on the inside 105 of the foot contact surface 3 than on the outside 106 of the foot contact surface 3. This arrangement of the pimples 5 is advantageous because the spacings of the stimulation points are smaller on the outside 106 of the foot 16 than on the inside 105. Owing to the divergent orientation, the spacings of the pimples 5 increase in the longitudinal direction of the foot contact surface from the outside 106 to the inside 105, i.e. transversely to the longitudinal direction. Furthermore, the foot arch of the foot 16 is taken into account thereby.
During the further rolling movement, the ball of the foot 104 and the toes 101 of the foot come into contact on the foot contact surface 3 in a zone in which the pimples 5 are arranged in the longitudinal direction of the foot contact surface 3 in five imaginary lines, corresponding to the bony parts 100 of the toes 101. In this case, the pimples 5 are arranged in imaginary lines corresponding to the reference signs 1, 6, 11, 16, 21, 26, the reference signs 2, 7, 12, 17, 22, 27, the reference signs 3, 8, 13, 18, 23, 28, the reference signs 4, 9, 14, 19, 24, 29 and finally corresponding to the reference signs 5, 10, 15, 20, 25, 30. The distribution of the pimples 5 thus corresponds to the representation of the bony parts 100 that form the toes 101, and the pathways 200 arranged along said bony parts, such that in this zone the stimulation points of the toes 101 arranged on the bony parts 100 or the pathways 200 are stimulated in a targeted manner by the pimples 5 during the rolling movement.
The insole 6 shown in
In
The orthopaedic footbed 1 can be designed both as an insole 6 and as a part of a lower shoe. All that is important is that the foot contact surface 3 is correspondingly shaped or that the foot contact surface 1 forms the corresponding foot contact surface 3 in the shoe. In this case, the footbed 1 can in addition comprise a leather coating or textile coating, as a result of which wearing the shoe 2 can be made more comfortable. Furthermore, the footbed 1 should be designed so as to be permanently elastic, breathable, liquid-absorbing and conducting. The resiliency of the footbed 1 should be such that it subjects the foot contact surface 16 to sufficient resistance, the resiliency being intended to allow for slight penetration of the foot 16 into the foot contact surface 3 without the basic distribution of the contact surface, according to the principle, being lost. In particular, the resiliency should be selected such that the foot 16 does not sink in so far as to be in contact over the entire surface thereof, since otherwise the desired loading of the foot 16 is not achieved. This is the case in particular if the foot 16 is structurally and functionally healthy and the foot contact surface 3 is formed only by a planar base surface 4, as is shown in
If the orthopaedic footbed 1 is designed as an insole 6, this may be intrinsically resilient, and the functional zones therein may be formed having a greater strength or hardness. In this case, the insole 6 can have a resiliency that is such that said insole can be put into a bag folded, bent back or rolled up, without being damaged in the process. After the insole 6 has been removed from the bag, it unfolds automatically or with slight assistance, owing to the resiliency thereof, back into the original shape, and can thus be inserted into the shoe 2. Simply owing to the greater hardness of the footbed 1 in the region of the functional zones 8, the foot 16 experiences greater support and stimulation here than in the remaining regions of the base surface 4. Furthermore, in addition to the greater hardness thereof, the functional zones 8 can of course also be of a greater height or thickness and optionally comprise additional pimples 5 for stimulation of the sole of the foot.
Firstly, a range of different orthopaedic footbeds 1 having differently shaped foot contact surfaces 3 for different foot types, in different shoe sizes, shoe last widths and possibly also having different hardnesses, is kept available in a shop or a clinic, in which the people can select and test their orthopaedic footbed 1, which is matched individually to their feed 16, under specialist guidance from correspondingly trained consultants. In this case, the left and right foot 16 may also be different, and therefore different orthopaedic footbeds 1 may be deliberately selected for the left and right foot 16.
Firstly, the customer K is assessed visually and by means of measurements, within the context of an initial assessment E, by the consultant, optionally with the aid of corresponding sensor means such as pressure-sensitive standing surfaces or treadmills. In this case, further aids such as foot and shoe size measurement, a measuring device for measuring the posture and in particular the statics, may be used within the context of a diagnosis D. The consultant then identifies a specific foot type, with or without structural and/or functional disorders and/or with or without impaired statics.
Structurally healthy is denoted in the flow diagram by SG, structural impaired by SK, functionally healthy by FG, and functionally impaired by FK.
If it is ascertained that the feet are both structurally and functionally healthy SG, FG, it is firstly determined that a standard footbed SFB comprising an orthopaedic footbed 1 having a planar base surface 4 according to
If one of the feet 16 is structurally healthy SG and functionally impaired FK, the type of the functional disorder is firstly determined in a further step DFK and a correspondingly individualized orthopaedic footbed 1 comprising a functional zone 8 individually provided for the disorder is selected. A functional disorder of this kind may be talipes valgus for example, the functional zone 8 in this case being the talipes valgus correction surface 9 shown in
The orthopaedic footbeds 1 shown in
If the diagnosis identifies both a structurally impaired SK foot 16 and a functionally impaired FK foot 16, a recommendation is made for a medical examination (EAU), and optionally a recommendation is made for wearing a standard footbed SFB until the results of the medial examination are available. A subsequent follow-up appointment KT may in addition also be arranged.
The advantage of the proposed solution is considered to be that the health of the feet and the posture of a very large number of people can be improved, or the likelihood of the development of disorders and postural defects can be reduced, by means of preventative measures, using simple means basic knowledge of specialists which can be conveyed in specialist seminars for example. In this case, the invention makes use of the advantage that the orthopaedic footbeds 1 are kept available not specifically depending on the individual foot 16, but instead in a person-independent manner for various foot disorders, in the form of a range. The person-specific manufacture of the insoles used hitherto firstly requires production of an individual footprint, on the basis of which the insole is then manufactured. The person could therefore not take the insole immediately, but said insole instead had to be manufactured in an orthopaedics workshop that is specialized in this. As a result, the insole could be collected and worn only after a waiting time of several days or weeks. Overall, providing the insoles was thus associated with corresponding time expenditure and manufacturing outlay, resulting in a drop in the acceptance of wearing insoles. Insoles were worn only if already serious, medically identified disorders of the function and structure of the feet were already present.
According to the method according to the invention for providing the footbed, the orthopaedic footbeds 1 are manufactured in large numbers, having various foot contact surfaces 3 which, although not person-specific, are instead type-specific, i.e. are adapted to the type of the foot 16 by means of the planar base surface 4 or by means of the combination of the base surface 4 with different functional zones 8 that are specially adapted to the structural and functional disorders, and thus allow for significantly more healthy walking. Since the footbeds 1 are tested on-site and can be taken away immediately after being selected, the outlay for obtaining a footbed 1 of this kind is significantly reduced, as a result of which a significantly larger number of people can be convinced to wear footbeds 1 of this kind, at least as a trial. As a result, the health of the population can be significantly improved, on average, by the increased acceptance of orthopaedic footbeds 1, which footbeds can be described as a new biointerface owing to the special distribution of the pimples 5. The distribution of the pimples 5 essentially achieves a biointerface which is used to stimulate the stimulation points of the sole of the foot during walking, and thus to strengthen the biotensegrity system. As a result, the person's normal walking movement itself is used for stimulating the biotensegrity system and for associated improvement of posture and gait.
The foot contact surface 3 comprising the pimples 5 provided thereon can be divided, in the same manner, into different regions in which the person comes into contact by the heel 102, the midfoot region 103, the ball of the foot 104 and finally with the toes 101 of the foot 16.
Both locally arranging pimples 5 having a greater hardness, and forming the base surface 4 so as to have a greater hardness and/or so as to be at a higher level locally result in the desired local stimulation effect on the sole of the foot being intensified. As a result, both the gait and the posture of the person can be positively influenced and corrected, since the perception in the sole of the foot leads to a postural change, in accordance with what is known as the vector addition model.
Furthermore,
In the base surface 4, the orthopaedic footbed 1 comprises an EVA base layer 110 and an EVA cover layer 111 which are separated from one another by a stimulation layer 113. The EVA base layer 110 is covered, on the lower face, by a carrier layer 114, and the EVA cover layer 111 is covered, on the top face, by a functional tissue layer 112 having fluid-conducting and breathable properties, which layer simultaneously forms the foot contact surface 3. The EVA base layer 110, the EVA cover layer 111, the stimulation layer 113, the functional tissue layer 112, and the carrier layer 114 each have a constant thickness, such that the orthopaedic footbed 1 has a constant thickness in the region of the base surface 4, apart from the pimples 5 (not visible) which are arranged thereon.
In the right-hand drawing, the EVA base layer 110 is of a greater thickness, in order to form the functional zone 8, while the thickness of the remaining layers is constant. The raising of the foot contact surface 3 in the region of the functional zone 8 is thus achieved merely by increasing the thickness in the EVA base layer 110. The thickening of the EVA base layer 110 is shown in the right-hand drawing, by the zone II of the EVA base layer 110 in the region of the functional zone 8, above the zone I.
The functional tissue layer 112 is preferably formed by a breathable and fluid-permeable textile material, while the carrier layer 114 is formed by a wear-resistant plastics material, for example having a carbon effect.
Both the EVA cover layer 111 and the EVA base layer 110 are manufactured from an EVA material, and virtually form the volume material of the footbed 1. The stimulation layer 113 is manufactured from a hard plastics material and defines the hardness of the footbed 1.
The “heart of feet function” brought about by the orthopaedic footbed 1 according to the invention will be explained again, in greater detail, in the following.
The sole of the foot is a blood and lymphatic pump and assists the return transport of the blood supplied by the heart. This return transport is brought about by the muscle-vein pump in the foot, formed by the vessels, the fasciae system, the bones and the muscles, together with gravity.
Owing to the particular anatomical structure comprising the tissues encased in fasciae, natural movements and the pressure changes in the foot that are induced or stimulated by the footbed 1 according to the invention result in fluid-displacement effects owing to the constant change in tissue pressure gradients. When compressed and elongated, the pressure on the tissue portions protruding into the fasciae-encased chambers is significant, the alternating peaks and troughs of the pressure build-up brings about a pumping mechanism which is weakened but still present in the case of impaired venous and lymphatic vessels.
The theory of the pumping movement in the sole of the feet of people can be explained as follows: The basis of the pumping movement is a grille having pressure gradients that are generated by deformation: Upon stretching, the pressure in the enclosed chambers increases owing to the movement of the connective tissue fasciae lines, and pressurized movement of the fluid takes place in a manner channelled from the foot to the centre of the body. If the movement of the grille recedes, the pressure gradient reduces again, resulting in fluid collecting in the chambers, between the grille elements. These movements alternate cyclically, as a result of which the body transports lymphatic and venous fluid from the narrowest tissue gaps to the heart, outside of vessels and in the smallest of vessels.
The fasciae lines around each cell are thus inter alia also a person's “other heart”, which represents and is therefore responsible for the centripetal pumping movement, in the way in which the heart represents a large portion of the centrifugal pumping movement.
The material of the “heart of feet” zone of the orthopaedic footbed 1 according to the invention, in portion 107 of
The pressure increase results in expulsion of at least 20 to 40 cubic centimetres of blood and lymphs from the foot back towards the heart with each tread. Increasing the pressure relative to the orthopaedic footbed 1 without a “heart of feet” function significantly assists the venous and lymphatic return flow to the heart, in order to assist the insufficient, i.e. weakly pumping, venous and lymphatic vessels of the foot in their natural function.
Number | Date | Country | Kind |
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102017201885.2 | Feb 2017 | DE | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2018/051569 | 1/23/2018 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
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WO2018/145892 | 8/16/2018 | WO | A |
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