2, 11 At the same time, this analytical study recognized 3D printed insoles as successful in alleviating pain with an increase in the feeling of comfort (comfort score 3, 6, 20, 21, 28) and a possible effect on foot biomechanics. 4, 19, 20 A detailed analysis of the results 3 showed that the evidence is insufficient and that extensive research is needed. 3 Initial studies also report that properly designed and manufactured 3D-printed CMIs effectively manage heel pain 3, 4 and influence altering lower limb biomechanics. 4 However, they significantly affect comfort perception 3, 6 and reduce painful symptoms. 3, 6 Current research 3 shows CMIs do not significantly affect foot re-aligning. 3, 12 They reported a reduction in damage to symptomatic flat feet. Several studies 1, 3, 6, 15, 18–20 have investigated whether 3D-printed CMIs can reduce metatarsal pressure by distributing it over the midfoot. 5, It is precisely for this purpose that digitizing dimensions is of great importance. Other crucial things are the correct shoe size, adequate space 19 for the exact insole inside, which is in contact 5, 8, 18 with the foot during all dynamic and postural movements, 9 such as standing, walking, and running. 1, 12, 15–18 Therefore, comfort evaluation is essential 8 because the perception of poor comfort 6 may lead to poor user compliance.
3 An insole must bear the often-extreme loads 3, 8, 9 in athletes. 1–10 These severe accompanying phenomena make ordinary life miserable and are why a person seeks professional help. Pain in the lower limbs and muscle fatigue are characteristic symptoms of flat feet. In general, the main principle in the design of CMI is the correction of deformities, 1, 3, 7–9 reductions of painful symptoms, 3–10and adequate load distribution. 1, 3–5, 7, 15, 21, 27, 28 It follows from the above that a fundamental assumption for the successful designing CMIs is to understand the correlation of the foot to posture 29 and other aspects of the musculoskeletal system, 1, 3–9 to perceive relationships to associated diseases and cognition of the biomechanics, 1, 4, 5, 12 weight-bearing activities 1, 3, 5–7, 9 of humans, and pathological forces 1, 3, 5–7, 13 which affect the foot. The production of a CMI that meets the biomechanical requirements for damping and support is demanding from material and mechanical points of view, knowledge, and skills. 2 They are responsible for diagnosis establishing, 2 and defining the correction elements on the insoles. 1–28 Only orthopedic physicians and podiatrists can prescribe CMIs. Custom-made Orthopedic Insoles (CMIs) are an ordinary conservative solution to the complications associated with pes planus (flatfoot).
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