Clinical Evaluation and Prescription of Insoles

Abstract

Prefabricated insoles offer basic cushioning and minimal customization, suitable for low-risk patients. Effective insoles utilize materials like soft foams (EVA, Poron) for cushioning and redistribution, often in multilayer constructions, combined with firmer materials for structural support. Design features include deep heel cups, arch supports, and metatarsal pads to fine-tune pressure relief. Advanced technologies, including CAD/CAM, 3D printing, artificial intelligence for foot classification, and wearable pressure sensors, are being integrated to enhance precision, personalization, and real-time feedback. Clinical evaluation uses outcome measures like foot ulceration incidence and quantitative plantar pressure metrics, with a key target being substantial peak pressure reduction, ideally keeping pressure below 200 kPa. Successful insole prescription is confirmed by follow-up measurements showing substantial offloading of vulnerable areas.