Citation: Brognara, L.; Fantini, M.;
Morellato, K.; Graziani, G.; Baldini,
N.; Cauli, O. Foot Orthosis and
Sensorized House Slipper by 3D
Printing. Materials 2022, 15, 4064.
https://doi.org/10.3390/
ma15124064
Received: 7 May 2022
Accepted: 4 June 2022
Published: 8 June 2022
Publisher’s Note: MDPI stays neutral
with regard to jurisdictional claims in
published maps and institutional affil-
iations.
Copyright: © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
materials
Article
Foot Orthosis and Sensorized House Slipper by 3D Printing
Lorenzo Brognara
1
, Massimiliano Fantini
2
, Kavin Morellato
3
, Gabriela Graziani
4
, Nicola Baldini
5
and Omar Cauli
6,7,
*
1
Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of
Bologna, 40123 Bologna, Italy; lorenzo.brognara2@unibo.it
2
Romagna Tech s.c.p.a., 47121 Forli, Italy; msm.fantini@gmail.com
3
Department of Industrial Engineering, Alma Mater Studiorum, University of Bologna, Via Terracini 28,
40131 Bologna, Italy; morellato.kavin@gmail.com
4
Laboratory of Nanobiotechnology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10,
40136 Bologna, Italy; gabriela.graziani@ior.it
5
Biomedical Science and Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10,
40136 Bologna, Italy; nicola.baldini@ior.it
6
Nursing Department, University of Valencia, Avda Menendez Pelayo 19, 46010 Valencia, Spain
7
Frailty Research Organizad Group, University of Valencia, Avda Menendez Pelayo 19, 46010 Valencia, Spain
* Correspondence: omar.cauli@uv.es
Abstract: Background: In clinical practice, specific customization is needed to address foot pathology,
which must be disease and patient-specific. To date, the traditional methods for manufacturing
custom functional Foot Orthoses (FO) are based on plaster casting and manual manufacturing, hence
orthotic therapy depends entirely on the skills and expertise of individual practitioners. This makes
the procedures difficult to standardize and replicate, as well as expensive, time-consuming and
material-wasting, as well as difficult to standardize and replicate. 3D printing offers new perspectives
in the development of patient-specific orthoses, as it permits addressing all the limitations of currently
available technologies, but has been so far scarcely explored for the podiatric field, so many aspects
remain unmet, especially for what regards customization, which requires the definition of a protocol
that entails all stages from patient scanning to manufacturing. Methods: A feasibility study was
carried out involving interdisciplinary cooperation between industrial engineers and podiatrists. To
that end: (i) For patient-specific data acquisition, 3D scanning of the foot is compared to traditional
casting. (ii) a modelling GD workflow is first created to design a process permitting easy creations
of customized shapes, enabling the end user (the podiatrist) to interactively customize the orthoses.
Then, (iii) a comparison is made between different printing materials, in order to reproduce the
same mechanical behavior shown by standard orthoses. To do this, the mechanical properties of
standard materials (Polycarbonate sheets), cut and hand-shaped, are compared with four groups
of 3D printed samples: poly(ethylene glycol) (PETG), poly(acrylonitrile-butadiene.styrene) (ABS),
polycarbonate (PC) and poly(lactic acid) (PLA) obtained by Fused Filament Fabrication (FFF). Results:
Differences found between the foot plaster model obtained with the plaster slipper cast in a neutral
position and the model of the real foot obtained with 3D scanning in the same position can be
ascribed to the non-stationarity of the patient during the acquisition process, and were limited by
a locking system with which no substantial differences in the almost entire sole of the foot scan
were observed. Conclusions: Using the designed GD workflow, podiatrists with limited CAD skills
can easily design and interactively customize foot orthoses to adapt them to the patients’ clinical
needs. 3D printing enables the complex shape of the orthoses to be reproduced easily and quickly.
Compared to Polycarbonate sheets (gold standard), all the printed materials were less deformable
and reached lower yield stress for comparable deformation. No modifications in any of the materials
as a result of printing process were observed.
Keywords: gait; foot care; foot orthosis; mechanical properties; polymers
Materials 2022, 15, 4064. https://doi.org/10.3390/ma15124064 https://www.mdpi.com/journal/materials