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Trial registered on ANZCTR
Registration number
ACTRN12620000960954
Ethics application status
Approved
Date submitted
1/08/2020
Date registered
25/09/2020
Date last updated
12/01/2025
Date data sharing statement initially provided
25/09/2020
Date results provided
12/01/2025
Type of registration
Retrospectively registered
Titles & IDs
Public title
A step in the right direction - comparing 3D printed orthoses and traditional orthoses in individuals with flat feet.
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Scientific title
A step in the right direction - comparing the effect 3D printed orthoses and traditional orthoses on the walking gait of individuals with flat feet.
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Secondary ID [1]
301930
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RSH4955
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
heel pain
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flat feet
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Condition category
Condition code
Physical Medicine / Rehabilitation
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0
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Other physical medicine / rehabilitation
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Musculoskeletal
316803
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This preliminary study employs a within-subject single-blinded randomised crossover study design.
Fifteen flat footed adults with heel pain in one foot will be recruited. This sample size is the maximum number of recruitment allowed within the funding allocation. Participants will be recruited from the CQUniversity Health Clinic.
The inclusion criteria include: being over 18 years of age and having heel pain in one foot for more than 6 months. Exclusion criteria include having a BMI > 36 kgm2, any medical conditions affecting gait, skin allergies to double sided tape and adhesives.
An information sheet will be provided which will explain the risks and benefits of their participation. They will be given the opportunity ask questions and have them answered to their satisfaction. They will attend an initial assessment session at the CQUniversity Health Clinic which will take about 1 hour. The potential participants need to provide written informed consent before being assessed by podiatrists registered with the
Australian Health Practitioner Regulation Agency (AHPRA). Standard CQUniversity Health Clinic podiatry assessment forms will be used.
The podiatrist will assess the potential participant to ensure that they fit the inclusion criteria and that their heel pain is clinically suitable for orthotic therapy. Those individuals who are excluded will be referred to the appropriate health care professional for continued care. Those who fully meet the inclusion criteria will have their foot moulds taken by podiatrists [MH and JN] with 3D foot scanning and with plaster casting. Foot moulds will be sent to the same external orthotic laboratory which will use 3D printing techniques and traditional methods to fabricate two pairs of orthotic devices. The foot scans and casts will be coded in order to blind the orthotic laboratory as to the individual whom the orthoses is intended. This will reduce potential bias in the manufacture process.
When the two pairs of orthoses are ready, dimensions will be measured and compared. The same member of the research team will measure all the orthoses to ensure consistency in measurement.
The participant will attend a second session lasting approximately 2 hours at the CQUniversity biomechanics laboratory for data collection. Participant's height and mass will be recorded at the start of the session followed by a three-dimensional gait analysis. Reflective markers will be attached to the participants. The reflective markers are tracked by a special camera system (Vicon Motion Systems Ltd, Oxford, UK) which only collects the reflection of the markers. No standard video of the participant is collected. Participants will then be asked to complete a series of walking trials (minimum 10 trials per condition) over a 8m walkway during which time, lower limb and foot kinematics(i.e. joint angles) and kinetics (i.e. forces),will be collected using an 8-camera Vicon motion capture system (Vicon Motion Systems Ltd, Oxford, UK) synchronised with an AMTI force plate (Advanced Mechanical Technology, Inc., Watertown, Massachusetts). Participants will complete the gait analysis under the three conditions: (1) without orthoses (control),
(2) with the 3D printed orthoses, and (3) the traditionally made orthoses, in a randomised order. The order of conditions are determined by a random number software. The trials of the conditions will occur one after the other with a rest period of about 5 minutes in between trials. A standard canvas lace up shoe, modified with cut outs for the placement of reflective markers, will be supplied to the participant and used for the entire gait analysis.
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Intervention code [1]
318215
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Treatment: Devices
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Comparator / control treatment
No foot orthoses
The participants will be wearing a standardised pair of canvas lace up sneakers provided to all participants, with the existing flat insole that comes with the shoe.
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Control group
Active
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Outcomes
Primary outcome [1]
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Composite outcomes for change in hip, knee, ankle and foot kinematics and kinetics. This will be assessed using an 8 camera Vicon motion capture system and AMTI forceplate.
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Assessment method [1]
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Timepoint [1]
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Measured at each walking trial at the single visit
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Secondary outcome [1]
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comfort score measured on a 100mm comfort scale
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Assessment method [1]
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Timepoint [1]
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Measured at the end of each walking trial at the single visit.
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Eligibility
Key inclusion criteria
Participants must have heel pain in one foot for more than 6 months,
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
BMI of less than 36 kg/m2,
Skin allergies to double sided tape and adhesives
Currently using foot orthotic devices
pathological conditions affecting gait e.g. Parkinson's disease, Stroke etc
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Number of patients required (n=15) were limited by the research grant funds available to find the fabrication of 30 pairs of foot orthoses.
Paired t-tests and repeated measures analysis of variance (ANOVA) will be used to examine the differences in outcome variables between conditions. Statistical significance will be set at an alpha level of 0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
2/12/2019
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Date of last participant enrolment
Anticipated
2/11/2020
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Actual
2/11/2020
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Date of last data collection
Anticipated
31/12/2020
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Actual
1/01/2021
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Sample size
Target
15
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Accrual to date
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Final
13
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment postcode(s) [1]
30884
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4701 - North Rockhampton
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Central Queensland University
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Address [1]
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Central Queensland University; 554-700 Yaamba Rd, Norman Gardens Rockhampton QLD 4701
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Central Queensland University
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Address
Central Queensland University;
554-700 Yaamba Rd, Norman Gardens QLD.
Rockhampton QLD 4701
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
306848
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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CQ University's Human Research Ethics Committee
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Ethics committee address [1]
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Central Queensland University; 554-700 Yaamba Rd, Norman Gardens QLD. Rockhampton QLD 4701
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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24/01/2019
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Approval date [1]
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15/02/2019
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Ethics approval number [1]
306553
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21471
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Summary
Brief summary
A foot orthosis is an insert worn inside shoes to help realign the foot and ankle to reduce excessive movements that lead to pain, stress, and strain in the lower limb during functional tasks. The traditional process of orthotic fabrication is time consuming and labour intensive with the quality and effectiveness of the final product largely dependent on the skill level of the podiatrist fabricating the device. The use of computer aided design and manufacture (3D printing) has the potential to reduce the time and cost of orthotic manufacture, and reduce dependence on podiatrist's skill. Despite the reported benefits of the technology driven foot orthoses, the efficacy of 3D printed orthoses in changing gait kinematics, compared to traditionally made orthoses, has not been adequately investigated. This project will compare the immediate effects of traditionally manufactured orthoses and 3D printed orthoses in regards to: (1) manufacturing specifications (e.g. size and shape of the orthoses), (2) lower limb kinematics and kinetics, and (3) comfort levels in patients with clinically diagnosed heel pain. The results of this study will show how orthoses made using new technology compare with those made using traditional methods. Paired t-tests and repeated measures analysis of variance (ANOVA) will be used to examine the differences in outcome measures between conditions.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Malia Ho
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Address
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Central Queensland University; 554-700 Yaamba Rd, Norman Gardens QLD. Rockhampton QLD 4701
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Country
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Australia
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Phone
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+61 7 4930 9469
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Malia Ho
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Address
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Central Queensland University; 554-700 Yaamba Rd, Norman Gardens QLD. Rockhampton QLD 4701
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Country
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Australia
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Phone
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+61 7 4930 9469
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Malia Ho
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Address
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Central Queensland University; 554-700 Yaamba Rd, Norman Gardens QLD. Rockhampton QLD 4701
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Country
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Australia
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Phone
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+61 7 4930 9469
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Fax
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Email
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
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only researchers who provide a methodologically sound proposal, case-by-case basis at the discretion of Primary Sponsor
Conditions for requesting access:
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-
What individual participant data might be shared?
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individual participant data underlying published results only
What types of analyses could be done with individual participant data?
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only to achieve the aims in the approved proposal, for IPD meta-analyses
When can requests for individual participant data be made (start and end dates)?
From:
Immediately following publication, no end date
To:
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Where can requests to access individual participant data be made, or data be obtained directly?
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access subject to approvals by Principal Investigator (
[email protected]
)
Are there extra considerations when requesting access to individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Study results article
Yes
https://doi.org/doi: 10.1097/PXR.0000000000000068
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The biomechanical effects of 3D printed and traditionally made foot orthoses in individuals with unilateral plantar fasciopathy and flat feet.
2022
https://dx.doi.org/10.1016/j.gaitpost.2022.06.006
N.B. These documents automatically identified may not have been verified by the study sponsor.
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