Background Several footwear design characteristics are known to have detrimental effects on the foot. However, one characteristic that has received relatively little attention is the point where the sole flexes in the sagittal plane. Several footwear assessment forms assume that this should ideally be located directly under the metarsophalangeal joints (MTPJs), but this has not been directly evaluated. The aim of this study was therefore to assess the influence on plantar loading of different locations of the shoe sole flexion point. Method Twenty-one asymptomatic females with normal foot posture participated. Standardised shoes were incised directly underneath the metatarsophalangeal joints, proximal to the MTPJs or underneath the midfoot. The participants walked in a randomised sequence of the three shoes whilst plantar loading patterns were obtained using the Pedar® in-shoe pressure measurement system. The foot was divided into nine anatomically important masks, and peak pressure (PP), contact time (CT) and pressure time integral (PTI) were determined. A ratio of PP and PTI between MTPJ2-3/MTPJ1 was also calculated. Results Wearing the shoe with the sole flexion point located proximal to the MTPJs resulted in increased PP under MTPJ 4–5 (6.2%) and decreased PP under the medial midfoot compared to the sub-MTPJ flexion point (−8.4%). Wearing the shoe with the sole flexion point located under the midfoot resulted in decreased PP, CT and PTI in the medial and lateral hindfoot (PP: −4.2% and −5.1%, CT: −3.4% and −6.6%, PTI: −6.9% and −5.7%) and medial midfoot (PP: −5.9% CT: −2.9% PTI: −12.2%) compared to the other two shoes. Conclusion The findings of this study indicate that the location of the sole flexion point of the shoe influences plantar loading patterns during gait. Specifically, shoes with a sole flexion point located under the midfoot significantly decrease the magnitude and duration of loading under the midfoot and hindfoot, which may be indicative of an earlier heel lift.
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The percentage of sports and leisure shoes sold worldwide is gradually increasing. However, consumers have little or no objective information on the mechanical properties of the shoes. A justified selection protocol of sports and leisure shoes based on static and dynamic shoe properties considering the intended use is essential. Today, commonly accepted dynamic test protocols for (sports) shoes do not exist. The development of an artificial parametric foot as part of an innovative robot gait simulator is a tool to objectify shoe properties independently from possible compensations encountered during assessment of test persons. This contribution discusses the development of an artificial foot enabling objective testing of the mechanical and functional properties of sports and leisure shoes.
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Already for many centuries shoemaking exists as a craft. Orthopaedic shoemaking is a relative new profession that has emerged and evolved during the last century. Originated from the craft of shoemaking it has developed into a profession on the intersection between healthcare and technology. Important drivers were unity of language, developments in science and technology, but also developments in the relationship with society. Whereas in the past shoes were made for patients, today shoes are made with patients, driven by patients’ requirements. This development urges orthopaedic shoemaking to shift from shoe design to the design of mobility solutions, to adopt new ways of interdisciplinary cooperation and to innovate the manufacturing process. This offers many opportunities for research.
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Network Applied Design Research (NADR) made an inventory of the current state of Circular Design Research in the Netherlands. In this publication, readers will find a summary of six promising ‘gateways to circularity’ that may serve as entry points for future research initiatives. These six gateways are: Looped Systems; Extension of Useful Lifetime; Servitisation; New Materials and Production Techniques; Information Technology and Digitization; and Creating Public and Industry Awareness. The final chapter offers an outlook into topics that require more profound examination. The NADR hopes that this publication will serve as a starting point for discussions among designers, entrepreneurs, and researchers, with the goal of initiating future collaborative projects. It is the NADR's belief that only through intensive international cooperation, we can contribute to the realization of a sustainable, circular, and habitable world.
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BACKGROUND: The design and manufacturing of effective foot orthoses is a complex multidisciplinary problem involving biomedical and gait pattern aspects, technical material and geometric design elements as well as psychological and social contexts. This complexity contributes to the current trial-and-error and experience-based orthopedic footwear practice in which a major part of the expertise is implicit. This hampers knowledge transfer, reproducibility and innovation. OBJECTIVE/METHODS: A systematic review of literature has been performed to find evidence of explicit knowledge, quantitative guidelines and design motivations of pedorthists. RESULTS: 17 studies have been included. No consensus is found on which measurable parameters ensure proper foot and ankle functioning. Parameters suggested are: neutral foot positioning and control of rearfoot motion, maximum arch, but also tibial internal/external rotation as well as a three point force system. Also studies evaluating foot orthoses centering on the diagnosis or orthosis type find no clear guidelines for treatment or for measuring the effectiveness. CONCLUSIONS: A gap in the translation from diagnosis to a specific, customized and quantified effective orthosis design is identified. Suggested solutions are both top-down, fitting of patient data in simulations, as well as bottom-up, quantifying current practices of pedorthists in order to develop new practical guidelines and evidence-based procedures.
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Abstract 1 Im Laufe der Jahre haben die Orthopädieschuhmacher ihr Handwerk als eine Spezialisierung der traditionellen Schuhmacherei entwickelt. Im Gegensatz zu regulären Schuhmachern, die Schuhe für gesunde Füße machen, helfen Orthopädieschuhmacher Menschen mit Fußproblemen, welche ihre Mobilität behindern. Die Orthopädie-schuhmacher tun dies durch die Anpassung oder Änderung von Schuhen, je nach Schwere des Mangels des Fußes, in einem Bereich von einfachen Modifikationen der Standard-Schuhen bis zu vollständig maßgeschneiderten Schuhlösungen. In der Vergangenheit wurden die Orthopädieschuhmacher im Rahmen einer Lehre in der Berufspraxis ausgebildet. Auf diese Weise wurden berufliche Kenntnisse, Fähigkeiten und Fertigkeiten des Schuhmachermeisters an die Lehrlinge/Gesellen von Generation zu Generation übertragen. Diese Basiskenntnis wurde übertragen wie eine Katalog an Erfahrungswissen, zusammen gestellt aus: 1) Wissen über bekannte Probleme und 2) die dazu gehörige Lösungen. Weiterhin wurden 3) die Kenntnisse, Fähigkeiten und Erfahrungswissen formuliert und als prozedurales Wissen gelehrt, um effektive Lösungen zu entwickeln. Folge war, dass verschiedene Schuhmacher-Gruppen verschiedene Lösungen für die gleichen Probleme entwickelten, wofür jede "empirische Gültigkeit“ beanspruchte. Diese Kenntnisbasis von Orthopädieschuhmachern kann man charakterisieren als: Herstellung orientiert an impliziten, durch Tradition bestimmten Lösungsentwürfen. Da die empirischen Lösungen der Nachfrage entsprachen, waren die Begründung der Lösung und der methodische Entwurf der Orthopädieschuhe keine explizit geforderte Aktivität. Vor kurzem wurde in den Niederlanden diese traditionsbestimmte Kenntnisbasis der Orthopädieschuhmacher durch die Krankenkassen in Frage gestellt, da die Kassen wissen wollten, ob und warum ein Lösungsvorschlag wirksam wäre. Erfolgt diese Begründung nicht, wird nur die preiswerteste Lösung zurückerstattet. Die Kassen stellten die Begründungsfrage und forderten also eine akzeptable wissenschaftliche Erklärung für die Lösung des Mobilitätsproblems. Diese Erklärung ist im Prinzip erreichbar, als zum Beispiel innovative Imaging-und Messmethoden zur Verfügung stehen. Es gab großen Widerstand in den Reaktionen auf die Aufforderung, traditionelles Wissen wissenschaftlich zu begründen. Es gab abwehrende (in Zusammenhang mit den Kosten) aber auch pro-aktive / innovative Reaktionen. Fontys University of Applied Sciences nahm die innovative Perspektive und identifizierte Möglichkeiten um das Orthopädieschuhmacher-Handwerk qualitativ aufzuwerten zu einem modernen, mehr professionellen und mit wissenschaftlichen Einsichten unterstützten Beruf. Aus dieser Perspektive hat Fontys einen neuen Lehrplan gestaltet und die Schlüsselperspektiven: 1) Begründung und 2) methodischer Entwurf inkorporiert. Der Lehrplan wird die vorläufigen IVO Kriterien für eine Cat-II Akkreditierung erfüllen. Derzeit wird die Gestaltung von Lehrplänen in Vietnam als Teil der internationalen Kooperationsprojekte pilotiert. Keywords: Vom Handwerk zur Profession, Wissensarten, Methodischer Entwurf Abstract 2 Over the years, orthopaedic shoemakers developed their craft as specialisation of traditional shoemaking. In contrast of shoemakers who make shoes for the healthy feet, the orthopaedic shoemakers assist people with foot related problems causing mobility disabilities. They do this by adapting and modifying shoes in a range from simple modifications of standard shoes to complete bespoke shoe solutions depending on the severity of the deficiency of the foot. In the past, orthopaedic shoemakers were trained in a craft-apprenticeship model which was used to transfer the professional knowledge of the master shoemaker to the apprentice, from generation to generation. This transferred knowledgebase can be perceived as an catalogue of empirical knowledge consisting of 1) knowledge of known problems and 2) associate solutions (know –how). In addition, 3) the knowledge, skills, tricks and traps, formulated in procedural knowledge (do this-do that) was taught to produce the solutions. Consequently, different groups of shoemakers had different solutions for the same issues and each claimed empirical success. This orthopaedic shoemakers knowledgebase can be characterised as manufacture driven with implicit tradition based designs. As the traditional empirical solutions met the demand, explanatory knowledge and explicit methodological shoe design were no issues. In the Netherlands, recently the knowledgebase -know how- of the orthopaedic shoemakers was challenged as the insurance companies wanted to know whether and why a proposed solution is effective. If not, the cheapest solution was refunded. They requested an acceptable scientific explanation – know why- which in principle became achievable as innovative imaging- and measurement methods became available. As a result, the orthopaedic shoe branch was challenged when their mode 2 knowledge was questioned. The reactions were contrasting, from reactive(follow the money) to pro active/innovative. Fontys University of Applied Sciences took an innovative perspective and perceived possibilities to upgraded the craft of orthopaedic shoemakers into a modern, more academic, profession. Therefore, Fontys designed a new curriculum and added the key characteristic: 1) explanatory knowledge (mode 1 knowledge) and 2) methodical design. The curriculum is set up to meet the provisional IVO guidelines for a cat-II accreditation. At present, the curriculum design is piloted in Vietnam as part of international cooperation project. Keywords: from craft to profession, types of knowledge, methodical design
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Social issues are becoming increasingly pressing. From dementia to climate change to corona; we as people, citizens, residents and city users - through our own experience or otherwise - have a sense of them. However, truly understanding and addressing these issues is difficult because there is no single owner. Everything is related, intertwined and also changing. Getting an overview and deciding together on necessary steps proves difficult. Complex issues thus become orphaned. Design and more specifically co-design - creative collaboration with others - is increasingly seen as a possible approach to these such issues and collaborations because it can deal with complexity and uncertainty, is optimistic and investigative in nature. With a co-design approach, we can find a shared desire and with that we connect with each other. By then searching together for mechanisms that can lead to the desired values, we gain insights on how to tilt a problematic situation. That enables us to imagine alternative futures. These help us on our way to a better, greener and more social world and social change.
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Introduction: Sensor-feedback systems can be used to support people after stroke during independent practice of gait. The main aim of the study was to describe the user-centred approach to (re)design the user interface of the sensor feedback system “Stappy” for people after stroke, and share the deliverables and key observations from this process. Methods: The user-centred approach was structured around four phases (the discovery, definition, development and delivery phase) which were fundamental to the design process. Fifteen participants with cognitive and/or physical limitations participated (10 women, 2/3 older than 65). Prototypes were evaluated in multiple test rounds, consisting of 2–7 individual test sessions. Results: Seven deliverables were created: a list of design requirements, a personae, a user flow, a low-, medium- and high-fidelity prototype and the character “Stappy”. The first six deliverables were necessary tools to design the user interface, whereas the character was a solution resulting from this design process. Key observations related to “readability and contrast of visual information”, “understanding and remembering information”, “physical limitations” were confirmed by and “empathy” was additionally derived from the design process. Conclusions: The study offers a structured methodology resulting in deliverables and key observations, which can be used to (re)design meaningful user interfaces for people after stroke. Additionally, the study provides a technique that may promote “empathy” through the creation of the character Stappy. The description may provide guidance for health care professionals, researchers or designers in future user interface design projects in which existing products are redesigned for people after stroke.
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This article describes how the 4 period rooms of the city museum in the Dutch town of Bergen op Zoom were redesigned using storytelling and how this design has been received by visitors. For this redesign, rooms were reframed as sets of the story of Marie Anne van Arenberg, Marquise of Bergen op Zoom, and the objects as props to stage her story, which was full of secrets and of unexpected turning points. The visitor is enticed to discover cues to unlock these secrets in order to get a grip on her story while exploring the museum space. This is however not a treasure hunt, nor simply a game, but an exploration in which visitors are invited to discover and to create meaning and a journey into what matters to them. To this end, they have indeed to resort to their own frame of reference and to their personal life story in order to come to a narrative closure at the end of their visit. We used Interpretative Phenomenological Analysis to understand the visitors’ lived experience, both emotionally and sensorially at different moments and situations during the story-driven experience and to understand how the chosen design helps tell the story and how visitors use their personal context and frame of reference to make sense of it.
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Walking meetings are a promising way to reduce unhealthy sedentary behavior at the office. Some aspects of walking meetings are however hard to assess using traditional research approaches that do not account well for the embodied experience of walking meetings. We conducted a series of 16 bodystorming sessions, featuring unusual walking meeting situations to engage participants (N=45) in a reflective experience. After each bodystorming, participants completed three tasks: a body map, an empathy map, and a rating of workload using the NASA-TLX scale. These embodied explorations provide insights on key themes related to walking meetings: material and tools, physical and mental demand, connection with the environment, social dynamics, and privacy. We discuss the role of technology and opportunities for technology-mediated walking meetings. We draw implications for the design of walking meeting technologies or services to account for embodied experiences, and the individual, social, and environmental factors at play.
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