EP3579715B1 - Orthopaedic foot bed and method for producing an orthopaedic foot bed - Google Patents

Description

The present invention relates to an orthopedic footbed having the features of the preamble of claim 1.

A problem of modern civilized societies is that the deformity of people's feet is increasing. The deformity of the feet can in turn cause postural damage, which can lead to significant health problems in the long term. It has been found that at least 90% of all people have a healthy foot at birth, while at least 60% of all people have a structurally and/or functionally diseased foot in adulthood.

In primitive peoples, on the other hand, where regular shoe use is the exception, foot deformities are much rarer. The healthy foot is practically preserved for much longer.

The increased foot deformation of people in civilized societies is due, among other things, to walking on hard surfaces and the decoupling of the feet from their natural perception of the environment, which leads in particular to a weakening of the feet. In principle, between structural damage to the feet and functional damage to the feet. Structural damage includes clubfoot and heeled heel, severe toe deformities such as hallux valgus and claw toes, i.e. damage to the foot itself. The proportion of structurally damaged feet has also increased in civilized societies due to the problems described above. A functional disorder of the foot, on the other hand, is understood to mean a malfunction of the foot such as unhealthy rolling behavior or incorrect statics. Such an incorrect static can lead in particular to an incorrect posture of the person, which can cause further muscular problems or problems of joints or the spine. Examples of this are splayfoot and, in particular, splayfoot and flatfoot. These disturbances have also increased significantly.

U.S. 5,400,526A discloses a shoe sole with ridges and pneumatic ventilation.

Against this background, the object of the invention is to provide an improved orthopedic footbed with which the problems described above can be solved inexpensively and as far as possible for the general public.

According to the invention, an orthopedic footbed with the features of claim 1 is used to achieve the object. Further preferred further developments can be found in the subclaims, the figures and the associated description.

According to the basic idea of the invention, it is proposed according to claim 1 that the footrest surface of the footbed a flat base surface is formed with a multiplicity of nubs arranged according to a foot orthopedically optimized distribution.

Commercially available shoes are usually provided with a footbed with a footrest surface, the footrest surface being deliberately adapted to the shape of the foot. In particular, the foot support surface in the area of the arch of the foot is increased, e.g. by a so-called pad, so that it is supported, regardless of whether the foot has a structural and/or functional disorder. As a result, the stress on the foot is reduced, which in turn weakens the foot's strength and shape over time.

In contrast, the invention takes a completely different approach. According to the invention, it is proposed that the foot support surface of the foot bedding is formed by a flat base surface, the foot thus stands on a deliberately flat foot support surface and is thereby deliberately stressed and strained, so that the foot is strengthened by the regular strain, which in turn As a result, the likelihood of structural and/or functional disorders of the foot is reduced. The solution according to the invention is based on the example of primitive peoples, who walk barefoot and therefore do not walk on a foot contact surface that is deliberately adapted to the sole of the foot. The proposed orthopedic footbed practically enables a combination of shoes used in modern civilized societies with a load on the feet similar to walking barefoot due to the flat base area in the shoe. The proposed footbed is also referred to as the standard footbed. A base surface with slight bumps, such as e.g Increases understood, which may be due to prolonged use, an uneven surface or manufacturing inaccuracies.

It is further proposed that the base surface has a large number of nubs which are arranged in a orthopedically optimized distribution. Such a distribution can be, for example, a distribution corresponding to the anatomical distribution of the bony components projected into the footrest surface and/or the distribution of the lymphatic and/or nerve and/or vascular pathways of a human foot resting on the footrest surface projected into the footrest surface be. As a result, the nubs deliberately form stimulation points for the sole of the foot that correspond to the bony components and/or the pathways of the foot. The bony components are assigned pathways, which are similar in all people with slight variations and can be understood as an evolutionary, generally applicable basic order. The course of the pathways is thus in the basic order an image of the bony components of the foot. The proposed arrangement of the nubs according to the bony components and/or the pathways deliberately stimulates the human biotensegrity system. The proposed distribution of the nubs is defined in relation to the bony components and/or the conductive pathways of a foot resting on the footrest surface in a normal position or predetermined orientation and position, so that the nubs on the footrest surface correspond to predetermined zones of the sole of the foot or associated with the bony components and/or the conduction pathways of a foot resting on the footrest surface.

The Biotensegrity System is an important scientifically recognized basic principle of the human body and describes an underlying tension system or a self-regulating stabilizing system in the human body. The term biotensegrity or generally tensegrity is a compound artificial word from the English words "tension" (tension) and "integrity" (wholeness, cohesion). According to the principle of the tensegrity concept, the ligaments and fascia in medicine correspond to fixed tension bands, while the bones correspond to the fixed thrust pieces of the model. In addition, there are the dynamic stabilizers of the system, the muscles that mediate the pretension of the system. The pre-tension created by the muscles determines the response of the Tensegrity system to additional loads. The stability of the entire system depends on the dynamic stabilizers under biological load and everyday conditions. The higher the prestress in the composite, the more stable the system. Too little pre-tension leads to buckling of the system and postural problems, too high a pre-tension means restricted mobility and other undesirable medical consequences such as tennis elbow and other tendon attachment disorders in orthopedics or foot malpositions such as pes cavus. In the still growing skeleton, this faulty organization of forces leads to scoliosis, postural disorders, foot malpositions and other anatomical conditions that develop unfavorably later in life. Because human muscle tension is reduced during sleep, humans, unlike certain animals, cannot stand up while they sleep. If the structure, eg the sliding pieces, the geometry and the biomechanics are defective, this means that the tension pieces can no longer be pretensioned by the dynamic tension generator formed by the muscles in such a way that they form a stable system.

If there is a structural disease, such as cerebral palsy, it can often only be corrected with mechanistic measures or with the help of an operation. In this case, the balancing and symmetry-creating pretension of the system is not given due to central neurological damage, which can result in misalignment of the joints. If the dynamic tension bands (tendons and fascia) are too soft, e.g. in the case of a connective tissue disease, the healthy dynamic tension generator muscle cannot pre-tension the biotensegrity system into a stable system either. In both of these cases of structural disease, the proposed orthopedic footbed is a compensation and training aid for the existing and expandable residual function of the Biotensegrity System. A complex therapy based on this understanding always includes balancing the tension in the dynamic parts of the system, i.e. the muscles in the human system. The human being can usually achieve this by improving the sensory system by generating the right muscle tension by comparing with centrally stored target values, whereby the improvement of the sensory system is further supported by muscular development training and targeted relaxation and stretching of shortened structures and strengthening of structures that are too soft can. The proposed footbed helps with all aspects of these scientific principles.

The distribution of the nubs corresponds to the anatomical distribution of the bony components or the pathways of the human foot and thus also the distribution of the sensory fields in the surface or sole of the foot. In particular, they follow the distribution of the bony components in the heel, the tarsal and tarsal transition area to the metatarsal and especially in the metatarsal toe area. With that stimulates the stimulation points in the sole of the foot in a specific way and sequence during the physiological rolling pattern of walking. The sequence of stimulation leads to a perception in the human brain that is coded in a certain way and leads to a reflex adaptation of posture and gait.

Furthermore, the human biotensegrity system comprises several chambers, in each of which scaled individual cells up to entire organs are arranged. Regardless of its size, each chamber is exposed to pressure changes caused by movement, muscle strength and body weight. The cyclical movement of humans when running means a time-coded change in pressure in the foot, i.e. first an increase in pressure in the heel, then an increase in pressure in the tarsal area, then an increase in pressure over the metatarsal area to the toes until the foot leaves the ground for the next prepare step. This pressure wave, which cycles through the foot, is the main pump for all of the foot's fluids, both venous and lymphatic. In contrast to human blood, which is pumped arterially from the heart to the foot, the lymphatic and venous fluid is not moved through the heart; the foot takes over this function to a certain extent. The foot could therefore also be understood as the heart or as a pump for the low-pressure system of the veins and the lymphatic vessels. This pump is activated or stimulated by the proposed distribution of the nubs, which practically strengthens the Biotensegrity system. This function can also be referred to as the "heart of feet function".

It is further proposed that the nubs in a zone of the foot support surface on which a foot with a front ball of the foot comes to rest, are arranged in five rows according to the alignment of the five toes forming bony components and / or along the associated pathways. The nubs run in five rows along the bony structures of the foot that form the toes and metatarsal bones, starting from the metatarsals to the tips of the toes or the last bony segment of the toes, and thus specifically stimulate the bony components or the pathways of the toes stimulation points. It is assumed here that the foot comes to rest on the footbed in the intended normal alignment, which inevitably results when the shoe is put on when the footbed is arranged in the shoe. This applies in principle to the entire application if the footbed is described in relation to a foot lying on it.

Furthermore, the nubs are preferably arranged in a circle in a zone of the foot support surface on which a foot comes to rest with a heel. The nubs arranged in an imaginary circle stimulate the foot in the area of the heel evenly, the arrangement of the nubs in the heel area being more preferably formed by a circle of nubs with further, evenly distributed nubs arranged within the circle. This gives a specific stimulation effect that results in a specific motion vector.

It is further proposed that the nubs in a zone of the footrest surface on which a foot comes to rest with a central region are arranged in at least two lines that diverge to an inner side of the footrest surface. The inside of the footrest surface is the side of the footrest surface which is the inside of a person standing on it Is assigned foot, the inside of the foot in turn is the side of the foot, which is adjacent to the other foot of the person in a normal standing position of the person. In principle, the distances between the stimulation points in the longitudinal direction of the sole of the foot increase, starting from the outside of the foot to the inside, which is taken into account by the solution according to the invention by the nubs arranged in divergent lines on the foot support surface.

It is also proposed that the distances between the nubs in the longitudinal direction of the footrest decrease from a zone of the footrest on which a foot rests with a central area to the front and/or rear of the footrest. The density of nubs on the footrest surface thus increases, starting from the central area to the front and rear of the footrest, which particularly stimulates the stimulation zones of the sole of the foot in the area of the zones of the sole of the foot that come to rest on the front and rear of the footrest, which are the biotensegrity system and the effect described above are of particular importance.

It is also proposed that the nubs have an identical height. The nubs can preferably have an identical height, at least when new, so that their upper sides again form a flat base surface, or so that they increase the flat base surface by an identical value. The entire sole of the foot is used as a sensor surface in order to modify the biological perception of symmetry, posture, muscle tension, weight distribution and positioning in space through targeted sensory impulses of the entire sole of the foot in such a way that the person using the footbed experiences an effect that improves posture and gait. Unless a stimulation of the foot only makes sense or is advantageous in a designated area, but it would also be conceivable to only provide the nubs in defined sections of the base area or to emphasize them in certain areas where the foot comes to rest with the area to be stimulated.

The nubs can preferably have a height of 2 to 3 mm in relation to the foot support surface and a diameter of 3 to 5 mm, which has been found to be sufficient to bring about the sensory stimulation effect. In special cases, however, deviations from this standard make sense.

It is also proposed that the diameter of the nubs can be dependent on the size of the shoe. The nubs in smaller shoe sizes, i.e. for children, preferably have a smaller diameter and height than in larger shoes for adults.

It is further proposed that the footrest surface can have at least one functional zone which is raised or lowered compared to the base surface and/or has a higher or lower hardness than the footbed in the remaining section. The functional zone allows the footbed to be individually adapted to a structural and/or functional disorder of the foot, whereby the functional zone can only be formed by a local elevation or depression, while the base surface is otherwise unchanged in the form of a flat surface.

The footbed can also have a higher hardness in the area of the functional zone and/or be formed by a group of nubs with a different hardness in relation to the other nubs, preferably with a higher hardness.

With the proposed further developments, the stimulation effect to be achieved by the nubs or the footbed can be further specifically reinforced locally in areas of the sole of the foot that come to rest on them, which are defined by the position of the functional zones.

If required, the functional zone can be raised or lowered by 3 to 5 mm, preferably by 4 mm, in relation to the base area in order to fulfill its purpose. The functional zones can harmoniously merge into the base area with corresponding radii and continuously rise or deepen.

In particular, the functional zone can be formed by a flat foot correction surface that is higher than the base surface and is arranged in a zone of the foot support surface on which the foot comes to rest with the inside of the front ball of the foot and the inside of the arch of the foot. The flat foot correction surface projects upwardly from the base surface and supports the foot on the inside, counteracting the person's tendency to buckle with the knees together.

Furthermore, the functional zone can also be formed by a static correction surface that is higher than the base surface, which is arranged in a zone of the foot support surface on which the foot comes to rest with a heel, so that the person's foot is slightly lifted at the heel and the foot statics is corrected. This makes it possible to achieve static leg length compensation.

According to a further preferred embodiment, it is proposed that the functional zone be formed by a surface opposite to the base increased hollow foot correction surface is formed, which is arranged in a zone of the foot support surface on which the foot comes to rest with the front foot part over the entire width. The hollow foot correction surface can preferably be combined with the static correction surface in order to counteract the tendency to have a hollow foot, since the foot is thereby slightly lifted both in the front area and in the area of the heel.

Furthermore, the functional zone can also be formed by a heel spur correction surface that is recessed compared to the base surface, which is arranged in a zone of the foot support surface on which the foot comes to rest with a central section of its heel and/or a central section of the arch of the foot, whereby the foot is deliberately in the area a heel spur is relieved.

Furthermore, the functional zone can preferably be formed by a section that is higher than the base surface and has a lower hardness than the base surface, which is arranged in a zone of the foot support surface on which a foot with a central area arranged between a heel and the ball of the foot rests on an inner side reached. The pumping system of the lymphatic and venous fluids in the human body, referred to as the "heart of feet function" in the invention, can be stimulated and intensified by the proposed functional zone of the orthopedic footbed. Due to the increase in the functional zone and its lower hardness in the described section of the foot support surface, the stimulation points in this area are specifically stimulated, with the shape of the described functional zone, in contrast to the pads known in the prior art, not being deliberately adapted to the shape of the arch of the foot, but instead is only increased, since the task of this functional zone is not to support the sole of the foot but instead only to intensify pressure build-up in this area. For this it is sufficient, for example, if the functional zone in this section is raised by a constant height in contrast to the pad.

If present, an anatomical leg length difference can also be achieved by adjusting the material thickness of the orthopedic footbed on the shortened side. The material thickness is adjusted or increased in particular by adjusting the thickness of the base layer located below the stimulation zone.

The functional zones and the base surface are each formed by uniform, predefined, person-independent surfaces, and the different orthopedic footbeds are formed as a range with different foot support surfaces by combining the base surface with different functional zones. The base surface and the functional zones are initially designed independently of the person for the different shoe sizes and combined to form the foot contact surface of an orthopedic foot bedding for a special type of foot. A different combination of the base area and the functional zones or even just the use of the base area alone can be used to produce different orthopedic footbeds with different footrest surfaces to form an assortment in large quantities, which can then be used for different people with different structural problems and/or functional disorders of the feet are applicable. Since the footbeds are not manufactured specifically for a person, but in a range in very large numbers, the manufacturing costs and distribution costs can be reduced by the proposed orthopedic footbed and the method for manufacturing the footbed be significantly reduced. All in all, the orthopedic footbeds can thus be manufactured inexpensively for a large number of people, which means that a significant contribution to improving the health of a large number of people from very broad sections of the population in all age groups can be achieved with little effort.

Alternatively, the footbed can be formed by a base body on which the base surface and/or the functional zones are formed or worked out. The base body can be a foam block, for example, in which both the base surface and the functional zone(s) are milled, for example. Alternatively, production using a 3D printing process, an injection molding process or a sintering process would also be conceivable. Furthermore, the footbed can also be made from different layers, from different materials with different properties, in particular with different strengths, which in turn can vary in layer thicknesses and strengths over the foot support surface in order to achieve the desired effect described in the application.

If the footbed is made from a base body, the functional zones can either be worked into the base area after the production of the base area, if they are deepened, or, if they are raised, already taken into account during the production of the base area.

Furthermore, to achieve the object, a method is proposed for providing a footbed adapted with regard to a structural and/or functional disorder of a person's foot, in which a plurality of different footbeds with a defined size are provided, which each have different, modularly composed footrest surfaces, wherein the modular footrest surfaces of the different footbeds are formed by one of the following predefined person-independent surfaces, a flat base surface or a combination of a flat base surface and a person-independent one adapted to a structural and/or functional disorder of the foot Functional zone, in which the person is examined for the presence of a structural and/or functional disorder of the foot, and if there is no structural and/or functional disorder of the foot, a footbed with a personal size and a foot support surface formed by a flat base surface is selected, and in the event of a structural and/or functional disorder, a footbed with a personal size and a footrest surface formed by a combination of a flat base surface and at least one functional zone is selected.

The footbeds are prefabricated in large numbers and ready on site, e.g. in a shoe shop, a physiotherapy or osteopathy practice, a podiatry practice, a doctor's practice, a sports shop, a trekking shop, a fitness center or even in a Taichi training center etc held. The person is then examined visually by a suitably qualified specialist for the presence of structural and/or functional disorders of the foot, whereby alternatively or additionally suitable sensor devices such as pressure-sensitive sensor plates can also be used, on which the person stands. If no structural and/or functional disorder of the foot is found, a footbed with a simple, flat base surface is selected, which can also be referred to as a standard footbed. Will against If a structural and/or functional disorder is determined, a footbed in a corresponding shoe size provided by the individual functional zone(s) specifically for the structural and/or functional disorder is selected.

Fig. 1

eine erfindungsgemäße orthopädische Fußbettung mit einer ebenen Basisfläche in Schrägansicht; und

Fig. 2

die Fußbettung der Figur 1 in Seitenansicht; und

Fig. 3 bis 6

verschiedene Fußbettungen mit verschiedenen Funktionszonen; und

Fig. 7

eine orthopädische Fußbettung mit den darauf vorgesehenen Noppen; und

Fig. 8

ein menschlicher Fuß mit seinen knöchernen Bestandteilen und Leitungsbahnen in Sicht von unten; und

Fig. 9

ein Verfahrensablaufdiagramm eines Verfahrens zur Bereitstellung einer orthopädischen Fußbettung; und

Fig. 10 bis 14

verschiedene Fußbettungen mit einer erfindungsgemäßen Verteilung der Noppen und darauf angeordneten Funktionszonen; und

Fig. 15

eine erfindungsgemäße orthopädische Fußbettung mit einer "Heart of Feet-function" in Sicht von oben und in zwei verschiedenen Schnittdarstellungen.

The invention is explained below on the basis of preferred embodiments with reference to the accompanying figures. while showing

1

an orthopedic footbed according to the invention with a flat base surface in an oblique view; and

2

the footbed of figure 1 in side view; and

Figures 3 to 6

different footbeds with different functional zones; and

7

an orthopedic footbed with the nubs provided on it; and

8

a human foot with its bony components and pathways viewed from below; and

9

a process flow diagram of a method for providing an orthopedic footbed; and

Figures 10 to 14

various footbeds with a distribution of the nubs according to the invention and functional zones arranged thereon; and

15

an orthopedic footbed according to the invention with a "heart of feet function" viewed from above and in two different sectional views.

In the figure 1 is an orthopedic footbed 1 in the form of an insert 6 to see which in the figure 2 can be seen in a side view with a foot 16 standing on it. The insole 6 has a footrest surface 3 formed by a continuous, flat base surface 4 with knobs 5 arranged thereon. The footrest surface 3 is designed to be continuous and flat and is intended for people with structurally and/or functionally healthy feet. Furthermore, the insert 6 has a flat base 7 on the underside. The insole 6 is thus intended for shoes with a flat inner bearing surface. The nubs 5 have an identical height of 3 to 5 mm, preferably 4 mm and an identical diameter of 3 to 5 mm on the foot support surface 3 or the base surface 4 and, together with their end faces, again form a flat surface for support of the indicated foot 16.

In the figure 7 is the orthopedic footbed 1 next to the one in the figure 8 Foot 16 shown can be seen with its bony components 100 and conductive pathways 200 in the projection from below. If in the description of the invention in general on a standing on the footrest 3, in the figures 2 and 8th foot 16 to be recognized is referred to, it is assumed that the foot 16 stands up on the footrest surface 3 in accordance with the normal position or the predetermined position.

The numbers 1 to 56 each individually represent a knob 5 on the orthopedic footbed 1, so that the distribution of the numbers 1 to 56 of the distribution of the knobs 5 on the footrest surface 3 corresponds. The distribution of the nubs 5 corresponds in its basic arrangement to the arrangement of the essential bony components 100 of the bone structure of the foot 16 and the conductive paths 200 running thereon in the projection into the footrest surface 3 of the orthopedic footbed 1, as can be seen by comparing the Figures 7 and 8 is easy to spot.

The Indian figure 8 The basic structure of the foot 16 seen from below comprises the bony components 100 with the heel 102, the middle area 103, the ball of the foot 104 and finally the toes 101. In the event that the person walks with a healthy rolling behavior, they sit down first with the heel 102, and then continues to roll over the central region 103, the ball of the foot 104 and finally over the toes 101. The heel 102 forms an approximately circular contact area from which the central area 103 extends forward in the walking direction. Starting from the central area 103, the bony components 100 extend further in the form of chains of individual bone links, which together form the ball of the foot 104 and the individual toes 101 with the last bone links of the chain. The conduction paths 200 are arranged along the bony components 100 and thus correspond in their distribution and in their course to the distribution and the course of the bony components 100. The conduction paths 200 contain the lymph and/or the nerves and/or the vessels of the foot 16 . In their basic structure, the bony components 100 run from the central region 103 in five bone link chains arranged in lines, the individual bone links of which are connected to one another via joints.

In the figure 7 shows the orthopedic footbed 1 with the nubs 5 and the various zones on which the foot comes to rest with the respective bony components 100, the various zones of the bony components 100 with which the foot 16 rests on the foot support surface 3 reached, are identified by the reference numerals 101 to 104. The orthopedic footbed 1 can thus also be regarded as an anatomical and neurological footbed 1 since it is specially adapted to the anatomy and neurology of the foot 16 due to the proposed distribution of the nubs 5 . The orthopedic footbed 1 thus forms a kind of "bio-interface" via which the stimulation points in the sole of the foot are stimulated while walking, with the proposed distribution of the nubs 5 being of particular importance, since the walking movement leads to additional stimulation of the stimulation points and the associated improvement of the biotensegrity system is used. The orthopedic footbed 1 quasi forms an interface in the contact surface of the sole of the foot that is specially adapted to the stimulation points of the sole of the foot.

In the rear zone of the foot support surface 3, on which the foot 16 comes to rest with the heel 102, the knobs 5 are arranged in a circle in an imaginary ring, which can be seen from the numbers 41 to 52. In the middle of the imaginary ring, four more knobs 5 with the numbers 53 to 56 are arranged in a square as evenly as possible, with identical distances in the longitudinal direction and transverse to the longitudinal direction of the footrest surface 3 . The foot 16 is thus uniformly stimulated at the beginning of the rolling movement in the stimulation zones of the heel 102, as a result of which the pumping process described at the outset is triggered. In this case, the stimulus signals triggered in the stimulation zones in the The human brain generates corresponding signals for the pressure change in the associated chambers of the cells or the human organs, whereby the segmentally organized nervous system and the organs are specifically stimulated or vitalized.

During the further rolling movement, the person rolls with the foot 16 with a central region 103 on the footrest surface 3 and rolls over a zone of the footrest surface 3 in which the nubs 5 run in two transverse to the longitudinal direction of the footrest surface 3, towards the inside 105 of the footrest surface 3 divergent imaginary lines corresponding to the numbers 40 to 36 and 35 to 31 are arranged. Due to the divergent orientation of the lines, the distances between the knobs 5 in the longitudinal direction of the footrest surface 3 are greater on the inside 105 of the footrest surface 3 than on the outside 106 of the footrest surface 3. This arrangement of the knobs 5 is advantageous in that the distances between the Stimulation points on the outside 106 of the foot 16 are smaller than on the inside 105. Due to the divergent alignment, the distances between the knobs 5 increase in the longitudinal direction of the foot support surface, starting from the outside 106 towards the inside 105, that is to say transversely to the longitudinal direction. Furthermore, the arch of the foot 16 is thereby taken into account.

During the further rolling movement, the foot comes to rest with the ball of the foot 104 and the toes 101 in a zone on the footrest surface 3, in which the nubs 5 are arranged in five imaginary lines corresponding to the bony components 100 of the toes 101, in the longitudinal direction of the footrest surface 3 are. The knobs 5 are in imaginary lines corresponding to the numbers 1,6,11,16,21,26, the numbers 2,7,12,17,22,27, the numbers 3,8,13,18,23,28 , the digits 4,9,14,19,24,29 and finally corresponding to the digits 5,10,15,20,25,30 arranged. The distribution of the nubs 5 thus corresponds to the image of the bony components 100 forming the toes 101 and the conductive paths 200 arranged along them, so that the nubs 5 in this zone specifically target the stimulation points of the toes arranged on the bony components 100 or the conductive paths 200 101 are stimulated during the rolling movement.

The one in the figure 1 The insole 6 shown has a consistently flat foot support surface 3 and can also be regarded as a standard footbed SFB. When viewed from the inner, medial side, the person's foot 16 stands up, in particular with the heel 102 and the front ball of the foot 104, so that in a healthy foot there is a gap between the arch of the foot and the footrest surface 3, and the foot 16 in the area of the arch of the foot is deliberately not supported. The foot 16 is thereby deliberately "stressed" and thereby strengthened when it is subjected to a load, ie when standing or walking. Furthermore, the foot 16 is stimulated by the sensomotoric knobs 5, which changes the muscle activation and the foot 16 is dynamically strengthened by the tensegrity system explained in more detail at the beginning. In addition, the vein and lymphatic system of the person is stimulated.

In the Figures 3 to 6 Different variants of the orthopedic footbed 1 can be seen which, in addition to the flat base surface 4, also have various raised or reinforced or deepened or weakened functional zones 8. Here, the functional zones 8 are formed by surfaces which deliberately stimulate the foot 16 through their geometry and arrangement on specific sensor surfaces. For this purpose, the functional zones 8 can either be raised or reinforced differently in relation to the base area 4 or weakened or deepened in relation to this. The base surface 4 with the standard nub distribution forms the ideal support surface for structurally and functionally healthy feet for long-term maintenance of foot health, while the need-based modified stimulation units in the functional zones 8 form the base surface 4 for taking into account individual disorders of the structure and/or the function of the feet to an individual foot type supplement or adapt adapted footrest surface 3. To simplify understanding, the footrest surface 3 of the orthopedic footbed 1 is in the Figures 3 to 6 divided into different points or sections with knobs 5 corresponding to the numbers 1-56. The functional zones 8 are formed here by groups of increased stimulating nubs 5, which together have an increased support-stimulating effect for certain zones of the foot 16 due to their end faces. The enhanced stimulation effect is produced by zonal hardening or thickening of the figure 15 to be recognized EVA base layer 110 or alternatively by raising certain knobs 5 and the stimulation points realized thereby. Alternatively, the nubs 5 in the functional zones 8 can also have greater strength than the nubs 5 in the area of the remaining footrest surface 3 .

In the figure 3 the functional zone 8 is formed by a flat foot correction surface 9, which is arranged on the foot support surface 3 in such a way that the foot 16 connects to the inside of the front ball of the foot 104 at points 11, 16, 22 and 21 in an area 9b and to the inside of the arch of the foot in the points 26, 27, 31, 32, 36 and 37 in the area 9a of the footrest surface 3 it comes to rest or is stimulated more intensely in this area. The increased stimulation can stimulate a counter-control by the central nervous system and prevent the foot 16 from buckling to the inside in the direction of the other foot. In the fall of the flat foot It is a functional disorder of the foot 16 in which the person does not put down the foot 16 straight but instead buckles to the inside, which can also lead to knock knees, hip and spinal posture disorders.

In the figure 4 An orthopedic foot bedding 1 can be seen in which an additional functional zone 8 in the form of a static correction surface 10 is provided in addition to the flat foot correction surface 9 . The static correction surface 10 is formed by raising the nubs 5 and the resulting stimulation effect in the foot support surface 3 in the area of points 41 to 56, which form the area where the person's heel 102 comes to rest. As a result, the stimulation points or pressure receptors in the heel area are stimulated more intensively, so that the static is adjusted by neurological regulation in the sense of a correction. This is due to the sensorimotor effect of the intensified stimulation according to the law of the vector addition model.

In the figure 5 Another orthopedic footbed 1 with a flat base surface 4 and two functional zones 8 can be seen. One of the functional zones 8 in the area of the heel 102 is again provided as a static correction surface 10 and another functional zone 8 is provided in the area of the front ball of the foot 104 over the entire width of the points 11 to 21 in the form of a hollow foot correction surface 11 . Both the static correction surface 10 and the hollow foot correction surface 11 are each 3 to 5 mm higher than the base surface 4 functional zones 8, which slightly stimulate the person's foot 16 in the heel 102 and in the front foot area and are formed by stimulation nubs.

In the figure 6 a further alternative embodiment of the orthopedic footbed 1 can be seen, in which a functional zone 8 in the form of a heel spur correction surface 12 is provided in the base surface 4, which is caused by a depression of 3 to 5 mm in the central area of the heel 102 and the rear adjoining heel Center section 103 is formed in the area of points 32, 33, 37, 38, 42, 43, 44 and 53-56. The heel spur correction surface 12 is free of nubs or recessed compared to the base surface 4, so that the foot 16 is deliberately not stimulated and/or relieved in this area.

The orthopedic footbed 1 can be designed both as an insole 6 and as part of an undershoe; it is only important that the footrest surface 3 is shaped accordingly, or that the footbed 1 forms the corresponding footrest surface 3 in the shoe. In this case, the footbed 1 can additionally have a leather cover or textile cover, as a result of which the wearing of the shoe 2 can be made more comfortable. Furthermore, the footbed 1 should be designed to be permanently elastic, breathable, liquid-absorbing and permeable. The elasticity of the footbed 1 should be such that it offers sufficient resistance to the foot 16, whereby the elasticity should allow the foot 16 to penetrate slightly into the foot support surface 3 without losing the basic distribution of the support surface in principle. In particular, the elasticity should be selected so that the foot 16 does not sink so far that it rests over the entire surface, since otherwise the desired stress on the foot 16 is not achieved. This is particularly the case when the foot 16 is structurally and functionally sound and the footrest surface 3 is formed solely by a flat base surface 4, as is shown in FIGS figures 1 and 2 is shown. In this In this case, the foot 16 should deliberately rest in a bridge shape and not be supported in the area of the arch of the foot. The elasticity can also be tailored specifically to the type of person wearing the shoe 2 . For example, it would be conceivable to use a particularly soft footbed 1 specifically for diabetics and a particularly hard footbed 1 for athletes. A possible material would be ethylene vinyl acetate EVA, for example.

If the orthopedic footbed 1 is designed as an insert 6, it can be elastic and the functional zones 8 in it can be designed with greater strength or hardness. The insert 6 can have such an elasticity that it can be folded up, bent back or rolled up and put into the pocket without being damaged in the process. After the insole 6 has been removed from the pocket, it unfolds back into its original shape either automatically or with a little help due to its elasticity and can thus be inserted into the shoe 2 . The foot 16 experiences greater support and stimulation in the area of the functional zones 8 than in the other areas of the base surface 4 simply because of the greater hardness of the footbed 1 have additional knobs 5 for stimulating the sole of the foot.

In the figure 9 a flowchart of a method according to the invention for providing an orthopedic footbed 1 is shown.

First of all, an assortment of different orthopedic footbeds 1 with a different shape of the Foot support surfaces 3 for different foot types in different shoe sizes, last widths and possibly also with different hardnesses in a sales outlet or also a counseling center, in which the people can select and test their individually fitting orthopedic foot bedding 1 for their feet 16 under the professional guidance of appropriately trained specialist advisors . The left and the right foot 16 can also be designed differently, so that different orthopedic footbeds 1 can be deliberately selected for the left and the right foot 16 .

First of all, the customer K is visually and metrologically assessed as part of an initial inspection E by the specialist advisor, possibly with the help of appropriate sensor devices such as pressure-sensitive standing areas or moving walkways. Other aids such as foot and shoe size measurement, a measuring device for measuring posture and in particular statics as part of a diagnosis D can be used. The specialist consultant then determines a specific type of foot with or without structural and/or functional disorders and/or with or without disturbed statics.

Structurally healthy is marked with SG in the flowchart, structurally ill with SK, functionally healthy with FG and functionally ill with FK.

If it is determined that the feet are both structurally and functionally healthy SG, FG, it is first determined that a standard footbed SFB with an orthopedic footbed 1 with a flat base surface 4 according to Figures 1 and 2 with a distribution of the nubs 5 according to Figure 10 is to be chosen. Among other things, it can be determined that the person has a slightly forward-leaning posture, which is also referred to as anterior static AS. The slightly forward-leaning statics, or neutral statics, corresponds to a healthy posture and usually does not require any correction, i.e. no functional zone 8. Then, in a second step, it is checked whether there is a medial lowering of the MGA foot arch. If there is no medial lowering, the standard footbed SFB type 1a is selected, which has a footrest surface 3 formed by a flat base surface 4 according to the figure 1 with a distribution of the knobs 5 after figure 10 having. If, on the other hand, there is such a medial depression, a standard SFB footbed of type 1b is selected, in which the flat base surface 4 is supplemented by a functional zone 8 in the form of a slight elevation of approx. 2 mm or in the form of a section with greater hardness in area 9a the flat foot correction surface 9 reduced to it is supplemented. The slight lowering of the medial arch of the foot is regarded as a functional disorder of the foot 16, with the tendency towards a progressive increase in the disorder being able to be counteracted by the increase or stiffening in the area 9a and the resulting increase in stimulation.

If one of the feet 16 is structurally healthy SG and functionally ill FK, the type of functional disorder is first determined in a further step DFK and a correspondingly individualized orthopedic footbed 1 with a functional zone 8 individually provided for the disorder is selected. Such a functional disorder can be, for example, a pes valgus, in which case the functional zone 8 is the one in FIG figure 3 shown flatfoot correction surface 9 is. Then, in a further step, it is checked whether there is also a posterior static PS, ie a backward-leaning posture of the person. If there is no posterior statics PS, an orthopedic footbed 1 without a statics correction surface is used 10 is selected, while a static correction area 10 is added if there is a posterior static PS. In a second step, it is checked whether there is a medial lowering of the arch of the foot MAG or not. If this is not the case and the foot 16 also has a posterior static PS, an orthopedic footbed 1 of type 2a is selected, which has a foot support surface 3 formed solely by the base surface 4 and the static correction surface 10 . If, on the other hand, a medial lowering of the arch of the foot MAG is determined and the foot 16 also has a posterior static PS, the foot support surface 3 is expanded in addition to the static correction surface 10 by stiffening or reinforcing the foot support surface 3 in the area 9a to form a type 2b .

The in the Figures 5 and 6 The orthopedic footbeds 1 shown with the individual footrest surfaces 3 represent further examples of the range of orthopedic footbeds 1, which can be selected by examining or determining further disorders. It cannot be ruled out that the range of orthopedic footbeds 1 will be supplemented by footbeds 1 with other forms of foot support surface 3, or that further individual functional zones 8 will be developed which can be combined with the base surface 4 and the functional zones described.

If both a structurally diseased SK foot 16 and a functionally diseased FK foot 16 are found after the diagnosis, a medical examination EÄU is recommended and, if necessary, wearing a standard footbed SFB is recommended until the result of the medical examination is available. In addition, a subsequent control appointment KT can be agreed.

The advantage of the proposed solution can be seen in the fact that the health of the feet and the posture of a very large number of people can be improved with simple means and with basic knowledge of the specialist staff, e.g can be reduced by preventive measures. The invention utilizes the advantage that the orthopedic footbeds 1 are not kept available specifically for the individual foot 16 but in the manner of an assortment, independently of the person, for various diseases of the feet. The previously used person-specific production of the insoles first required the production of an individual footprint, after which the insole was then produced. The person could not take the insoles with him immediately, but had to have them made in a specialized orthopedic workshop. This meant that the insoles could only be picked up and worn after a waiting period of several days or weeks. All in all, the provision of the insoles was associated with a corresponding expenditure of time and production effort, as a result of which the acceptance of wearing insoles was fundamentally reduced. Insoles were only worn when serious medically determined disorders of the function and structure of the feet were already present.

According to a method for providing the orthopedic footbeds 1 are produced in large numbers with different foot support surfaces 3, which are not person-specific but type-specific, i.e. through the flat base surface 4 or through the combination of the base surface 4 with different structural and Functional disorders specially adapted functional zones 8 to the type of the foot 16 are adapted, and thus enable a much healthier run. Since the footbeds 1 can be tested on site and taken away immediately after selection, the effort required to obtain such a footbed 1 is significantly reduced, which means that a significantly larger number of people can be persuaded to wear such footbeds 1 at least on a trial basis. In this way, public health can be significantly improved on average through the increased acceptance of orthopedic footbeds 1, which can be described as a novel biointerface through the special distribution of the nubs 5. A biointerface is practically realized by the distribution of the nubs 5, which is used to stimulate the stimulation points of the sole of the foot when walking and thereby to strengthen the biotensegrity system. In this way, the normal human walking movement is used to stimulate the biotensegrity system and to improve posture and gait associated with it.

In the figure 10 is the orthopedic footbed 1 according to the invention with the knobs 5 provided thereon in a distribution according to the invention according to FIG figure 7 to recognize, only that the knobs 5 are represented here by circles according to their geometry instead of by the numbers 1 to 56.

The foot support surface 3 with the nubs 5 provided on it can be divided in the same way into different areas in which the person's heel 102, the central area 103, the ball of the foot 104 and finally the toes 101 of the foot 16 come to rest.

In the figure 11 is the orthopedic footbed 1 with an additional functional zone 8 in the form of a section 107 of the central area 103 on the inside 105 with a higher level but of a lower hardness. The section 107 with the lesser hardness can be realized by raising the base surface 4 so that the nubs 5 arranged thereon stimulate the stimulation points in the section of the sole of the foot resting thereon earlier and somewhat more firmly during walking. The proposed functional zone 8, formed by the higher section 107, the pump system of the sole of the foot for the lymphatic and venous fluids described above can be particularly strengthened, so that in the figure 11 Footbed 1 shown is preferably advantageous for people with lymphatic and/or venous insufficiency. By the proposed in the figure 11 shown variant of the orthopedic footbed 1, the so-called "heart of feet function" of the sole can be stimulated and intensified. In principle, any variant of the orthopedic footbed 1 can be provided with the so-called "heart of feet function" for optimizing the lymphatic and venous fluid transport by providing the functional zone 8 in the section 107 .

In the figure 12 Another orthopedic footbed 1 with a static correction surface 10 can be seen, which in the embodiment of FIG figure 13 is expanded by a functional zone 8 in the form of a flat foot correction area 9 . Both the static correction surface 10 and the flat foot correction surface 9 are formed by sections of the footbed 1 with a higher hardness, which are formed either by a section of the base surface 4 with a higher hardness or by nubs 5 with a higher hardness arranged in these sections or by a combination of a Base surface 4 can be formed with a higher hardness in these sections with knobs 5 with a higher hardness.

Both the local arrangement of nubs 5 with a higher level of hardness and the local formation of the base area 4 with a higher level of hardness and/or a higher level result in the desired local stimulation effect of the sole of the foot being intensified. As a result, both the gait pattern and the posture of the person can be positively influenced and corrected, since the perception in the sole of the foot leads to a change in posture according to the so-called vector addition model.

In the figure 14 the orthopedic footbed 1 with a functional zone 8 formed by the pes valgus correction surface 9 can be seen, which is specifically provided for a foot 16 with neutral statics and an unstable medial arch of the foot.

Furthermore, in the figure 15 again the orthopedic footbed 1 with one of the embodiment of figure 11 corresponding distribution of the knobs 5 to intensify the "heart of feet function" described above. In the illustrations below, the structure of the footbed can be seen on the left in a sectional view through the base surface 4 and on the right in a sectional view through the base surface 4 raised to the functional surface 8 .

The orthopedic footbed 1 has an EVA base layer 110 and an EVA cover layer 111 in the base surface 4 , which are separated from one another by a stimulation layer 113 . The EVA base layer 110 is covered on the underside by a carrier layer 114 and the EVA cover layer 111 is covered on the top by a functional fabric layer 112 with liquid-permeable and breathable properties, which forms the foot support surface 3 at the same time. The EVA base layer 110, the EVA top layer 111, the stimulation layer 113, the functional fabric layer 112 and also the carrier layer 114 each have a constant thickness, so that the orthopedic footbed 1 has a constant thickness in the area of the base surface 4 apart from the nubs 5 arranged thereon which cannot be seen.

In the illustration on the right, the EVA base layer 110 for realizing the functional zone 8 has a greater thickness, while the thickness of the remaining layers is constant. The increase in the foot support surface 3 in the area of the functional zone 8 is thus realized solely by increasing the thickness of the EVA base layer 110 . The thickening of the EVA base layer 110 can be seen in the illustration on the right through zone II of the EVA base layer 110 in the area of the functional zone 8 above zone I.

The functional fabric layer 112 is preferably made of a breathable and liquid-permeable textile material, while the carrier layer 114 is made of an abrasion-resistant plastic material, e.g. with a carbon look.

Both the EVA top layer 111 and the EVA base layer 110 are made from an EVA material and practically form the volume material of the footbed 1. The stimulation layer 113 is made from a hard plastic and defines the hardness of the footbed 1.

The "heart of feet function" induced by the orthopedic footbed 1 according to the invention is described in more detail below.

The sole of the foot is a blood and lymph pump and supports the return transport of the blood supplied by the heart. This Return transport is effected by the muscular vein pump in the foot, formed by the vessels, the fascial system, the bones and the muscles together with gravity.

Due to the special anatomical structure with the tissues encased by fascia, natural movements and the pressure changes induced or stimulated by the footbed 1 according to the invention result in liquid-displacing effects in the foot due to the constant change in tissue pressure gradients. Compressed and elongated, the pressure on the tissue parts in the fascia-encased chambers is great. The alternating peaks and valleys of the pressure build-up cause a pumping mechanism, which is also present to a lesser extent in diseased veins and lymphatic vessels.

The theory of the pumping movement in the sole of the human foot can be explained as follows: The pumping movement is based on a scissor lattice with pressure gradients generated by deformation: When stretching, the pressure increases due to the movement of the connective tissue fascia in the enclosed chambers, resulting in a powerful movement the fluid channels in the direction from the foot to the center of the body. If the movement of the scissor lattice decreases, the pressure gradient decreases again, which leads to a pooling of liquid in the chambers between the scissor lattice elements. These movements alternate cyclically, whereby the body transports lymph and venous fluid from the finest tissue gaps extravascularly and very small vasally back to the heart.

The fascia straps around each cell are also "the other heart" of the human being, the one for the centripetal one pumping motion and is therefore responsible for how the heart is responsible for much of the centrifugal pumping motion.

The material of the "Heart of Feet" zone of the orthopedic footbed 1 according to the invention in section 107 of figure 15 should be as follows:
For example, a 5-15 mm high soft material layer can be provided, which is arranged between the EVA base layer 110 and the stimulation layer 113, alternatively if necessary also between the stimulation layer 113 and the EVA cover layer 111 in the area marked in the sketch. The additional layer of material is represented here by area II. The material is soft enough not to support the foot, but stable enough to compress the connective tissue of the foot from the skin through the subcutaneous fat tissue to the vascular region and the muscle compartment of the longitudinal arch of the foot, in which some of the venous and lymphatic vessels are stored. The materials used for this functional zone are silicone, EVA materials or other similarly functioning soft and permanently elastic materials, with a soft restoring force and a rapid return to the old shape after the respective deformation with each step.

The increase in pressure causes at least 20 to 40 cubic centimeters of blood and lymph to be expelled from the foot towards the heart each time it occurs. By increasing the pressure compared to the orthopedic footbeds 1 without the "Heart of Feet" function, the venous and lymphatic return flow to the heart is significantly supported in order to support the natural function of the insufficient venous and lymphatic vessels in the foot, i.e. those that have become weak to pump .

Claims (15)

1. Orthopaedic footbed (1) for a shoe (2), comprising

   - a foot contact surface (3),

   characterized in that

   the foot contact surface (3) is formed by a planar base surface (4) having a plurality of pimples (5) that are arranged in accordance with a distribution that is optimized for podiatry, wherein

   - the distribution of the pimples (5) that is optimized for podiatry corresponds to the anatomical distribution, projected in the foot contact surface (3), of the bony parts (100), and/or the distribution, projected in the foot contact surface (3), of the pathways (200) comprising the lymphs and/or nerves and/or vessels, of a human foot (16) that comes into contact on the foot contact surface (3), wherein

   - the pimples (5) are arranged in a zone of the foot contact surface (3) on which a foot (16) comes into contact by a front ball (104) of the foot, in five rows, corresponding to the orientation of the bony parts (100) that form the toes (101) and/or along the pathways (200) assigned thereto.
2. Orthopaedic footbed (1) according to claim 1, characterized in that

   - the pimples (5) are arranged in a circular manner in a zone of the foot contact surface (3) on which a heel (102) of a foot (16) comes into contact.
3. Orthopaedic footbed (1) according to any of the preceding claims, characterized in that

   - the pimples (5) are arranged, in a zone of the foot contact surface (3) on which a midfoot region (103) of a foot (16) comes into contact, in at least two lines that diverge towards the inside (105) of the foot contact surface (3).
4. Orthopaedic footbed (1) according to any of the preceding claims, characterized in that

   - the spacings between the pimples (5) reduce, in the longitudinal direction of the foot contact surface (3), proceeding from a zone of the foot contact surface (3) on which a midfoot region (103) of a foot (16) comes into contact, to a front and/or rear face of the foot contact surface (3).
5. Orthopaedic footbed (1) according to any of the preceding claims, characterized in that

   - the pimples (5) are of an identical height.
6. Orthopaedic footbed (1) according to any of the preceding claims, characterized in that

   - the pimples (5) are of a height of from 2 to 3 mm with respect to the foot contact surface (3).
7. Orthopaedic footbed (1) according to any of the preceding claims, characterized in that

   - the pimples (5) have a diameter of from 3 to 5 mm.
8. Orthopaedic footbed (1) according to claim 7, characterized in that

   - the diameter and/or the arrangement of the pimples (5) are dependent on the shoe size and/or dependent on the shoe last size.
9. Orthopaedic footbed (1) according to any of the preceding claims, characterized in that

   - the foot contact surface (3) comprises at least one functional zone (8) which is raised or depressed relative to the base surface (4) and/or has a greater or lesser hardness than the footbed (1) in the remaining portion.
10. Orthopaedic footbed (1) according to claim 9, characterized in that

    - the functional zone (8) is preferably be formed so as to have a greater hardness by means of a group of pimples (5) of a different hardness with respect to the remaining pimples (5).
11. Orthopaedic footbed (1) according to either claim 9 or claim 10, characterized in that

    - the functional zone (8) is raised or depressed by 3 to 5 mm, preferably by 4 mm, relative to the base surface (4).
12. Orthopaedic footbed (1) according to any of claims 9 to 11, characterized in that

    - the functional zone (8) is formed by a talipes valgus correction surface (9) which is raised relative to the base surface (4) and is arranged in a zone of the foot contact surface (3) on which a foot (16) comes into contact by a front ball (104) of the foot and a foot arch.
13. Orthopaedic footbed (1) according to any of claims 9 to 12, characterized in that

    - the functional zone (8) is formed by a statics correction surface (10) which is raised relative to the base surface (4) and is arranged in a zone of the foot contact surface (3) on which a foot (16) comes into contact by a heel (102).
14. Orthopaedic footbed (1) according to any of claims 9 to 13, characterized in that

    - the functional zone (8) is formed by a pes cavus correction surface (11) which is raised relative to the base surface (4) and is arranged in a zone of the foot contact surface (3) on which the entire width of the front foot part of a foot (16) comes into contact.
15. Orthopaedic footbed (1) according to any of claims 9 to 14, characterized in that

    - the functional zone (8) is formed by a calcaneal spur correction surface (12) which is depressed relative to the base surface (4) and is arranged in a zone of the foot contact surface (3) on which a foot (16) comes into contact by a central portion of the heel (102) thereof and/or by a central region (103) of the foot arch.

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