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Patients with diabetes often desperately need ankle foot orthotics (AFO) to perform daily activities. In Indonesia, experienced shoemakers employ manual procedures and follow the prescriptions given by a doctor or orthopaedic technician. This process remains traditional in that each pair of AFO is handmade, not precise, and is time consuming. This article describes the development of the design process and fabrication of a new AFO product for patients with diabetes based on a computer aided reverse engineering system (CARESystem). The reverse innovative design approach method discussed in this paper sought to achieve the best shoe last. The results also shows a functional test with highly satisfactory results. The shape of the shoe fit the standard AFO and the first patient experienced comfort for the 4-week long testing period. This article proves that the CARESystem technology successfully reduced the time for both the design and fabrication of the AFOs by 64%.

Herein, a machining strategy to fabricate custom orthotic insoles with high surface finish and wide fit tolerance is presented. CNC milling was used to machine ethylene-vinyl acetate (EVA) foam for insoles with various surface hardness, and the Taguchi-response surface method (TM-RSM) was adopted to optimize the parameters of the CNC milling process (cutting speed, feed rate, tool path strategy, and step over). EVA foam with varying surface hardness and the tolerance of the wide fit insoles corresponding to the surface roughness were analyzed. Subsequently, a mathematical model was established to determine the optimal CNC milling parameters for a standard milling cutter under dry coolants. The results of the six parameters corresponding to the mean values of surface roughness were initially examined using the signal-to-noise ratio of the Taguchi method (TM). The surface roughness obtained with the TM-RSM was up to 4.13% higher than that obtained with the TM. The EVA foam insole with a surface hardness of 50–60 HRC and a wide fit tolerance of 0.75 mm provided the ideal level of comfort and support for patients with diabetes. The results of this study demonstrated that CNC milling provided a better surface finish of orthotic shoe insoles than other methods, which can serve as guidance in the development of machining strategies for insoles made from EVA foam.

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