Better understanding the life of the user to improve the design of orthopaedic footwear

BACKGROUND: A relatively high number of users is dissatisfied with their orthopaedic device. The term `user practice' was introduced to emphasise the idea that users of orthopaedic devices perform activities within an environment, which are characteristic for that environment. OBJECTIVE: To investigate to what extend orthopaedic shoe engineers map the specific environments in which users live and the activities they perform within these environments during the first intake for custom made orthopaedic footwear. METHODS: Orthopaedic shoe engineers were recruited from orthopaedic service providers across The Netherlands. The intake with a new client for orthopaedic footwear was recorded and analysed using four user environments: daily life at home, transport, work, and leisure. RESULTS: Our study showed that orthopaedic shoe engineers cover at best less than 50% of activities within the four user environments. Consequently, there is no guarantee that the resulting design of the orthopaedic footwear fits all of the activities and environments of the users. CONCLUSIONS: The principles of user practices, consisting of specific environments and activities of the user, are not yet adequately used in the field of orthopaedic shoe engineering. By not using them, too little understanding of the life of the user can result in dissatisfaction and non-usage of the orthopaedic device.