{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:06:33Z","timestamp":1790071593353,"version":"4.0.1"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Digital ankle\u2013foot orthosis (AFO) workflows depend on accurate lower limb geometry acquisition. Direct 3D scanning on the lower limb may reduce plaster use, but its geometrical agreement with orthotist plaster casting remains insufficiently investigated. Objective: This study compared posterior lower limb surfaces captured by direct 3D scanning with surfaces obtained from orthotist plaster casts digitised using the same scanner. Methods: Seven healthy paediatric participants underwent bilateral direct scanning and bilateral plaster casting, giving 14 limb comparisons. Cast meshes were digitised, trimmed to reduce boundary effect, globally registered to the direct scans, and segmented into posterior foot, ankle, calf and knee proxy regions. Cast-to-scan distances were then calculated. Results: The ankle region showed the greatest residual mismatch, with a weighted mean distance of 3.49 mm (95% CI 3.16\u20133.81 mm). It also had the highest proportions of vertices exceeding 2 mm (74.8%) and 5 mm (21.2%), and was the highest-error region in 13 of 14 limbs. The knee region had the lowest weighted mean distance (2.28 mm, 95% CI 1.92\u20132.60 mm) but showed the largest upper-tail spread. Conclusions: These preliminary findings indicate direct scanning and plaster casting did not produce completely interchangeable posterior limb surfaces in this cohort. The ankle was the most consistently discrepant AFO-relevant region, indicating that digital AFO workflows should include local geometric quality control rather than relying only on whole-limb agreement.<\/jats:p>","DOI":"10.3390\/medsci14050589","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:04:17Z","timestamp":1790067857000},"page":"589","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Direct 3D Scans and Plaster Casts in Digital Ankle\u2013Foot Orthosis Workflows"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2240-9232","authenticated-orcid":false,"given":"Chenxi","family":"Peng","sequence":"first","affiliation":[{"name":"CSIRO (Commonwealth Scientific and Industrial Research Organisation) Technology, Clayton South, VIC 3169, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lalor","sequence":"additional","affiliation":[{"name":"The Royal Children\u2019s Hospital Melbourne, Parkville, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasim","family":"Shokoohi","sequence":"additional","affiliation":[{"name":"The Royal Children\u2019s Hospital Melbourne, Parkville, VIC 3052, Australia"},{"name":"Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia"},{"name":"Murdoch Children\u2019s Research Institute, Parkville, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0677-5005","authenticated-orcid":false,"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"CSIRO (Commonwealth Scientific and Industrial Research Organisation) Technology, Clayton South, VIC 3169, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2292-0946","authenticated-orcid":false,"given":"Erich","family":"Rutz","sequence":"additional","affiliation":[{"name":"The Royal Children\u2019s Hospital Melbourne, Parkville, VIC 3052, Australia"},{"name":"Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia"},{"name":"Murdoch Children\u2019s Research Institute, Parkville, VIC 3052, Australia"},{"name":"The Hugh Williamson Gait Analysis Laboratory, The Royal Children\u2019s Hospital Melbourne, Parkville, VIC 3052, Australia"},{"name":"Medical Faculty, The University of Basel, 4001 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15082","DOI":"10.1038\/nrdp.2015.82","article-title":"Cerebral palsy","volume":"2","author":"Graham","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1177\/0269215518771824","article-title":"Effect of ankle-foot orthoses on gait, balance and gross motor function in children with cerebral palsy: A systematic review and meta-analysis","volume":"32","author":"Lintanf","year":"2018","journal-title":"Clin. Rehabil."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Graham, H.K., Thomason, P., Willoughby, K., Hastings-Ison, T., Stralen, R.V., Dala-Ali, B., Wong, P., and Rutz, E. (2021). Musculoskeletal Pathology in Cerebral Palsy: A Classification System and Reliability Study. Children, 8.","DOI":"10.3390\/children8030252"},{"key":"ref_4","first-page":"e25-00236","article-title":"Epidemiology of Lower Limb Musculoskeletal Pathology in Cerebral Palsy: A Population-Based, Cohort Study","volume":"10","author":"Korbal","year":"2025","journal-title":"JB JS Open Access"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.rehab.2017.05.004","article-title":"Efficacy of ankle foot orthoses types on walking in children with cerebral palsy: A systematic review","volume":"60","author":"Aboutorabi","year":"2017","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3109\/03093641003674288","article-title":"A systematic review to determine best practice reporting guidelines for AFO interventions in studies involving children with cerebral palsy","volume":"34","author":"Ridgewell","year":"2010","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1302\/1863-2548.11.160256","article-title":"Do research papers provide enough information on design and material used in ankle foot orthoses for children with cerebral palsy? A systematic review","volume":"11","author":"Eddison","year":"2017","journal-title":"J. Child. Orthop."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zhou, C., Yang, Z., Li, K., and Ye, X. (2022). Research and Development of Ankle-Foot Orthoses: A Review. Sensors, 22.","DOI":"10.3390\/s22176596"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Schr\u00f6der, J.-H., Barandun, G.A., Leimer, P., Morand, R., G\u00f6pfert, B., and Rutz, E. (2024). Novel Modular Walking Orthosis (MOWA) for Powerful Correction of Gait Deviations in Subjects with a Neurological Disease. Children, 11.","DOI":"10.3390\/children11010030"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"19068","DOI":"10.1038\/s41598-021-98786-z","article-title":"Digital mapping of a manual fabrication method for paediatric ankle-foot orthoses","volume":"11","author":"Wang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13047-019-0321-6","article-title":"Feasibility of designing, manufacturing and delivering 3D printed ankle-foot orthoses: A systematic review","volume":"12","author":"Wojciechowski","year":"2019","journal-title":"J. Foot Ankle Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13047-020-00442-8","article-title":"Comparison of 3D scanning versus traditional methods of capturing foot and ankle morphology for the fabrication of orthoses: A systematic review","volume":"14","author":"Farhan","year":"2021","journal-title":"J. Foot Ankle Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e70097","DOI":"10.1002\/jfa2.70097","article-title":"Feasibility of Designing, Manufacturing and Delivering 3D Printed Ankle-Foot Orthoses: An Updated Systematic Review","volume":"18","author":"Wang","year":"2025","journal-title":"J. Foot Ankle Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/PXR.0000000000000421","article-title":"Orthotists\u2019 perspectives on the adjustment of 3D printed ankle foot orthoses: A mixed methods feasibility study","volume":"49","author":"Leith","year":"2025","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_15","first-page":"77","article-title":"Additive manufacturing of custom orthoses and prostheses-A review","volume":"12","author":"Chen","year":"2016","journal-title":"Addit. Manuf."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Raj, R., Dixit, A.R., Lukaszewski, K., Wichniarek, R., Rybarczyk, J., Kuczko, W., and Gorski, F. (2022). Numerical and Experimental Mechanical Analysis of Additively Manufactured Ankle-Foot Orthoses. Materials, 15.","DOI":"10.3390\/ma15176130"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Dombroski, C.E., Balsdon, M.E., and Froats, A. (2014). The use of a low cost 3D scanning and printing tool in the manufacture of custom-made foot orthoses: A preliminary study. BMC Res. Notes, 7.","DOI":"10.1186\/1756-0500-7-443"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Silva, R., Veloso, A., Alves, N., Fernandes, C., and Morouco, P. (2022). A Review of Additive Manufacturing Studies for Producing Customized Ankle-Foot Orthoses. Bioengineering, 9.","DOI":"10.3390\/bioengineering9060249"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Atallah, H., Qufabz, T., Bakhsh, H.R., and Ferriero, G. (2025). The current state of 3D-printed orthoses clinical outcomes: A systematic review. BMC Musculoskelet. Disord., 26.","DOI":"10.1186\/s12891-025-09070-4"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e70006","DOI":"10.1002\/jfa2.70006","article-title":"Comparison of accuracy and speed between plaster casting, high-cost and low-cost 3D scanners to capture foot, ankle and lower leg morphology of children requiring ankle-foot orthoses","volume":"17","author":"Farhan","year":"2024","journal-title":"J. Foot Ankle Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Silva, R., Silva, B., Fernandes, C., Morouco, P., Alves, N., and Veloso, A. (2024). A Review on 3D Scanners Studies for Producing Customized Orthoses. Sensors, 24.","DOI":"10.3390\/s24051373"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1757-1146-3-19","article-title":"The use of 3D surface scanning for the measurement and assessment of the human foot","volume":"3","author":"Telfer","year":"2010","journal-title":"J. Foot Ankle Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13047-023-00617-z","article-title":"Methodological and statistical approaches for the assessment of foot shape using three-dimensional foot scanning: A scoping review","volume":"16","author":"Allan","year":"2023","journal-title":"J. Foot Ankle Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/PXR.0000000000000066","article-title":"Reliability and validity of 3D limb scanning for ankle-foot orthosis fitting","volume":"46","author":"Powers","year":"2022","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.gaitpost.2019.01.020","article-title":"The impact of ankle-foot orthosis stiffness on gait: A systematic literature review","volume":"69","author":"Totah","year":"2019","journal-title":"Gait Posture"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kerkum, Y.L., Buizer, A.I., van den Noort, J.C., Becher, J.G., Harlaar, J., and Brehm, M.A. (2015). The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0142878"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/17483107.2019.1629114","article-title":"A study on the efficacy of AFO stiffness prescriptions","volume":"16","author":"Vasiliauskaite","year":"2021","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1097\/JPO.0b013e3181f9082e","article-title":"Trimline severity significantly affects rotational stiffness of ankle-foot orthosis","volume":"22","author":"Bielby","year":"2010","journal-title":"JPO J. Prosthet. Orthot."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3390","DOI":"10.36922\/ijb.3390","article-title":"Tuning the mechanical responses of 3D-printed ankle-foot orthoses: A numerical study","volume":"10","author":"Peng","year":"2024","journal-title":"Int. J. Bioprinting"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1115\/1.2800830","article-title":"Viscoelastic properties of ovine adipose tissue covering the gluteus muscles","volume":"129","author":"Gefen","year":"2007","journal-title":"J. Biomech. Eng."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1757-1146-4-9","article-title":"Reliability of capturing foot parameters using digital scanning and the neutral suspension casting technique","volume":"4","author":"Carroll","year":"2011","journal-title":"J. Foot Ankle Res."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/5\/589\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:34:18Z","timestamp":1790069658000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/5\/589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,19]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["medsci14050589"],"URL":"https:\/\/doi.org\/10.3390\/medsci14050589","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,19]]}}}