Biomechanical and Perceived Comfort Analysis of FDM 3D-Printed Insoles for Flatfoot Treatment: A Systematic Literature Review
Main Article Content
Keywords
flatfoot, 3D, FDM, flexible material, biomechanics, perceived comfort, systematic literature review
Abstract
Flatfoot (pes planus), characterized by a reduced or absent medial arch, cause biomechanical disorders, pain and a risk of injury. Customized insoles are a key intervention, with the emergence of 3D printing fused deposition modelling (FDM) based on flexible materials such as thermoplastic polyurethane (TPU) and thermoplastic elastomer (THE). This systematic literature review, based on PRISMA guidelines and analysis of six Scopus studies, assesses the biomechanical and ergonomic properties of these insoles. The results show that flexible 3D printed inserts significantly improve biomechanics by increasing the height of the navicular arch, reducing excessive ankle joint eversion, increasing dorsiflexion and improving the distribution of plantar plate pressure. Regarding perceived comfort, evaluations using the Visual Analog Scale (VAS), the Likert scale and the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire consistently indicate improved user comfort over no insole or conventional option. Despite these advantages, challenges include limited material options, inconsistent print quality and technical fabrication problems. Further research is needed, especially large-scale studies, to resolve these problems and to improve the clinical use of the product. In conclusion, flexible inserts printed with FDM have the potential to improve both the biomechanical function and the perceived comfort of the footwear use.
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References
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[15] K. L. Yick and C. Y. Tse, “Textiles and other materials for orthopaedic footwear insoles,” in Handbook of Footwear Design and Manufacture, Elsevier, 2013, pp. 341–371. doi: 10.1533/9780857098795.4.341.
[16] W. T. Lo, K. L. Yick, S. P. Ng, and J. Yip, “New methods for evaluating physical and thermal comfort properties of orthotic materials used in insoles for patients with diabetes,” J Rehabil Res Dev, vol. 51, no. 2, pp. 311–324, 2014, doi: 10.1682/JRRD.2013.01.0012.
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[18] T. Finnegan, “Preventing discoloration in thermoplastic polyurethanes,” in Annual Technical Conference - ANTEC, Conference Proceedings, 2019.
[19] P. Chandramohan, M. S. Bala Santhosh, and R. Raghu, “Process Parameters Optimization Through Response Surface Methodology for Enhanced Strength of Additively Manufactured Thermoplastic Polyurethane Parts,” 2025, pp. 351–368. doi: 10.1007/978-981-97-6016-9_28.
[20] M. C. Chang and Y. J. Choo, “Comparative Efficacy of 3D-Printed Insoles in Managing Common Foot Conditions: A Review,” Medical Science Monitor, vol. 31, Jan. 2025, doi: 10.12659/MSM.947252.
[21] U. Kalita, B. Parameswaran, and N. K. Singha, “Thermoplastic Elastomers,” in Kirk-Othmer Encyclopedia of Chemical Technology, Wiley, 2022, pp. 1–39. doi: 10.1002/0471238961.2008051808151204.a01.pub3.
[22] G. Holden, “Thermoplastic Elastomers,” in Applied Plastics Engineering Handbook, Elsevier, 2024, pp. 97–113. doi: 10.1016/B978-0-323-88667-3.00020-5.
[23] R. Varma, “Meeting the design challenges of tomorrow’s healthcare industry with high-performance TPEs,” Rubber World, vol. 238, no. 3, 2008.
[24] G. Holden, “Thermoplastic Elastomers,” in Applied Plastics Engineering Handbook, Elsevier, 2017, pp. 91–107. doi: 10.1016/B978-0-323-39040-8.00005-5.
[25] B. L. Bermúdez-Bencomo et al., “Feasibility of Thermoplastic Elastomer in the Design of Pediatric Orthopedic Insoles by 3D Printing,” 2025, pp. 100–110. doi: 10.1007/978-3-031-89510-4_9.
[26] C. W. Burr and R. T. Vanderbilt, “Improved stabilization for TPEs,” Rubber World, vol. 247, no. 1, 2012.
[27] S. Liu, D. Wang, G. Guo, J. Zhang, J. Qiu, and A. Zhang, “Thermal‐Oxidative Aging Behavior and Factors of Polystyrene‐Based Thermoplastic Elastomers‐Based Automotive Interior Skin,” J Appl Polym Sci, vol. 142, no. 16, Apr. 2025, doi: 10.1002/app.56769.
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Dec 31, 2025
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L. D. Fathimahhayati, A. Ardiyanto, F. Trapsilawati, X. Liu, A. Zolfagharian, and H. Herianto, “Biomechanical and Perceived Comfort Analysis of FDM 3D-Printed Insoles for Flatfoot Treatment: A Systematic Literature Review”, J. Optimasi Sist. Ind., vol. 24, no. 2, pp. 345–366, Dec. 2025.
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Author Biographies
Xiao Liu, Deakin University
School of Information Technology
Ali Zolfagharian, Deakin University
School of Engineering
