Focused rigidity casts: an overview.

Focused rigidity casts (FRCs) are a novel treatment made from polymer semi-flexible cast material, used in the management of plantar foot ulceration to offload the site of ulceration. Current anecdotal evidence suggests that use of FRCs helps achieve quicker healing time. While FRCs were first used in the treatment of fractures, previous reports suggest that the FRC may be effective in the treatment of plantar foot ulceration. Although there is a paucity of evidence to support the use of FRCs in the treatment of foot ulceration, current evidence demonstrates a decrease in both wound healing time and plantar pressure. The aim of the paper is to examine the importance of offloading plantar ulcerations and introduce FRCs.

The effects of focused-rigidity casts on forefoot plantar pressures: a pilot investigation.

OBJECTIVE: To establish if focused rigidity casts (FRCs) reduce forefoot pressures in healthy participants, and to examine the effects of FRCs on contact area, contact pressure, peak pressure and force­time integral on the forefoot and the plantar pressures of the whole foot in participants with differing foot posture. METHOD: Thirty-one healthy participants were recruited from a convenience sample of university staff and students. This study employed a repeated measures design, where walking in FRCs was compared with a control (canvas shoe). An in-shoe pressure measuring system was used to record changes in plantar pressure and the foot posture index was used to record foot posture. RESULTS: A statistically significant reduction in contact pressure (p ≤ 0.000; n=31) and peak pressures(p ≤ 0.002; n=31) was observed in the forefoot. A statistically significant reduction in contact area and contact pressure over the whole foot and rear foot when participants wore the FRC was also found. The greatest decrease occurred in participants with a supinated foot posture while the least occurred in participants with a pronated foot posture. An increase in peak pressure was found in the mid foot for participants with a normal and supinated foot postures when the FRC was worn. CONCLUSION: The results suggest that FRCs are an effective way of reducing forefoot pressures when compared with the control shoe. FRC's work by redistributing pressure away from the forefoot to the area of increased rigidity beneath the cast.