A comparison of trial shoe and shell shoe fitting techniques.

In Europe, bespoke orthopaedic shoes are usually sent for a trial fitting in order to check the fit and indicate any modifications required before final finishing. The use of shell shoes at the fit assessment stage, rather than the traditional alternative of partially or fully finished shoes, can offer service advantages, and is widely used for example in the Netherlands. However the comparability of shell fit assessment with the traditional method of trial shoe fit assessment has not been evaluated, either to assess its sensitivity or to elucidate any difference in assessment technique required of the orthotist. In this work, the results of fit assessments by both methods are compared. The trial involved a group of normal subjects wearing high street shoes of styles similar to those used for orthopaedic footwear. The results indicate that the shell fit assessments were in the main comparable to those for trial shoe fit. The only consistent area of deviation noted, in the heel at the topline, is attributable to a construction factor in shoe making. Apart from this area, the orthotist need not adjust his technique to make use of the shell method.