Japan: 20 years of pedorthics at Kobe College

Students, participants and lecturers after the workshops at Kobe College.

The Kobe College for Medical Welfare has been running courses in pedorthics for twenty years. IVO Japan took this 20-year anniversary as an opportunity to host this year‘s annual congress in Kobe. The motto of the event was ‘Design and Performance‘, focusing both on solutions to foot disorders and design aspects.

Prof. Dr. Seiji Sawamura, one of the directors of Kobe College and for many years a patron of the orthopedic trades, officially kicked off this year‘s congress, to which a number of speakers from Europe were invited as well. Dr. Franz Landauer, President of ISPO Austria, addressed the topic of foot deformities in his lecture. Using case studies as examples, he not only explained how such malformations develop, but also showed how they can be treated surgically as well as with assistive devices.

Dr. Ullrich Illgner and master pedorthist Michael Möller complemented one another in their lectures on the diabetic foot. Dr. Illgner explained the medical background of the diabetic foot and its various manifestations. Michael Möller presented the concept of pedorthic accessory devices defined by risk classes. The system, developed in Germany in 2006 and now attracting more and more international attention, ensures that the treatment with pedorthic accessory devices is always precisely adapted to the stage of the disease.

The aim is to prevent ulcerations of the foot and the recurrence of such injuries as well as to optimally promote the healing process. The system starts with simple, ready-made pedorthic accessory devices if there is no diabetic foot syndrome or foot deformities and goes up to risk class 7, wherein foot ulceration is treated with double-shell orthoses. The goal of treatment is always the same: Provide relief to endangered or injured foot regions by reducing pressure via the biomechanical effect of the pedorthic accessory devices or by redistributing pressure to less at-risk foot regions.

Beforehand, Dr. Hiroto Terashi from the University of Kobe had introduced special issues relating to the treatment of diabetic foot and also reported on the regional and international epidemiology of diabetes and diabetic foot syndrome. According to Dr. Terashi, given the number of sufferers, there are still too few foot specialists in Japan to address this problem.

Shoe design for custom orthotic shoes

Master pedorthist Anastasia Anastasiadou from Germany and Saki Takimi from Japan were in charge of the “Design“ area of the congress program. Takimi is a shoe designer and presented a women’s shoe that she had developed herself. The idea behind the shoe is that it be comfortable and foot-friendly thanks to the special shape of its last, while at the same time remaining stylish and sporting a heel. Anastasia Anastasiadou has built up quite a fan community in her native Germany with her extraordinary creations for shoe soles and shafts.

The striking thing about Ms. Anastasiadou‘s work: She doesn‘t apply her creative solutions to ready-made shoes, but to custom-made orthopedic footwear. Based on the experience of this young woman pedorthist, what initially seems incompatible can actually end up working very well in practice. People with disabilities are also enthusiastic about unique design concepts.

The topics Design and Performance were central to other congress lectures as well. A number of short presentations, some also given by graduates of Kobe College, focused on case studies with real pedorthic solutions as well as aesthetically sophisticated designs.
The accompanying exhibition showcased numerous works that the students and graduates produced as exemplars of craftsmanship and aesthetics. For example, the high-quality craftsmanship resulting from a special course on traditional tradesman production techniques. On the other hand, the exhibit also featured many shoes that had been fabricated specifically for patients.

Dr. Hiroto Terashi (Photo: Clemens Hagen)  Dr. Franz Landauer (Photo: Clemens Hagen)  Saki Takimi (Photo: Clemens Hagen)  Michael Möller (Photo: Clemens Hagen)

The accompanying info boards provided visitors with an overview of the clinical pictures and the specific treatment objectives.
Eduard Herbst, technical director of the Pedorthics course at Kobe College, was particularly pleased that the students not only demonstrated their capabilities with this exhibition, but were also exemplary in organizing the congress and attending to the guests. All in all, with the roughly 170 guests and the students from both classes, the congress attracted over 200 visitors.

Not only were they offered interesting lectures, but also a comprehensive trade exhibition. Eduard Herbst‘s thanks therefore were extended not only to the helpers, but to the exhibitors and sponsors as well. He added that it had only been possible to invite the speakers from Europe to Kobe with the help of the two “Gold“ sponsors, Nora and Renia, as well as the “Silver“ sponsors Nitta and Lucky Bell.

Kobe College took advantage of the European speakers‘ visit to offer various workshops to its students and association members on the two days leading up to the congress. Franz Landauer provided the students with insights into how muscle dysfunction can influence skeletal growth. Michael Möller and Ullrich Illgner used practical examples to show how the pressure on at-risk regions can be reduced in patients with diabetic foot. Anastasia Anastasiadou brought along many examples of creative sole designs, including materials students could use to create their own soles.

Looking back on 20 years of Pedorthics courses

The first course for pedorthists at Kobe College for Medical Welfare was offered in 1999. Pedorthist Eduard Herbst has been  teaching there since the very beginning. Trained in Austria – this is also where he passed his Master Pedorthist examination – he has been living in Japan for more than 25 years and has not only taught at the college, but has continuously developed the Pedorthics curriculum over the years so as to best prepare students for their future careers.

Before the congress, students from the Kobe College of Medical Welfare and members of IVO Japan had the chance to meet some of the speakers of the congress in workshops. Anastasia Ansastasiadou (r.) brought many examples of creatively designed custom orthotic shoes (Photo: Christian Volk) (Photo: Christian Volk)

After all, he doesn’t get that much time to prepare them. During their only two-year school training, the students need to be taught both the medical knowledge and technical skills that will enable them to independently develop and fabricate an assistive device – insoles or shoes – according to a doctor‘s specifications.

About 460 students have completed the course over the last twenty years. Most of those who have remained in the profession today work at orthopedic technology companies, where they are the specialists for shoes and insoles. Unfortunately, self-employment is as yet only a limited option, as pedorthists in Japan are still not able to invoice their services directly to health insurance providers. Technical director of the Pedorthics curriculum, Eduard Herbst reports that its graduates are also sought-after experts in other areas.

He points out that some students were working at the research facility operated by sports shoe manufacturer Asics in Kobe, where they were responsible, among other things, for the individualized care of top athletes. He also notes that graduates are in demand among shoe manufacturers, especially those who manufacture foot-friendly shoes or therapeutic footwear.

Some graduates, he says, also find their “professional home” in specialized shoe shops, where they are advise customers and are responsible for pedorthic insoles. Lastly, he stated that several students had even found their way to Germany where, for example, Franz Fischer or Michael Möller have welcomed them into their workshop, allowing them to expand their knowledge and skills.

The exhibition showcased numerous works that the students and graduates produced as exemplars of craftsmanship and aesthetics (Photo: Christian Volk)  (Photo: Christian Volk)  The stands of the exhibitors attracted many visitors (Photo: Clemens Hagen)