3D printed auxetic heel pads for patients with diabetic mellitus

Leung, Mason C.P.; Yick, Kit Lun; Sun, Yu; Chow, Lung; Ng, S.W.

doi:10.1016/j.compbiomed.2022.105582

Cited by 18 publications

(14 citation statements)

References 37 publications

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“…Previous studies have concluded that walking at a rate of 4 km/h and wearing an ethylene-vinyl acetate (EVA) insole can reduce plantar pressure at the forefoot [ 46 ]. A heel pad with an auxetic structure has been proven to reduce the pressure in the heel area during walking [ 47 ]. Chen et al [ 48 ] also recommended dividing the plantar of the foot into support and soft areas, so that honeycomb and auxetic structures for support and pressure offloading could be applied, respectively.…”

Section: Resultsmentioning

confidence: 99%

Analysis of Diabetic Foot Deformation and Plantar Pressure Distribution of Women at Different Walking Speeds

Zhang

Liu

Yick

et al. 2023

IJERPH

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Official guidelines state that suitable physical activity is recommended for patients with diabetes mellitus. However, since walking at a rapid pace could be associated with increased plantar pressure and potential foot pain, the footwear condition is particularly important for optimal foot protection in order to reduce the risk of tissue injury and ulceration of diabetic patients. This study aims to analyze foot deformation and plantar pressure distribution at three different walking speeds (slow, normal, and fast walking) in dynamic situations. The dynamic foot shape of 19 female diabetic patients at three walking speeds is obtained by using a novel 4D foot scanning system. Their plantar pressure distributions at the three walking speeds are also measured by using the Pedar in-shoe system. The pressure changes in the toes, metatarsal heads, medial and lateral midfoot, and heel areas are systematically investigated. Although a faster walking speed shows slightly larger foot measurements than the two other walking speeds, the difference is insignificant. The foot measurement changes at the forefoot and heel areas, such as the toe angles and heel width, are found to increase more readily than the measurements at the midfoot. The mean peak plantar pressure shows a significant increase at a faster walking speed with the exception of the midfoot, especially at the forefoot and heel areas. However, the pressure time integral decreases for all of the foot regions with an increase in walking speed. Suitable offloading devices are essential for diabetic patients, particularly during brisk walking. Design features such as medial arch support, wide toe box, and suitable insole material for specific area of the foot (such as polyurethane for forefoot area and ethylene-vinyl acetate for heel area) are essential for diabetic insole/footwear to provide optimal fit and offloading. The findings contribute to enhancing the understanding of foot shape deformation and plantar pressure changes during dynamic situations, thus facilitating the design of footwear/insoles with optimal fit, wear comfort, and foot protection for diabetic patients.

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Section: Resultsmentioning

confidence: 99%

Analysis of Diabetic Foot Deformation and Plantar Pressure Distribution of Women at Different Walking Speeds

Zhang

Liu

Yick

et al. 2023

IJERPH

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“…One of the most common designs considered for research and products is the re-entrant unit cell. This design has been studied in numerous applications, such as cardiac patches by Kapnisi M. et al, 2018 [7], oesophageal stents by M. N. Ali et al, 2014 [8], and heel pads by M.S.-H. Leung et al, 2022 [9]. The S-shaped unit cell (right) and re-entrant unit cell are displayed in Figure 1.…”

Section: Geometric Designsmentioning

confidence: 99%

Auxetics in Biomedical Applications: A Review

Rose¹,

Siu²,

Zhu³

et al. 2023

JMMCE

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Materials exhibiting auxetic properties have a negative Poisson's ratio, which intrigued researchers to understand the behavior of auxetic structure. Several researchers focused on the different auxetic cell designs, while others focused on the auxetic applications. With the advance of additive manufacturing methods, computer-aided design and finite element analysis in recent decades, auxetics have been explored. One of the interesting applications is in the field of biomedical devices or implants, especially for certain natural biomedical organs such as tissues, certain ligaments that have auxetic properties. This paper is an overview of auxetic design approaches and biomedical applications.

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“…Materials with a negative or zero Poisson ratio, known as auxetic materials, exhibit exceptional characteristics such as energy absorption and dissipation, pressure reduction, fatigue toughness, and fracture resistance [13][14][15]. Compared to diabetic shoes with traditional PU foam heel pads, heel pads with auxetic re-entrant honeycomb structures significantly reduce the peak and average pressures on the heel [16]. Shoe midsoles utilizing mass-tunable auxetic geometry can effectively reduce ground reaction forces compared to traditional midsoles, lowering the risk of foot injuries during intense physical activities [17].…”

Section: Introductionmentioning

confidence: 99%

Pressure-Reducing Design of 3D-Printed Diabetic Shoe Midsole Utilizing Auxetic Lattice Structure

Zhang,

Lu,

Lin

et al. 2024

Applied Sciences

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With the global rise in the prevalence of diabetes, diabetic patients need innovative footwear designs to reduce the risk of foot ulcers. This study examined the mechanical properties of diabetic shoe midsoles featuring auxetic lattice structures. Through the construction of finite element models and simulation, this research compared the biomechanical parameter differences in the plantar regions of the metatarsal head, midfoot, and hindfoot when wearing two types of auxetic midsoles with internal angles of 60° and 75° and a non-auxetic midsole with an internal angle of 90° under both walking and running conditions. Compared to the non-auxetic midsole, the auxetic midsoles significantly reduced the peak plantar pressure and optimized the pressure distribution across various plantar regions. Notably, the auxetic 60° midsole reduced the peak plantar pressure by 19.68–55.25% and 16.19–54.39% compared to the non-auxetic 90° midsole during walking and running, respectively. This study also verified that the auxetic midsoles exhibited greater adaptability and compliance to the plantar foot shape, contributing to reductions in plantar pressure in comparisons of deformation values and plantar contact areas across the different midsoles. Auxetic midsoles manufactured using 3D printing technology have significant potential to prevent diabetic foot ulcers and maintain human foot health. This research integrates insights and techniques from materials science and ergonomics, offering a new direction for footwear design.

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3D printed auxetic heel pads for patients with diabetic mellitus

Cited by 18 publications

References 37 publications

Analysis of Diabetic Foot Deformation and Plantar Pressure Distribution of Women at Different Walking Speeds

Analysis of Diabetic Foot Deformation and Plantar Pressure Distribution of Women at Different Walking Speeds

Auxetics in Biomedical Applications: A Review

Pressure-Reducing Design of 3D-Printed Diabetic Shoe Midsole Utilizing Auxetic Lattice Structure

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