Biomechanical Analysis of the Three-Dimensional Foot Structure During Gait: A Basic Tool for Clinical Applications

Gefen, Amit; Megido-Ravid, M.; Itzchak, Y; Arcan, M.

doi:10.1115/1.1318904

Cited by 245 publications

(175 citation statements)

References 36 publications

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“…Future investigations should examine applied pressures and ST strain in a three dimensional manner. Finite element models are one means investigators are pursuing to examine the three dimensional effect of pressure on the ST of the foot (Lemmon et al, 1997;Gefen et al, 2000;Jacob and Patil, 1999;Cheung et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Effect of footwear and orthotic devices on stress reduction and soft tissue strain of the neuropathic foot

Lott

Hastings²,

Commean

et al. 2007

Clinical Biomechanics

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Background-Ground reaction forces from walking result in stress (pressure) and soft tissue strain at the plantar aspect of the foot. Excessive plantar pressure and tissue strain on the insensate foot may lead to ulceration. Our study investigated the effect of therapeutic footwear and custom-made orthotic inserts on pressure and tissue strain along the second ray of the plantar foot, and how these two variables are associated.Methods-Twenty subjects (mean age 57.3 [SD 9.3], 12 male, 8 female, body mass index 32.5 [SD 7.4]) with diabetes mellitus, peripheral neuropathy, and a history of a plantar ulcer participated. Plantar pressure data were recorded during computed tomography scans for four conditions (barefoot, shoe, shoe+total contact insert, and shoe+total contact insert+metatarsal pad). For each condition tested, tissue strain and plantar pressure were determined at the second metatarsal head and at 15 other points along the second ray. Intepretation-Footwear and orthotic devices tested in this study decreased pressure and soft tissue strain at the second ray of the foot, and these two variables were strongly related. A better understanding of the role tissue strain plays in distributing plantar forces may lead to improvements in the design of orthotic devices. Findings-Differences

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Section: Discussionmentioning

confidence: 99%

Effect of footwear and orthotic devices on stress reduction and soft tissue strain of the neuropathic foot

Lott

Hastings²,

Commean

et al. 2007

Clinical Biomechanics

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show abstract

“…Figure 1 shows the individual two-dimensional models in the sagittal plane as developed for metatarsal 2 in the simulated push-off position using the finite element analysis program StressCheck (Engineering Software Research & Development, Inc., St. Louis, MO). Linear elastic material properties were used for bones E = 7300 MPa [18], cartilage E = 10 MPa [19], flexor tendon E = 15 MPa [20][21][22], and fascia E = 85 MPa [22]. Muscle and fat were grouped into a single material type (tissue) with nonlinear elastic properties characterized by a strain energy density function as reported in [14]: (1) where W is the strain energy density, W L is the linear strain energy, C is a constant, e is te base of the natural logarithm, [D] is the linear stiffness matrix and {ε} is the strain tensor.…”

Section: Numerical Simulationmentioning

confidence: 99%

Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking

Actis

Ventura

Lott

et al. 2008

Med Biol Eng Comput

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There is evidence that appropriate footwear is an important factor in the prevention of foot pain in otherwise healthy people or foot ulcers in people with diabetes and peripheral neuropathy. A standard care for reducing forefoot plantar pressure is the utilization of orthotic devices such as total contact inserts (TCI) with therapeutic footwear. Most neuropathic ulcers occur under the metatarsal heads, and foot deformity combined with high localized plantar pressure, appear to be the most significant factors contributing to these ulcers. In this study, patient-specific finite element models of the second ray of the foot were developed to study the influence of TCI design on peak plantar pressure (PPP) under the metatarsal heads. A typical full contact insert was modified based on the results of finite element analyses, by inserting 4 mm diameter cylindrical plugs of softer material in the regions of high pressure. Validation of the numerical model was addressed by comparing the numerical results obtained by the finite element method with measured pressure distribution in the region of the metatarsal heads for a shoe and TCI condition. Two subjects, one with a history of forefoot pain and one with diabetes and peripheral neuropathy, were tested in the laboratory while wearing therapeutic shoes and customized inserts. The study showed that customized inserts with softer plugs distributed throughout the regions of high plantar pressure reduced the PPP over that of the TCI alone. This supports the outcome as predicted by the numerical model, without causing edge effects as reported by other investigators using different plug designs, and provides a greater degree of flexibility for customizing orthotic devices than current practice allows.

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“…Stresses within the foot structure are dependent on the threedimensional geometry of its components, including anatomical areas through which muscular and skeletal forces are transferred 18 . The directions and magnitudes of these forces are basic factors that determine the stress state of foot 19 . These vectored forces are transferred through the soft tissues of the foot to the ground 20 .…”

Section: Discussionmentioning

confidence: 99%

Occupation related differences in the thickness of metatarsal fat pads: an in vivo assessment in a young male adult population

Augustine

Akunna

2018

Bangladesh J Med Sci

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Background:The foot combines mechanical complexities with structural strength to withstand pressure and the metatarsal fat pads play a major role in this. Methods Material: In this study, we determined the metatarsal fat pad thickness of 40 male students that constituted a control group and an age-matched 40 male auto mechanic artisans within Abakaliki metropolis, southeast Nigeria, which served as the quasi-experimental group. Evaluation was made using a brightness mode ultrasound system. Their weights, heights, foot length, foot breadth and mid foot circumference were measured. Results: Results show a significant (P<0.05) difference in the mid-foot circumference and metatarsal fat pad thickness between the control (9.99±0.55cm and 2.04±0.35mm respectively) and artisans (9.58±2.0.59cm and 2.50±2.0.38mm respectively). However, there was no significant (P>0.05) differences in the foot breadth and length between the control (9.86±0.84cm and 26.96±1.03cm) and artisans (10.03±0.54cm and 26.16±1.39cm). Conclusion: These findings indicate that occupation related physical activity that increases plantar pressure can induce an unprecedented thickening of the Metatarsal fat pads thereby reducing elasticity and shock absorbing ability of the fat pads. This could trigger the development of overuse injuries of the foot and plantar foot ulcers. The assessment could also serve as a guidepost in the biomechanical evaluation of the metatarsal fat pad thickness.

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Biomechanical Analysis of the Three-Dimensional Foot Structure During Gait: A Basic Tool for Clinical Applications

Cited by 245 publications

References 36 publications

Effect of footwear and orthotic devices on stress reduction and soft tissue strain of the neuropathic foot

Effect of footwear and orthotic devices on stress reduction and soft tissue strain of the neuropathic foot

Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking

Occupation related differences in the thickness of metatarsal fat pads: an in vivo assessment in a young male adult population

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