Local plantar pressure relief in therapeutic footwear: design guidelines from finite element models

Erdemir, Ali; Saucerman, Jeffrey J.; Lemmon, David R.; Loppnow, Bryan; Turso, Brie; Ulbrecht, Jan S.; Cavanagh, Peter R.

doi:10.1016/j.jbiomech.2004.09.009

Cited by 96 publications

(59 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This creates a potential problem because of the stiffness discontinuity at the boundary between the softer plug and the rest of the insole. It has been reported that localized high plantar pressure may develop in this region depending on the configuration of the plugs [13].…”

Section: Tci Design Modificationsmentioning

confidence: 98%

“…Nonlinear material properties were specified for the standard TCI (#2 plastizote), the softer plugs (Poron) and shoe sole (rubber). The material properties for rubber and plastizote were obtained by compression testing of samples taken from the shoe sole and insert [14] utilizing an Instron testing machine (Wilson Instruments, Canton, MA) and following the procedures described in the ASTM standard D575−91, while those of the Poron were obtained from the literature [13]. For the TCI and plugs, a 5-parameter nonlinear material description was used, characterized by the slope of the initial linear portion (E), the Poisson's ratio (v), the strain at the end of the linear range (ε 1 ), the slope of a second linear region (Et), the starting point on the second linear part of the stress-strain relationship given by the strain (ε 2 ) and the corresponding stress (σ 2 ).…”

Section: Numerical Simulationmentioning

confidence: 99%

“…Research by other investigators include a partial 2D-model of the 2 nd metatarsal region of the foot to study the effect on plantar pressure due to changes in insole and tissue thickness [9]; a 3D-model of the standing foot to study the effect of flat and conforming insole of different materials in the plantar pressure distribution [10,11]; a 2D-model of the heel region of the foot to study the effect that shape, material properties and thickness of the insole have on PPP [12]; a similar partial model of the 2 nd metatarsal described by Lemmon et al [9] to investigate the effect of softer single plugs of different shapes penetrating the complete thickness of the shoe midsole [13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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.

show abstract

Section: Tci Design Modificationsmentioning

confidence: 98%

Section: Numerical Simulationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…The mechanical properties of foot tissue are useful to the design of differing types of footwear [1][2] and in the detection and diagnosis of foot tissue abnormalities [3][4].…”

Section: Introductionmentioning

confidence: 99%

An indentation apparatus for evaluating discomfort and pain thresholds in conjunction with mechanical properties of foot tissue in vivo

Xiong

Goonetilleke²,

Witana³

et al. 2010

JRRD

View full text Add to dashboard Cite

Abstract-The mechanical properties of human foot tissue in vivo as well as discomfort and pain thresholds are important for various applications. In this study, an apparatus for measuring the discomfort and pain thresholds and the mechanical properties of human tissues is presented. The apparatus employs a stepper motor that controls the indentation speed, as well as a load cell and potentiometer that determine the corresponding reaction force and tissue deformation (displacement), respectively. A LabVIEW program (LabVIEW 8, National Instruments Corporation; Austin, Texas) was developed to control the indentation via a data acquisition card. The apparatus can accommodate indentor displacements up to 35 mm and can impart forces up to 150 N at a controlled indentation speed in the range of 0 to 10 mm/s. Tests showed that the displacement measurement error is 0.17 mm in the nominal range (0.5% in the full scale) and the measurement error of force is 1.6 N in the nominal range (1.1% in the full scale). Experimental results indicate that the apparatus is reliable and flexible for measuring the mechanical properties of foot tissue in vivo in conjunction with pain and discomfort thresholds.

show abstract

“…A avaliação da distribuição da pressão plantar pode determinar quantitativamente locais de risco para o desenvolvimento de úlceras plantares e avaliar se o calçado selecionado pelo paciente ou modificações realizadas nas palmilhas, ou até mesmo a confecção destas, são eficazes para aliviar pressões em áreas suscetíveis a lesões ou em áreas já ulceradas. Também é uma importante aliada na educação do paciente, ajudando-o a compreender a importância de se utilizar calçados adequados (Mueller et al, 1999) e auxiliá-lo no melhor entendimento dos mecanismos de alívio de pressão que ocorre nas regiões do pé em função de determinadas estratégias terapêuticas (Erdemir et al, 2005).…”

Section: Contribuição E Efeitos Da Intervenção Fisioterapêutica Nas Runclassified

Contribuições da biomecânica para o estudo da neuropatia diabética e suas consequências para o movimento plantar

Sacco¹

View full text Add to dashboard Cite

Local plantar pressure relief in therapeutic footwear: design guidelines from finite element models

Cited by 96 publications

References 13 publications

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

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

An indentation apparatus for evaluating discomfort and pain thresholds in conjunction with mechanical properties of foot tissue in vivo

Contribuições da biomecânica para o estudo da neuropatia diabética e suas consequências para o movimento plantar

Contact Info

Product

Resources

About