The compressive mechanical properties of diabetic and non-diabetic plantar soft tissue

Pai, Shruti; Ledoux, William R.

doi:10.1016/j.jbiomech.2010.02.021

Cited by 116 publications

(132 citation statements)

References 35 publications

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“…While there was no significant difference in the values of viscoelastic coefficients between diabetic and non-diabetic feet, it was claimed that changes in plantar soft tissue were mainly recognised at the structural level, and not reflected effectively at the material level [38,39].…”

Section: In Vitro Testsmentioning

confidence: 93%

“…The energy dissipation or hysteresis (area between loading and unloading in force-deformation graph) was also shown to be significantly higher in people with diabetes [38,65]. Furthermore, in people with diabetes the ability of recovering the shape of the heel pad after unloading reduces which can be linked to the increase in the amount of energy dissipation [62,65].…”

Section: Effect Of Other Pathologies On Mechanical Behaviourmentioning

confidence: 98%

“…In some studies, the heel pad behaviour was characterised using an in vitro or in situ method to quantify the material properties of the plantar soft tissue [32,[35][36][37][38][39][40]. Miller-Young et al [35] performed a series of tests on the cylindrical samples of plantar soft tissue extracted from cadaveric feet.…”

Section: In Vitro Testsmentioning

confidence: 99%

“…Although the in vitro test can provide more repeatable data due to eliminating geometrical complexities of the plantar soft tissue, it cannot provide a realistic assessment of the mechanical behaviour of the plantar soft tissue during weight-bearing activities [38,39]. Furthermore, the in situ tests cannot be used to assess the mechanical behaviour of the heel pad in different individuals.…”

Section: In Situ Testsmentioning

confidence: 99%

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Viscoelasticity in Foot-Ground Interaction

Naemi¹,

Behforootan²,

Chatzistergos³

et al. 2016

Viscoelastic and Viscoplastic Materials

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Mechanical properties of the plantar soft tissue, which acts as the interface between the skeleton and the ground, play an important role in distributing the force underneath the foot and in influencing the load transfer to the entire body during weight-bearing activities. Hence, understanding the mechanical behaviour of the plantar soft tissue and the mathematical equations that govern such behaviour can have important applications in investigating the effect of disease and injuries on soft tissue function. The plantar soft tissue of the foot shows a viscoelastic behaviour, where the reaction force is not only dependent on the amount of deformation but also influenced by the deformation rate. This chapter provides an insight into the mechanical behaviour of plantar soft tissue during loading with specific emphasis on heel pad, which is the first point of contact during normal gait. Furthermore, the methods of assessing the mechanical behaviour including the in vitro/in situ and in vivo are discussed, and examples of creep, stress relaxation, rate dependency and hysteresis behaviour of the heel pad are shown. In addition, the viscoelastic models that represent the mechanical behaviour of the plantar soft tissue under load along with the equations that govern this behaviour are elaborated and discussed.

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Section: In Vitro Testsmentioning

confidence: 93%

Section: Effect Of Other Pathologies On Mechanical Behaviourmentioning

confidence: 98%

Section: In Vitro Testsmentioning

confidence: 99%

Section: In Situ Testsmentioning

confidence: 99%

See 2 more Smart Citations

Viscoelasticity in Foot-Ground Interaction

Naemi¹,

Behforootan²,

Chatzistergos³

et al. 2016

Viscoelastic and Viscoplastic Materials

View full text Add to dashboard Cite

show abstract

“…Therefore, quantifying the mechanical properties of plantar soft tissue has been an exciting and evolving topic for the past few years. Several approaches involving in vivo and in vitro testing have been utilised to measure and quantify the subject specific mechanical behaviour of the plantar soft tissue (Chatzistergos et al, 2015;Erdemir et al, 2006;Miller-young et al, 2002;Naemi et al, 2016;Pai and Ledoux, 2010).…”

Section: Introductionmentioning

confidence: 99%

A clinically applicable non-invasive method to quantitatively assess the visco-hyperelastic properties of human heel pad, implications for assessing the risk of mechanical trauma

Behforootan

Chatzistergos

Chockalingam

et al. 2017

Journal of the Mechanical Behavior of Biomedical Materials

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Cite this article as: Sara Behforootan, Panagiotis E. Chatzistergos, Nachiappan Chockalingam and Roozbeh Naemi, A clinically applicable non-invasive method to quantitatively assess the visco-hyperelastic properties of human heel pad with implications for assessing the risk of mechanical trauma, Journal of the Mechanical Behavior of Biomedical Materials, http://dx.doi.org/10.1016Materials, http://dx.doi.org/10. /j.jmbbm.2017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Purpose: To develop a clinically viable non-invasive method of assessing the mechanical properties of the heel pad. Furthermore the effect of non-linear mechanical behaviour of the heel pad on its ability to uniformly distribute foot-ground contact loads in light of the effect of overloading is also investigated. Methods:An automated custom device for ultrasound indentation was developed along with custom algorithms for the automated subject specific modeling of heel pad. Non-time-dependent and time-dependent material properties were inverse engineered from results from quasistatic indentation and stress relaxation test respectively. The validity of the calculated coefficients was assessed for five healthy participants. The implications of altered mechanical properties on the heel pad's ability to uniformly distribute plantar loading were also investigated in a parametric analysis. Results:The subject specific heel pad models with coefficients calculated based on quasi-static indentation and stress relaxation were able to accurately simulate dynamic indentation.Average error in the predicted forces for maximum deformation was only 6.6 ± 4.0%. When the inverse engineered coefficients were used to simulate the first instance of heel strike the error in terms of peak plantar pressure was 27%. The parametric analysis indicated that the heel pad's ability to uniformly distribute plantar loads is influenced both by its overall deformability and by its stress/ strain behaviour. When overall deformability stays constant, changes in stress/strain behaviour leading to a more "linear" mechanical behaviour appear to improve the heel pad's ability to uniformly distribute plantar loading. Conclusions:The developed technique can accurately assess the visco-hyperelastic behaviour of heel pad. It was observed that specific change in stress-strain behaviour can enhance/weaken the heel pad's ability to uniformly distribute plantar loading that will increase/decrease the risk for overloading and trauma.

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