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  • Virtually optimized insoles for offloading the diabetic foot: A randomized crossover study

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    Woodburn459711-Accepted.pdf (361.0Kb)
    File version
    Accepted Manuscript (AM)
    Author(s)
    Telfer, S
    Woodburn, J
    Collier, A
    Cavanagh, PR
    Griffith University Author(s)
    Woodburn, Jim
    Year published
    2017
    Metadata
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    Abstract
    Integration of objective biomechanical measures of foot function into the design process for insoles has been shown to provide enhanced plantar tissue protection for individuals at-risk of plantar ulceration. The use of virtual simulations utilizing numerical modeling techniques offers a potential approach to further optimize these devices. In a patient population at-risk of foot ulceration, we aimed to compare the pressure offloading performance of insoles that were optimized via numerical simulation techniques against shape-based devices. Twenty participants with diabetes and at-risk feet were enrolled in this study. Three ...
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    Integration of objective biomechanical measures of foot function into the design process for insoles has been shown to provide enhanced plantar tissue protection for individuals at-risk of plantar ulceration. The use of virtual simulations utilizing numerical modeling techniques offers a potential approach to further optimize these devices. In a patient population at-risk of foot ulceration, we aimed to compare the pressure offloading performance of insoles that were optimized via numerical simulation techniques against shape-based devices. Twenty participants with diabetes and at-risk feet were enrolled in this study. Three pairs of personalized insoles: one based on shape data and subsequently manufactured via direct milling; and two were based on a design derived from shape, pressure, and ultrasound data which underwent a finite element analysis-based virtual optimization procedure. For the latter set of insole designs, one pair was manufactured via direct milling, and a second pair was manufactured through 3D printing. The offloading performance of the insoles was analyzed for forefoot regions identified as having elevated plantar pressures. In 88% of the regions of interest, the use of virtually optimized insoles resulted in lower peak plantar pressures compared to the shape-based devices. Overall, the virtually optimized insoles significantly reduced peak pressures by a mean of 41.3 kPa (p < 0.001, 95% CI [31.1, 51.5]) for milled and 40.5 kPa (p < 0.001, 95% CI [26.4, 54.5]) for printed devices compared to shape-based insoles. The integration of virtual optimization into the insole design process resulted in improved offloading performance compared to standard, shape-based devices.
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    Journal Title
    Journal of Biomechanics
    Volume
    60
    DOI
    https://doi.org/10.1016/j.jbiomech.2017.06.028
    Copyright Statement
    © 2017 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
    Subject
    Biomedical engineering
    Mechanical engineering
    Sports science and exercise
    Science & Technology
    Life Sciences & Biomedicine
    Biophysics
    Publication URI
    http://hdl.handle.net/10072/405474
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    • Journal articles

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