A Tunable Self-Offloading Module for Plantar Pressure Regulation in Diabetic Patients

Abstract

Plantar pressure plays a crucial role in the pathogenesis of foot ulcers among patients with diabetes and peripheral polyneuropathy. Pressure relief is a key requirement for both the prevention and treatment of plantar ulcers. Conventional medical practice to enable such an action is usually realized by means of dedicated insoles and special footwear. Another technique for foot pressure offloading (not in medical practice) can be achieved by sensing/estimating the current state (pressure) and, accordingly, enabling a pressure release mechanism once a defined threshold is reached. Though these mechanisms can make plantar pressure monitoring and release possible, overall, they make shoes bulkier, power-dependent, and expensive. In this work, we present a passive and self-offloading alternative to keep plantar pressure within a defined safe limit. Our approach is based on the use of a permanent magnet, taking advantage of its non-linear field reduction with distance. The proposed solution is free from electronics and is a low-cost alternative for smart shoe development. The overall size of the device is 13 mm in diameter and 30 mm in height. The device allows more than 20-times the tunability of the threshold pressure limit, which makes it possible to pre-set the limit as low as 38 kPa and as high as 778 kPa, leading to tunability within a wide range. Being a passive, reliable, and low-cost alternative, the proposed solution could be useful in smart shoe development to prevent foot ulcer development. The proposed device provides an alternative for offloading plantar pressure that is free from the power feeding requirement. The presented study provides preliminary results for the development of a complete offloading shoe that could be useful for the prevention/care of foot ulcers among diabetic patients.