Analysis of Diabetic Foot Deformation and Plantar Pressure Distribution of Women at Different Walking Speeds

Abstract

Official guidelines state that suitable physical activity is recommended for patients with diabetes mellitus. However, since walking at a rapid pace could be associated with increased plantar pressure and potential foot pain, the footwear condition is particularly important for optimal foot protection in order to reduce the risk of tissue injury and ulceration of diabetic patients. This study aims to analyze foot deformation and plantar pressure distribution at three different walking speeds (slow, normal, and fast walking) in dynamic situations. The dynamic foot shape of 19 female diabetic patients at three walking speeds is obtained by using a novel 4D foot scanning system. Their plantar pressure distributions at the three walking speeds are also measured by using the Pedar in-shoe system. The pressure changes in the toes, metatarsal heads, medial and lateral midfoot, and heel areas are systematically investigated. Although a faster walking speed shows slightly larger foot measurements than the two other walking speeds, the difference is insignificant. The foot measurement changes at the forefoot and heel areas, such as the toe angles and heel width, are found to increase more readily than the measurements at the midfoot. The mean peak plantar pressure shows a significant increase at a faster walking speed with the exception of the midfoot, especially at the forefoot and heel areas. However, the pressure time integral decreases for all of the foot regions with an increase in walking speed. Suitable offloading devices are essential for diabetic patients, particularly during brisk walking. Design features such as medial arch support, wide toe box, and suitable insole material for specific area of the foot (such as polyurethane for forefoot area and ethylene-vinyl acetate for heel area) are essential for diabetic insole/footwear to provide optimal fit and offloading. The findings contribute to enhancing the understanding of foot shape deformation and plantar pressure changes during dynamic situations, thus facilitating the design of footwear/insoles with optimal fit, wear comfort, and foot protection for diabetic patients.

The effects of different inner pressures of air insoles and walking durations on peak plantar pressure

“…6). [50] The more the load is shifted to the forefoot during stance might induce high PPP after 20 minutes walking duration. [17,51] The hardness value of the air insole in different pressures in this study was 51.7 to 57.7 Shore.…”

“…6 ). [ 50 ] The more the load is shifted to the forefoot during stance might induce high PPP after 20 minutes walking duration. [ 17 , 51 ]…”

Ultra-dense Motion Capture: An exploratory full-automatic approach for dense tracking of breast motion in 4D

“…4D scanning systems have been used in ergonomic and anthropometry research to investigate shape changes and deformation patterns during various activities. While the foot [ 19 , 20 , 25 , 26 ] and face [ 21 ] have received more attention, there is a growing interest in applying 4D scanning technology to analyze body and breast dynamics [ 22 – 24 ]. Although only a limited number of studies have explored this area, it has been recognized as having great potential for ergonomics studies and sportswear design [ 18 ].…”

“…However, despite the advancement in 4D data collection, there remain two major challenges associated with data processing: (i) the lack of automation schemes: with a scanning rate up to 120 fps (or 7200 frames per minute), manually processing the generated data to extract critical anthropometric measurements is unacceptable. Current research [22][23][24][25] usually only extracts a few frames from each scan for processing, leading to discarding subtle information about dynamic procedures and diminishing the value of high-speed scanning capabilities; (ii) the lack of accurate and consistent method to reveal the dense correspondence between frames. While adjacent frames correspond to each other, i.e.…”