Effect of different orthotic materials on plantar pressures: a systematic review

Gerrard, James M.; Bonanno, Daniel R; Whittaker, Glen A; Landorf, Karl B

doi:10.1186/s13047-020-00401-3

Cited by 31 publications

(27 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The function, reducing the pressure under the sole of the foot, can be achieved with CMI or PRI (Hellstrand Tang et al 2014 ; Van Netten et al 2020 ; Paton et al 2012 ). The advantages of CMI are that they are (1) individually matched to the form of the foot and have a pressure-reducing effect under the heel (Hellstrand Tang et al 2014 ), (2) some patients prefer walking on thicker, cushioning insoles (Gerrard et al 2020 ) and (3) adjustment, e.g. medial or lateral support of the foot, is easier with thicker insoles.…”

Section: Methods and Study Settingmentioning

confidence: 99%

Measuring sustainability in healthcare: an analysis of two systems providing insoles to patients with diabetes

Hellstrand¹,

Sundberg²,

Karlsson

et al. 2020

Environ Dev Sustain

View full text Add to dashboard Cite

There is an increasing demand to quantify the footprints, ecological, economic and social, in terms of the effect of different interventions in healthcare. The aim of this study was to compare two systems providing patients with diabetes with insoles in terms of their ecological, economic and social footprints. Prefabricated insoles (PRI) were compared with custom-made insoles (CMI). Using a welfare-economic monetary approach, costs were estimated for (1) treatment, (2) travelling to and from the hospital in terms of both fuel and time consumed by the patients and (3) society through emissions contributing to climate change. The proportion of patients/year that could be supplied within the same budget, for each individual treatment, was calculated. The cost of the insoles was 825 SEK (PRI) and 1450 SEK (CMI), respectively. The cost, mean value/patient due to the consumption of patients' time at the department, was 754 SEK (PRI) and 1508 SEK (CMI), respectively. Emissions, in terms of CO 2 equivalent, were 13.7 (PRI) and 27.4 (CMI), respectively. Using PRI, a total of 928 patients could be provided/year compared with 500 patients if CMI are used. By using PRI, the cost/treatment was reduced by 46%. The cost of treatment dominated and the cost of time consumed by patients were also substantial. The societal cost of contributing to climate change was of low importance. By using PRI, the needs of 86% more patients could be met within the same budget. Using these methods, the contribution of healthcare systems to the 17 Sustainable Development Goals approved by the UN can be quantified.

show abstract

Section: Methods and Study Settingmentioning

confidence: 99%

Measuring sustainability in healthcare: an analysis of two systems providing insoles to patients with diabetes

Hellstrand¹,

Sundberg²,

Karlsson

et al. 2020

Environ Dev Sustain

View full text Add to dashboard Cite

show abstract

“…Material stiffness, CMI thickness and insole contour to the foot have an effect on plantar pressure distribution [16,25]. Increasing the material stiffness and thickness of the insole can enhance the stability during gait.…”

Section: Introductionmentioning

confidence: 99%

Effects of Custom-Made Insole Materials on Frictional Stress and Contact Pressure in Diabetic Foot with Neuropathy: Results from a Finite Element Analysis

Nouman¹,

Dissaneewate²,

Chong³

et al. 2021

Applied Sciences

View full text Add to dashboard Cite

Offloading plantar pressure in a diabetic foot with neuropathy is challenging in conventional clinical practice. Custom-made insole (CMI) materials play an important role in plantar pressure reduction, but the assessment is costly and time-consuming. Finite element analysis (FEA) can provide an efficient evaluation of different insoles on the plantar pressure distribution. This study investigated the effect of CMI materials and their combinations on plantar pressure reduction for the diabetic foot with neuropathy using FEA. The study was conducted by constructing a three-dimensional foot model along with CMI to study the peak contact pressure between the foot and CMI. The softer material (E = 5 MPa) resulted in a better reduction of peak contact pressure compared with the stiffer material (E = 11 MPa). The plantar pressure was well redistributed with softer material compared with the stiffer material and its combination. In addition, the single softer material resulted in reduced frictional stress under the first metatarsal head compared with the stiffer material and the combination of materials. The softer material and its combination have a beneficial effect on plantar pressure reduction and redistribution for a diabetic foot with neuropathy. This study provided an effective approach for CMI material selection using FEA.

show abstract

“…9 There are different effects of CMI materials on plantar pressure distribution depending on the material stiffness, insole thickness and CMI contour to the foot. 10,11 Increasing the material stiffness and thickness of the insole enhances stability during gait; however, the cushioning is reduced when increasing the insole stiffness, and stiff insoles are contraindicated towards the diabetic foot. 12,13 Cushioning is an important factor as it acts as a shock absorber and reduces the impact on joints; especially the ankle, knee and the lower back.…”

Section: Introductionmentioning

confidence: 99%

“…Besides EVA, insoles fabricated from Poron ® tend to reduce plantar pressure compared to the shod gait. 10,17 However, using Poron ® increases the tendency of abrasion on the plantar surface of the foot. Whilst, there is a vast variety of commercial materials available that claim to reduce the peak plantar pressure, very few materials can be prescribe to the diabetic foot with neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Finite Element Approach Towards Selection of Appropriate Materials to Redistribute Peak Plantar Pressure in Diabetic Foot with Neuropathy

2021

View full text Add to dashboard Cite

Objective: The aim of this study was to assess the effect of customized insole (CMI) variations on plantar pressure in diabetic foot with neuropathy, using finite element analysis (FEA). Material and Methods: A three-dimensional foot model was constructed using FEA to study the peak contact pressure between the foot and the CMI. Nora® Lunalastike, Ethylene Vinyl Acetate (EVA), Amfit® and TPU were chosen for insole materials; and from these eight CMI models were created. The top surface of the tibia and fibula were fixed, and a displacement of 3 mm was exerted from the ground along with upwards Achilles tendon force.Results: The peak contact pressure contour showed that a softer material, CMI-A (E = 1.04 MPa), resulted in a better reduction of peak contact pressure compared to a stiffer material; CMI-D (E = 11 MPa). In addition, it was shown that the use of a single material to fabricate the CMI resulted in higher peak contact pressure; with the exception of CMI-A, in comparison to a dual-layer material of CMI-E and CMI-F. Using FEA, can effectively enhance the insole material selection process, without need of a trial and error practice in a clinical setting.Conclusion: The use of dual materials to fabricate CMIs, with the softer material as a top layer, is beneficial compared to a stiffer top layer material in the reduction of peak plantar pressure for diabetic foot with neuropathy.

show abstract

Effect of different orthotic materials on plantar pressures: a systematic review

Cited by 31 publications

References 65 publications

Measuring sustainability in healthcare: an analysis of two systems providing insoles to patients with diabetes

Measuring sustainability in healthcare: an analysis of two systems providing insoles to patients with diabetes

Effects of Custom-Made Insole Materials on Frictional Stress and Contact Pressure in Diabetic Foot with Neuropathy: Results from a Finite Element Analysis

Finite Element Approach Towards Selection of Appropriate Materials to Redistribute Peak Plantar Pressure in Diabetic Foot with Neuropathy

Contact Info

Product

Resources

About