New methods for evaluating physical and thermal comfort properties of orthotic materials used in insoles for patients with diabetes

Lo, Wai Ting; Yick, Kit Lun; Ng, Sun Pui; Yip, Joanne

doi:10.1682/jrrd.2013.01.0012

Cited by 31 publications

(29 citation statements)

References 30 publications

(13 reference statements)

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“…The thickness of the custom cushioning materials was close to the top end of the range that is used for the fabrication of insoles 14. However, the fact that the material’s stress/strain behaviour remains the same regardless of the sample’s thickness means that the pressure leading to bottoming out will also remain the same.…”

Section: Discussionmentioning

confidence: 99%

Subject Specific Optimisation of the Stiffness of Footwear Material for Maximum Plantar Pressure Reduction

et al. 2017

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Current selection of cushioning materials for therapeutic footwear and orthoses is based on empirical and anecdotal evidence. The aim of this investigation is to assess the biomechanical properties of carefully selected cushioning materials and to establish the basis for patient-specific material optimisation. For this purpose, bespoke cushioning materials with qualitatively similar mechanical behaviour but different stiffness were produced. Healthy volunteers were asked to stand and walk on materials with varying stiffness and their capacity for pressure reduction was assessed. Mechanical testing using a surrogate heel model was employed to investigate the effect of loading on optimum stiffness. Results indicated that optimising the stiffness of cushioning materials improved pressure reduction during standing and walking by at least 16 and 19% respectively. Moreover, the optimum stiffness was strongly correlated to body mass (BM) and body mass index (BMI), with stiffer materials needed in the case of people with higher BM or BMI. Mechanical testing confirmed that optimum stiffness increases with the magnitude of compressive loading. For the first time, this study provides quantitative data to support the importance of stiffness optimisation in cushioning materials and sets the basis for methods to inform optimum material selection in the clinic.Electronic supplementary materialThe online version of this article (doi:10.1007/s10439-017-1826-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Subject Specific Optimisation of the Stiffness of Footwear Material for Maximum Plantar Pressure Reduction

et al. 2017

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“…Studies have employed thermocouples, thermography and hygrometer devices to monitor the microclimate at a loaded skin interface [ 47 ]. They have revealed elevated temperature and humidity values in the plantar aspects of the foot [ 48 ], the residual amputee stump-socket interface of amputees [ 49 ] or at tissues where high forces are transmitted through foot orthoses [ 50 ]. These changes will inevitably reduce the skin tolerance to mechanical-induced damage [ 51 – 53 ].…”

Section: A Bioengineering Approach Measurement and Simulationmentioning

confidence: 99%

Technologies to monitor the health of loaded skin tissues

Bader

Worsley

2018

BioMed Eng OnLine

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There are many situations where the skin and underlying soft tissues are compromised by mechanical loading in the form or pressure, or pressure in combination with shear. If sustained, this can lead to damage in the tissues particularly adjacent to bony prominences, resulting in chronic wounds. An array of bioengineering technologies have been adopted to assess the integrity of loaded soft tissues. This paper aims to review these approaches for the quantification, simulation and early detection of mechanically-induced skin damage. The review considers different measurements at the interface between the skin and support surface/medical device, involving pressure, shear, friction and the local microclimate. The potential of the techniques to monitor the physiological response of the skin to these external stimuli including biophysical measurement devices and sampling of biofluids are critically analysed. In addition, it includes an analysis of medical imaging technologies and computational modelling to provide a means by which tissue deformation can be quantified and thresholds for tissue damage defined. Bioengineering measurement and imaging technologies have provided an insight into the temporal status of loaded skin. Despite the advances in technology, to date, the translation to clinical tools which are robust and cost effective has been limited. There is a need to adapt existing technologies and simulation platforms to enable patients, carers and clinicians to employ appropriate intervention strategies to minimise soft tissue damage.

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“…Such a measure may include values of viscoelasticity and shock absorption capability of liner materials. For example, Lo et al developed a set of test methods to quantify mechanical property and thermal comfort variables of materials used in diabetic shoe insole fabrication [48]. These variables included force reduction, compression stress, coefficient of friction, shear, moisture regain, and water vapor transmission.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of effects of current transtibial prosthetic socket designs—Part 1: Qualitative outcomes

Safari

Meier

2015

J Rehabil Res Dev

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Abstract-This review is an attempt to untangle the complexity of transtibial prosthetic socket fit, determine the most important characteristic for a successful fitting, and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. Further, it is intended to provide directions for future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design or type of outcome measure. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that incorporated the Downs and Black risk of bias assessment checklist. Results for the qualitative outcomes (n = 19 articles) are synthesized. Total surface bearing sockets lead to greater activity levels and satisfaction in active persons with amputation, those with a traumatic cause of amputation, and younger persons with amputation than patellar tendon bearing sockets. Evidence on vacuum-assisted suction and hydrostatic sockets is inadequate, and further studies are much needed. To improve the scientific basis for prescription, comparison of and correlation between mechanical properties of interface material, socket designs, user characteristics, and outcome measures should be conducted and reported in future studies.

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New methods for evaluating physical and thermal comfort properties of orthotic materials used in insoles for patients with diabetes

Cited by 31 publications

References 30 publications

Subject Specific Optimisation of the Stiffness of Footwear Material for Maximum Plantar Pressure Reduction

Subject Specific Optimisation of the Stiffness of Footwear Material for Maximum Plantar Pressure Reduction

Technologies to monitor the health of loaded skin tissues

Systematic review of effects of current transtibial prosthetic socket designs—Part 1: Qualitative outcomes

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