Review of Foot Plantar Pressure—Focus on the Development of Foot Ulcerations

DeBerardinis, Jessica; Trabia, Mohamed B.; Dufek, Janet S.

doi:10.11131/2016/101158

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…Today, footwear and off-loading devices, i.e., removable casts and specifically made shoes, are employed to mitigate excessive plantar pressures, helping diabetic foot ulcer treatment [ 22 ]. However, these devices generally intervene only when the ulcer has already developed [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Modeling, Fabrication and Integration of Wearable Smart Sensors in a Monitoring Platform for Diabetic Patients

Pascali

Francioso

Giampetruzzi

et al. 2021

Sensors

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The monitoring of some parameters, such as pressure loads, temperature, and glucose level in sweat on the plantar surface, is one of the most promising approaches for evaluating the health state of the diabetic foot and for preventing the onset of inflammatory events later degenerating in ulcerative lesions. This work presents the results of sensors microfabrication, experimental characterization and FEA-based thermal analysis of a 3D foot-insole model, aimed to advance in the development of a fully custom smart multisensory hardware–software monitoring platform for the diabetic foot. In this system, the simultaneous detection of temperature-, pressure- and sweat-based glucose level by means of full custom microfabricated sensors distributed on eight reading points of a smart insole will be possible, and the unit for data acquisition and wireless transmission will be fully integrated into the platform. Finite element analysis simulations, based on an accurate bioheat transfer model of the metabolic response of the foot tissue, demonstrated that subcutaneous inflamed lesions located up to the muscle layer, and ischemic damage located not below the reticular/fat layer, can be successfully detected. The microfabrication processes and preliminary results of functional characterization of flexible piezoelectric pressure sensors and glucose sensors are presented. Full custom pressure sensors generate an electric charge in the range 0–20 pC, proportional to the applied load in the range 0–4 N, with a figure of merit of 4.7 ± 1 GPa. The disposable glucose sensors exhibit a 0–6 mM (0–108 mg/dL) glucose concentration optimized linear response (for sweat-sensing), with a LOD of 3.27 µM (0.058 mg/dL) and a sensitivity of 21 µA/mM cm2 in the PBS solution. The technical prerequisites and experimental sensing performances were assessed, as preliminary step before future integration into a second prototype, based on a full custom smart insole with enhanced sensing functionalities.

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Section: Introductionmentioning

confidence: 99%

Modeling, Fabrication and Integration of Wearable Smart Sensors in a Monitoring Platform for Diabetic Patients

Pascali

Francioso

Giampetruzzi

et al. 2021

Sensors

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“…Previous reviews in this area have examined tactile sensor technology [44], [45], use of plantar pressure to diagnose disease and gait disorders [46], [47], physiological aspects of DFU formation [48] and plantar pressure measurement in general terms [49]- [52]. In this paper, we seek to build on these works, providing an engineering perspective on recent developments of wearable technology for plantar stress measurement in the diabetic foot.…”

Section: Introductionmentioning

confidence: 99%

A Review of Wearable Sensor Systems to Monitor Plantar Loading in the Assessment of Diabetic Foot Ulcers

Wang

Jones

Chapman

et al. 2020

IEEE Trans. Biomed. Eng.

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Diabetes is highly prevalent throughout the world and imposes a high economic cost on countries at all income levels. Foot ulceration is one devastating consequence of diabetes, which can lead to amputation and mortality. Clinical assessment of diabetic foot ulcer (DFU) is currently subjective and limited, impeding effective diagnosis, treatment and prevention. Studies have shown that pressure and shear stress at the plantar surface of the foot plays an important role in the development of DFUs. Quantification of these could provide an improved means of assessment of the risk of developing DFUs. However, commerciallyavailable sensing technology can only measure plantar pressures, neglecting shear stresses and thus limiting their clinical utility. Research into new sensor systems which can measure both plantar pressure and shear stresses are thus critical. Our aim in this paper is to provide the reader with an overview of recent advances in plantar pressure and stress sensing and offer insights into future needs in this critical area of healthcare. Firstly, we use current clinical understanding as the basis to define requirements for wearable sensor systems capable of assessing DFU. Secondly, we review the fundamental sensing technologies employed in this field and investigate the capabilities of the resultant wearable systems, including both commercial and research-grade equipment. Finally, we discuss research trends, ongoing challenges and future opportunities for improved sensing technologies to monitor plantar loading in the diabetic foot.

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