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Document Type

Original Study

Subject Areas

Biomechanics

Keywords

semi-porous, custom-made insole, finite element analysis, plantar pressure.

Abstract

Diabetic patients frequently face complications such as foot ulcers which are the primary cause of lower-limb amputation. Recent research has found that reducing plantar pressure can dramatically minimize the chance of developing a diabetic foot ulcer. Using orthopedic insoles can lead to reducing and redistributing pressure on the foot's sole. The purpose of this study was to develop a technique using Finite Element Analysis (FEA) for creating dedicated, low-cost insoles for diabetic patients to reduce maximal plantar pressure, and to rapidly refine designs and assess their effectiveness in meeting a predefined pressure threshold for foot offloading in diabetic neuropathic patients. Initially, a three-dimensional model of the foot was created using Computed Tomography (CT) scan images. Subsequently, three customized insole designs are created: single-layer which divided into semi-porous and flat, and three-layer. Six different materials; Amfit EVA, Nora Lunalastike, Plastazote PE, Thermoplastic polyurethane (TPU), Nora Lunairflex, and Poron were employed to create the proposed three customized insole models. Additionally, FEA software was employed to compute foot plantar pressure distribution. The results indicated that, in comparison to the flat insole model, the semi-porous and three-layer customized insole models showed a significant reduction in foot contact stress. Employing Nora Lunairflex, Nora Lunalastike on Middle-layer, and Amfit EVA materials on the top-layer, the middle-layer, and the base-layer of the three-layer custom-insole model, respectively, resulted in 12.88%, 20.46%, and 6.91% plantar pressure reduction compared to the other three material combinations used in this paper. Lastly, the semi-porous insole model with Nora Lunalastike material decreased peak contact stress by 29.09%, outperforming all simulated models and materials in our study.

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