Diabetic foot load monitor

NewsBot · Apr 9, 2008

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The Diabetic Foot Load Monitor: A Portable Device for Real-Time Subject-Specific Measurements of Deep Plantar Tissue Stresses During Gait
Eran Atlas; Ziva Yizhar; Amit Gefen
J. Med. Devices -- March 2008 -- Volume 2, Issue 1,

Elevated stresses in deep plantar tissue of diabetic neuropathic patients were associated with an increased risk for foot ulceration, but only interfacial foot pressures are currently measured to evaluate susceptibility to ulcers. The goals of this study were to develop a real-time patient-specific plantar tissue stress monitor based on the Hertz contact theory. The biomechanical model for stress calculations considers the heel and metatarsal head pads, where most ulcers occur. For calculating stress concentrations around the bone-pad interface, plantar tissue is idealized as elastic and incompressible semi-infinite bulk (with properties measured by indentation), which is penetrated by a rigid sphere with the bone's radius of curvature (from X-ray). Hertz's theory is used to solve the bone-pad mechanical interactions, after introducing correction coefficients to consider large deformations. Foot-shoe forces are measured to solve and display the principal compressive, tensile, and von Mises plantar tissue stresses in real time. Our system can be miniaturized in a handheld computer, allowing plantar stress monitoring in the patient's natural environment. Small groups of healthy subjects (N=6) and diabetic patients (N=3) participated in an evaluation study in which the differences between free walking and treadmill walking were examined. We also compared gait on a flat surface to gait on an ascending/descending slope of 3.5 deg and when ascending/descending stairs. Peak internal compression stress was about threefold greater than the interface pressure at the calcaneus region. Subjects who were inexperience in treadmill walking displayed high gait-cycle variability in the internal stresses as well as poor foot loading. There was no statistical difference between gait on a flat surface and gait when ascending/descending a slope. Internal stresses under the calcaneus during gait on a flat surface, however, were significantly higher than when ascending/descending stairs. We conclude that the present stress monitor is a promising tool for real-time patient-specific evaluation of deep tissue stresses, providing valuable information in the effort to protect diabetic patients from foot ulceration. Clinical studies are now underway to identify which stress parameters can distinguish between diabetic and normal subjects; these parameters may be used for establishing injury threshold criteria.
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Brett1501 · Jun 30, 2009

Sounds like a very usefull tool, I wonder if it will be usefull in providing indications of effectiveness while wearing corrective/deflective soft orthoses?

NewsBot · Jun 21, 2017

Real-Time Smart Textile-Based System to Monitor Pressure Offloading of Diabetic Foot Ulcers.
Raviglione A et al
J Diabetes Sci Technol. 2017 Feb 1:1932296817695339. doi: 10.1177/1932296817695339

BACKGROUND:
The lifetime risk of developing a diabetic foot ulcer (DFU) is at least 25%. A DFU carries a 50% risk for infection and at least 20% of those receive some form of amputation. The most significant parameter that prevents or delays ulcer healing is high plantar pressure. To improve the patient's healing process, the DFU's plantar pressure should remain cumulatively low. Therefore, a tool that continuously measures the DFU loading, and provides real-time feedback can improve the healing outcome.
METHODS:
We report the development of a system capable of continuously measuring the pressure, which could have applications to monitor DFU. The system contains a textile pressure sensor attached to a stretchable band, hardware that collects data and transmits them via Bluetooth to a phone, an app that gathers the data and stores them in the cloud, and a web dashboard that displays the data to the clinician. The sensor was characterized in vitro using the system, and the web-dashboard was developed and tested on simulated patient data.
RESULTS:
We demonstrate the feasibility of developing the system and characterize the pressure response of the device. As a result, we demonstrate a viable method for monitoring DFU off-loading in real time.
CONCLUSIONS:
The presented study demonstrates the feasibility to develop a simple, modular wearable system that opens up new possibilities for diabetic foot ulcer care by providing a way of monitoring the pressure under the ulcer in real time.
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NewsBot · Jan 12, 2020

A Review of Wearable Sensor Systems to Monitor Plantar Loading in the Assessment of Diabetic Foot Ulcers.
Wang L, Jones D, Chapman GJ, Siddle HJ, Russell DA, Alazmani Nodeh A, Culmer P.
IEEE Trans Biomed Eng. 2019 Dec 27

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, commercially-available 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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NewsBot · Dec 3, 2020

A smart wearable device for monitoring and self-management of diabetic foot: A proof of concept study
Khadijeh Moulaei et al
Int J Med Inform. 2020 Nov 19

Background and objective: Diabetic foot is one of the important complications of diabetes, which is occurred due to the destructive parameters in different anatomical sites of feet. Management and monitoring of these parameters are very important to decrease or prevent foot ulcers. We aimed to develop a smart wearable device to monitor these parameters to prevent diabetic foot.

Methods: Following literature review and expert panel discussions, we considered pressure, temperature and humidity to develop the system. During these sessions, we also developed the system architecture and determined the required technologies. We also developed a mobile application. Finally, all sensors were evaluated for accurate monitoring of pressure, temperature and humidity. A standard protocol was used to evaluate each of these sensors. To this end, five people (four with diabetes and one healthy person) participated. They did a series of movements including walking, sitting, and standing. We considered the pressure measured by Pedar system as the gold standard. Furthermore, we changed the environment temperature and humidity during several experiments and considered the environment temperature and humidity as gold standard. We compared the measured values by sensors with these gold standards.

Results: The evaluation indicated the accurate performance of pressure, humidity and temperature sensors. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the system to provide alarms based on the pressure measured using Pedar were 100, 50, 92.5, 91.8, and 100 %, respectively. The performance of temperature sensors in smart shoes was confirmed by slight differences compared to thermometers. Relatively equal values of humidity measured by two sensors on the left and right feet and the increased difference with the environment humidity showed the exact humidity measured using these sensors.

Conclusion: This smart shoes monitors pressure, humidity, and temperature of patients' feet and sends this data to their smart phone by the Bluetooth module. Furthermore, it controls these parameters; as each of these parameters exceeds the defined threshold, alerts are given to patients for self-management.
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NewsBot · Jan 4, 2022

Patient and Provider Perspective of Smart Wearable Technology in Diabetic Foot Ulcer Prevention: A Systematic Review
Giorgio Orlando et al
Medicina (Kaunas). 2021 Dec 13;57(12):1359

Background and Objectives: Smart wearable devices are effective in diabetic foot ulcer (DFU) prevention. However, factors determining their acceptance are poorly understood. This systematic review aims to examine the literature on patient and provider perspectives of smart wearable devices in DFU prevention. Materials and Methods: PubMed, Scopus, and Web of Science were systematically searched up to October 2021. The selected articles were assessed for methodological quality using the quality assessment tool for studies with diverse designs. Results: A total of five articles were identified and described. The methodological quality of the studies ranged from low to moderate. Two studies employed a quantitative study design and focused on the patient perspective, whereas three studies included a mixed, quantitative/qualitative design and explored patient or provider (podiatrist) perspectives. Four studies focused on an insole system and one included a smart sock device. The quantitative studies demonstrated that devices were comfortable, well designed and useful in preventing DFU. One mixed design study reported that patients did not intend to adopt an insole device in its current design because of malfunctions, a lack of comfort. and alert intrusiveness, despite the general perception that the device was a useful tool for foot risk monitoring. Two mixed design studies found that performance expectancy was a predictor of a podiatrist's behavioural intention to recommend an insole device in clinical practice. Disappointing participant experiences negatively impacted the podiatrists' intention to adopt a smart device. The need for additional refinements of the device was indicated by patients and providers before its use in this population. Conclusions: The current evidence about patient and provider perspectives on smart wearable technology is limited by scarce methodological quality and conflicting results. It is, thus, not possible to draw definitive conclusions regarding acceptability of these devices for the prevention of DFU in people with diabetes.
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NewsBot · Mar 8, 2022

Development of a low-cost textile sensor based insole to monitor foot pressure of diabetic patients
Nuzat Nuary Alam et al
J Med Eng Technol. 2022 Feb 25;1-12

A common but preventable complication of diabetes is diabetic foot ulcer. If appropriate care is not provided such foot lesions progress to the most severe diabetic foot complication, like infection, gangrene, amputation and even death. Diabetic neuropathy results abnormal planter pressure points under the foot and triggers the tendency of foot ulcer. The aim of this paper is to present the development of a low cost, power efficient, soft, lightweight and simple in-shoe planter pressure measurement system. The system is capable to determine the average static pressure under ball and heel of the foot. The insole is comfortable due to the use of textile pressure sensor and its simple data acquisition method makes operation easy for the users. An experiment with 10 participants with and without diabetes was carried out to observe the outcome of the system. The practical implication of this study is to minimise the damage caused by foot ulcer by determining the pressure abnormality at earliest with a fully developed cost effective design. The system is capable to identify the difference in average planter pressure values in different groups of participants. To monitor the foot health proactively, the proposed system is found to be a useful device and can successfully scan the planter pressure under ball and heel of the foot.
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Brett1501 Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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