Fit and comfort of medical-grade footwear

NewsBot · Jan 6, 2017

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Medical-grade footwear: the impact of fit and comfort
Bessie Hurst, Helen Branthwaite, Andrew Greenhalgh and Nachiappan Chockalingam
Journal of Foot and Ankle Research201710:2

Background
Pressure-related skin lesions on the digits are a significant cause of discomfort. Most foot pain related to ill-fitting shoes occurs in the forefoot and digital areas. Pain has been associated with poor shoe fit, reduced toe box volume, as well as contour and shape of the shoe Off-the-shelf medical-grade footwear is designed as an intervention for chronic lesions on the digits. These shoes are designed with a flexible neoprene fabric upper that is thought to reduce pressure on the forefoot and reduce discomfort associated with ill-fitting shoes. The aim of this study was to investigate the effect of an off-the-shelf, medical-grade shoe on dorsal digital pressure and perceived comfort when compared to participant’s own preferred shoe.

Methods
Thirty participants (18 females, 12 males) scored their perceived comfort whilst wearing each footwear style using a visual analog comfort scale. Dorsal digital and interdigital pressures were measured in using the WalkinSense® in-shoe pressure system. Sensors were placed on predetermined anatomical landmarks on the digits. Participants were randomly assigned the test shoe and their own shoe. Once wearing the shoe, the participants walked across a 6 m walkway and pressure data from each sensor was collected and processed to obtain peak pressure, time to peak pressure and contact time.

Results
Participants scored the test shoe with higher comfort points than their own footwear. Overall peak pressure, pressure time integral and contact time decreased, whilst the time taken to reach peak pressure increased across all anatomical landmarks whilst wearing the test shoe. Statistically significant changes were observed for all of the measured variables relating to pressure on the medial border of the first metatarsophalangeal joint.

Conclusion
The test shoe provided greater comfort and reduced the amount of pressure on the forefoot. The medical-grade footwear therefore, is a viable alternative to custom made prescription footwear and is more suitable than a regular everyday shoe when treating digital lesions associated with pressure.
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Admin2 · Jan 6, 2017

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NewsBot · Dec 30, 2017

PRESCRIPTION VARIABLES FOR THE MEDICAL FOOTWEAR
Daniel PETCU
Revista de Pielărie Încălţăminte 17 (2017) 4

Medical footwear is a medical device used in the conserva# ve treatment of foot and lower limb pathomechanics. The standard
EN ISO 9999:2016 - “Assis# ve products for person with disability-Classifi ca# on and terminology”, includes orthopedic shoes in the category
of foot orthoses which are medical devices that encompass the whole or part of the foot, being divided in two categories: prefabricated or
custom fabricated. According to the legal requirements, a custom fabricated device is based on a medical prescrip# on containing the specifi c
design characteris# cs as established by the medical prac# # oner. In many situa# ons from clinical prac# ce, the medical prescrip# on does not
contain the specifi c design characteris# cs but only some generic data such as the name and type of the orthopedic footwear. The purpose
of this paper is to review the basic prescrip# on variables of the medical footwear according to the experience from developed foot care systems.
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NewsBot · Dec 19, 2019

State of the art design protocol for custom made footwear for people with diabetes and peripheral neuropathy.
Bus SA et al
Diabetes Metab Res Rev. 2019 Dec 16:e3237

Supported by evidence-based guidelines, custom-made footwear is often prescribed to people with diabetes who are at risk for ulceration. However, these guidelines do not specify the footwear design features, despite available scientific evidence for these features. We aimed to develop a design protocol to support custom-made footwear prescription for people with diabetes and peripheral neuropathy. The population of interest was people with diabetes who are at moderate-to-high risk of developing a foot ulcer, for whom custom-made footwear (shoes and/or insoles) can be prescribed. A group of experts from rehabilitation medicine, orthopaedic shoe technology (pedorthics) and diabetic foot research, reviewed the scientific literature and met during 12 face-to-face meetings to develop a footwear design algorithm and evidence-based pressure-relief algorithm as parts of the protocol. Consensus was reached where evidence was not available. Fourteen domains of foot pathology in combination with loss of protective sensation were specified for the footwear design algorithm and for each domain shoe-specific and insole (orthosis)-specific features were defined. Most insole-related features and some shoe-related features were evidence based, whereas most shoe-related features were consensus based. The pressure-relief algorithm was evidence based using recent footwear trial data and specifically targeted patients with a healed plantar foot ulcer. These footwear design and pressure-relief algorithms are the first of their kind and should facilitate more uniform decision making in the prescription and manufacturing of adequate shoes for moderate-to-high-risk patients, reducing variation in footwear provision and improving clinical outcome in the prevention of diabetic foot ulcers.
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NewsBot · May 14, 2021

Towards Customized Footwear with Improved Comfort
Rafaela Teixeira et al
Materials (Basel). 2021 Apr 1;14(7):1738

A methodology enabling the customization of shoes for comfort improvement is proposed and assessed. For this aim, 3D printed graded density inserts were placed in one of the critical plantar pressure zones of conventional insoles, the heel. A semi-automated routine was developed to design the 3D inserts ready for printing, which comprises three main stages: (i) the definition of the number of areas with different mesh density, (ii) the generation of 2D components with continuous graded mesh density, and (iii) the generation of a 3D component having the same 2D base mesh. The adequacy of the mesh densities used in the inserts was previously assessed through compression tests, using uniform mesh density samples. Slippers with different pairs of inserts embedded in their insoles were mechanically characterized, and their comfort was qualitatively assessed by a panel of users. All users found a particular pair, or a set, of prototype slippers more comfortable than the original ones, taken as reference, but their preferences were not consensual. This emphasizes the need for shoe customization, and the usefulness of the proposed methodology to achieve such a goal.
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NewsBot · Mar 25, 2022

Foot deformation analysis with different load-bearing conditions to enhance diabetic footwear designs
Liying Zhang et al
PLoS One. 2022 Mar 23;17(3):e0264233

In-depth analyses of foot surface measurements upon weight bearing are crucial to understand how the dorsal and plantar surfaces of the foot deform during motion to enhance the fit of footwear, which is particularly important for diabetic patients with stringent fit requirements to redistribute the plantar weight forces. This study analyzes diabetic foot deformations under 3 different weight bearing conditions (no weight bearing, half weight bearing, and 80% weight bearing) by using a novel foot scanning method that enables efficient scanning of the dorsal and plantar surfaces of the foot simultaneously. The feet of 48 patients with diabetes mellitus (DM) are scanned. With increased load on the feet, the width of the forefoot increases by 9.7%-10.4%, height of the midfoot decreases by 15.1%-18.2%, forefoot and midfoot rotate to the medial side by 16.9%-23.9% while the rearfoot rotates to the lateral side by 15.2% simultaneously, and the plantar of the foot increases contact with the floor by 11.4%-23.0%. Gender differences in foot shape are also found between males and females, males have a broader foot than females for the same foot length. Precise anthropometric information of foot changes and deformation therefore enables adequate foot protection, fit and comfort when designing footwear. This research contributes to shoe design considerations that focus on the deformation of the foot under different loads.
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NewsBot · Jul 24, 2023

Shoe Last Customization: A Systematic Review.
Wrześniowska, Karolina
International Journal of Engineering & Technology Innovation . Jul2023, Vol. 13 Issue 3, p230-250. 21p.

In recent years, there is an increase in research into shoe last customization and topic analysis methods. The work aims to systematically review the literature on the customization of shoe lasts. The method used in this work is to perform a five-phase systematic review algorithm. Data on the research performed are extracted and synthesized from each study: main research objectives, authors, date of publication, journal, or conference in which the article was published, and the quality of each article. The studies included in the review are published between 2018 and 2022. The results of the review are nineteen papers about the process of customization of the shoe last. The conclusions of the analysis indicate that the quality of research has not changed over time, in 2020 there was a decrease in work. Most often, researchers analyze the impact of anthropometric factors on the correct shoe last modeling and methods of shoe last parameterization.
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