materials for foot orthotics in diabetic patients

anDRe · Dec 27, 2010

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Hello to all my fellow podiatrist colleagues

I am currently preparing a study on new materials used in the manufacture of foot orthotics for diabetic patients and I am wondering if anyone out there can help me find research articles written recently about this issue because most of the articles I found are very antique!

Any information you can give me would be appreciated!

Thanks for all your help in advance, I await anxiously for your response.

Kind regards and happy holidays to all:santa:

André

javier · Dec 28, 2010

anDRe said: ↑

new materials used in the manufacture of foot orthotics for diabetic patients and I am wondering if anyone out there can help me find research articles written recently about this issue
Click to expand...

Joshua Burns, Lindy Begg, and Mauro Vicaretti
Comparison of Orthotic Materials on Foot Pain, Comfort, and Plantar Pressure in the Neuroischemic Diabetic Foot: A Case Report
J Am Podiatr Med Assoc 2008 98: 143-148

Angel Camp Faulí, Cristina Llobell Andrés, Norberto Porta Rosas, Maria José Fernández, Enrique Montiel Parreño, and César Orgilés Barceló
Physical Evaluation of Insole Materials Used to Treat the Diabetic Foot
J Am Podiatr Med Assoc 2008 98: 229-238.*

I hope it helps.

robby · Jan 4, 2011

Hi Andre

you could contact Joanne Paton at Plymouth University Pod Dept she did extensive work on materials for diabtic patients orthoses a couple of years ago.

you should be able to get her through joanne.paton@plymouth.ac.uk

hope this helps

Robby

mike weber · Jan 5, 2011

Andre,

Maybe shoot off an email to David Armstrong. He has done well tons of work on biomechancis and diabetic feet. Has helped with the design of the Vasyli diabetic Armstrong device

http://www.presentdiabetes.com/profile/profile.php?id=1157

Heres some reading for you also = http://www.vasylimedical.com/products/product_armstrong_orthotic.html

mike weber · Jan 5, 2011

this maybe of interst.

Three-dimensional finite element analysis of the foot during standing—a material sensitivity study
Jason Tak-Man Cheung,Aaron Kam-Lun Leung
Abstract
Information on the internal stresses/strains in the human foot and the pressure distribution at the plantar support interface under loading is useful in enhancing knowledge on the biomechanics of the ankle–foot complex. While techniques for plantar pressure measurements are well established, direct measurement of the internal stresses/strains is difficult. A three-dimensional (3D) finite element model of the human foot and ankle was developed using the actual geometry of the foot skeleton and soft tissues, which were obtained from 3D reconstruction of MR images. Except the phalanges that were fused, the interaction among the metatarsals, cuneiforms, cuboid, navicular, talus, calcaneus, tibia and fibula were defined as contact surfaces, which allow relative articulating movement. The plantar fascia and 72 major ligaments were simulated using tension-only truss elements by connecting the corresponding attachment points on the bone surfaces. The bony and ligamentous structures were embedded in a volume of soft tissues. The encapsulated soft tissue was defined as hyperelastic, while the bony and ligamentous structures were assumed to be linearly elastic. The effects of soft tissue stiffening on the stress distribution of the plantar surface and bony structures during balanced standing were investigated. Increases of soft tissue stiffness from 2 and up to 5 times the normal values were used to approximate the pathologically stiffened tissue behaviour with increasing stages of diabetic neuropathy. The results showed that a five-fold increase in soft tissue stiffness led to about 35% and 33% increase in the peak plantar pressure at the forefoot and rearfoot regions, respectively. This corresponded to about 47% decrease in the total contact area between the plantar foot and the horizontal support surface. Peak bone stress was found at the third metatarsal in all calculated cases with a minimal increase of about 7% with soft tissue stiffening.
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New developments in the biomechanics of the diabetic foot
Peter R. Cavanagh, Jan S. Ulbrecht, Gregory M. Caputo

Keywords:diabetes;foot;neuropathy;biomechanics;ulcer;prevention
Abstract
Biomechanical issues are now widely recognized as being important in the treatment of diabetic foot disease. The purpose of the present review is to identify advances that have occurred since the previous International Conference on the Diabetic Foot in 1995 in the understanding of foot biomechanics in relation to diabetes. Attention continues to be focused on the identification of a threshold plantar pressure that leads to tissue damage. Recent studies have suggested that peak barefoot pressure may be only 65% specific for the development of ulceration. The association between foot deformity and plantar pressure has been the subject of several quantitative studies, but new questions have been raised about the etiology of claw toes. The measurement of shear stress continues to be an elusive goal although several small studies have presented possibly feasible technical approaches. The importance of callus as a precursor to ulceration has been confirmed experimentally and quantitative measures of motor neuropathy have been presented. Although a number of new devices have been introduced as alternatives to the Total Contact Cast, few clinical studies of their efficacy are available yet. New information on the properties of insole materials has been published including data on changes with repeated cycling. Complications of prophylactic surgery have been shown to include a high rate of Charcot fractures. Two new series describing the fixation of such fractures have also been reported. Biomechanical issues have also been addressed in two sets of guidelines for treatment that have recently been published. These many studies confirm the central role of mechanical stress and its relief in the treatment of neuropathic foot problems in diabetes
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Petcu Daniel · May 8, 2011

Does anyone has a copy of the article : Angel Camp Faulí and colab "Physical Evaluation of Insole Materials Used to Treat the Diabetic Foot"
J Am Podiatr Med Assoc 2008 98: 229-238. ? Thank you in advance !
Daniel

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