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Towards an In-Shoe Pneumatic Insole to Plantar Injury Prevention in Diabetic Foot

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Proceedings of the 10th Congress of the Portuguese Society of Biomechanics (CNB 2023)

Part of the book series: Lecture Notes in Bioengineering ((LNBE))

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Abstract

Diabetic foot is a serious complication of diabetes that affects millions of people around the world. It is characterized by poor circulation, nerve damage and high plantar pressure that can lead to the development of foot ulcers and amputations. Offloading plantar pressure in certain regions is extremely important. In this paper we propose a preliminary methodology for a new concept of pneumatic insole for plantar pressure offloading. It consists of an insole with pockets, located in critical regions of the diabetic foot, which can be inflated or deflated to maintain adequate pressure. The main goal of this work is to select the most suitable fluid for the system and that provides a better applicability for this new solution, describing its pros and cons. When analyzing the results, the use of compressed air as a fluid to regulate the pressure in the insole pockets stood out as the most appropriate and advantageous option compared to other gaseous or liquid fluids. Liquid fluids have negative aspects, such as the risk of damaging electronic components in case of leaks and the need for additional reservoirs. In addition, air has a better thermal insulation capacity and does not pose a risk of toxicity, an important aspect for a system that will be in direct contact with the diabetic foot. The availability and zero cost of air, its lightness, and the absence of the need for reservoirs make the pneumatic insole more accessible and low cost, also providing greater cushioning, shock absorption and pressure redistribution.

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References

  1. Bus S et al (2020) Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). Diab/Metab Res Rev 36(S1):1–18

    Google Scholar 

  2. Mishra S, Chhatbar K, Kashikar A, Mehndiratta A (2017) Diabetic foot. The BMJ 359(SUPP 1):1–7

    Google Scholar 

  3. Hidmark A et al (2014) A new paradigm to understand and treat diabetic neuropathy. Exp Clin Endocrinol Diab 226(1):201–202

    Google Scholar 

  4. Armstrong D, Boulton A, Bus S (2017) Diabetic foot ulcers and their recurrence. N Engl J Med 376(24):2367–2375

    Article  PubMed  Google Scholar 

  5. Lazzarini P, O’Rourke S, Russell A, Derhy P, Kamp M (2015) Reduced incidence of foot-related hospitalisation and amputation amongst persons with diabetes in Queensland Australia. PLoS ONE 10(6):e0130609

    Article  PubMed  PubMed Central  Google Scholar 

  6. Guiotto A, Sawacha Z, Guarneri G, Cristoferi G, Avogaro A, Cobelli C (2013) The role of foot morphology on foot function in diabetic subjects with or without neuropathy. Gait Posture 37(4):603–610

    Article  PubMed  Google Scholar 

  7. Chen W, Lee T, Lee P, Lee J, Lee S (2010) Effects of internal stress concentrations in plantar soft-tissue—a preliminary three-dimensional finite element analysis. Med Eng Phys 32(4):324–331

    Article  PubMed  Google Scholar 

  8. Chao C, Zheng Y, Cheing G (2011) Epidermal thickness and biomechanical properties of plantar tissues in diabetic foot. Ultrasound Med Biol 37(7):1029–1038

    Article  PubMed  Google Scholar 

  9. Pai S, Ledoux W (2010) The compressive mechanical properties of diabetic and non-diabetic plantar soft tissue. J Biomech 43(9):1754–1760

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ulbrecht J, Cavanagh P, Caputo G (2004) Foot problems in diabetes: an overview. Clin Infect Dis 39(2)

    Google Scholar 

  11. Bus S, Haspels R, Busch-Westbroek T (2011) Evaluation and optimization of therapeutic footwear for neuropathic diabetic foot patients using in-shoe plantar pressure analysis. Diabetes Care 34(7):1595–1600

    Article  PubMed  PubMed Central  Google Scholar 

  12. Collings R, Freeman J, Latour J, Paton J (2021) Footwear and insole design features for offloading the diabetic at risk foot—a systematic review and meta-analyses. Endocrinol Diab Metab 4(1):e00132

    Article  Google Scholar 

  13. Ahmed S, Barwick A, Butterworth P, Nancarrow S (2020) Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: a systematic literature review. J Foot Ankle Res 13(30):1–13

    Google Scholar 

  14. Zwaferink J, Custers W, Paardekooper I, Berendsen H, Bus S (2020) Optimizing footwear for the diabetic foot: data-driven custom-made footwear concepts and their effect on pressure relief to prevent diabetic foot ulceration. PLoS One 15(4)

    Google Scholar 

  15. Korada H, Maiya A, Rao S, Hande M (2020) Effectiveness of customized insoles on maximum plantar pressure in diabetic foot syndrome: A systematic review. Diab Metab Syndr Clin Res Rev 14(5):1093–1099

    Google Scholar 

  16. Jarl G, Tranberg R, Johansson U, Alnemo J, Lundqvist L (2020) Predictors of adherence to wearing therapeutic footwear among people with diabetes. J Foot Ankle Res 3(1)

    Google Scholar 

  17. Jorgetto J, Gamba M, Kusahara D (2019) Evaluation of the use of therapeutic footwear in people with diabetes mellitus—a scoping review. J Diab Metab Disord 18(2):613–624

    Article  Google Scholar 

  18. Telfer S, Woodburn J, Collier A, Cavanagh P (2017) Virtually optimized insoles for offloading the diabetic foot: a randomized crossover study. J Biomech 60:157–161

    Article  CAS  PubMed  Google Scholar 

  19. Arts M, Waaijman R, Haart M, Keukenkamp R, Nollet F, Bus S (2012) Offloading effect of therapeutic footwear in patients with diabetic neuropathy at high risk for plantar foot ulceration. Diab Med 29(12):1534–1541

    Article  CAS  Google Scholar 

  20. Owings T et al (2009) Plantar pressures in diabetic patients with foot ulcers which have remained healed. Diab Med 26(11):1141–1146

    Article  CAS  Google Scholar 

  21. Van G, Haddad j, Bensimon Y, Dillard L, Jacobs D (2017) Biofeedback strategy and reduction of foot pressure in diabetic patient with neuropathy: benefit of connected insoles FEETME: a preliminary study. Ann Phys Rehabil Med 60, e40

    Google Scholar 

  22. Abbott C et al (2019) Innovative intelligent insole system reduces diabetic foot ulcer recurrence at plantar sites: a prospective, randomised, proof-of-concept study. The Lancet Digital Health 1(6):e308–e318

    Article  PubMed  Google Scholar 

  23. Low J, Khin P, Yeow C (2015) A pressure-redistributing insole using soft sensors and actuators. In: Proceedings—IEEE international conference on robotics and automation. IEEE, Seattle, WA, USA, pp 2926–2930

    Google Scholar 

  24. Grivon D, Civet Y, Pataky Z, Perriard Y (2015) Design and characterization of a soft magneto-rheological miniature shock absorber for a controllable variable stiffness sole. Arch Electr Eng 64(4):547–558

    Article  Google Scholar 

  25. Götz J et al (2017) Off-loading strategies in diabetic foot syndrome—evaluation of different devices. Int Orthop 41(2):239–246

    Article  PubMed  Google Scholar 

  26. Jacobs D, Ferris D (2016) Evaluation of a low-cost pneumatic plantar pressure insole for predicting ground contact kinetics. J Appl Biomech 32(2):215–220

    Article  PubMed  Google Scholar 

  27. Hayakawa Y, Kimata Y, Kida K (2020) Study on human behavior classification by using high-performance shoes equipped with pneumatic actuators. J Rob Mechatron 32(5):947–957

    Article  Google Scholar 

  28. Hayakawa Y, Kida K, Nakanishi Y, Ichii H, Hirota Y (2022) Development and application of silicone outer shell-type pneumatic soft actuators. J Robot Mechatron 34(2):444–453

    Article  Google Scholar 

  29. Bus S et al (2020) Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2019 update). Diab/Metab Res Rev 36(S1):1–18

    Google Scholar 

  30. PubChem Homepage, National Library of Medicine, National Center for Biotechnology Information, Explore Chemistry, https://pubchem.ncbi.nlm.nih.gov/. Accessed 07 Feb 2023

  31. Viswanathan B (2017) Petroleum. Energy sources, pp 29–57

    Google Scholar 

  32. Castrol Homepage, Hydraulic Fluids, Mineral and synthetic oils, https://www.castrol.com/en/global/corporate/products/industrial/lubricants/hydraulic-fluids.html. Accessed 07 Feb 2023

  33. LORD Corporation Homepage, MRF-132DG Magneto-Rheological Fluid, https://www.lord.com. Accessed 12 June 2022

  34. Grivon D, Civet Y, Pataky Z, Perriard Y (2015) Design and comparison of different Magneto-Rheological valves configurations. In: IEEE/ASME international conference on advanced intelligent mechatronics. IEEE, Busan, Korea, pp 818–823

    Google Scholar 

Download references

Acknowledgements

PCM's contribution to this work was within the scope of a PhD grant (UI/BD/151285/2021) financed by the Portuguese Foundation for Science and Technology (FCT, Portugal). Part this work was developed in the scope of the “Smart-Health-4-All—Smart medical technologies for better health and care” project (POCI-01-0247-FEDER-046115; LISBOA-01-0247-FEDER-046115), which was co-financed by Portugal 2020, under the Operational Program for Competitiveness and Internationalization (COMPETE 2020) through the European Regional Development Fund (ERDF).

Author information

Authors and Affiliations

  1. Faculty of Engineering, University of Porto, Porto, Portugal

    Pedro Castro-Martins & Mário Vaz

  2. CIETI, School of Engineering—Polytechnic of Porto, Porto, Portugal

    Pedro Castro-Martins, Luís Pinto-Coelho & Arcelina Marques

  3. Centre for Robotics in Industry and Intelligent Systems, INESC-TEC, Porto, Portugal

    Luís Pinto-Coelho

  4. Institute for Science and Innovation in Mechanical and Industrial Engineering, Porto, Portugal

    Mário Vaz & Arcelina Marques

  5. ROPAR, SA, Vila Do Conde, Portugal

    Marcelino Pinto

Authors
  1. Pedro Castro-Martins
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  2. Luís Pinto-Coelho
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  3. Mário Vaz
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  4. Marcelino Pinto
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  5. Arcelina Marques
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Corresponding author

Correspondence to Pedro Castro-Martins .

Editor information

Editors and Affiliations

  1. University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, Coimbra, Portugal

    Ana Martins Amaro

  2. Polytechnic Institute of Coimbra, Coimbra Institute of Engineering, CEMMPRE, ARISE, Coimbra, Portugal

    Luis Roseiro

  3. University of Coimbra, CEMMPRE, ARISE, Faculty of Medicine, Coimbra, Portugal

    Ana Lúcia Messias

  4. University of Coimbra, CIDAF, Faculty of Sport Sciences and Physical Education, Coimbra, Portugal

    Beatriz Gomes

  5. Polytechnic Institute of Leiria, School of Technology and Management, CIIC, Leiria, Portugal

    Henrique Almeida

  6. Polytechnic Institute of Leiria, School of Health Sciences, Leiria, Portugal

    Maria António Castro

  7. University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, Coimbra, Portugal

    Maria Augusta Neto

  8. University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, Coimbra, Portugal

    Maria de Fátima Paulino

  9. University of Coimbra, CEMMPRE, ARISE, Department of Mechanical Engineering, Coimbra, Portugal

    Vítor Maranha

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© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

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Castro-Martins, P., Pinto-Coelho, L., Vaz, M., Pinto, M., Marques, A. (2023). Towards an In-Shoe Pneumatic Insole to Plantar Injury Prevention in Diabetic Foot. In: Martins Amaro, A., et al. Proceedings of the 10th Congress of the Portuguese Society of Biomechanics. CNB 2023. Lecture Notes in Bioengineering. Springer, Cham. https://doi.org/10.1007/978-3-031-47790-4_29

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  • DOI: https://doi.org/10.1007/978-3-031-47790-4_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-47789-8

  • Online ISBN: 978-3-031-47790-4

  • eBook Packages: MedicineMedicine (R0)

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