Exclusive: Rehabilitation technical aids and engineering

Advances in technical aids for diabetic foot

  • REN Weiyan ,
  • PU Fang ,
  • FAN Yubo
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  • 1. Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Rehabilitation Technical Aids of Ministry of Civil Affair, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China;
    2. School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China

Received date: 2019-07-02

  Revised date: 2019-10-09

  Online published: 2019-11-30

Abstract

The diabetic foot is one of the most serious complications of diabetes mellitus. A well-designed footwear can effectively relieve the plantar pressure and optimize the pressure redistribution, to reduce the incidence of foot ulcers and amputation, and improve the health of the foot tissue and the quality of life in diabetics. This paper reviews the pre-clinical diagnosis of the diabetic foot, the design principles and the manufacturing technology of the diabetic foot orthoses, and related clinical effects. It is found that the current diabetic foot orthoses are mainly designed for optimizing the distribution of the plantar pressure, but without a proper physiological evaluation and an active protection, which should be considered in the further design of intelligent technical aids for the diabetic foot.

Cite this article

REN Weiyan , PU Fang , FAN Yubo . Advances in technical aids for diabetic foot[J]. Science & Technology Review, 2019 , 37(22) : 69 -77 . DOI: 10.3981/j.issn.1000-7857.2019.22.008

References

[1] Kavitha K V, Tiwari S, Purandare V B, et al. Choice of wound care in diabetic foot ulcer:A practical approach[J]. World Journal of Diabetes, 2014, 5(4):546-556.
[2] Sandu M M, Protasiewicz D C, Firanescu A G, et al. Data regarding the prevalence and incidence of diabetes mellitus and prediabetes[J]. Romanian Journal of Diabetes_Nutrition and Metabolism Disease, 2016, 23(1):95-103.
[3] 王爱红, 赵湜, 李强, 等. 中国部分省市糖尿病足调查及医学经济学分析[J]. 中华内分泌代谢杂志, 2005, 21(6):496-499.
[4] Bowering C K. Diabetic foot ulcers. Pathophysiology, assessment, and therapy[J]. Canadian Family Physician Médecin De Famille Canadien, 2001, 47(5):1007-1018.
[5] Busch K, Chantelau E. Effectiveness of a new brand of stock ‘diabetic’ shoes to protect against diabetic foot ulcer relapse. A prospective cohort study[J]. Diabetic Medicine, 2003, 20(8):665-669.
[6] Boulton A J, Armstrong D G, Albert S F, et al. Comprehensive foot examination and risk assessment a report of the task force of the foot care interest group of the American diabetes association, with endorsement by the American association of clinical endocrinologists[J]. Diabetes care, 2008, 31(8):1679-1685.
[7] Frykberg R G. Diabetic foot ulcers:Pathogenesis and management[J]. American Family Physician, 2002, 66(9):1655-1662.
[8] Association A D. Peripheral arterial disease in people with diabetes[J]. Diabetes Care, 2003, 26(12):3333-3341.
[9] Tomesov a J, Gruberova J, Lacigova S, et al. Differences in skin microcirculation on the upper and lower extremities in patients with diabetes mellitus:Relationship of diabetic neuropathy and skin microcirculation[J]. Diabetes Technology & Therapeutics, 2013, 15(11):968-975.
[10] Jan Y K, Shen S, Foreman R D, et al. Skin blood flow response to locally applied mechanical and thermal stresses in the diabetic foot[J]. Microvascular Research, 2013, 89:40-46.
[11] Owings T, Apelqvist J, Stenström A, et al. Plantar pressures in diabetic patients with foot ulcers which have remained healed[J]. Diabetic Medicine, 2009, 26(11):1141-1146.
[12] Bus S A, Haspels R, Buschwestbroek T E. Evaluation and optimization of therapeutic footwear for neuropathic diabetic foot patients using in-shoe plantar pressure analysis[J]. Diabetes Care, 2011, 34(7):1595-1600.
[13] Fernandez M L G, Lozano R M, Diaz M I G-Q, et al. How effective is orthotic treatment in patients with recurrent diabetic foot ulcers?[J]. Journal of the American Podiatric Medical Association, 2013, 103(4):281-290.
[14] Dahmen R, Haspels R, Koomen B, et al. Therapeutic footwear for the neuropathic foot:An algorithm[J]. Diabetes Care, 2001, 24(4):705-709.
[15] 曹萍, 吴小高. 3D打印技术在矫形鞋垫中的应用进展[J]. 中国康复理论与实践, 2015, 7(21):753-756.
[16] Seidl M, Šafka J, Bobek J, et al. Mechanical properties of products made of ABS with respect to individuality of FDM productions process[J]. Modern Machinery Science Journal, 2017(1):1748-1751.
[17] Yarwindran M, Azwani Sa'aban N, Ibrahim M, et al. Thermoplastic elastomer infill pattern impact on mechanical properties 3D printed customized orthotic insole[J]. ARPN Journal of Engineering and Applied Sciences, 2016, 11(10):6519-6524.
[18] Bus S A, Ulbrecht J S, Cavanagh P R. Pressure relief and load redistribution by custom-made insoles in diabetic patients with neuropathy and foot deformity[J].Clinical Biomechanics, 2004, 19(6):629.
[19] Bus S A, Ulbrecht J S, Cavanagh P R. Pressure relief and load redistribution by custom-made insoles in diabetic patients with neuropathy and foot deformity[J]. Clinical Biomechanics, 2004, 19(6):629-638.
[20] Guldemond N A, Leffers P, Schaper N C, et al. The effects of insole configurations on forefoot plantar pressure and walking convenience in diabetic patients with neuropathic feet[J]. Clinical Biomechanics, 2007, 22(1):81-87.
[21] Actis R L, Ventura L B, Lott D J, et al. Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking[J]. Medical & Biological Engineering & Computing, 2008, 46(4):363-371.
[22] Bus S A, van Deursen R W, Kanade R V, et al. Plantar pressure relief in the diabetic foot using forefoot offloading shoes[J]. Gait & Posture, 2009, 29(4):618-622.
[23] Burns J, Wegener C, Begg L, et al. Randomized trial of custom orthoses and footwear on foot pain and plantar pressure in diabetic peripheral arterial disease[J]. Diabetic Medicine, 2009, 26(9):893-899.
[24] Charanya G, Patil K M, Narayanamurthy V B, et al. Effect of foot sole hardness, thickness and footwear on foot pressure distribution parameters in diabetic neuropathy[J]. Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine, 2004, 218(6):431-443.
[25] Viswanathan V, Madhavan S, Gnanasundaram S, et al. Effectiveness of different types of footwear insoles for the diabetic neuropathic foot:A follow-up study[J]. Diabetes Care, 2004, 27(2):474-477.
[26] Lobmann R, Kayser R, Kasten G, et al. Effects of preventative footwear on foot pressure as determined by pedobarography in diabetic patients:A prospective study[J]. Diabetic Medicine A Journal of the British Diabetic Association, 2001, 18(4):314-319.
[27] Lavery L A, Lafontaine J, Higgins K R, et al. Shear-reducing insoles to prevent foot ulceration in high-risk diabetic patients[J]. Advances in Skin & Wound Care, 2012, 25(11):525-526.
[28] Rizzo L, Tedeschi A, Fallani E, et al. Custom-made orthesis and shoes in a structured follow-up program reduces the incidence of neuropathic ulcers in high-risk diabetic foot patients[J]. International Journal of Lower Extremity Wounds, 2012, 11(1):59-64.
[29] Fernandez M L, Lozano R M, Diaz M I, et al. How effective is orthotic treatment in patients with recurrent diabetic foot ulcers?[J]. Journal of the American Podiatric Medical Association, 2013, 103(4):281-290.
[30] Perrier A, Vuillerme N, Luboz V, et al. Smart diabetic socks:Embedded device for diabetic foot prevention[J]. Innovation and Research in BioMedical engineering, 2014, 35(2):72-76.
[31] Atlas E, Yizhar Z, Khamis S, et al. Utilization of the foot load monitor for evaluating deep plantar tissue stresses in patients with diabetes:Proof-of-concept studies[J]. Gait & Posture, 2009, 29(3):377-382.
[32] Pu F, Yang Y, Fan X, et al. Optimal estimation of total plantar force for monitoring gait in daily life activities with low-price insole system[J]. Journal of Mechanics in Medicine & Biology, 2014, 14(3):1450037.
[33] Pu F, Fan X, Yang Y, et al. Feedback system based on plantar pressure for monitoring toe-walking strides in children with cerebral palsy[J]. American Journal of Physical Medicine & Rehabilitation, 2014, 93(2):122-129.
[34] Ren L, Li D, Liu C, et al. Design of in-shoe plantar pressure monitoring system for daily activity exercise stress assessment[C]//4th International Conference on Biomedical Engineering and Informatics. Shanghai:IEEE, 2011:1373-1376.
[35] Yavuz M, Brem R W, Davis B L, et al. Temperature as a predictive tool for plantar triaxial loading[J]. Journal of Biomechanics, 2014, 47(15):3767-3770.
[36] van Netten J J, van Baal J G, Liu C, et al. Infrared thermal imaging for automated detection of diabetic foot complications[J]. Journal of diabetes science and technology, 2013, 7(5):1122-9.
[37] Morley R E, Richter E J, Klaesner J W, et al. In-shoe multisensory data acquisition system[J]. IEEE Transactions on Bio-medical Engineering, 2001, 48(7):815-820.
[38] Cobb J, Claremont D. An in-shoe laser Doppler sensor for assessing plantar blood flow in the diabetic foot[J]. Medical Engineering & Physics, 2001, 23(6):417-425.
[39] Maloney-Hinds C, Petrofsky J S, Zimmerman G. The effect of 30 Hz vs. 50 Hz passive vibration and duration of vibration on skin blood flow in the arm[J]. Medical Science Monitor International Medical Journal of Experimental & Clinical Research, 2008, 14(3):CR112.
[40] Maloney-Hinds C, Petrofsky J S, Zimmerman G, et al. The role of nitric oxide in skin blood flow increases due to vibration in healthy adults and adults with type 2 diabetes[J]. Diabetes Technology & Therapeutics, 2009, 11(1):39-43.
[41] Sañudo B, Alfonso-Rosa R, Pozo-Cruz B D, et al. Whole body vibration training improves leg blood flow and adiposity in patients with type 2 diabetes mellitus[J]. European Journal of Applied Physiology, 2013, 113(9):2245-2252.
[42] Eze A R, Comerota A J, Cisek P L, et al. Intermittent calf and foot compression increases lower extremity blood flow[J]. American Journal of Surgery, 1996, 172(2):130-134.
[43] Malanin K, Kolari P J, Havu V K. The role of low resistance blood flow pathways in the pathogenesis and healing of venous leg ulcers[J]. Acta Derm-Venereol, 1999, 79(2):156-60.
[44] Delis K T, Husmann M J W, Nicolaides A N, et al. Enhancing foot skin blood flux in peripheral vascular disease using intermittent pneumatic compression:Controlled study on claudicants and grafted arteriopaths[J]. World Journal of Surgery, 2002, 26(7):861-866.
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