Biomechanical Solutions for Diabetic Foot Complications: Material and Design Approaches
Abstract views: 60
/ 
PDF downloads: 24
Keywords:
Diabetic Neuropathy, Orthotic Insoles, Foot Ulcers, Plantar Pressure Optimization, Finite Element ModelingAbstract
Many of the foot problems are concerns for diabetics, and even the mildest can lead to severe
ones. The majority of diabetic patients have neuropathy, or damaged nerves, and in conjunction with other
factors, this leads to foot problems. Peripheral artery disease and neuropathy are the products of active
diabetes as a result of the summation of all the elaborated metabolic reactions. Coexistence of peripheral
neuropathy, peripheral artery disease and ischemia might allow the possibility of foot ulcers. Diabetes
mellitus is a hyperglycemic state due to abnormalities in insulin secretion and action and results in chronic
hyperglycemia and metabolic changes. A multitude of physiological changes and interactions precede
diabetic foot conditions. In diabetic foot syndrome, there exists clear evidence of significant threats
regarding ulceration and amputation. New material research for orthotic insoles underlines the importance
of material stiffness and pressure distribution properties. However, standardization of quantitative methods
to determine suitable materials and design in diabetic neuropathy management is still lacking in the
literature. In this review, the different studies on the mechanical compatibility of heel and insole are
comparatively analyzed, considering their methodologies, used materials, and obtained results. This paper
assembles various findings aimed at investigating optimum geometries of support and single material
properties in personalized footwear design to enhance the quality of life of diabetic neuropathy patients. It
also discusses some of the methodologies that can be employed in establishing ways of minimizing plantar
pressure to avoid complications, such as finite element modeling and biomechanical tests.
Downloads
References
Akhtar, S., Ali, A., Ahmad, S., Khan, M., Shah, S., & Hassan, F. (2022). The prevalence of foot ulcers in diabetic patients in Pakistan: A systematic review and meta-analysis. Frontiers in Public Health, 10.
Olmez, N., Değirmenci, Y., & Kececi, H. (2015). Effects of pain and disability on quality of life in patients with diabetic polyneuropathy. Neuroscience & Medicine, 06(03), 98-106.
Suresh, S., Raj, S., & Manoj, P. (2023). Study of clinical patterns of diabetic neuropathy in patients of type 2 diabetes mellitus in a tertiary care hospital. BIJRDPM, 1(2), 39-44.
Sananta, P., Pratama, W., Widasmara, D., & Fuzianingsih, E. (2023). Body mass index and knee osteoarthritis: A retrospective cross-sectional study in Baptis Hospital, Batu City. Jurnal Ilmiah Kedokteran Wijaya Kusuma, 12(1), 84.
Pirker, W., & Katzenschlager, R. (2016). Gait disorders in adults and the elderly. Wiener Klinische Wochenschrift, 129(3-4), 81-95.
(2020). Cryotherapy in knee osteoarthritis. Indian Journal of Public Health Research & Development.
Ong, C., Geijtenbeek, T., Hicks, J., & Delp, S. (2019). Predicting gait adaptations due to ankle plantarflexor muscle weakness and contracture using physics-based musculoskeletal simulations. PLOS Computational Biology, 15(10), e1006993.
Tanaka, Y., & Ueno, T. (2023). Results of neuropathy screening test for lower limb amputees with diabetes mellitus and their prosthetic rehabilitation: A cross-sectional study. Cureus.
Iijima, H. (2023). Compensatory gait mechanics in a person with multiple toe amputation: A single case report. Clinical Case Reports, 11(8).
Bus, S., Netten, J., Lavery, L., Monteiro-Soares, M., Rasmussen, A., Jubiz, Y., ... & Price, P. (2016). IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes/Metabolism Research and Reviews, 32(S1), 16-24.
Martinez-Santos, A., Preece, S., & Nester, C. (2019). Evaluation of orthotic insoles for people with diabetes who are at-risk of first ulceration. Journal of Foot and Ankle Research, 12(1).
Akkus, G., & Sert, M. (2022). Diabetic foot ulcers: A devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities. World Journal of Diabetes, 13(12), 1106.
Kanchanasamut, W., & Pensri, P. (2017). Effects of weight-bearing exercise on a mini-trampoline on foot mobility, plantar pressure and sensation of diabetic neuropathic feet: A preliminary study. Diabetic Foot & Ankle, 8(1), 1287239.
Francia, P., Gulisano, M., Anichini, R., & Seghieri, G. (2014). Diabetic foot and exercise therapy: Step by step the role of rigid posture and biomechanics treatment. Current Diabetes Reviews, 10(2), 86-99.
Arts, M., Haart, M., Waaijman, R., Dahmen, R., Berendsen, H., Nollet, F., ... & Bus, S. (2015). Data-driven directions for effective footwear provision for the high-risk diabetic foot. Diabetic Medicine, 32(6), 790-797.
Telfer, S., Erdemir, A., Woodburn, J., & Cavanagh, P. (2014). What has finite element analysis taught us about diabetic foot disease and its management? A systematic review. PLOS One, 9(10), e109994.
Weledji, E., & Fokam, P. (2014). Treatment of the diabetic foot – to amputate or not? BMC Surgery, 14(1).
Cheuy, V., Hastings, M., Commean, P., Ward, S., & Mueller, M. (2013). Intrinsic foot muscle deterioration is associated with metatarsophalangeal joint angle in people with diabetes and neuropathy. Clinical Biomechanics, 28(9-10), 1055-1060.
Monteiro-Soares, M., Boyko, E., Ribeiro, J., Ribeiro, I., & Dinis-Ribeiro, M. (2012). Predictive factors for diabetic foot ulceration: A systematic review. Diabetes/Metabolism Research and Reviews, 28(7), 574-600.
Al-Rubeaan, K., Derwish, M., Ouizi, S., Youssef, A., Subhani, S., Ibrahim, H., ... & Alamri, B. (2015). Diabetic foot complications and their risk factors from a large retrospective cohort study. PLOS One, 10(5), e0124446.
Allan, J., et al. (2016). Lower limb biomechanical characteristics in patients with diabetic foot: Analysis and efficacy of modified orthopedic insoles. Materials Express, 11(12), 1-12.
Edmonds, M., et al. (2021). Advancements in diabetic foot insoles: A comprehensive review of design, manufacturing, and performance evaluation. Frontiers in Bioengineering and Biotechnology.
Kerr, M., et al. (2019). A scientometric analysis and visualization of diabetic foot research from 1955 to 2022. International Wound Journal.
Chatwin, K., et al. (2020). Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: A systematic literature review. Journal of Foot and Ankle Research, 13(30).
Allan, J., et al. (2021). Lower limb biomechanical characteristics in patients with diabetic foot: Analysis and efficacy of modified orthopedic insoles. Materials Express.
Edmonds, M., et al. (2021). Advancements in diabetic foot insoles: A comprehensive review of design, manufacturing, and performance evaluation. Frontiers in Bioengineering and Biotechnology.
Nouman, A., et al. (2021). Evaluation of parameters influencing plantar pressure distribution in diabetic neuropathic foot using finite element analysis. Journal of Foot and Ankle Research.
Kerr, M., et al. (2019). A scientometric analysis and visualization of diabetic foot research from 1955 to 2022. International Wound Journal.
Chatwin, K., et al. (2020). Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: A systematic literature review. Journal of Foot and Ankle Research.
Singh, S., et al. (2021). Design considerations for diabetic foot insoles: A review on material properties and performance evaluation. Materials Express.
Liu, Y., Wang, H., Zhao, Z., & Zhang, J. (2023). Analysis of the effectiveness of different footwear designs on diabetic foot ulcer prevention: A meta-analysis. Diabetic Foot & Ankle, 14(1), 123-130.
Balaji, S., et al. (2022). Mechanical properties of various insole materials for diabetic footwear: Implications for ulcer prevention. Journal of Biomechanics, 135, 111042.
Wawro, M., et al. (2021). Assessment of the impact of custom orthotics on gait parameters in patients with diabetic neuropathy: A randomized controlled trial. Journal of Foot and Ankle Research, 14(1).
Gupta, P., & Thakur, N. (2024). Advances in technology for monitoring plantar pressure: A review. Diabetes Technology & Therapeutics, 26(2), 95-101.
Nouman, M., Chong, D. Y., Srewaradachpisal, S., & Chatpun, S. (2022). The effect of customized insole pads on plantar pressure distribution in a diabetic foot with neuropathy: Material and design study using finite element analysis approach. Applied Sciences.
Ghazali, M. J., Ren, X., Rajabi, A., Zamri, W. F. H. W., & Mustafah, N. M. (2021). Finite element analysis of cushioned diabetic footwear using ethylene vinyl acetate polymer. Polymers, 13(14).
