DESIGN CRITERIA FOR THERAPEUTIC FOOTWEAR IN DIABETES

糖尿病治疗鞋的设计标准

• 批准号: 6388068
• 负责人: PETER Robert CAVANAGH
• 金额: $ 34.7万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-10 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6388068
• 关键词: assistive device /technology; bioengineering /biomedical engineering; biomechanics; clinical research; diabetes mellitus therapy; foot; human subject; human tissue; measurement; mechanical pressure; physical model; postmortem

DESCRIPTION: (adapted from Investigator's abstract) Lower extremity amputation in people with diabetes continues to be a major public health problem. More than 65,000 amputations are performed annually on diabetic patients in the US and, despite recent efforts, this number is increasing. Ulceration in the neuropathic foot is a major precursor of amputation and therapeutic footwear has been shown to be an important component of ulcer prevention. Unfortunately, there are still no overall guidelines to help with the prescription and construction of such shoes. The investigators believe that a comprehensive understanding of the problem of matching a given "at risk" neuropathic foot to a given therapeutic footwear intervention is unlikely flow just from human experimental work. Based on encouraging pilot results, they therefore propose in this application to develop in ABAQUS a series of increasingly complex finite element models of the forefoot based upon individual high resolution MRI images. The models will include the action of the flexor tendons, the plantar fascia, the transverse tarsal ligament, the major joints of the forefoot and a sliding interface between the foot and the ground or the footwear. A number of mechanical tests are proposed to develop material properties and model boundary conditions. The models will be validated using both a unique cadaver model and by measurements of pressure and plantar tissue thickness in walking human subjects. Once accurate predictions are achieved under these simple conditions, a series of typical footwear modifications will be examined. These will include insoles of different thickness and stiffness, "plugs" for local stress relief, metatarsal pads, and insoles with a molded forefoot. These results will again be validated against cadaver and human subject measurements. This work should result in significant advances in the modeling of the foot, and should provide. a detailed understanding of the design principles for footwear interventions that can reduce plantar pressure under the forefoot

描述：（根据调查员的摘要改编）下肢截肢 在糖尿病患者中，仍然是一个重大的公共卫生问题。更多的 每年对美国糖尿病患者进行超过65,000次截肢 而且，尽管最近做出了努力，但这个数字仍在增加。溃疡 神经性脚是截肢和治疗鞋类的主要先驱 已被证明是预防溃疡的重要组成部分。很遗憾， 仍然没有总体准则可以帮助处方和 建造这样的鞋子。调查人员认为全面 了解将给定的“处于危险”的神经性脚匹配的问题 给定的治疗性鞋类干预不太可能从人类 实验工作。基于鼓励的飞行员结果，他们建议 在此应用中，在Abaqus中开发一系列日益复杂的 前脚的有限元模型基于单个高分辨率MRI 图像。这些型号将包括屈肌肌腱的作用 筋膜，横向tarsal韧带，前脚的主要关节和 脚和地面或鞋类之间的滑动接口。许多 提出了机械测试来开发材料特性和模型边界 状况。这些模型将使用唯一的尸体模型和 通过测量压力和足底组织的厚度 主题。一旦在这些简单条件下实现了准确的预测， 将检查一系列典型的鞋类修改。这些将包括 厚度和刚度不同的鞋垫，“插头”，以缓解局部压力， meta骨垫和带模制的前脚的鞋垫。这些结果将再次 可以根据尸体和人类主题测量进行验证。这项工作应该 在脚的建模中取得了重大进展，应提供。 对鞋类干预的设计原理的详细理解 可以降低前脚下的足底压力