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Yang XG, Peng Z, Liu X, Liu XL, Lu S. A narrative review of the measurement methods for biomechanical properties of plantar soft tissue in patients with diabetic foot. Front Endocrinol (Lausanne) 2024; 15:1332032. [PMID: 39135623 PMCID: PMC11317276 DOI: 10.3389/fendo.2024.1332032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 07/08/2024] [Indexed: 08/15/2024] Open
Abstract
This article provides an overview of the development history and advantages and disadvantages of measurement methods for soft tissue properties of the plantar foot. The measurement of soft tissue properties is essential for understanding the biomechanical characteristics and function of the foot, as well as for designing and evaluating orthotic devices and footwear. Various methods have been developed to measure the properties of plantar soft tissues, including ultrasound imaging, indentation testing, magnetic resonance elastography, and shear wave elastography. Each method has its own strengths and limitations, and choosing the most appropriate method depends on the specific research or clinical objectives. This review aims to assist researchers and clinicians in selecting the most suitable measurement method for their specific needs.
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Affiliation(s)
- Xiong-gang Yang
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Key Laboratory of Digital Orthopedics of Yunnan Province, Kunming, Yunnan, China
| | - Zhi Peng
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiang Liu
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiao-liang Liu
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Sheng Lu
- Department of Orthopedics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- The Key Laboratory of Digital Orthopedics of Yunnan Province, Kunming, Yunnan, China
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Wu L, Huang R, Tang L, Ning X, Zhu J, Ma X. A novel in-situ dynamic mechanical analysis for human plantar soft tissue: The device design, definition of characteristics, test protocol, and preliminary results. Heliyon 2024; 10:e29986. [PMID: 38707476 PMCID: PMC11068617 DOI: 10.1016/j.heliyon.2024.e29986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
The in-situ mechanical characterization of elastomers is not highly regarded due to the existence of a well-established set of sample-based standard tests for research and industry. However, there are certain situations or materials, like biological soft tissue, where an in-situ approach is necessary due to the impossibility of sampling from a living body. We have developed a dynamic mechanical analysis (DMA)-like device to approach in-vivo and in-situ multidimensional stress-strain properties of human plantar soft tissues. This work elucidates the operational mechanism of the novel measurement, with the definition of a new set of moduli, test standardization and protocol. Exploratory results of a volunteer's living plantar, silica rubber samples are presented with well preciseness and consistence as expected.
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Affiliation(s)
- Longyan Wu
- Academy for Engineering and Technology, Fudan University, Shanghai, 200433, China
| | - Ran Huang
- Academy for Engineering and Technology, Fudan University, Shanghai, 200433, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, 322000, China
- Center for Innovation and Entrepreneurship, Taizhou Institute of Zhejiang University, Taizhou, Zhejiang, 318000, China
| | - Lisheng Tang
- Center for Innovation and Entrepreneurship, Taizhou Institute of Zhejiang University, Taizhou, Zhejiang, 318000, China
| | - Xinyi Ning
- Academy for Engineering and Technology, Fudan University, Shanghai, 200433, China
| | - Jun Zhu
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, 322000, China
| | - Xin Ma
- Academy for Engineering and Technology, Fudan University, Shanghai, 200433, China
- Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, China
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Guo H, Lan Y, Gao Z, Zhang C, Zhang L, Li X, Lin J, Elsheikh A, Chen W. Interaction between eye movements and adhesion of extraocular muscles. Acta Biomater 2024; 176:304-320. [PMID: 38296013 DOI: 10.1016/j.actbio.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
The contact and pull-off tests and finite element simulations were used to study the extraocular muscle-sclera adhesion and its variation with eye movement in this research. The effect of the adhesion on the eye movements was also determined using equilibrium equations of eye motion. The contact and pull-off tests were performed using quasi-static and non-quasi-static unloading velocities. Finite element models were developed to simulate these tests in cases with high unloading velocity which could not be achieved experimentally. These velocities range from the eye's fixation to saccade movement. The tests confirmed that the pull-off force is related to the unloading velocity. As the unloading velocity increases, the pull-off force increases, with an insignificant increase at the high ocular saccade velocities. The adhesion moment between the extraocular muscles and the sclera exhibited the same trend, increasing with higher eye movement velocities and higher separation angles between the two interfaces. The adhesion moment ratio to the total moment was calculated by the traditional model and the active pulley model of eye movements to assess the effect of adhesion behavior on eye movements. At the high ocular saccade velocities (about 461 deg/s), the adhesion moment was found to be 0.53% and 0.50% of the total moment based on the traditional and active pulley models, respectively. The results suggest that the adhesion behavior between the extraocular muscles and the sclera has a negligible effect on eye movements. At the same time, this adhesion behavior can be ignored in eye modeling, which simplifies the model reasonably well. STATEMENT OF SIGNIFICANCE: 1. Adhesion behavior between the extraocular muscles and the sclera at different indenter unloading velocities determined by contact and pull-off tests. 2. A finite element model was developed to simulate the adhesive contact between the extraocular muscles and the sclera at different indenter unloading velocities. The bilinear cohesive zone model was used for adhesive interactions. 3. The elastic modulus and viscoelastic parameters of the extraocular muscle along the thickness direction were obtained by using compressive stress-relaxation tests. 4. The influence of the adhesion moment between the extraocular muscles and the sclera on eye movement was obtained according to the equation of oculomotor balance. The adhesion moment between the extraocular muscles and the sclera was found to increase with increased eye movement velocity and increased separation angle between the two interfaces.
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Affiliation(s)
- Hongmei Guo
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China; Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital), Taiyuan 030032, China.
| | - Yunfei Lan
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Zhipeng Gao
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Chenxi Zhang
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Liping Zhang
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Xiaona Li
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Jianying Lin
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Weiyi Chen
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
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Jin J, Wang K, Ren L, Qian Z, Lu X, Liang W, Xu X, Zhao S, Zhao D, Wang X, Ren L. Optimization Design of the Inner Structure for a Bioinspired Heel Pad with Distinct Cushioning Property. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 10:bioengineering10010049. [PMID: 36671620 PMCID: PMC9854970 DOI: 10.3390/bioengineering10010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
In the existing research on prosthetic footplates, rehabilitation insoles, and robot feet, the cushioning parts are basically based on simple mechanisms and elastic pads. Most of them are unable to provide adequate impact resistance especially during contact with the ground. This paper developed a bioinspired heel pad by optimizing the inner structures inspired from human heel pad which has great cushioning performance. The distinct structures of the human heel pad were determined through magnetic resonance imaging (MRI) technology and related literatures. Five-layer pads with and without inner structures by using two materials (soft rubber and resin) were obtained, resulting in four bionic heel pads. Three finite element simulations (static, impact, and walking) were conducted to compare the cushioning effects in terms of deformations, ground reactions, and principal stress. The optimal pad with bionic structures and soft rubber material reduced 28.0% peak vertical ground reaction force (GRF) during walking compared with the unstructured resin pad. Human walking tests by a healthy subject wearing the 3D printed bionic pads also showed similar findings, with an almost 20% decrease in peak vertical GRF at normal speed. The soft rubber heel pad with bionic structures has the best cushioning performance, while the unstructured resin pad depicts the poorest. This study proves that with proper design of the inner structures and materials, the bionic pads will demonstrate distinct cushioning properties, which could be applied to the engineering fields, including lower limb prosthesis, robotics, and rehabilitations.
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Affiliation(s)
- Jianqiao Jin
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
| | - Kunyang Wang
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
- Weihai Institute for Bionics, Jilin University, Weihai 264402, China
- Correspondence: (K.W.); (L.R.)
| | - Lei Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
- Weihai Institute for Bionics, Jilin University, Weihai 264402, China
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester M13 9PL, UK
- Correspondence: (K.W.); (L.R.)
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
| | - Xuewei Lu
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester M13 9PL, UK
| | - Wei Liang
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
| | - Xiaohan Xu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
| | - Shun Zhao
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
| | - Di Zhao
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
| | - Xu Wang
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
| | - Luquan Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun 130025, China
- Weihai Institute for Bionics, Jilin University, Weihai 264402, China
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Teng ZL, Yang XG, Geng X, Gu YJ, Huang R, Chen WM, Wang C, Chen L, Zhang C, Helili M, Huang JZ, Wang X, Ma X. Effect of loading history on material properties of human heel pad: an in-vivo pilot investigation during gait. BMC Musculoskelet Disord 2022; 23:254. [PMID: 35292004 PMCID: PMC8925218 DOI: 10.1186/s12891-022-05197-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was aimed to develop a novel dynamic measurement technique for testing the material properties and investigating the effect of continuous compression load on the structural and mechanical properties of human heel pad during actual gait. METHODS The dual fluoroscopic imaging system (DFIS) and dynamic foot-ground contact pressure-test plate were used for measuring the material properties, including primary thickness, peak strain, peak stress, elastic modulus, viscous modulus and energy dissipation rate (EDR), both at time zero and following continuous loading. Ten healthy pilot subjects, aged from 23 to 72 (average: 46.5 ± 17.6), were enrolled. A "three-step gait cycle" is performed for all subjects, with the second step striking at a marked position on the force plate with the heel to maintain the location of the tested foot to be in the view of fluoroscopes. The subjects were measured at both relaxed (time-zero group) and fatigue (continuous-loading group) statuses, and the left and right heels were measured using the identical procedures. RESULTS The peak strain, peak stress, elastic modulus, and EDR are similar before and after continuous load, while the viscous modulus was significantly decreased (median: 43.9 vs. 20.37 kPa•s; p < 0.001) as well as primary thicknesses (median: 15.99 vs. 15.72 mm; p < 0.001). Age is demonstrated to be moderately correlated with the primary thicknesses both at time zero (R = -0.507) and following continuous load (R = -0.607). The peak stress was significantly correlated with the elastic modulus before (R = 0.741) and after continuous load (R = 0.802). The peak strain was correlated with the elastic modulus before (R = -0.765) and after continuous load (R = -0.801). The correlations between the viscous modulus and peak stress/ peak strain are similar to above(R = 0.643, 0.577, - 0.586 and - 0.717 respectively). The viscous modulus is positively correlated with the elastic modulus before (R = 0.821) and after continuous load (R = 0.784). CONCLUSIONS By using dynamic fluoroscopy combined with the plantar pressure plate, the in vivo viscoelastic properties and other data of the heel pad in the actual gait can be obtained. Age was negatively correlated with the primary thickness of heel pad and peak strain, and was positively correlated with viscous modulus. Repetitive loading could decrease the primary thickness of heel pad and viscous modulus.
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Affiliation(s)
- Zhao-Lin Teng
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Xiong-Gang Yang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Xiang Geng
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China.
| | - Yan-Jie Gu
- Academy for Engineering & Technology, Fudan University, No.220 Handan Road, Shanghai, 200438, China
| | - Ran Huang
- Academy for Engineering & Technology, Fudan University, No.220 Handan Road, Shanghai, 200438, China
| | - Wen-Ming Chen
- Academy for Engineering & Technology, Fudan University, No.220 Handan Road, Shanghai, 200438, China
| | - Chen Wang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Li Chen
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Chao Zhang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Maimaitirexiati Helili
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Jia-Zhang Huang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Xu Wang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Xin Ma
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No.12 Wulumuqi Middle Road, Shanghai, 200040, China.
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Yang XG, Teng ZL, Zhang ZM, Wang K, Huang R, Chen WM, Wang C, Chen L, Zhang C, Huang JZ, Wang X, Ma X, Geng X. Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait. Front Endocrinol (Lausanne) 2022; 13:894383. [PMID: 36060939 PMCID: PMC9428762 DOI: 10.3389/fendo.2022.894383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study was aimed to compare the material properties of heel pad between diabetes patients and healthy adults, and investigate the impact of compressive loading history and length of diabetes course on the material properties of heel pad. METHODS The dual fluoroscopic imaging system (DFIS) and dynamic foot-ground contact pressure-test plate were used for measuring the material properties, including primary thickness, peak strain, peak stress, stiffness, viscous modulus and energy dissipation ratio (EDR), both at time zero and following continuous loading. Material properties between healthy adults and DM patients were compared both at time zero and following continuous weight bearing. After then, comparison between time-zero material properties and properties following continuous loading was performed to identify the loading history-dependent biomechanical behaviour of heel pad. Subgroup-based sensitivity analysis was then conducted to investigate the diabetes course (<10 years vs. ≥10 years) on the material properties of heel pad. RESULTS Ten type II DM subjects (20 legs), aged from 59 to 73 (average: 67.8 ± 4.9), and 10 age-matched healthy adults (20 legs), aged from 59 to 72 (average: 64.4 ± 3.4), were enrolled. Diabetes history was demonstrated to be associated with significantly lower primary thickness (t=3.18, p=0.003**), higher peak strain (t=2.41, p=0.021*), lower stiffness (w=283, p=0.024*) and lower viscous modulus (w=331, p<0.001***) at time zero, and significantly lower primary thickness (t=3.30, p=0.002**), higher peak strain (w=120, p=0.031*) and lower viscous modulus (t=3.42, p=0.002**) following continuous loading. The continuous loading was found to be associated with significantly lower primary thickness (paired-w=204, p<0.001***) and viscous modulus (paired-t=5.45, p<0.001***) in healthy adults, and significantly lower primary thickness (paired-w=206, p<0.001***) and viscous modulus (paired-t=7.47, p<0.001***) in diabetes group. No any significant difference was found when conducting the subgroup analysis based on length of diabetes course (<10 years vs. ≥10 years), but the regression analysis showed that the length of diabetes history was positively associated with the peak strain, at time zero (r=0.506, p<0.050) and following continuous loading (r=0.584, p<0.010). CONCLUSIONS Diabetes patients were found to be associated with decreased primary thickness and viscous modulus, and increased peak strain, which may contribute to the vulnerability of heel pad to injury and ulceration. Pre-compression history-dependent behaviour is observable in soft tissue of heel pad, with lowered primary thickness and viscous modulus.
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Affiliation(s)
- Xiong-gang Yang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhao-lin Teng
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhen-ming Zhang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Kan Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ran Huang
- Academy for Engineering & Technology, Fudan University, Shanghai, China
| | - Wen-ming Chen
- Academy for Engineering & Technology, Fudan University, Shanghai, China
| | - Chen Wang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Chen
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Chao Zhang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jia-zhang Huang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin Ma
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Xiang Geng, ; Xin Ma,
| | - Xiang Geng
- Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Xiang Geng, ; Xin Ma,
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Spartacus V, Shojaeizadeh M, Raffault V, Shoults J, Van Wieren K, Sparrey CJ. In vivo soft tissue compressive properties of the human hand. PLoS One 2021; 16:e0261008. [PMID: 34898632 PMCID: PMC8668133 DOI: 10.1371/journal.pone.0261008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 11/22/2021] [Indexed: 12/25/2022] Open
Abstract
Background/Purpose Falls onto outstretched hands are the second most common sports injury and one of the leading causes of upper extremity injury. Injury risk and severity depends on forces being transmitted through the palmar surface to the upper extremity. Although the magnitude and distribution of forces depend on the soft tissue response of the palm, the in vivo properties of palmar tissue have not been characterized. The purpose of this study was to characterize the large deformation palmar soft tissue properties. Methods In vivo dynamic indentations were conducted on 15 young adults (21–29 years) to quantify the soft tissue characteristics of over the trapezium. The effects of loading rate, joint position, tissue thickness and sex on soft tissue responses were assessed. Results Energy absorbed by the soft tissue and peak force were affected by loading rate and joint angle. Energy absorbed was 1.7–2.8 times higher and the peak force was 2–2.75 times higher at high rate loading than quasistatic rates. Males had greater energy absorbed than females but not at all wrist positions. Damping characteristics were the highest in the group with the thickest soft tissue while damping characteristics were the lowest in group with the thinnest soft tissues. Conclusion Palmar tissue response changes with joint position, loading rate, sex, and tissue thickness. Accurately capturing these tissue responses is important for developing effective simulations of fall and injury biomechanics and assessing the effectiveness of injury prevention strategies.
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Affiliation(s)
- Victoria Spartacus
- Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia, Canada
- * E-mail:
| | - Maedeh Shojaeizadeh
- Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia, Canada
| | - Vincent Raffault
- Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia, Canada
| | - James Shoults
- Science Technical Center, Simon Fraser University, Burnaby, BC, Canada
| | - Ken Van Wieren
- Science Technical Center, Simon Fraser University, Burnaby, BC, Canada
| | - Carolyn J. Sparrey
- Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada
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Using Elastographic Ultrasound to Assess Plantar Tissue Stiffness after Walking at Different Speeds and Durations. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10217498] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Exercise has been demonstrated to improve health in people with diabetes. However, exercise may increase risk for foot ulcers because of increased plantar pressure during most weight-bearing physical activities. To date, there is no study investigating the effect of various walking speeds and durations (i.e., the most common form of exercise in daily living) on the plantar foot. The objective of this study was to investigate the effect of various walking intensities on plantar tissue stiffness. A 3 × 2 factorial design, including three walking speeds (1.8, 3.6 and 5.4 mph) and two durations (10 and 20 min), was tested in 12 healthy participants. B-mode and elastographic ultrasound images were measured from the first metatarsal head to quantify plantar tissue stiffness after walking. Two-way ANOVA was used to examine the results. Our results showed that the walking speed factor caused a significant main effect of planar stiffness of the superficial layers (p = 0.007 and 0.003, respectively). However, the walking duration factor did not significantly affect the plantar stiffness. There was no interaction between the speed and duration factors on plantar tissue stiffness. Regarding the walking speed effect, there was a significant difference in the plantar stiffness between 1.8 and 3.6 mph (56.8 ± 0.8% vs. 53.6 ± 0.9%, p = 0.017) under 20 min walking duration. This finding is significant because moderate-to-fast walking speed (3.6 mph) can decrease plantar stiffness compared to slow walking speed (1.8 mph). This study suggests people at risk for foot ulcers walk at a preferred or fast speed (3.6 mph) rather than walk slowly (1.8 mph).
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