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Peng Y, Wang Y, Zhang Q, Chen SF, Zhang M, Li G. Custom orthotic design by integrating 3D scanning and subject-specific FE modelling workflow. Med Biol Eng Comput 2024; 62:2059-2071. [PMID: 38446392 PMCID: PMC11189969 DOI: 10.1007/s11517-024-03067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Abstract
The finite element (FE) foot model can help estimate pathomechanics and improve the customized foot orthoses design. However, the procedure of developing FE models can be time-consuming and costly. This study aimed to develop a subject-specific scaled foot modelling workflow for the foot orthoses design based on the scanned foot surface data. Six participants (twelve feet) were collected for the foot finite element modelling. The subject-specific surface-based finite element model (SFEM) was established by incorporating the scanned foot surface and scaled foot bone geometries. The geometric deviations between the scaled and the scanned foot surfaces were calculated. The SFEM model was adopted to predict barefoot and foot-orthosis interface pressures. The averaged distances between the scaled and scanned foot surfaces were 0.23 ± 0.09 mm. There was no significant difference for the hallux, medial forefoot, middle forefoot, midfoot, medial hindfoot, and lateral hindfoot, except for the lateral forefoot region (p = 0.045). The SFEM model evaluated slightly higher foot-orthoses interface pressure values than measured, with a maximum deviation of 7.1%. These results indicated that the SFEM technique could predict the barefoot and foot-orthoses interface pressure, which has the potential to expedite the process of orthotic design and optimization.
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Affiliation(s)
- Yinghu Peng
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong, 999077, SAR, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong, 999077, SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Qida Zhang
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Shane Fei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong, 999077, SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong, 999077, SAR, China.
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China.
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong, SAR, China.
| | - Guanglin Li
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
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Talbott H, Jha S, Gulati A, Brockett C, Mangwani J, Pegg EC. Clinically useful finite element models of the natural ankle - A review. Clin Biomech (Bristol, Avon) 2023; 106:106006. [PMID: 37245282 DOI: 10.1016/j.clinbiomech.2023.106006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/19/2023] [Accepted: 05/17/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Biomechanical simulation of the foot and ankle complex is a growing research area but compared to simulation of joints such as hip and knee, it has been under investigated and lacks consistency in research methodology. The methodology is variable, data is heterogenous and there are no clear output criteria. Therefore, it is very difficult to correlate clinically and draw meaningful inferences. METHODS The focus of this review is finite element simulation of the native ankle joint and we will explore: the different research questions asked, the model designs used, ways the model rigour has been ensured, the different output parameters of interest and the clinical impact and relevance of these studies. FINDINGS The 72 published studies explored in this review demonstrate wide variability in approach. Many studies demonstrated a preference for simplicity when representing different tissues, with the majority using linear isotropic material properties to represent the bone, cartilage and ligaments; this allows the models to be complex in another way such as to include more bones or complex loading. Most studies were validated against experimental or in vivo data, but a large proportion (40%) of studies were not validated at all, which is an area of concern. INTERPRETATION Finite element simulation of the ankle shows promise as a clinical tool for improving outcomes. Standardisation of model creation and standardisation of reporting would increase trust, and enable independent validation, through which successful clinical application of the research could be realised.
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Affiliation(s)
| | - Shilpa Jha
- University Hospitals of Leicester, Leicester, UK
| | - Aashish Gulati
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Claire Brockett
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | | | - Elise C Pegg
- Department of Mechanical Engineering, University of Bath, Bath, UK.
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Yang Z, Cui C, Wan X, Zheng Z, Yan S, Liu H, Qu F, Zhang K. Design feature combinations effects of running shoe on plantar pressure during heel landing: A finite element analysis with Taguchi optimization approach. Front Bioeng Biotechnol 2022; 10:959842. [PMID: 36177186 PMCID: PMC9513060 DOI: 10.3389/fbioe.2022.959842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022] Open
Abstract
Large and repeated impacts on the heel during running are among the primary reasons behind runners’ injuries. Reducing plantar pressure can be conducive to reducing running injury and improving running performance and is primarily achieved by modifying the design parameters of running shoes. This study examines the effect of design parameters of running shoes (i.e., heel-cup, insole material, midsole material, and insole thickness) on landing peak plantar pressure and determines the combination of different parameters that optimize cushion effects by employing the Taguchi method. We developed the foot–shoe finite element (FE) model through reverse engineering. Model assembly with different design parameters was generated in accordance with the Taguchi method orthogonal table. The effectiveness of the model was verified using the static standing model in Ansys. The significance and contribution of different design parameters, and the optimal design to reduce plantar pressure during landing, were determined using the Taguchi method. In the descending order of percentage contribution was a conforming heel-cup (53.18%), insole material (25.89%), midsole material (7.81%), and insole thickness (2.69%). The more conforming heel-cup (p < 0.001) and softer insole (p = 0.001) reduced the heel pressure during landing impact. The optimal design of running shoe in this study was achieved with a latex insole, a 6 mm insole thickness, an Asker C-45 hardness midsole, and a 100% conforming heel-cup. The conforming heel-cup and the insole material significantly affected the peak plantar pressure during heel landing. The implementation of a custom conforming heel-cup is imperative for relieving high plantar pressure for long-distance heel-strike runners.
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Affiliation(s)
- Zihan Yang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
- Fashion Accessory Art and Engineering College, Beijing Institute Of Fashion Technology, Beijing, China
| | - Chuyi Cui
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Xianglin Wan
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
| | - Zhiyi Zheng
- Anta Sports Science Laboratory, Xiamen, China
| | - Songhua Yan
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Hui Liu
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Feng Qu
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
| | - Kuan Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- *Correspondence: Kuan Zhang,
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Peng Y, Wang Y, Wong DWC, Chen TLW, Chen SF, Zhang G, Tan Q, Zhang M. Different Design Feature Combinations of Flatfoot Orthosis on Plantar Fascia Strain and Plantar Pressure: A Muscle-Driven Finite Element Analysis With Taguchi Method. Front Bioeng Biotechnol 2022; 10:853085. [PMID: 35360398 PMCID: PMC8960448 DOI: 10.3389/fbioe.2022.853085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/18/2022] [Indexed: 11/23/2022] Open
Abstract
Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. A flatfoot-orthosis finite element model was constructed by considering the three-dimensional geometry of plantar fascia. The plantar fascia model accounted for the interaction with the bulk soft tissue. The Taguchi approach was adopted to analyze the significance of four design factors combination (arch support height, medial posting inclination, heel cup height, and material stiffness). Predicted plantar pressure and plantar fascia strains in different design combinations at the midstance instant were reported. The results indicated that the foot orthosis with higher arch support (45.7%) and medial inclination angle (25.5%) effectively reduced peak plantar pressure. For the proximal plantar fascia strain, arch support (41.8%) and material stiffness (37%) were strong influencing factors. Specifically, higher arch support and softer material decreased the peak plantar fascia strain. The plantar pressure and plantar fascia loading were sensitive to the arch support feature. The proposed statistics-based finite element flatfoot model could assist the insole optimization and evaluation for individuals with flatfoot.
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Affiliation(s)
- Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Shane Fei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- *Correspondence: Ming Zhang,
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Lv ML, Ni M, Sun W, Wong DWC, Zhou S, Jia Y, Zhang M. Biomechanical Analysis of a Novel Double-Point Fixation Method for Displaced Intra-Articular Calcaneal Fractures. Front Bioeng Biotechnol 2022; 10:791554. [PMID: 35356772 PMCID: PMC8959616 DOI: 10.3389/fbioe.2022.791554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
The development of minimally invasive procedures and implant materials has improved the fixation strength of implants and is less traumatic in surgery. The purpose of this study was to propose a novel “double-point fixation” for calcaneal fractures and compare its biomechanical stability with the traditional “three-point fixation.” A three-dimensional finite element foot model with a Sanders type IIIAB calcaneal fracture was developed based on clinical images comprising bones, plantar fascia, ligaments, and encapsulated soft tissue. Double-point and three-point fixation resembled the surgical procedure with a volar distal radius plate and calcaneal locking plate, respectively. The stress distribution, fracture displacement, and change of the Böhler angle and Gissane’s angle were estimated by a walking simulation using the model, and the predictions between the double-point and three-point fixation were compared at heel-strike, midstance, and push-off instants. Double-point fixation demonstrated lower bone stress (103.3 vs. 199.4 MPa), but higher implant stress (1,084.0 vs. 577.9 MPa). The model displacement of double-point fixation was higher than that of three-point fixation (3.68 vs. 2.53 mm). The displacement of the posterior joint facet (0.127 vs. 0.150 mm) and the changes of the Böhler angle (0.9° vs. 1.4°) and Gissane’s angle (0.7° vs. 0.9°) in double-point fixation were comparably lower. Double-point fixation by volar distal radius plates demonstrated sufficient and favorable fixation stability and a lower risk of postoperative stress fracture, which may potentially serve as a new fixation modality for the treatment of displaced intra-articular calcaneal fractures.
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Affiliation(s)
- Miko Lin Lv
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Ming Ni
- Department of Orthopedics, Pudong New Area People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Wanju Sun
- Department of Orthopedics, Pudong New Area People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Shuren Zhou
- School of Computer and Communication Engineering, Changsha University of Science and Technology, Changsha, China
| | - Yongwei Jia
- Department of Spine Surgery, Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Yongwei Jia,
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Wang M, Li S, Teo EC, Fekete G, Gu Y. The Influence of Heel Height on Strain Variation of Plantar Fascia During High Heel Shoes Walking-Combined Musculoskeletal Modeling and Finite Element Analysis. Front Bioeng Biotechnol 2022; 9:791238. [PMID: 34988067 PMCID: PMC8720874 DOI: 10.3389/fbioe.2021.791238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022] Open
Abstract
The therapeutic benefit of high heel shoes (HHS) for plantar fasciitis treatment is controversial. It has been suggested that plantar fascia strain can be decreased by heel elevation of shoes which helps in body weight redistribution throughout the length of the foot. Yet it is a fact that the repetitive tension caused by HHS wearing resulting in plantar fasciitis is a high-risk disease in HHS individuals who suffer heel and plantar pain. To explore the biomechanical function on plantar fascia under HHS conditions, in this study, musculoskeletal modeling (MsM) and finite element method (FEM) were used to investigate the effect of heel height on strain distribution of plantar fascia. Three-dimensional (3D) and one-dimensional (1D) finite element models of plantar fascia were generated to analyze the computed strain variation in 3-, 5-, and 7-cm heel heights. For validation, the computed foot contact pressure was compared with experimental measurement, and the strain value on 1D fascia was compared with previous studies. Results showed that the peak strain of plantar fascia was progressively increased on both 3D and 1D plantar fascia as heel elevated from 3 to 7 cm, and the maximum strain of plantar fascia occurs near the heel pain site at second peak stance. The 3D fascia model predicted a higher strain magnitude than that of 1D and provided a more reliable strain distribution on the plantar fascia. It is concluded that HHS with narrow heel support could pose a high risk on plantar fasciitis development, rather than reducing symptoms. Therefore, the heel elevation as a treatment recommendation for plantar fasciitis is questionable. Further studies of different heel support structures of shoes to quantify the effectiveness of heel elevation on the load-bearing mechanism of plantar fascia are recommended.
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Affiliation(s)
- Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Faculty of Health and Safety, Óbuda University, Budapest, Hungary
| | - Shudong Li
- Faculty of Health and Safety, Óbuda University, Budapest, Hungary
| | - Ee-Chon Teo
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| | - Gusztáv Fekete
- Savaria Institute of Technology, Eötvös Loránd University, Budapest, Hungary
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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