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Haris F, Jan YK, Liau BY, Hsieh CW, Shen WC, Tai CC, Shih YH, Lung CW. Plantar pressure gradient and pressure gradient angle are affected by inner pressure of air insole. Front Bioeng Biotechnol 2024; 12:1353888. [PMID: 38529404 PMCID: PMC10961410 DOI: 10.3389/fbioe.2024.1353888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/21/2024] [Indexed: 03/27/2024] Open
Abstract
Clinically, air insoles may be applied to shoes to decrease plantar pressure gradient (PPG) and increase plantar gradient angle (PGA) to reduce foot ulcers. PPG and PGA may cause skin breakdown. The effects of different inner pressures of inflatable air insoles on dynamic PPG and PGA distributions are largely unknown in non-diabetics and people with diabetes. This study aimed to explore the impact of varying inner air insole pressures on PPG and PGA to establish early mitigation strategies for people at risk of foot ulcers. A repeated measures study design, including three air insoles (80 mmHg, 160 mmHg, and 240 mmHg) and two walking durations (10 and 20 min) for a total of six walking protocols, was tested on 13 healthy participants (height, 165.8 ± 8.4 cm; age, 27.0 ± 7.3 years; and weight, 56.0 ± 7.9 kg, BMI: 20.3 ± 1.7 kg/m^2) over three consecutive weeks. PPG, a measurement of the spatial variation in plantar pressure around the peak plantar pressure (PPP) and PGA, a variation in the gradient direction values at the three plantar regions, big toe (T1), first metatarsal head (M1), and second metatarsal head (M2), were calculated. This study indicated that PPG was lower at 80 mmHg air insoles after 20 min of walking in the M1 region (p = 0.010). The PGA in the M2 increased at an air insole of 80 mmHg compared to 240 mmHg (p = 0.015). Compared to 20 min, the 10 min walking duration at 240 mmHg of air insole had the lowest PPG in the M1 (p = 0.015) and M2 (p = 0.034) regions. The 80 mmHg air insole significantly lowered the PPG compared to a 160 mmHg and 240 mmHg air insole. Moreover, the 80 mmHg air insole significantly decreased PPP and increased PGA compared to the 160 mmHg and 240 mmHg air insole. A shorter walking period (10 min) significantly lowered PPG. The findings of this study suggest that people with a higher risk of foot ulcers should wear softer air insoles to have a lower PPG, as well as an increased PGA.
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Affiliation(s)
- Fahni Haris
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Ben-Yi Liau
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
| | - Chang-Wei Hsieh
- Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan
| | - Wei-Cheng Shen
- Department of Digital Media Design, Asia University, Taichung, Taiwan
| | - Chien-Cheng Tai
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Chi-Wen Lung
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Department of Creative Product Design, Asia University, Taichung, Taiwan
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Fu Y, Pu H, Huang Q, Qiu P, Zhao D, Cheng Y. Application of 3D Printing Insole by Hemodynamics in Older Patients with Critical Limb Ischemia: Protocol for a Randomized Clinical Trial. Int J Gen Med 2023; 16:5241-5246. [PMID: 38021061 PMCID: PMC10644844 DOI: 10.2147/ijgm.s429768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Critical limb ischemia (CLI) is a severe condition characterized by inadequate blood flow to the lower extremities, often leading to tissue damage and amputation. CLI is characterized by microcirculatory dysfunction, muscle tissue necrosis, and inflammation. Patients may suffer from the traumatic pain and the increase of plantar pressure, and foot care for patients with CLI has become the "last mile" to improve their life quality. Traditional shoe insoles often lack individual customization, failing to address the unique anatomical needs and hemodynamic characteristics of patients. The study aims to investigate the effects of this innovative intervention on improving the clinical outcomes, and quality of life in CLI patients. Methods and Analysis This Critical Limb Ischemia Hemodynamic Insole Study is a randomized controlled study performed to explore the effect of a 3D printing insole on foot care of CLI patients. This study recruitment began on November 1, 2021. Patients with CLI confirmed by clinical symptoms and imaging were recruited as the research objects. Participants will be randomly assigned to either the experimental group, which will receive 3D-printed insoles customized based on their hemodynamics, or the control group, which will receive traditionally manufactured insoles. Both groups were followed up for up to 24 months after surgery, including claudication distance, claudication time, pain score, rehospitalization, etc. Trial Registration Number ChiCTR2100051857.
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Affiliation(s)
- Yan Fu
- Department of Nursing, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hongji Pu
- Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Qun Huang
- Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Peng Qiu
- Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Deyin Zhao
- Second Ward of General Surgery, Suzhou Hospital of Anhui Medical University (Suzhou Municipal Hospital of Anhui Province), Anhui, People’s Republic of China
| | - Yong Cheng
- Department of Nursing, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Haris F, Jan YK, Liau BY, Hsieh CW, Shen WC, Tai CC, Shih YH, Lung CW. The effects of different inner pressures of air insoles and walking durations on peak plantar pressure. Medicine (Baltimore) 2023; 102:e35704. [PMID: 37904356 PMCID: PMC10615489 DOI: 10.1097/md.0000000000035704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/28/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Exercise reduces chronic complications in individuals with diabetes and peripheral vascular diseases. In clinical practice, the use of air insole may reduce peak plantar pressure (PPP), and risk for diabetic foot ulcers (DFUs). However, there is no guideline on selecting air insole pressure for effectively reducing PPP. Therefore, this study aimed to investigate the effects of different air insole pressure on PPP at different walking durations. METHODS We tested 13 participants using repeated measures study design, including 3 air insole pressures (80, 160, and 240 mm Hg) and 2 walking durations (10 and 20 minutes) for 6 walking conditions. PPP values at the first toe, first metatarsal head, and second metatarsal head were calculated. RESULTS The one-way ANOVA showed significant pairwise differences of PPP at 20 minutes duration in the first metatarsal head between 80 and 240 mm Hg (P = .007) and between 160 and 240 mm Hg (P = .038); in the second metatarsal head between 80 and 240 mm Hg (P = .043). The paired t test confirmed that walking duration significantly has lower PPP at 10 minutes than 20 minutes with 240 mm Hg air insole in the first metatarsal head (P = .012) and the second metatarsal head (P = .027). CONCLUSION People at risk of foot ulcers are suggested to wear shoes with 80 mm Hg of air insole for reducing PPP in the first metatarsal head and the second metatarsal head. Moreover, people may avoid wearing the stiffer insole (240 mm Hg) for more than 20 minutes.
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Affiliation(s)
- Fahni Haris
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ben-Yi Liau
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
| | - Chang-Wei Hsieh
- Department of Computer Science & Information Engineering, Asia University, Taichung, Taiwan
| | - Wei-Cheng Shen
- Department of Digital Media Design, Asia University, Taichung, Taiwan
| | - Chien-Cheng Tai
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Chi-Wen Lung
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Department of Creative Product Design, Asia
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Zhao Y, Zhong J, Wang Y, Chen Q, Yin J, Wang J, Zhao H, Li Y, Gong H, Huang W. Photocurable and elastic polyurethane based on polyether glycol with adjustable hardness for 3D printing customized flatfoot orthosis. Biomater Sci 2023; 11:1692-1703. [PMID: 36626200 DOI: 10.1039/d2bm01538b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Orthopedic insoles is the most commonly used nonsurgical treatment method for the flatfoot. Polyurethane (PU) plays a crucial role in the manufacturing of orthopedic insoles due to its high wear resistance and elastic recovery. However, preparing orthopedic insoles with adjustable hardness, high-accuracy, and matches the plantar morphology is challenging. Herein, a liquid crystal display (LCD) three-dimensional (3D) printer was used to prepare the customized arch-support insoles based on photo-curable and elastic polyurethane acrylate (PUA) composite resins. Two kinds of photo-curable polyurethanes (DL1000-PUA and DL2000-PUA) were successfully synthesized, and a series of fast-photocuring polyurethane acrylate (PUA) composite resins for photo-polymerization 3D printing were developed. The effects of different acrylate monomers on the Shore hardness, viscosity, and mechanical properties of the PUA composite resins were evaluated. The PUA-3-1 composite resin exhibited low viscosity, optimal hardness, and mechanical properties. A deviation analysis was conducted to assess the accuracy of printed insole. Furthermore, the stress conditions of the PUA composite resin and ethylene vinyl acetate (EVA) under the weight load of healthy adults were compared by finite element analysis (FEA) simulation. The results demonstrated that the stress of the PUA composite resin and EVA were 0.152 MPa and 0.285 MPa, and displacement were 0.051 mm and 3.449 mm, respectively. These results indicate that 3D-printed arch-support insole based on photocurable PUA composite resin are high-accuracy, and can reduce plantar pressure and prevent insoles premature deformation, which show great potential in the physiotherapeutic intervention for foot disorders.
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Affiliation(s)
- Yanyan Zhao
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Jing Zhong
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China. .,Dermatology Hospital, Southern Medical University, Guangzhou, 510091, China
| | - Yilin Wang
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Qiwei Chen
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Junfeiyang Yin
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Jiejie Wang
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Hong Zhao
- Guangdong Medical University, Zhanjiang, 524001, China
| | - Yanbing Li
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
| | - Haihuan Gong
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China. .,Department of Stomatology, Affiliated Hospital of Guangdong Medical University, Guangdong medical university, Zhanjiang, 524000, China
| | - Wenhua Huang
- Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China. .,Guangdong Medical University, Zhanjiang, 524001, China
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Hudak YF, Li JS, Cullum S, Strzelecki BM, Richburg C, Kaufman GE, Abrahamson D, Heckman JT, Ripley B, Telfer S, Ledoux WR, Muir BC, Aubin PM. A novel workflow to fabricate a patient-specific 3D printed accommodative foot orthosis with personalized latticed metamaterial. Med Eng Phys 2022; 104:103802. [PMID: 35641072 PMCID: PMC9210925 DOI: 10.1016/j.medengphy.2022.103802] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/09/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022]
Abstract
Patients with diabetes mellitus are at elevated risk for secondary complications that result in lower extremity amputations. Standard of care to prevent these complications involves prescribing custom accommodative insoles that use inefficient and outdated fabrication processes including milling and hand carving. A new thrust of custom 3D printed insoles has shown promise in producing corrective insoles but has not explored accommodative diabetic insoles. Our novel contribution is a metamaterial design application that allows the insole stiffness to vary regionally following patient-specific plantar pressure measurements. We presented a novel workflow to fabricate custom 3D printed elastomeric insoles, a testing method to evaluate the durability, shear stiffness, and compressive stiffness of insole material samples, and a case study to demonstrate how the novel 3D printed insoles performed clinically. Our 3D printed insoles results showed a matched or improved durability, a reduced shear stiffness, and a reduction in plantar pressure in clinical case study compared to standard of care insoles.
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Affiliation(s)
- Yuri F Hudak
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States; Department of Mechanical Engineering, University of Washington, Seattle, WA, United States
| | - Jing-Sheng Li
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States; Department of Mechanical Engineering, University of Washington, Seattle, WA, United States
| | - Scott Cullum
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States; Department of Mechanical Engineering, University of Washington, Seattle, WA, United States
| | - Brian M Strzelecki
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States
| | - Chris Richburg
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States
| | - G Eli Kaufman
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States
| | - Daniel Abrahamson
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States
| | - Jeffrey T Heckman
- James A. Haley Veterans' Hospital & Clinics, Tampa, FL, United States; Department of Rehabilitation Medicine, University of South Florida, Tampa, FL, United States
| | - Beth Ripley
- Department of Radiology, VA Puget Sound Health Care System, Seattle, WA ,United States
| | - Scott Telfer
- Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, United States
| | - William R Ledoux
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States; Department of Mechanical Engineering, University of Washington, Seattle, WA, United States; Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, United States
| | - Brittney C Muir
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States; Department of Mechanical Engineering, University of Washington, Seattle, WA, United States.
| | - Patrick M Aubin
- VA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, WA, United States; Department of Mechanical Engineering, University of Washington, Seattle, WA, United States
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Kutnjak-Mravlinčić S, Sutlović A, Glogar MI, Ercegović Ražić S, Godec D. Innovative Development of Batch Dyed 3D Printed Acrylonitrile/Butadiene/Styrene Objects. Molecules 2021; 26:molecules26216637. [PMID: 34771046 PMCID: PMC8588224 DOI: 10.3390/molecules26216637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/28/2021] [Accepted: 10/28/2021] [Indexed: 11/24/2022] Open
Abstract
According to the great impact of additive technology on the development of modern industry, a lot of research is being done to obtain 3D printed parts with better properties. This research is extremely important because there are no scientific papers in the field of post dyeing of acrylonitrile/butadiene/styrene (ABS) 3D printed parts. The experiment was carried out using disperse dyes on ABS specimens. The obtained coloration of the specimens was in the primary colors (yellow, red, and blue) in the specified dyestuff concentration range and was evaluated using an objective CIELab system. Based on the obtained color parameters, remission values and Kubelka-Munk coefficient, dye mixtures and an ombre effect were performed to obtain patterns in the desired hues. Abrasion resistance of disperse dyed specimens was tested using different abrasive materials over a wide range of fineness to simulate different indoor and outdoor soils and was compared to abrasion resistance of specimens produced from the industrially dyed wire with the master batch. The results show that 3D printed ABS products can be produced in one or more desired shades with satisfactory abrasion resistance. This undoubtedly represents the added value of 3D printed ABS parts and extends their application to the field of creative industries and design, specifically footwear design.
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Affiliation(s)
- Suzana Kutnjak-Mravlinčić
- Design and Production of Footwear, Faculty of Textile Technology, University of Zagreb, 42000 Varaždin, Croatia;
| | - Ana Sutlović
- Department of Textile Chemistry and Ecology, Faculty of Textile Technology, University of Zagreb, 10000 Zagreb, Croatia;
- Correspondence:
| | - Martinia Ira Glogar
- Department of Textile Chemistry and Ecology, Faculty of Textile Technology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Sanja Ercegović Ražić
- Department of Materials, Fibres and Textile Testing, Faculty of Textile Technology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Damir Godec
- Department of Technology, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, 10000 Zagreb, Croatia;
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