Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations
The high prevalence of lower extremity ulceration and amputation in people with diabetes is strongly linked to difficulties in achieving and maintaining a reduction of high plantar pressures (PPs) which remains an important risk factor. The effectiveness of current offloading footwear is opposed in...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-07-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1166513/full |
| _version_ | 1797787748551098368 |
|---|---|
| author | Sarah L. Hemler Sarah L. Hemler Sofia Lydia Ntella Kenny Jeanmonod Christian Köchli Bhawnath Tiwari Yoan Civet Yves Perriard Zoltan Pataky Zoltan Pataky Zoltan Pataky |
| author_facet | Sarah L. Hemler Sarah L. Hemler Sofia Lydia Ntella Kenny Jeanmonod Christian Köchli Bhawnath Tiwari Yoan Civet Yves Perriard Zoltan Pataky Zoltan Pataky Zoltan Pataky |
| author_sort | Sarah L. Hemler |
| collection | DOAJ |
| description | The high prevalence of lower extremity ulceration and amputation in people with diabetes is strongly linked to difficulties in achieving and maintaining a reduction of high plantar pressures (PPs) which remains an important risk factor. The effectiveness of current offloading footwear is opposed in part by poor patient adherence to these interventions which have an impact on everyday living activities of patients. Moreover, the offloading devices currently available utilize primarily passive techniques, whereas PP distribution is a dynamically changing process with frequent shifts of high PP areas under different areas of the foot. Thus, there is a need for pressure offloading footwear capable of regularly and autonomously adapting to PPs of people with diabetes. The aim of this article is to summarize the concepts of intelligent pressure offloading footwear under development which will regulate PPs in people with diabetes to prevent and treat diabetic foot ulcers. Our team is creating this intelligent footwear with an auto-contouring insole which will continuously read PPs and adapt its shape in the forefoot and heel regions to redistribute high PP areas. The PP-redistribution process is to be performed consistently while the footwear is being worn. To improve adherence, the footwear is designed to resemble a conventional shoe worn by patients in everyday life. Preliminary pressure offloading and user perceptions assessments in people without and with diabetes, respectively, exhibit encouraging results for the future directions of the footwear. Overall, this intelligent footwear is designed to prevent and treat diabetic foot ulcers while enhancing patient usability for the ultimate prevention of lower limb amputations. |
| first_indexed | 2024-03-13T01:27:13Z |
| format | Article |
| id | doaj.art-7b2027d273794b7c82b23efcb243e3cc |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-13T01:27:13Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-7b2027d273794b7c82b23efcb243e3cc2023-07-04T13:43:40ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-07-011410.3389/fendo.2023.11665131166513Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputationsSarah L. Hemler0Sarah L. Hemler1Sofia Lydia Ntella2Kenny Jeanmonod3Christian Köchli4Bhawnath Tiwari5Yoan Civet6Yves Perriard7Zoltan Pataky8Zoltan Pataky9Zoltan Pataky10Faculty of Medicine, University of Geneva, Geneva, SwitzerlandUnit of Therapeutic Patient Education, WHO Collaborating Centre, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, Geneva University Hospitals, Geneva, SwitzerlandIntegrated Actuators Laboratory (LAI), École polytechnique fédérale de Lausanne (EPFL), Neuchâtel, SwitzerlandIntegrated Actuators Laboratory (LAI), École polytechnique fédérale de Lausanne (EPFL), Neuchâtel, SwitzerlandIntegrated Actuators Laboratory (LAI), École polytechnique fédérale de Lausanne (EPFL), Neuchâtel, SwitzerlandIntegrated Actuators Laboratory (LAI), École polytechnique fédérale de Lausanne (EPFL), Neuchâtel, SwitzerlandIntegrated Actuators Laboratory (LAI), École polytechnique fédérale de Lausanne (EPFL), Neuchâtel, SwitzerlandIntegrated Actuators Laboratory (LAI), École polytechnique fédérale de Lausanne (EPFL), Neuchâtel, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandUnit of Therapeutic Patient Education, WHO Collaborating Centre, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, Geneva University Hospitals, Geneva, SwitzerlandFaculty Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, SwitzerlandThe high prevalence of lower extremity ulceration and amputation in people with diabetes is strongly linked to difficulties in achieving and maintaining a reduction of high plantar pressures (PPs) which remains an important risk factor. The effectiveness of current offloading footwear is opposed in part by poor patient adherence to these interventions which have an impact on everyday living activities of patients. Moreover, the offloading devices currently available utilize primarily passive techniques, whereas PP distribution is a dynamically changing process with frequent shifts of high PP areas under different areas of the foot. Thus, there is a need for pressure offloading footwear capable of regularly and autonomously adapting to PPs of people with diabetes. The aim of this article is to summarize the concepts of intelligent pressure offloading footwear under development which will regulate PPs in people with diabetes to prevent and treat diabetic foot ulcers. Our team is creating this intelligent footwear with an auto-contouring insole which will continuously read PPs and adapt its shape in the forefoot and heel regions to redistribute high PP areas. The PP-redistribution process is to be performed consistently while the footwear is being worn. To improve adherence, the footwear is designed to resemble a conventional shoe worn by patients in everyday life. Preliminary pressure offloading and user perceptions assessments in people without and with diabetes, respectively, exhibit encouraging results for the future directions of the footwear. Overall, this intelligent footwear is designed to prevent and treat diabetic foot ulcers while enhancing patient usability for the ultimate prevention of lower limb amputations.https://www.frontiersin.org/articles/10.3389/fendo.2023.1166513/fulldiabetes mellituspressure offloadingfoot ulcersamputationsmedical devicehuman factors |
| spellingShingle | Sarah L. Hemler Sarah L. Hemler Sofia Lydia Ntella Kenny Jeanmonod Christian Köchli Bhawnath Tiwari Yoan Civet Yves Perriard Zoltan Pataky Zoltan Pataky Zoltan Pataky Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations Frontiers in Endocrinology diabetes mellitus pressure offloading foot ulcers amputations medical device human factors |
| title | Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations |
| title_full | Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations |
| title_fullStr | Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations |
| title_full_unstemmed | Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations |
| title_short | Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations |
| title_sort | intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations |
| topic | diabetes mellitus pressure offloading foot ulcers amputations medical device human factors |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1166513/full |
| work_keys_str_mv | AT sarahlhemler intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT sarahlhemler intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT sofialydiantella intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT kennyjeanmonod intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT christiankochli intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT bhawnathtiwari intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT yoancivet intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT yvesperriard intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT zoltanpataky intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT zoltanpataky intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations AT zoltanpataky intelligentplantarpressureoffloadingforthepreventionofdiabeticfootulcersandamputations |