Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait
ObjectiveThis 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.MethodsThe dual fluoroscopic imaging system (DFIS)...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.894383/full |
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| author | Xiong-gang Yang Zhao-lin Teng Zhen-ming Zhang Kan Wang Ran Huang Wen-ming Chen Chen Wang Li Chen Chao Zhang Jia-zhang Huang Xu Wang Xin Ma Xiang Geng |
| author_facet | Xiong-gang Yang Zhao-lin Teng Zhen-ming Zhang Kan Wang Ran Huang Wen-ming Chen Chen Wang Li Chen Chao Zhang Jia-zhang Huang Xu Wang Xin Ma Xiang Geng |
| author_sort | Xiong-gang Yang |
| collection | DOAJ |
| description | ObjectiveThis 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.MethodsThe 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.ResultsTen 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).ConclusionsDiabetes 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. |
| first_indexed | 2024-04-13T13:11:21Z |
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| id | doaj.art-f8bd8895bc2540ea86e3d46422cfbcd8 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-13T13:11:21Z |
| publishDate | 2022-08-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-f8bd8895bc2540ea86e3d46422cfbcd82022-12-22T02:45:37ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.894383894383Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gaitXiong-gang Yang0Zhao-lin Teng1Zhen-ming Zhang2Kan Wang3Ran Huang4Wen-ming Chen5Chen Wang6Li Chen7Chao Zhang8Jia-zhang Huang9Xu Wang10Xin Ma11Xiang Geng12Department of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Radiology, Huashan Hospital, Fudan University, Shanghai, ChinaAcademy for Engineering & Technology, Fudan University, Shanghai, ChinaAcademy for Engineering & Technology, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedic Surgery, Huashan Hospital, Fudan University, Shanghai, ChinaObjectiveThis 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.MethodsThe 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.ResultsTen 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).ConclusionsDiabetes 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.https://www.frontiersin.org/articles/10.3389/fendo.2022.894383/fullmaterial propertiesdiabetesheel paddual fluoroscopic systemgaitloading history |
| spellingShingle | Xiong-gang Yang Zhao-lin Teng Zhen-ming Zhang Kan Wang Ran Huang Wen-ming Chen Chen Wang Li Chen Chao Zhang Jia-zhang Huang Xu Wang Xin Ma Xiang Geng Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait Frontiers in Endocrinology material properties diabetes heel pad dual fluoroscopic system gait loading history |
| title | Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait |
| title_full | Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait |
| title_fullStr | Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait |
| title_full_unstemmed | Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait |
| title_short | Comparison of material properties of heel pad between adults with and without type 2 diabetes history: An in-vivo investigation during gait |
| title_sort | comparison of material properties of heel pad between adults with and without type 2 diabetes history an in vivo investigation during gait |
| topic | material properties diabetes heel pad dual fluoroscopic system gait loading history |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.894383/full |
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