Abstract
Objective. To investigate the effects of total contact insoles on the plantar stress redistribution
using three-dimensional finite element analysis.
Design. The efficacies of stress reduction and redistribution of two total contact insoles
with different material combinations were compared with those of a regular flat insole
used as a baseline condition.
Background. Many specially designed total contact insoles are currently used to reduce the high
plantar pressure in diabetic patients. However, the design of total contact insoles
is mostly empirical and little scientific evidence is available to provide a guideline
for persons who prescribe such insoles.
Methods. To use three-dimensional finite element models of the foot together with insoles
to investigate the effects of total contact insoles on the foot plantar pressure redistributions.
Nonlinear foam material properties for the different insole materials and the contact
behavior in the foot–insole interface were considered in the finite element analysis.
Results. Results showed that the peak and the average normal stresses were reduced in most
of the plantar regions except the midfoot and the hallux region when total contact
insoles were worn compared with that of the flat insole condition. The reduction ratios
of the peak normal stress ranged from 19.8% to 56.8%.
Conclusions. Finite element analysis results showed that the two sets of total contact insoles
used in the current study can both reduce high pressures at regions such as heel and
metatarsal heads and can redistribute the pressure to the midfoot region when compared
with the flat insole condition.Relevance
It is possible to simulate foot deformities, change in material properties, different
ambulatory loading conditions, and different orthotic conditions by altering the finite
element model in a relatively easy manner and these may be of interests to the medical
professionals who treat foot-related problems.
Keywords
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© 2003 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
