Design and Preliminary Validation of Individual Customized Insole for Adults with Flexible Flatfeet Based on the Plantar Pressure Redistribution

Yangzheng Jiang, Duojin Wang, Jiming Ying, Pengfei Chu, Yu Qian, Wenming Chen, Yangzheng Jiang, Duojin Wang, Jiming Ying, Pengfei Chu, Yu Qian, Wenming Chen

Abstract

Flatfoot is a common musculoskeletal deformity. One of the most effective treatments is to wear individually customized plantar pressure-based insoles to help users change the abnormally distributed pressure on the pelma. However, most previous studies were divided only into several plantar areas without detailed plantar characteristic analysis. In this study, a new insole is designed which redistributes pressure following the analysis of characteristic points of plantar pressure, and practical evaluation during walking of subjects while wearing the insole. In total, 10 subjects with flexible flatfeet have participated in the performance of gait experiments by wearing flat insoles, orthotic insoles, and plantar pressure redistribution insoles (PPRI). The results showed that the stance time of PPRI was significantly lower than that of the flat insoles under slow gait. PPRI in the second to third metatarsal and medial heel area showed better unloading capabilities than orthotic insoles. In the metatarsal and heel area, the PPRI also had its advantage in percentage of contact area compared to flat insole and orthotic insole. The results prove that PPRI improves the plantar pressure distribution and gait efficiency of adults with flexible flatfeet, and can be applied into clinical application.

Keywords: 3D modeling; flatfoot; gait; insole; plantar pressure redistribution.

Conflict of interest statement

All authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Self-designed plantar pressure test plate; (b) Wireless insole.
Figure 2
Figure 2
Design process of PPRI. (a) Characteristic point data collection of plantar pressure; (b) 3D map of insole surface characteristic point cloud; (c) Insole software model preview; (d) PPRI 3D printing.
Figure 3
Figure 3
Conversion of pressure distribution to height information in each area (including T, M, MF, and H area). (a) Original pressure value. (b) Redistribution plan for the pressure value of four plantar areas.
Figure 4
Figure 4
Comparison of different insoles (a) PPRI; (b) Orthotic insole; (c) Flat insole.
Figure 5
Figure 5
The peak pressure of the T, M2, and MH area. * significant difference found between the PPRI and orthotic insole. † significant difference found between the PPRI and flat insole. ‡ significant difference found between the orthotic insole and flat insole.

References

    1. Razeghi M., Batt M.E. Foot type classification: A critical review of current methods. Gait Posture. 2002;15:282–291. doi: 10.1016/S0966-6362(01)00151-5.
    1. Funk D.A., Cass J.R., Johnson K.A. Acquired adult flat foot secondary to posterior tibial-tendon pathology. J. Bone Jt. Surg. Am. Vol. 1986;68:95–102. doi: 10.2106/00004623-198668010-00012.
    1. Dare D.M., Dodwell E.R. Pediatric flatfoot: Cause, epidemiology, assessment, and treatment. Curr. Opin. Pediatr. 2014;26:93–100. doi: 10.1097/MOP.0000000000000039.
    1. Han J.T., Koo H.M., Jung J.M., Kim Y.J., Lee J.H. Differences in Plantar Foot Pressure and COP between Flat and Normal Feet during Walking. J. Phys. Ther. Sci. 2011;23:683–685. doi: 10.1589/jpts.23.683.
    1. Donatelli R.A. The biomechanics of the foot and ankle. J. Orthop. Sports Phys. Ther. 1987;9:11. doi: 10.2519/jospt.1987.9.1.11.
    1. Siu W.-S., Shih Y.-F., Lin H.-S. Effects of Kinesio tape on supporting medial foot arch in runners with functional flatfoot: A preliminary study. Res. Sports Med. 2019;28:168–180. doi: 10.1080/15438627.2019.1638258.
    1. Wang Z.Y., Tang K.L. Treatment and diagnosis of adult flatfoot. Natl. Med. J. China. 2010;90:2305–2307.
    1. Del Rossi G., Fiolkowski P., Horodyski M.B., Bishop M., Trimble M. For how long do temporary techniques maintain the height of the medial longitudinal arch? Phys. Ther. Sport. 2004;5:84–89. doi: 10.1016/j.ptsp.2004.02.001.
    1. Francisco R., Chiodo C.P., Wilson M.G. Management of the rigid adult acquired flatfoot deformity. Foot Ankle Clin. 2007;12:317–327. doi: 10.1016/j.fcl.2007.03.013.
    1. Denning J.R. Tarsal Coalition in Children. Pediatr. Ann. 2016;45:139–143. doi: 10.3928/00904481-20160309-01.
    1. Arachchige S.N.K., Chander H., Knight A. Flatfeet: Biomechanical implications, assessment and management. Foot. 2019;38:81–85. doi: 10.1016/j.foot.2019.02.004.
    1. Tang S.F.-T., Chen C.-H., Wu C.-K., Hong W.-H., Chen K.-J., Chen C.-K. The effects of total contact insole with forefoot medial posting on rearfoot movement and foot pressure distributions in patients with flexible flatfoot. Clin. Neurol. Neurosurg. 2015;129:8–11. doi: 10.1016/S0303-8467(15)30004-4.
    1. Lee Y.-C., Lin G., Wang J.M.-J. Comparing 3D foot scanning with conventional measurement methods. J. Foot Ankle Res. 2014;7:44. doi: 10.1186/s13047-014-0044-7.
    1. Munteanu S.E., Scott L.A., Bonanno D.R., Landorf K.B., Pizzari T., Cook J.L., Menz H.B. Effectiveness of customised foot orthoses for Achilles tendinopathy: A randomised controlled trial. Br. J. Sports Med. 2015;49:989. doi: 10.1136/bjsports-2014-093845.
    1. Jin H., Xu R., Wang S., Wang J. Use of 3D-Printed Heel Support Insoles Based on Arch Lift Improves Foot Pressure Distribution in Healthy People. Med. Sci. Monit. Int. Med. J. Exp. Clin. Res. 2019;25:7175–7181. doi: 10.12659/MSM.918763.
    1. Korada H., Maiya A., Rao S.K., Hande M. Effectiveness of customized insoles on maximum plantar pressure in diabetic foot syndrome: A systematic review. Diabetes Metab. Syndr. Clin. Res. Rev. 2020;14:1093–1099. doi: 10.1016/j.dsx.2020.06.041.
    1. Huang Y.-P., Peng H.-T., Wang X., Chen Z.-R., Song C.-Y. The arch support insoles show benefits to people with flatfoot on stance time, cadence, plantar pressure and contact area. PLoS ONE. 2020;15:e0237382.
    1. Wang C.-S. An analysis and evaluation of fitness for shoe lasts and human feet. Comput. Ind. 2010;61:532–540. doi: 10.1016/j.compind.2010.03.003.
    1. Zhai J.N., Wang J., Qiu Y.S. Plantar pressure differences among adults with mild flexible flatfoot, severe flexible flatfoot and normal foot when walking on level surface, walking upstairs and downstairs. J. Phys. Ther. Sci. 2017;29:641–646. doi: 10.1589/jpts.29.641.
    1. Chuckpaiwong B., Nunley J.A., Mall N.A., Queen R.M. The effect of foot type on in-shoe plantar pressure during walking and running. Gait Posture. 2008;28:405–411. doi: 10.1016/j.gaitpost.2008.01.012.
    1. MacWilliams B.A., Cowley M., Nicholson D.E. Foot kinematics and kinetics during adolescent gait. Gait Posture. 2003;17:214–224. doi: 10.1016/S0966-6362(02)00103-0.
    1. Lange J.S., Maiwald C., Mayer T.A., Schwanitz S., Odenwald S., Milani T.L. Relationship between plantar pressure and perceived comfort in military boots. Footwear Sci. 2009;1:30–32. doi: 10.1080/19424280902977129.
    1. Richie D. Biomechanics and Orthotic Treatment of the Adult Acquired Flatfoot. Clin. Podiatr. Med. Surg. 2020;37:71–89. doi: 10.1016/j.cpm.2019.08.007.
    1. Cotoros D., Stanciu A. Composite Insoles for Improving the Distribution of Plantar Pressure. Macromol. Symp. 2020;389:1900081. doi: 10.1002/masy.201900081.
    1. Sneyers C.J., Lysens R., Feys H., Andries R. Influence of malalignment of feet on the plantar pressure pattern in running. Foot Ankle Int. 1995;16:624–632. doi: 10.1177/107110079501601008.
    1. Luczak T., Burch V.R.F., Smith B.K., Carruth D.W., Lamberth J., Chander H., Prabhu R.K. Closing the wearable gap—Part V: Development of a pressure-sensitive sock utilizing soft sensors. Sensors. 2020;20:208. doi: 10.3390/s20010208.
    1. Zhang X.Y., Li B. Influence of in-shoe heel lifts on plantar pressure and center of pressure in the medial–lateral direction during walking. Gait Posture. 2014;39:1012. doi: 10.1016/j.gaitpost.2013.12.025.
    1. Lieberman D.E., Venkadesan M., Werbel W.A., Daoud A.I., D’Andrea S., Davis I.S., Mang’Eni R.O., Pitsiladis Y. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010;463:531–535. doi: 10.1038/nature08723.
    1. Chang J.-S., Park J.-W., Kim C.-S. The Changes of Plantar Foot Pressure by External Loads during Walking in Flatfoot. J. Korean Soc. Phys. Med. 2010;5:543–549.
    1. Chia K.K., Suresh S., Kuah A., Ong J.L., Phua J.M., Seah A.L. Comparative trial of the foot pressure patterns between corrective orthotics, formthotics, bone spur pads and flat insoles in patients with chronic plantar fasciitis. Ann. Acad. Med. 2009;38:869–875.
    1. Aminian G., Safaeepour Z., Farhoodi M., Pezeshk A.F., Saeedi H., Majddoleslam B. The effect of prefabricated and proprioceptive foot orthoses on plantar pressure distribution in patients with flexible flatfoot during walking. Prosthet. Orthot. Int. 2013;37:227–232. doi: 10.1177/0309364612461167.
    1. Khodaei B., Saeedi H., Jalali M., Farzadi M., Norouzi E. Comparison of plantar pressure distribution in CAD-CAM and prefabricated foot orthoses in patients with flexible flatfeet. Foot. 2017;33:76–80. doi: 10.1016/j.foot.2017.07.002.
    1. Kirmizi M., Sengul Y.S., Angin S. The effects of gait speed on plantar pressure variables in individuals with normal foot posture and flatfoot. Acta Bioeng. Biomech. 2020;22:267–282. doi: 10.37190/ABB-01652-2020-02.

Source: PubMed

3
Se inscrever