Search Results (145)

Background: This study was performed to validate the addition of capacitive-based pressure sensors to an existing smart sock developed by the research team. This study focused on evaluating the accuracy of soft robotic sensor (SRS) pressure data and its relationship with laboratory-grade Kistler force plates in collecting ground force reaction data. Methods: Nineteen participants performed walking trials while wearing the smart sock with and without shoes. Data was collected simultaneously with the sock and the force plates for each gait phase including foot-flat, heel-off, and midstance. The correlation between the smart sock and force plates was analyzed using Pearson’s correlation coefficient and R-squared values. Results: Overall, the strength of the relationship between the smart sock’s SRS data and the vertical ground reaction force (GRF) data from the force plates showed a strong correlation, with a Pearson’s correlation coefficient of 0.85 ± 0.1; 86% of the trials had a value higher than 0.75. The linear regression models also showed a strong correlation, with an R-squared value of 0.88 ± 0.12, which improved to 0.90 ± 0.07 when including a stretch-SRS for measuring ankle flexion. Conclusions: With these strong correlation results, there is potential for capacitive pressure sensors to be integrated into the proposed device and utilized in telehealth and sports performance applications. Full article

There is limited knowledge about the benefits of functional textile in arthritis management. This study aimed to evaluate the effect of wearing functional socks in patients with rheumatoid or psoriatic arthritis. Patients were randomized into an experimental group (n = 23) and control group (n = 18). The intervention involved wearing functional textile socks for 12 weeks. Sock composition was analyzed using X-ray fluorescence spectrometry and scanning electron microscopy. Outcome measures included the Numeric Rating Scale, Health Assessment Questionnaire–Disability Index (HAQ-DI), and RAND-36 (Estonian version). At week 12, the experimental group showed significantly lower metatarsophalangeal and toe joint pain (p = 0.001), stiffness (p = 0.005), and ankle stiffness (p = 0.017) scores than the control group. Improvements were also observed in HAQ-DI reaching (p = 0.035) and activity (p = 0.028) scores. RAND-36 scores were higher in physical functioning (p = 0.013), social functioning (p = 0.024), and bodily pain (p = 0.006). Role limitations due to physical problems improved in the experimental group but worsened in the control group (p = 0.029). In conclusion, wearing functional socks led to some statistically significant improvements in foot and ankle pain and stiffness, physical function, and health-related quality of life. However, the effect sizes were small, and the clinical relevance of these findings should be interpreted with caution. Full article

Running socks play an important role in alleviating foot impact and preventing foot injuries. Despite the variety of commercial options, their cushioning effectiveness is not well understood. This study examines three different types of running socks made of bio-based and synthetic textiles. Material testing includes compression, tensile, and shock absorption, while wear tests assess plantar loading in 10 adult recreational runners on a treadmill. Results show that specialized running socks offer superior shock absorption compared to regular running socks, largely due to fabric thickness and weight. Socks made of high-performance bio-composite fibers significantly reduced maximum peak pressure and impulse in the great toe (p < 0.05) and first metatarsal head (p < 0.05) during running. Additionally, ground contact time in the forefoot (p < 0.05) area was significantly lower with specialized running socks. Compared to regular running socks, five-toed running socks can reduce the pressure load on the forefoot area. These findings can guide the design of specialized sockwear for better foot protection and improved sports performance. Full article

Background: Wearing custom-made footwear is key in diabetes-related foot ulcer prevention. However, adhering to wearing footwear is challenging, in particular at home. Evidence-based interventions with proven effect are needed, but scarce. We developed a multi-modal intervention to improve custom-made footwear use, and investigated short-term efficacy. Methods: We used a multidisciplinary multiphase approach to develop a three-modality intervention: structured education, motivational interviewing, and custom-made indoor footwear. To assess efficacy, we measured mean 2-week wearing time of custom-made footwear with a validated sensor, at baseline and after three months (primary outcome), and in the two weeks directly before and after each modality was administered (secondary outcomes). We assessed differences between timepoints using within-subjects paired t-tests. Results: 53 participants with high risk for ulceration were included: 30 with low [<8 h/day] baseline adherence), 17% females, mean age 66 (SD: 10) years, all with peripheral neuropathy and a recent foot ulcer (mean time since healing: 6 (SD: 9) months). Wearing time increased non-significantly from 4.0 (SD: 2.5) at baseline to 5.5 (SD: 4.3) after three months in the low adherence group (p = 0.068); this was 11.9 (SD: 2.3) to 12.0 (SD: 2.8) in the high adherence group (p = 0.898). Following provision of indoor footwear, wearing time increased significantly for low baseline adherence (∆2.7 h/day (95% CI: 1.0–4.4; p = 0.004) and high baseline adherence (∆2.0 h/day (95% CI: 0.5–3.4; p = 0.010). Following structured education, wearing time increased non-significantly in those with low baseline adherence (∆1.0 h/day (95% CI: −0.2–2.2; p = 0.098). Following motivational interviewing, wearing time remained similar in both groups. Conclusions: The multi-modal intervention program combining structured education, motivational interviewing and custom-made indoor footwear did not result in a statistically significant improvement in the wearing time of custom-made footwear after three months. However, significant improvements followed the provision of indoor footwear, and clinically relevant improvements followed structured education in people with low adherence, providing avenues for implementation and research. Full article

Background: Defects of the foot and ankle area pose a significant challenge for both patients and surgeons. While the primary objective of microvascular free flap reconstructions of lower leg defects is limb preservation, there should be an effort to obtain the best functional and aesthetic results possible and to restore the patient’s quality of life. The aim of this study was to investigate the long-term post-operative functional outcome, health-related quality of life, scar quality, and aesthetic satisfaction in patients following microsurgical reconstructions of defects of the foot and ankle area. Methods: We conducted a monocentric, controlled cohort study of adult patients who underwent microsurgical reconstructions for defects of the foot and ankle area between 2006 and August 2022 at our department. As a control, we recruited healthy individuals. Patient-Reported Outcome Measures questionnaires were used to assess long-term results regarding functionality (LEFS: Lower Extremity Functional Scale), health-related quality of life (SF-36: Short-Form 36 Health Survey Questionnaire), scar quality (PSAS: Patient Scar Assessment Scale), aesthetic satisfaction (Aesthetic Likert Scale), pain at rest and activity (10-point Numeric Rating Scale) and usage of footwear. Results: Of the 55 potential patients who had received microvascular free flaps for reconstructions of ankle and foot defects and were eligible for study inclusion, 13 (23.6%) agreed to participate in this study. The study cohort consisted of 84.6% male subjects and the mean follow-up period was 8.6 years (±5.2). Significant moderate limitations were observed with regard to physical function of the lower extremity (LEFS: 42.5 ± 20.5, p = 0.002). Significant limitations were found in the SF-36 subscales of pain (55.8 ± 34.5, p = 0.019), physical functioning (55.0 ± 29.7, p = 0.013), and physical role functioning (38.5 ± 44.0, p = 0.006). The study yielded favorable outcomes with regard to aesthetic satisfaction (14.3 ± 4.4) and scar quality (23.5 ± 13.5). Out of all the patients, 61% were required to wear orthopedic shoes or insoles. Conclusions: Patients undergoing microsurgical reconstructions for ankle and foot defects experience moderate long-term physical limitations and persistent pain during activity. Furthermore, we observed a significant long-term impact on specific physical domains of health-related quality of life, whereas mental health seems less affected. Full article

Background/Objectives: Orthoses are commonly used in the treatment of various foot and ankle injuries and deformities. An effective technology in foot orthoses is a vacuum system to improve the fit and function of the orthosis. Recently, a new technology was designed to facilitate the wearing of the foot orthoses while maintaining function without the need for vacuum suction. Methods: A plantar dynamic pressure distribution measurement was carried out in 25 healthy subjects (13 w/12 m, age 23–58 y) using capacitive measuring insoles in two differently designed inlays within the VACOpedes^® orthosis (Group A: vacuum inlay vs. Group B: XELGO^® inlay) and a regular off-the-shelf shoe (Group C, OTS). The peak plantar pressure, mean plantar pressure and maximum force were analyzed in the entire foot and in individual regions of the medial and lateral forefoot, the midfoot and the hindfoot. Finally, the wearing comfort was compared using a visual analog scale from 1 to 10 (highest comfort). Results: The peak pressure of both inlays was significantly lower than in the OTS shoe (A: 230.6 ± 44.6 kPa, B: 218.0 ± 49.7 kPa, C: 278.6 ± 50.5 kPa; p < 0.001). In a sub-analysis of the different regions, the XELGO^® inlay significantly reduced plantar pressure in the medial forefoot compared to the vacuum orthosis (A: 181.7 ± 45.7 kPa, B: 158.6 ± 51.7 kPa, p < 0.002). The wearing comfort was significantly higher with the XELGO^® inlay compared to the vacuum inlay (A: 5.68/10, B: 7.24/10; p < 0.001). Conclusions: The VACOpedes^® orthosis with a new XELGO^® inlay showed at least equivalent relief in all pressure distribution measurements analyzed and greater relief in the forefoot area than the VACOpedes^® orthosis with a vacuum inlay, as well as increased wearing comfort. Full article

Introduction: Therapeutic footwear has been often prescribed in clinical practice for accommodating foot deformities and preventing the development of ulceration, yet scientific evidence is limited and outdated. This study aimed to investigate the effects of two types of Orthofeet therapeutic footwear in comparison to low-cost generic as well as participants’ own athletic shoes on plantar pressure as well as lower extremity kinematics and kinetics. Methods: Twenty healthy participants without foot disorders or pain walked at self-paced speeds under each of the four footwear conditions. In-shoe plantar pressures were measured using F-Scan, and the gait kinematics and kinetics in the sagittal plane were obtained. The foot was divided into eight anatomical zones and three combined zones (forefoot, mid-foot, and hind foot), with peak plantar pressures recorded in each zone. Results: The therapeutic footwear showed significantly greater ankle dorsiflexion during late midstance and less ankle plantar flexion during push-off than generic shoes. Similarly, larger ankle plantar flexor torques were shown when wearing therapeutic footwear. Therapeutic footwear modified the plantar pressure distribution, increasing the peak pressure under the big toe while slightly reducing the peak pressure under the medial heel. The participants’ own athletic shoes provided slightly distinct outcome measures yet comparable performance when compared to therapeutic footwear. Conclusions: This study suggests that therapeutic footwear offers some distinct biomechanical modifications compared with generic shoes. Future studies are needed to assess if these changes lead to meaningful clinical outcomes, such as reduced injury risk or improved foot health. Full article

When natural disasters such as earthquakes occur, accurate navigation and positioning information may not be available, making a purely inertial pedestrian navigation system particularly important for rescuers. In this paper, researchers propose a zero-velocity update architecture for pedestrian navigation based on the Informer model, which is integrated into wearable devices. This architecture modifies the fully connected layer of the Informer model to be used for the binary classification task of the zero-velocity update method (ZUPT), allowing for accurate identification of gait information at each moment using only inertial measurement data. By wearing the device on the foot during natural disasters like earthquakes, the location of the pedestrian can be more accurately determined, facilitating rescue efforts. During the experimental process, a Kalman filter model was constructed to achieve zero-velocity updating of the pedestrian’s motion trajectory. A 2000 m walking experiment and a 210 m mixed-gait experiment were conducted to accurately identify gait information at each moment, thereby reducing the cumulative error of the inertial system. Subsequently, a convolutional neural network (CNN) model and a model combining CNN with a long short-term memory network (CNN + LSTM) were introduced as comparative experiments to verify the performance of the proposed architecture. The experimental results demonstrate that the proposed architecture enhances the adaptability of the zero-velocity update algorithm in underground or sheltered spaces, with all results outperforming the other two models. Full article

A key role of drilling optimization is reducing the cost and non-productive time (NPT) for drilling operations. The rate of penetration (ROP) directly affects the overall cost and cost per foot of drilling operations and could lead to significant cost savings or expenses. Traditionally, empirical ROP modeling is used to predict bit response or estimate ROP using nearby offset data. Due to the complexity and nonlinearity of ROP, data-driven modeling, such as machine learning (ML), became more attractive. The objective of this paper is to develop an ROP data-driven artificial neural network (ANN) model using drilling and formation data collected from three nearby wells. Additionally, drilling optimization was conducted and compared with traditional empirical ROP models. The advantages and disadvantages of both methods are discussed, and the direction of future data-driven modeling is highlighted. The data-driven ANN model demonstrated strong performance when compared to the field data. The ANN model showed an RMSE and R² of 3.89 m/h and 0.93 for the training data and an RMSE and R² of 4.16 m/h and 0.92 for the testing dataset. The sensitivity analysis showed that the ANN model predicted higher ROP than the empirical models in the selected interval. Due to the limited bit wear data compared to the operational parameters, coupled simultaneous data-driven and empirical modeling is believed to be the future direction for data-driven drilling optimization. Full article

Background and Objectives: Weight-bearing activities exacerbate pain and fatigue in functional flat foot, with uphill walking presenting additional challenges due to increased external loads. The current study investigates whether 3D-printed customized arch-support insoles can enhance gait variables and ankle alignment during uphill walking. Materials and Methods: Twenty healthy young adults, divided into two groups (normal foot condition (control, n = 10), functional flat foot (FF, n = 10)), walked on a treadmill at a 10% incline under two conditions: wearing shoes alone (shoe) or wearing shoes with 3D-printed customized arch-support insoles (SI). Gait pattern, center of force (COF), and ankle joint angles were analyzed by OptoGait, Tekscan, and Kinovea, respectively. Results: The foot flat phase of the gait pattern was prolonged in individuals with FF compared to the control under both shoe and SI conditions, whereas the propulsive phase was shortened with the SI. Medial deviation of the COF during the propulsive phase, observed in individuals with FF under the shoe condition, was corrected to a more lateral alignment with the SI, resembling the COF alignment of the control. Additionally, individuals with FF under the shoe condition exhibited increased ankle pronation compared to the control, whereas the SI moderated pronation, achieving alignment closer to that of the control. Conclusions: These findings indicate that the 3D-printed customized arch-support insoles can improve gait mechanics and ankle alignment in individuals with FF, particularly under challenging conditions such as uphill walking. Full article

This study investigates the benefits of innovative full-contact insoles, crafted using polyester fabric sheets of thermoplastic extruded materials, for individuals with hallux valgus-induced plantar pain. Thirty-five individuals with hallux valgus-induced foot pain were randomly allocated to either the experimental group, wearing innovative full-contact insoles 6 h daily, or the control group, using regular foot insoles, over a period of 12 weeks. Data collection occurred at baseline, and at 1 week, 2 months, and 3 months after the initial fitting. Results indicated that the innovative full-contact insoles significantly reduced anteroposterior displacement by an average of 0.9 cm (p = 0.025) and displacement area by 0.79 cm² (p = 0.012). Gait improvements included an increase in the swing phase (36.46%, p = 0.008) and a reduction in stance phase duration (63.54%, p = 0.019). Pressure peaks at critical foot regions like the second metatarsal and medial heel were reduced by up to 39.45 kPa (p = 0.016) and 104.07 kPa (p = 0.031), while contact areas in the midfoot increased by 6.17 cm² (p = 0.039). Foot pain decreased by an average score of 1.28 points on a 10-point scale across various measures (p = 0.041). These findings suggest that the innovative full-contact insoles effectively enhance pressure distribution and gait dynamics in patients with hallux valgus, providing a viable option for managing foot discomfort. Full article

Chronic ankle instability (CAI), due to its chronic nature and biomechanical complexity, is well-suited for continuous monitoring and tele-rehabilitation using wearable sensor technology. This study assessed whether a smart insole system, equipped with 4 force-sensing resistor sensors and an inertial measurement unit, combined with functional tests and biomechanical indices, could distinguish CAI patients from healthy controls. A total of 21 CAI patients (23.8 ± 5.1 years) and 16 controls (22.62 ± 2.60 years) completed a battery of functional performance tests while wearing the smart insole system. The results showed an increased medial-lateral pressure ratio in the CAI during heel raise (p = 0.031, effect size = 0.82) and hop tests, suggesting an everted foot position. Significant deviations in center-of-pressure trajectory during double-leg heel raises (p = 0.005, effect size = 1.10) suggested asymmetric motion coordination, while compensatory fluctuations of the lifted limb during single-leg balance tests (p = 0.011, effect size = 1.03) were greater in CAI patients. These findings facilitated the development of features to characterize CAI-specific movement patterns. Together, this system shows promise as a quantitative assessment tool for CAI, supporting improved treatment outcomes through tele-rehabilitation. Full article

This study investigated the effects of ankle dorsiflexion angle adjustments in ankle–foot orthoses (AFOs) on the gait of healthy individuals. Fifteen healthy participants engaged in treadmill walking tasks while wearing AFOs with dorsiflexion angles set at 0°, 5°, 10°, and 15°. Three-dimensional treadmill gait analysis was used to collect data during treadmill walking. The analysis focused on toe clearance and the contribution of the vertical component of limb shortening (LS), and compared them across different dorsiflexion angles. The results indicated a significant increase in toe clearance at 10° (median [interquartile change]: 5.03 [0.90] vs. 5.98 [1.18], p < 0.01) and 15° (5.03 [0.90] vs. 5.82 [1.11], p < 0.01) dorsiflexion angle conditions compared to the 0° condition. Similarly, LS demonstrated significant increases at 10° (4.89 [1.97] vs. 5.87 [1.31], p < 0.01) and 15° (4.89 [1.97] vs. 5.61 [1.65], p < 0.01) conditions when compared with the 0° condition. These findings support the notion that higher dorsiflexion angles in AFOs lead to increased toe clearance and LS, suggesting the effectiveness of dorsiflexion angle adjustments as a strategy to address reduced toe clearance. Full article

Background: Flatfoot deformity is a common condition in children and teenagers that may increase the risk of knee, hip, and back pain. Most of the insoles suggested to treat flatfoot symptoms are not designed to adapt to foot temperature during walking, and they are either too soft to provide support or hard enough to be uncomfortable. Purpose: This study aims to develop an advanced solution to diagnose and treat flexible flatfoot (FFT) using infrared thermography measurements and a hybrid insole reinforced by nitinol (NiTiCu) smart-memory-alloy wires (SMAWs), this super-elastic alloy can return back to its pre-deformed shape when heated, which helps to reduce the local high-temperature points caused by the uneven pressure of FFT. This approach achieves a more uniform thermal distribution across the foot, which makes the hybrid insole more comfortable. Methods: The study involved 16 subjects, divided into two groups of eight flat-footed and eight normal. The procedure includes two parts, namely, designing a prototype insole with SMAW properties based on thermography measurement by using SolidWorks, and evaluating this design using Ansys. Second, a hybrid insole reinforced with SMAWs is customized for flatfoot subjects. The thermography measurement differences between the medial and lateral sides of the metatarsophalangeal line are compared for the normal and flatfoot groups before and after wearing the suggested design. Results: The results show that our approach safely diagnosed FFT and significantly improved the thermal distribution in FFT subjects by more than 80% after wearing the suggested design. A paired t-test reported significant (p-value > 0.001) thermal decreases in the high-temperature points after using the SMAW insole, which was closely approximated to the normal subjects. Conclusions: the SMAW-reinforced insole is comfortable and suitable for treating FFT deformity, and infrared thermography is an effective tool to evaluate FFT deformity. Full article

Ankle-foot orthoses (AFOs) have been commonly prescribed for stroke survivors with foot drop, but their impact on the contractions of paretic tibialis anterior (TA) and medial gastrocnemius (MG) has remained inconclusive. This study thus investigated the effect of AFOs on these muscle contractions in stroke survivors. The contractions of paretic TA and MG muscles were assessed in twenty stroke patients and compared between walking with and without AFOs, using a novel wearable dynamic ultrasound imaging and sensing system. The study found an increase in TA muscle thickness throughout a gait cycle (p > 0.05) and a significant increase in TA muscle surface mechanomyography (sMMG) signals during the pre- and initial swing phases (p < 0.05) when using an AFO. MG muscle thickness generally decreased with the AFO (p > 0.05), aligning more closely with trends seen in healthy adults. The MG surface electromyography (sEMG) signal significantly decreased during the initial and mid-swing phases when wearing an AFO (p < 0.05). The TA-MG co-contraction index significantly decreased during initial and mid-swing phases with the AFO (p < 0.05). These results suggest that AFOs positively influenced the contraction patterns of paretic ankle muscles during walking in stroke patients, but further research is needed to understand their long-term effects. Full article