Finite element analysis of plantar pressure distribution in diabetic foot during stance phase of the gait cycle without and with custom-made insole

Abstract

Diabetic foot complications tend to increase plantar pressure distribution increasing the chances of ulceration and re-ulceration. The knowledge about the factors associated with the causes of ulceration and effective offloading still lacks. Custom-made insole (CMI) is one of offloading techniques. This study aimed to investigate the plantar pressure distribution with shod gait and with CMI during stance phase of the gait cycle using a finite element (FE) approach. A subject-specific three-dimensional model without and with CMI was constructed. The ground reaction force from the experimental study was applied to the FE foot model during different phases of the gait cycle. The peak contact pressure was reduced with the use of CMI from all phases of the gait cycle. Moreover, frictional stress was reduced especially from the forefoot at midstance and terminal stance of the gait cycle. CMI redistributed the plantar pressure and tends to reduce the frictional stress during stance phase of the gait cycle. FE analysis provides better understanding of different parameters that are difficult to calculate with the conventional method. The FE analysis ease the investigation of various conditions including without and with CMI during different phases of the gait cycle.