糖尿病患者足底压力和鞋垫减压结构的有限元分析

doi:10.3969/j.issn.1006-9771.2021.07.019

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (7): 852-858.doi: 10.3969/j.issn.1006-9771.2021.07.019

糖尿病患者足底压力和鞋垫减压结构的有限元分析

曹子君^1,²,王芳^1,²(),何耀广^1,²,张宇^1,²,王萌秀^1,²,张建国^1,²()

1.天津科技大学机械工程学院,天津市300222
2.天津市轻工与食品工程机械装备集成设计与在线监控重点实验室,天津市300222

收稿日期:2020-12-04 修回日期:2021-05-24 出版日期:2021-07-25 发布日期:2021-07-28
通讯作者: 王芳,张建国 E-mail:fwang@tust.edu.cn;jg-zh@tust.edu.cn
作者简介:曹子君(1990-),男,汉族,山西广灵县人,博士研究生,主要研究方向：生物力学、糖尿病减压鞋具。
基金资助:
1.天津市企业科技特派员项目(18JCTPJC57600);2. 天津市高等学校基本科研业务费资助项目(2017KDYB21)

Plantar Pressure and Offloading Insole Structure for Diabetic Patients: A Finite Element Analysis

CAO Zi-jun^1,²,WANG Fang^1,²(),HE Yao-guang^1,²,ZHANG Yu^1,²,WANG Meng-xiu^1,²,ZHANG Jian-guo^1,²()

1. College of Mechanical Engineering, Tianjin University of Science and Technology, Tianjin 300222, China
2. Tianjin Key Laboratory of Integrated Design and Online Monitoring of Light Industry and Food Machinery and Equipment, Tianjin 300222, China

Received:2020-12-04 Revised:2021-05-24 Published:2021-07-25 Online:2021-07-28
Contact: WANG Fang,ZHANG Jian-guo E-mail:fwang@tust.edu.cn;jg-zh@tust.edu.cn
Supported by:
Tianjin Enterprise Science and Technology Commissioner Project(18JCTPJC57600);Fundamental Research Funds for Tianjin Universities(2017KDYB21)

摘要/Abstract

摘要：

目的分析糖尿病患者足底压力特征,设计鞋垫的减压结构,以降低足底软组织表面压力和内部应力。

方法基于CT影像建立人体足部三维有限元模型。在糖尿病患者足底高压区设计孔结构。采用正交试验和有限元法,分析孔的直径、深度、间距对足底软组织表面压力和内部应力的影响,得到最优方案,分别用有限元法和实验法分析多孔鞋垫的减压效果。

结果糖尿病患者足底压力峰值高于健康人。在跖骨区和跟骨区采用直径5 mm、深6 mm、间距2 mm的孔结构,降低软组织表面压力和内部应力的效果较好,行走过程中足趾区、跖骨区、中足区和跟骨区的压力峰值分别降低15.6%、45.6%、53.5%和10.1%。

结论有限元分析有助于了解糖尿病患者足底软组织内部应力;多孔鞋垫能降低软组织表面压力和内部应力。

关键词: 糖尿病, 足底压力, 减压鞋垫, 有限元法, 孔结构, 全接触鞋垫

Abstract:

Objective To investigate the plantar pressure features of diabetic patients, and design the offloading structure of insole to reduce the plantar pressure and internal stress of the soft tissue.

Methods A three-dimensional finite element model of foot was established based on CT images. Hole structure was designed in the high plantar pressure area of diabetic patients. The effects of diameter, depth and interval of holes on plantar pressure was analyzed through orthogonal test and finite element analysis, to obtain the optimal scheme; and the offloading effect was analyzed with finite element analysis and experiment.

Results The peak plantar pressure was higher in diabetic patients than in healthy individuals. The holes with 5 mm diameter, 6 mm depth and 2 mm interval in metatarsal and calcaneus regions might effectively reduce the plantar pressure and internal stress of soft tissue, which was 15.6%, 45.6%, 53.5% and 10.1% less of the peak plantar pressure on toes, metatarsal, midfoot and calcaneus area, respectively, compared to walking without insoles.

Conclusion Finite element analysis is helpful to explore the internal stress of soft tissue in diabetic patients, and insole with hole structure can reduce the plantar pressure and internal stress of soft tissue.

Key words: diabetes mellitus, plantar pressure, offloading insole, finite element, porous structure, total contact insole

中图分类号:

R496

曹子君,王芳,何耀广,张宇,王萌秀,张建国. 糖尿病患者足底压力和鞋垫减压结构的有限元分析[J]. 《中国康复理论与实践》, 2021, 27(7): 852-858.

CAO Zi-jun,WANG Fang,HE Yao-guang,ZHANG Yu,WANG Meng-xiu,ZHANG Jian-guo. Plantar Pressure and Offloading Insole Structure for Diabetic Patients: A Finite Element Analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(7): 852-858.

图/表 13

图1

图2

表1

表2

有限元模型材料参数"

名称	材料类型	材料参数
地面	线弹性	E = 17000 MPa, ν = 0.1
骨骼	线弹性	E = 7300 MPa, ν = 0.3
健康软组织	超弹性	$C 10$ = 0.08556; $C 01$ = -0.05841; $C 20$ = 0.03900; $C 11$ = -0.02319; $C 02$ = 0.00851; $D 1$ = 3.65273; $D 2$ = 0.0000
糖尿病软组织	超弹性	$C 10$ = 0.17113; $C 01$ = -0.11683; $C 20$ = 0.07800; $C 11$ = -0.04638; $C 02$ = 0.01702; $D 1$ = 1.82636; $D 2$ = 0.0000
鞋垫	超弹性泡沫	$μ 1$ = 0.213; $μ 2$ = -0.06209; $α 1$ = 10.3; $α 2$ = -3.349; $β 1$ = 0.32; $β 2$ = 0.32

表2

图3

表3

表4

表5

图4

图5

图6

表6

图7

参考文献 37

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试验号	方案	足底跟骨区	足底跖骨区	软组织内部
1	A₁B₃C₂	162.8	149.1	302.3
2	A₁B₂C₃	165.0	150.9	304.6
3	A₃B₂C₂	160.4	146.6	287.0
4	A₃B₁C₃	162.5	148.0	300.6
5	A₂B₁C₂	162.8	147.7	301.3
6	A₂B₃C₃	154.5	154.3	300.5
7	A₃B₃C₁	155.3	141.8	290.1
8	A₁B₁C₁	163.9	149.0	303.1
9	A₂B₂C₁	160.0	145.7	297.1

因素水平	跟骨区压力峰值(kPa)			跖骨区压力峰值(kPa)			软组织应力峰值(kPa)
因素水平	A	B	C	A	B	C	A	B	C
K₁	491.7	489.2	479.2	449.0	444.7	436.5	910.0	905.0	890.3
K₂	477.3	485.4	486	447.7	443.2	443.4	898.9	888.7	890.6
K₃	478.2	472.6	482.0	436.4	445.2	453.2	877.7	892.9	905.7
R	14.4	16.6	6.8	12.6	2.0	16.7	32.3	16.3	15.4
因素主次	B>A>C			C>A>B			A>B>C
较优方案	A₂B₃C₁			A₃B₂C₁			A₃B₂C₁

区域	赤足	A₂B₃C₁ +A₃B₂C₁	A₃B₃C₁
跟骨区	183.7	147.4	155.3
跖骨区	161.1	152.2	141.8
软组织内部	321.8	304.5	290.1

足底分区	无鞋垫	无孔鞋垫	孔结构鞋垫
足趾	321.8	340.7	271.4
跖骨区外侧	431.3	237.5	234.4
跖骨区中部	607.9	417.6	360.0
跖骨区内侧	516.5	408.5	340.8
中足	354.4	171.3	164.9
跟骨区外侧	637.5	622.6	572.8
跟骨区内侧	637.5	596.2	580.1

糖尿病患者足底压力和鞋垫减压结构的有限元分析

Plantar Pressure and Offloading Insole Structure for Diabetic Patients: A Finite Element Analysis

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水平	A	B	C
1	3	2	2
2	4	4	3
3	5	6	4