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

Abstract

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

CLC Number:

R496

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.

Figures/Tables 13

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

References 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

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