Abstract
BackgroundCurrently, custom foot and ankle orthosis prescription and design tend to be based on traditional techniques, which can result in devices which vary greatly between clinicians and repeat prescription. The use of computational models of the foot may give further insight in the biomechanical effects of these devices and allow a more standardised approach to be taken to their design, however due to the complexity of the foot the models must be highly detailed and dynamic.Methods/DesignFunctional and anatomical datasets will be collected in a multicentre study from 10 healthy participants and 15 patients requiring orthotic devices. The patient group will include individuals with metarsalgia, flexible flat foot and drop foot.Each participant will undergo a clinical foot function assessment, 3D surface scans of the foot under different loading conditions, and detailed gait analysis including kinematic, kinetic, muscle activity and plantar pressure measurements in both barefoot and shod conditions. Following this each participant will undergo computed tomography (CT) imaging of their foot and ankle under a range of loads and positions while plantar pressures are recorded. A further subgroup of participants will undergo magnetic resonance imaging (MRI) of the foot and ankle.Imaging data will be segmented to derive the geometry of the bones and the orientation of the joint axes. Insertion points of muscles and ligaments will be determined from the MRI and CT-scans and soft tissue material properties computed from the loaded CT data in combination with the plantar pressure measurements. Gait analysis data will be used to drive the models and in combination with the 3D surface scans for scaling purposes. Predicted plantar pressures and muscle activation patterns predicted from the models will be compared to determine the validity of the models.DiscussionThis protocol will lead to the generation of unique datasets which will be used to develop linked inverse dynamic and forward dynamic biomechanical foot models. These models may be beneficial in predicting the effect of and thus improving the efficacy of orthotic devices for the foot and ankle.
Highlights
Custom foot and ankle orthosis prescription and design tend to be based on traditional techniques, which can result in devices which vary greatly between clinicians and repeat prescription
This protocol will lead to the generation of unique datasets which will be used to develop linked inverse dynamic and forward dynamic biomechanical foot models
These models may be beneficial in predicting the effect of and improving the efficacy of orthotic devices for the foot and ankle
Summary
Custom foot and ankle orthosis prescription and design tend to be based on traditional techniques, which can result in devices which vary greatly between clinicians and repeat prescription. The design of these devices is largely based around capturing the foot shape using traditional techniques such as plaster casting, and determining abnormal foot function through clinical examination. These approaches may lead to variability in the prescription and restrict design choice and personalised function to simple parameters such as cushioning, support and range of motion control. Computational modelling of the human body - ranging from the force interactions of joints to the way cells communicate with each other - has advanced significantly in the past few decades and it is an important and useful tool for researchers and clinicians These models provide a method of simulating and assessing interventions that are being developed, reducing the time and risk involved with trialling in humans. This approach is appealing for studying foot biomechanics due to the challenging nature of directly investigating the internal loading and movements of the complex structure of bones and soft tissues of the foot that occur during gait
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