Abstract
Identification of over-pressure areas in the plantar side of the foot in patients with diabetic foot and reduction of plantar pressure play a major role in clinical practice. The use of individual orthopedic insoles is essential to reduce the over-pressure. The aim of the present study is to mark the over-pressure areas of the plantar part of the foot on a pedogram and describe them with high accuracy using a mathematical research method. The locally over-pressured areas with calluses formed due to repeated injuries were identified on the patients' pedograms. The geometric shapes of the over-pressure areas were described by means of the integral curves of the solutions to Dirichlet singular boundary differential equations. Based on the mathematical algorithm describing those curves, the computer programs were developed. The individual orthopedic insoles were produced on a computer numerical control milling machine considering the locally over-pressured areas. The ethylene vinyl acetate polymers of different degrees of hardness were used to produce the individual orthopedic insoles. For the over-pressure areas, a soft material with a hardness of 20 Shore A was used, which reduces the pressure on the plantar side of the foot and increases the contact area. A relatively hard material with a hardness of 40 Shore A was used as the main frame, which imparts the stability of shape to the insole and increases its wear life. The individual orthopedic insoles produced by means of such technology effectively reduce the pressure on the plantar side of the foot and protect the foot from mechanical damage, which is important for the treatment of the diabetic foot.
Highlights
Based on the biomechanics of human movement, the feet are the basis of the musculoskeletal system
An important novelty of the research is that the geometric shapes of the locally overpressured areas for the individual orthopedic insoles were described by the integral curves of the solutions to Dirichlet singular boundary differential equations [18]: u′′ðtÞ +
The study involved patients diagnosed with diabetes mellitus, type 2; diabetic angiopathy; diabetic sensorimotor peripheral neuropathy; and diabetic foot
Summary
Based on the biomechanics of human movement, the feet are the basis of the musculoskeletal system. The foot performs complex mechanical movements and its bone system and soft tissues are over-pressured. The patients with diabetes mellitus develop skin maceration, bruises, calluses, and other pathological changes on the locally over-pressured areas, which remain undetected due to diminution/loss of pain, temperature, and tactile sensations. An ulcer develops, which is infected [1]. Gangrene, and amputation cause great harm to the patient’s health, lower the quality of their life, and lead to premature disability. It should be noted that in Georgia, about 60% of patients with diabetic foot syndrome are aged 35 to 65 constituting the most productive part of the labor force, who can bring a great benefit to the country
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