Insole Research Articles

Effects of Customized Biomechanical Footwear on Gait and Balance in Individuals with Polio: A Randomized Controlled Trial

Background Evidence suggests that the factors behind the increased risk of falls among polio survivors are mainly categorized into intrinsic and extrinsic domains. The intrinsic category involves factors like muscle weaknesses, fear of falls and self-reported balance problem. In contrast, extrinsic factors include poor environmental circumstances and ambulatory issues that cause reduced ability to adapt to walking conditions in polio patients. Therefore, the present study aimed to investigate biomechanical footwear’s effects on gait and balance in individuals with polio. Methods A total of 30 participants were randomly divided into two groups of 15 each. The experimental group received customized shoe footwear with features such as medial arch support, metatarsal pad, rear foot control, fibreglass lateral counter, and a rocker sole. The control group did not receive specialized footwear. Results The intervention group showed significant improvements in several gait parameters compared to the control group, including step length (p=0.008), stride length (p=<0.001), step width (p=0.002), cadence (p<0.001) and speed (p=0.0009). The intervention group also showed significant improvements in Berg Balance Scale scores (p=0.07) compared to the control group. Conclusion Biomechanical footwear with medial arch support, metatarsal pad, and rear foot control can improve gait and balance in individuals with polio. Keywords Disability, Gait, Foot Orthosis, Poliovirus.

Study on progressive failure behavior and mechanical properties of tunnel arch support structures

Multi-layer composite support structure is widely applied in tunnel excavation but shows complicated failure behavior under rock pressure. Local joint broken, out-of-plane instability and arch-shotcrete interface slip widely exist and highly weaken the overall strength of support structure, which is inconsistent with the ideal assumption, leading to sever engineering disaster. Based on above situation, this paper adopts laboratory and numerical methods to investigate the bearing mechanism and failure behavior of arch joint, arch frame and arch-shotcrete composite lining. Then, a modified safety evaluation method of arch is proposed based on convergence-confinement method. The research results proved that, component strength and arch critical instability strength check are necessary in arch design. On the other hand, compared with thin-walled steel arch, the concrete-filled steel tube arch shows higher critical instability strength and better ductility, effective for controlling large deformation of soft rock. The research conclusions can provide reference for related tunnel design and construction.

Triboelectric Nanogenerator Based on Copper Foam with Graded Porous Architectures for Energy Harvesting and Human Motion Monitoring

With the rising development of the Internet of Things (IoTs) and artificial intelligence, triboelectric nanogenerators (TENGs) have shown great application potential to dramatically improve our daily lives as self-powered sensors in portable and wearable electronics. In this study, copper foam with graded porous architectures (CFGA), featuring interconnected micro- and nanoporous composite structures, has been developed via a cost-effective and convenient industrial strategy, including electro galvanizing, thermal diffusion, and corrosion methods in sequence. Based on the measurement and evaluation of compressed force, frequency, and reliability, the obtained CFGA can enlarge the contact surface areas and improve the output performance of TENG effectively as a positive electrode. The results show that TENG based on CFGA can yield an open-circuit voltage and a short circuit current of as high as 45.8 V and 1.88 μA, respectively. The corresponding maximum output peak power can reach ∼52.9 μW. For practical application, CFGA-TENG can be designed in a spacer-free structure for keyboards with the function of electronic code lock. Meanwhile, it can also be applied in smart shoe insoles as a self-powered CFGA-TENG sensor array for human motion monitoring in real time. Our work provides an industrial production approach for functional electronics as energy harvesters and sensors and makes it more accessible for practical applications.

Flexible ZnO:PVDF based free standing piezoelectric nanogenerator for vibrational energy harvesting and wearable shoe insole pedometer sensor

The increasing demand of energy harvesting and wearable electronics applications requires the development of flexible and highly durable piezoelectric nanogenerators (PENG). In this work, We have fabricated flexible ZnO:PVDF based PENGs for vibrational energy harvesting and shoe insole pedometer applications. ZnO nanorods were grown by hydrothermal method and incorporated into PVDF matrixes in the concentration range of 5–15 wt%. These homogeneous ZnO:PVDF composite films were sandwiched between Al electrodes to realize flexible free standing PENGs. The open circuit voltage (Voc), short circuit current (Isc) and instantaneous power density of PENGs increased from ∼ 4 V, 0.4 µA and 1.6 µW/cm2 to ∼ 14.6 V, 0.6 µA and 21.3 µW/cm2 respectively when ZnO nanorods concentration in PVDF increased from 0 to 10 wt% and decreased with further increase in ZnO nanorods concentration. The enhancement in output characteristics of ZnO:PVDF PENG with increasing ZnO concentration was attributed to β-phase crystallization of PVDF, which was confirmed by XRD and FTIR measurements. The deterioration in output characteristics beyond 10 wt% of ZnO nanorods concentration was explained considering the variation of dielectric constant and remnant polarization. The rectified output of the PENGs was effectively stored in various commercially available capacitors and used to power LEDs and stopwatch displays. The PENG with 10 wt% ZnO concentration was used to develop shoe insole pedometer which was interfaced with android based mobile application via Bluetooth. The shoe insole pedometer was successfully tested for 5000 steps at different walking frequencies ranging from 0.5 Hz to 2 Hz in the speed range of ∼ 1.4 km/h to 5.5 km/h. This study not only gives an insight into the mechanism of ZnO:PVDF based PENGs but also opens up their potential in vibration energy harvesting and shoe insole pedometer applications.

Asymmetric shoe height induces reactive changes in gait kinematics but not kinetics in healthy young adults

BackgroundFootwear interventions are a potential avenue to correct walking asymmetry in neurologic populations, such as stroke. However, the motor learning mechanisms that underlie the changes in walking imposed by asymmetric footwear are unclear. Research questionThe objectives of this study were to examine symmetry changes during and after an asymmetric shoe height intervention in (1) vertical impulse and (2) spatiotemporal gait parameters and (3) joint kinematics, in healthy young adults MethodsEleven healthy young adults (3 males, 8 females; 21.2 ± 3.1 years old) participated in this study. Participants walked on an instrumented treadmill at 1.3 m/s for four conditions: (1) a 5-minute familiarization with equal shoe height, (2) a 5-minute baseline with equal shoe height, (3) a 10-minute intervention, where participants walked with asymmetric shoe height with a 10 mm shoe insert in one shoe, and (4) a 10-minute post-intervention, where participants walked with equal shoe height. Asymmetry in kinetics and kinematics were used to identify changes during intervention and aftereffects, a hallmark of feedforward adaptation ResultsParticipants did not alter vertical impulse asymmetry (p = 0.667) nor stance time asymmetry (p = 0.228). During the intervention, step time asymmetry (p = 0.003) and double support asymmetry (p < 0.001) were greater compared to baseline. Leg joint asymmetry during stance (Ankle plantarflexion: p < 0.001; Knee flexion: p < 0.001; Hip extension: p = 0.011) was greater during the intervention compared to baseline. However, changes in spatiotemporal gait variables and joint mechanics did not demonstrate aftereffects. SignificanceOur results show that healthy human adults change gait kinematics, but not weight-bearing symmetry with asymmetrical footwear. This suggests that healthy humans prioritize maintaining vertical impulse by changing their kinematics. Further, the changes in gait kinematics are short-lived, suggesting feedback-based control, and a lack of feedforward motor adaptations

Clinical spectrum and frequency of Charcot-Marie-Tooth disease in Italy: Data from the National CMT Registry.

Data are reported from the Italian CMT Registry. The Italian CMT Registry is a dual registry where the patient registers and chooses a reference center where the attending clinician collects a minimal dataset of information and administers the Charcot-Marie-Tooth (CMT) Examination/Neuropathy Score. Entered data are encrypted. Overall, 1012 patients had registered (535 females) and 711 had received a genetic diagnosis. Demyelinating CMT (65.3%) was more common than axonal CMT2 (24.6%) and intermediate CMT (9.0%). The PMP22 duplication was the most frequent mutation (45.2%), followed by variants in GJB1 and MPZ (both ~10%) and MFN2 (3.3%) genes. A relatively high mutation rate in some "rare" genes (HSPB1 1.6%, NEFL 1.5%, SH3TC2 1.5%) and the presence of multiple mutation clusters across Italy was observed. CMT4A was the most disabling type, followed by CMT4C and CMT1E. Disease progression rate differed depending on the CMT subtype. Foot deformities and walking difficulties were the main features. Shoe inserts and orthotic aids were used by almost one-half of all patients. Scoliosis was present in 20% of patients, especially in CMT4C. Recessive forms had more frequently walking delay, walking support need and wheelchair use. Hip dysplasia occurred in early-onset CMT. The Italian CMT Registry has proven to be a powerful data source to collect information about epidemiology and genetic distribution, clinical features and disease progression of CMT in Italy and is a useful tool for recruiting patients in forthcoming clinical trials.

Effect of foot orthoses on dynamic balance in taekwondo athletes with flexible flatfoot: A randomized controlled trial

BackgroundFlexible flatfoot (FFF) cause biomechanical and sensorimotor disorders of the foot and ankle complex and reduce of postural stability. Postural stability is an important movement skill that affects the performance of taekwondo (TKD) athletes and can lead to fall injuries. The purpose of this study is the effect 12-week application of foot orthosis (FOs) on dynamic balance in TKD athletes with FFF. MethodIn this trial, 30 girls of the TKD athletes with FFF were recruited. They were randomly assigned to experimental and control groups (15 subjects in each group). The experimental group used FOs with medial longitudinal arch support for 12 weeks, and the control group did not have any intervention. The outcome measures include navicular drop and balance in three directions: anterior-posterior, medial-lateral and overall stability. Covariance analysis was used to compare the results between two groups. ResultsThe covariance results showed that the experimental group compared to the control group with a high effect size had a significant difference in reducing of navicular drop (P = 0.000, ηp2 =0.512), anterior-posterior sway (P = 0.000, (ηp2 =0.397) medial-lateral sway (P = 0.019, ηp2 = 0.186) and overall stability sway (P = 0.008, ηp2 = 0.232). ConclusionsThe FOs with medial longitudinal arch support leads to FFF correction and provides mechanical stability of the foot and ankle complex. Also, the impulses sent from plantar receptors are increased and a better understanding of postural sway is transmitted to the central nervous system and balance strategies are improved.

Stepping Beyond Efficacy: Understanding the User Experience of Wearables for Children with Idiopathic Toe Walking in the Natural Setting

Idiopathic Toe Walking is an atypical gait pattern that results in limited mobility, pain, and higher risk of falling. Current therapeutic interventions lack the ability to be implemented outside the clinic or lab. Beyond this, it is unclear if gait analysis and real-time feedback is technologically feasible to attain within a user's natural environment. In our research we aimed to understand the child and parent participants’ experience of an innovative wearable system. We surveyed children and parents after the deployment of a functional prototype with real time vibrotactile feedback for awareness of toe walking via a shoe insert paired with a smartphone for visual feedback. Findings revealed insights into design considerations for wearable technologies for children. Factors such as comfort of using the system (physically and psychologically), child's perception and response to the vibrotactile feedback, and children and parents’ perception of reduced fall risk, pain, and stigma are discussed.

Water absorption and dimensional stability of shoe insoles

The aim of this research was to study water absorption and dimensional stability of shoe insoles. The dimensional stability was indicated by swelling, increase in size of the sample, and shrinkage. Tests were performed ac­cording to the relevant ISO standards. Eight shoe insoles with different compositions were used in the experiment. The experimental results have shown that the water absorption ability of insoles is influenced by the composition and structure of insole components. The statistical analysis of the experimental results has shown a positive linear correlation between water absorption of insole and their swelling, and a negative linear correlation between swelling and increase in size of the samples. The shrinkage of all eight insoles was less than 1%.

Custom-Made Ethyl Vinyl Acetate Insoles with Arch Support Could Improve Static Balance in Diabetic Women with Neuropathic Foot.

Individuals with diabetic neuropathy may experience plantar ulcers and postural instability. Although use of an insole with arch support has the potential to decrease the incidence of plantar ulcers, the choice of proper design and material density concerning postural stability is challenging. The objective of this pilot study was to conduct a preliminary evaluation of the immediate effects of custom-made ethyl vinyl acetate insoles with arch support and Shore A values of 30 or 50 on static balance in patients with diabetes and neuropathic foot/feet. Ten women with diabetes participated in this study. Static balance was analyzed while in double-limb standing with eyes closed and eyes open and while standing on a dominant limb with eyes open wearing shoes only and wearing shoes and insoles with Shore A values of 30 and 50. With insole, the mean values of center of pressure excursions decreased significantly while standing on double limbs with eyes closed. The improvement in static balance was greater while using the insole with greater density; however, the difference was not statistically significant. An insole with arch support made of ethyl vinyl acetate Shore A of 30 and 50, which could decrease plantar pressure concentration, had no negative effect on the static balance of diabetes. Therefore, further research on the long-term effects of such insoles on the static balance of diabetes is suggested.

Novel 3D-printed foot orthoses with variable hardness: A comfort comparison to traditional orthoses.

Custom foot orthoses are used to treat a variety of foot pathologies. However, orthotic production requires significant hands-on fabrication time and expertise to produce orthoses that are both comfortable and effective. This paper introduces a novel 3D printed orthosis and fabrication method that utilizes custom architectures to produce variable-hardness regions. These novel orthoses are compared to traditionally fabricated orthoses during a 2-week user comfort study. Twenty (n=20) male volunteers underwent orthotic fitting for both traditional and 3D-printed foot orthoses prior to engaging in treadmill walking trials and 2 weeks of wear. Each participant undertook a regional comfort, acceptance, and comparison analysis of the orthoses at three time points throughout the study (0, 1, and 2 weeks). Both the 3D-printed and the traditionally fabricated foot orthoses demonstrated statistically significant increases in comfort when compared to the factory fabricated shoe insert. Additionally, the two orthosis groups were not significantly different from each other in comfort rankings both regionally and overall at any time point. The similar comfort achieved by the 3D-printed orthosis to the traditionally fabricated orthosis after 7 days and 14 days emphasizes the potential of the future use of the more reproducible and adaptable 3D-printed orthosis manufacturing methodology.

Selection of the means of auxiliary transportation facilities and adaptation of their parameters to specific operation conditions

Purpose. To improve selection methods of operation schedules as well as means of auxiliary transportation facilities involving adaptation of their parameters to the specific application environment while preparing new extraction pillars for coal mining. Methodology. The current methods for substantiating the operational parameters of the means of internal mine transport do not take into account the impact of mining-geological and technological factors, which change inadequately in space and time, on their productivity. The recommended method for selecting transport and technological schemes and increasing their adaptability in the real conditions of the mine environment is based on the comprehensive use of methods of expert evaluation of the operational indicators of the new generation of auxiliary transport means and modeling of the conditions of their interaction with arch support and side rocks at the stages of mining and their operation when preparing new mining pillars for cleaning mining. Findings. The expert evaluation concerning technological features of mining field preparation as well as assembling and dismantling operations has determined that for the specific conditions of Western Donbas mines, the suspended diesel monorail locomotive and self-propelled machines are the most promising options. Gear clutch rail diesel locomotives are recommended as the auxiliary transport for the accelerated preparation of extraction pillar and introduction of a longwall into operation. Originality. New approaches have been substantiated to improve selection of the efficient means of auxiliary transportation facilities and identify their operational parameters for the well-timed preparation of extraction pillars for their removal under the intensified underground mining conditions. A transportation schedule has been proposed to supply heavy tonnage loads by means of the suspended diesel rail locomotives as well as methods to calculate the expected loads on suspension members of the monorail road taking into consideration physico-mechanical characteristics of roof rocks within a development mine working. Practical value. It has been proved that under the conditions of the intensified mining operations, the recommended engineering solutions meet the requirements of the well-timed preparation of new extraction pillars. In addition, they are considered as a new tendency to improve current schemes of auxiliary transportation facilities for regional mines and provide operational reliability of the available underground transport equipment.

Analysis of Loose Surrounding Rock Deformation and Slope Stability at Shallow Double-Track Tunnel Portal: A Case Study

A low-clearance tunnel portal in the shallow-buried, joint-developed, broken, and loose surrounding rock slope deposit may cause safety issues during construction. In this study, the Guanyin Mountain Tunnel of the Chong-Ai expressway was taken as a case study, and the characteristics of the loose and broken surrounding rocks, their low clearance, and shallow buried bias were comprehensively studied. The three-dimensional numerical model of the Guanyin Mountain tunnel portal section was constructed by the Rhino, AutoCAD, and FLAC 3D software, and the whole construction process of the tunnel portal was simulated. Under the conditions of loose and broken surrounding rocks, the surrounding rock deformation, surface settlement, and slope stability at the portal of the shallow buried tunnel with a small clear distance during the construction of the center diaphragm (CD) method and circular reserved core soil method were studied. The following conclusions are drawn. During the simulated excavation of the tunnel, the maximum surface settlement is 10.74 mm, which meets the requirement of the specification. When the left tunnel is excavated, the surrounding rock deformation of the right arch shoulder should be carefully considered. The maximum deformation value can reach 14.314 mm. After excavation, the deformation rate of the right tunnel is large, and initial support should be installed in time. Since the stratum rock at the portal of the tunnel is strongly weathered, the uplift value of the arch bottom is large and gradually decreases along the axial direction. The tunnel arch bottom and arch foot are plastic areas prone to tensile damage. Therefore, it is imperative to strengthen the inverted arch support of the tunnel in the strongly weathered rock stratum. The excavation sequence of the tunnel portal section adopts the method of excavating the left tunnel first and then excavating the right tunnel, which is more conducive to ensuring the slope stability.

EFFECT OF A LEG LENGTH-EVENING DEVICE ON GAIT NORMALITY WHILE WEARING VACUUM ORTHOSES

Vacuum orthoses are being applied in the care of patients with foot and lower leg conditions, as ankle fractures or sprains. The lower leg is protected and immobilized, which increases mobility. Due to the design, the orthoses lead to a difference in leg length, i.e. the side with the orthosis becomes longer, which changes the gait kinematics. To prevent or mitigate the unfavourable effects of altered gait kinematics, leg length-evening devices (shoe lifts) are offered that are worn under the shoe on the healthy side. Our aim was to evaluate the effect of such a device on the normality of gait kinematics.Gait analysis was conducted with 63 adult, healthy volunteers having signed an informed consent form that were asked to walk on a treadmill at a speed of 4.5km/h in three different conditions:barefoot - as reference for establishing the normality score baselinewith a vacuum orthosis (VACOPed, OPED GmbH, Germany) and a sport shoewith a vacuum orthosis and a shoe lift (EVENup, OPED GmbH, Germany)Data was sampled using the gait analysis system MCU 200 (LaiTronic GmbH, Austria). The positions of the joint markers were exported from the software and evaluated for the joint angles during the gait cycle using custom software (implemented in DIAdem 2017, National Instruments).A normality score using a modification of the Gait Profile Score (GPS) was calculated in every 1%-interval of the gait cycle and evaluated with a Wilcoxon signed rank test.The GPS value was reduced by 0.33° (0.66°) (median and IQR) while wearing the shoe lift. The effect was statistically significant, and very large (W = 1535.00, p &lt; .001; r (rank biserial) = 0.52, 95% CI [0.29, 0.70]).The significant reduction of the GPS value indicates a more normal gait kinematics while using the leg length-evening device on the contralateral shoe. This rather simple and inexpensive device thus might improve patient comfort and balance while using the vacuum orthoses.

Steel Arch Support Deformations Forecast Model Based on Grey–Stochastic Simulation and Autoregressive Process

Relatively large deformations of the steel arch support in underground coal mines in the Republic of Serbia present one of the main problems for achieving the planned production of coal. Monitoring of the critical sections of the steel arch support in the underground roadways is necessary to gather quality data for the development of a forecasting model. With a new generation of 3D laser scanners that can be used in potentially explosive environments (ATEX), deformation monitoring is facilitated, while the process of collecting precise data is much shorter. In this paper, we used a combination of grey and stochastic system theory combined with an autoregressive process for processing collected data and the development of a forecasting model of the deformations of the steel arch support. Forecasted data accuracy based on the positions of the markers placed along the internal rim of support construction shows high accuracy with MAPE of 0.2143%. The proposed model can successfully be used by mining engineers in underground coal mines for steel arch support deformations prediction, consequentially optimizing the maintenance plan of the underground roadways and achieving planned production.

Design of tunnel steel arch looping manipulator with multiple actuators in limited space.

In order to overcome the low efficiency, high labor intensity and high risk of steel arch support operations in tunnel boring machines, a steel arch looping manipulator with multiple actuators was designed. Firstly, in order to simplify the complex design requirements of the manipulator, an exponential product model was established to analyze the influence of each single joint on the end output, and the manipulator was decomposed into different modules. The design is carried out separately, layer by layer, in the order of actuator-trunk module-branch module. Then, the optimal manipulator is obtained considering the limited space, equivalent flexibility, and joint control accuracy requirements. Finally, a prototype of the steel arch looping manipulator was manufactured and the feasibility of the manipulator was verified by experiments. The design method can provide a reference for the design of multi-actuator manipulator configuration in limited space.

Effects of footwear modification along with physiotherapy on activity of daily living (ADLS) in patients with medial knee osteoarthritis

Background: the management of osteoarthritis (OA) of the knee with biomechanical therapies claimed that application of orthotic devices is another crucial component of a rehabilitation program. Several footwear modifications are used to lessen medial knee loading (MKL), which helps to reduce pain and other symptoms. Objective: to compare the effects of lateral heel wedge insole alone and in combination with medial arch support on ADLs in patient with medial knee OA. Methodology: A randomized clinical trial was conducted on n=60 patients with medial knee OA were randomly allocated in to group A, received lateral heel wedge insole (LHWI) along with medial arch support (MAS) and group B only adjusted with LHWI. Nonprobability convenient sampling technique was used to collect the data on the knee injury and osteoarthritis outcomes score (KOOS) was used as outcome measures. The outcome measures were assessed at the baseline, and after 8 and 16 weeks. Results: The results of independent t-test showed that group A which received LHWI along with MAS showed more significant improvement (p&lt;0.05) in pain, ADLs, sports activity on KOOS questionnaire at each level of assessment than group B which only received the LHWI. But KOOS quality of life scores only showed significant improvement after 8 weeks of intervention in group A while after 16th weeks no significant difference (p=0.09) was observed. Conclusion: the lateral wedge insoles with medial arch support combined with conventional physical therapy protocol is more effective to improve activities of daily living (ADLS) in patients having medial knee osteoarthritis. Keywords: Footwear, osteoarthritis, lateral heel wedge insoles, KOOS, ADLs.

Does Kinesio taping of tibialis posterior or peroneus longus have an immediate effect on improving foot posture, dynamic balance, and biomechanical variables in young women with flexible flatfoot?

BackgroundFlexible flatfoot is common in young adults. One of its causes is the failure of dynamic stabilizers, which play an important role in the medial longitudinal arch support, and their appropriate function is necessary for the integrity of the lower extremity and the spine. ObjectiveThe study aimed to determine Kinesio taping on which extrinsic foot muscle provides greater benefit regarding enhancement of foot posture, dynamic balance, and biomechanical parameters in functional tasks immediately. MethodsThirty women were recruited for the study. They were randomly divided into groups (A = 15, B = 15). In group A, Kinesio taping was applied on the tibialis posterior (TP), and in group B, Kinesio taping was applied on the peroneus longus (PL) and remained for 30 min. Outcome measures were the navicular drop test (NDT), foot posture index (FPI), Y-balance test, and biomechanical parameters in functional tasks. Before/After within-group and between-group comparisons of outcome measures were performed. ResultsNDT and FPI decreased in both groups (p < 0.05) with no significant difference between groups. In group A, maximum total force of the stance phase (MaxTFSP) during running increased, and some temporal parameters were changed. (p < 0.05). In group B, Y-balance test improved in all directions, and the width of the gait line during walking increased. There were no significant differences in the postural stability parameters in the within-group comparison, except for mean center of pressure displacement in group B (p = 0.04). ConclusionKinesio taping of both muscles could improve foot posture. TP Kinesio taping can increase the MaxTFSP during running and alter some temporal parameters during walking and running tasks. PL Kinesio taping could lead to better dynamic stability and coordination during dynamic tasks. Each muscle can be considered a therapeutic target for a specific purpose.

Using a contralateral shoe lift to reduce gait deterioration during an offloading fast-walk setting in diabetic peripheral neuropathy: A comparative feasibility study

AimsDiabetic peripheral neuropathy (DPN) is a predictor of foot ulcers and leads to sedentary behaviour. This comparative study evaluated gait and feasibility of a 20-minute fast walk, at 40–60% of cardiopulmonary capacity, in individuals with DPN wearing an offloading boot and a contralateral shoe balancer. MethodsGait parameters were measured with inertial sensors on 32 individuals (group with DPN [n = 16], group with diabetes but without DPN [n = 9], and a group without diabetes/DPN [n = 7]). Feasibility was assessed by feedback on perceived effort and adverse events. Gait outcomes were compared between groups with or without a shoe balancer using one-way ANOVAs. ResultsThe three groups were equivalent in terms of activity level and age and gender except for the body mass index. Both groups with diabetes exhibited minimal decreased gait speed (p > 0.005) and the DPN group exhibited increased double-support percentage (+4.6%, p = 0.01) while walking with an offloading boot and contralateral shoe balancer. The use of a contralateral shoe balancer reduced gait asymmetry. Lower physical activity level was associated with further gait deterioration in all groups. Few adverse events were reported, and 91% of participants reported that the proposed activity would be feasible daily. ConclusionsThe offloading boot deteriorated gait function, but a contralateral shoe balancer minimized its impact, especially in the context of physical activity in people with diabetes and DPN.

WEIGHT DISTRIBUTION OF HUMAN FOOT FOR ERGONOMIC DESIGN OF SHOE

Human weight is distributed unevenly in unhealthy person .So to improve it , a proper balancing of weight distribution on human foot is required . Therefore, an Ergonomically designed shoe is mandatory. This work moves forward towards identifying the uneven distribution of weight on feet and would proceed towards identifying the disease using deep learning in MATLAB &amp; also proceed to changes in shoe design concerning with acupressure points specific for a person . Ergonomics involves designing the workplace to fit the needs of the user rather than trying to make the user adjust to the product. Ergonomics uses anthropometrical data to determine the optimum size, shape and form of a product, and make it easier for people to use. Ergonomists can help to identify which user characteristics should be taken into account during designprocess. An ergonomically designed shoe, which includes anatomical arch support, will keep feet in the proper position and shape to be fully functional and pain-free. Ergonomic soles help in reducing pressure on the heel and avoid shocks on the entire body, helping alleviate long-term foot, back and knee pain.An ergonomic sole provides extra protection by cushioning, contouring and supporting the foot. This increases blood circulation and reduces muscle strain. By reducing fatigue in feet ,thereby , reducingoverall body fatigue.Efforts to meet this concern are further multiplied by the critical factors to be considered in the design of each shoe: shock absorption, flexibility, fit, traction, sole wear, breathability, weight, etc. A firm arch that is too high will be painful. A soft arch that foot compresses will not provide long term relief. As the arch of the foot is squeezed against the upper, the upper pushes back against the arch. That force against the arch could cause pain. In this case, again, the more likely cause of the pain is the width, not arch supports. Incorrectly sized arch supports can cause restrictions in one’s foot movement and force to accommodate the awkward position, putting extra pressure on the midsole and causing more pain. Worn-out insoles will no longer provide the correct support to the feet and could cause more harm than good. High-heel is the target because of the marketing value and the challenge for ergonomics. The International Scientific Journal of Engineering and Management ISSN: 2583-6129 Volume: 02 Issue: 03 | March – 2023 DOI: 10.55041/ISJEM00165 www.isjem.com An International Scholarly || Multidisciplinary || Open Access || Indexing in all major Database &amp; Metadata © 2023, ISJEM (All Rights Reserved) | www.isjem.com | Page 2 center of gravity of the subject should be aligned with the heel region of the foot. Most of the body weight is concentrated at the heel region, then metatarsal region and the toes.When we walk, most of our weight passes from the heel, along the outside of the foot, then across the ball of the foot, and to the big toe. The big toe is a push-off point for the next stride. A number of authors and researchers have estimated the mean percentage plantar weight distribution of body weight in the standing position as 57 percent on the heel and 43 percent on the forefoot and arch.The posture while standing should look like a straight line from the ankle to the hip to the shoulder. One should slightly bend the knees to prevent cutting off circulation to the legs andshould hold the weight of body mostly on the balls of feet. One feet should also be about shoulder-width apart . Taking all this features , the weight distribution at acupressure points on foot need to be calculated. In this direction, this dissertation contains the work for measuring the weights on human foot at different points, which will help in ergonomic design of shoe. I also helps in proper material selection or composite sole for shoe. This will also help in diagnosing the disease and its treatment in further course.