Selected combinations of multidensity orthotic materials were tested under simulated walking conditions found in the forefoot of diabetic patients. Materials were compared for therapeutic effectiveness by their stress/strain properties and dynamic compression set. Results showed that all of the multidensity materials experienced losses in performance throughout the testing period of 100,000 cycles, with the greatest losses occurring within the first 10,000 cycles. Of the materials tested, Poron + Plastazote #2 and Spenco + Microcel Puff Lite had the highest dynamic material strain and the lowest dynamic compression set over 100,000 cycles. In comparison, these are better multidensity combinations than the others tested to use as therapeutic orthoses in footwear for diabetic patients.
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References
1.
. AshryH.R.LaveryL.A.MurdochD.P.FrolichM.LaveryD.C.: Effectiveness of diabetic insoles to reduce foot pressures. J. Foot Ankle Surg., 36: 268–271, 1997.
2.
. BirkeJ.A.FotoJ.G.: Poron orthoses absorb mechanical stress. J. BioMechanics, Special Report, 18–19, November1997.
3.
. BoultonA.J.M.BettsR.P.FranksC.L.WardJ.D.DuckworthT.: The natural history of foot pressure abnormalities in neuropathic diabetic subjects. Diabetes Res. Clin. Pract., 5: 73–77, 1987.
4.
. BrandP.W.: Repetitive Stress in the development of diabetic foot ulcers. The Diabetic Foot, 4th ed.St. Louis, C. V. Mosby, 1988, pp. 83–90.
5.
. BrodskyJ.W.KouroshS.StillsM.MooneyV.: Objective evaluation of insert material for diabetic and athletic footwear. Foot Ankle, 9: 111–116, 1988.
6.
. CampbellG.J.McLureM.NewellE.N.: Compressive behavior after simulated service conditions of some foamed materials intended as orthotic shoe insoles. J. Rehabil. Res. Dev., 21: 57–65, 1984.
7.
. CampbellG.NewellE.McLureM.: Compression testing of foamed plastics and rubbers for use as orthotic shoe insoles. Prosthet. Orthot. Int., 6: 48–52, 1982.
8.
. CavanaghP.R.UlbrechtJ.S.: Biomechanics of the foot in diabetes mellitus. In LevinM.E.O'NealL.W.BowkerJ.H., The Diabetic Foot, 5th Ed.St. Louis, Mosby-Year Book, 1992, pp. 199–232.
9.
. CinatsJ.ReidD.C.HaddowJ.B.: A biomechanical evaluation of sorbothane. Clin. Orthop. Rel. Res., 222: 281–288, 1987.
10.
. ColemanW.C.: Footwear in a management program for injury prevention. In LevinM.E.O'NealL.W.BowkerJ.H., The Diabetic Foot, 5th Ed.St. Louis, Mosby-Year Book, 1992, pp. 531–547.
11.
. FotoJ.G.BirkeJ.A.: Who's using what: an orthotic materials survey. BioMechanics, 3: 63–68, 1996.
12.
. GarciaA.DuraJ.RamiroJ.HoyosJ.VeraP.: Dynamic study of insole materials simulating real loads. Foot Ankle Int., 15: 311–322, 1994.
13.
. KuncirE.J.WirtaR.W.GolbransonF.L.: Load-bearing characteristics of polyethylene foam: an examination of structural and compression properties. J. Rehabil. Res. Dev.27: 229–238, 1990.
14.
. LaveryL.A.VelaS.A.AshryH.R.LanctotD.R.AthanasiouK.A.: Novel methodology to obtain salient biomechanical characteristics of insole materials. J. Am. Podiatr. Med. Assoc., 87: 266–271, 1997.
15.
. LeberCEvanskiP.M.: A comparison of shoe materials in plantar pressure relief. Prosthet. Orthot. Int., 10: 135–8, 1986.
16.
. LemmonD.ShiangT.Y.HashmiA.UlbrechtJ.S.CavanaghP.R.: The effect of insoles in therapeutic footwear: a finite element approach. J. Biomech., 30: 615–620, 1997.
17.
. LewisG.: Putting insoles through the paces. Mechanical Engineering, 4: 96–98, 1989.
18.
. LewisG.TanT.ShiueY.: Characterization of the performance of shoe insert materials. J. Am. Podiatr. Med. Assoc., 81: 418–424, 1991.
19.
. LordM.HoseinR.: Pressure redistribution by molded inserts in diabetic footwear: a pilot study. J. Rehabil. Res. Dev., 31: 214–221, 1994.
20.
. McPoilT.G.CornwallM.W.: Effect of insole material on force and plantar pressures during walking. J. Am. Podiatr. Med. Assoc., 82: 412–416, 1992.
21.
. MuellerM.J.StrubeM.J.AllenB.T.: Therapeutic footwear can reduce plantar pressures in patients with diabetes and transmetatarsal amputation. Diabetes Care, 20: 637–641, 1997.
22.
. PrattD.J.ReesP.H.RodgersC.: Assessment of some shock absorbing insoles. Prosthet. Orthot. Int., 10: 43–45, 1986.
23.
. RomeK.: A study of the properties of materials used in podiatry. J. Am. Podiatr. Med. Assoc., 81: 73–83, 1991.
24.
. ShibaN.KitaokaH.CahalanT.D.ChaoE.: Shock absorbing effect of shoe insert materials commonly used in management of lower extremity disorders. Clin. Orthop., 310: 130–136, 1995.
25.
. VevesA.MurrayH.J.YoungM.J.BoultonA.J.M.: The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia, 35: 660–663, 1992.
26.
. WhiteJ.: Therapeutic footwear for patients with diabetes. J. Am. Podiatr. Med. Assoc., 84: 472–479, 1994.
27.
. WojcieszakCM.FrederickE.C.: Determining the impact characteristics of replacement insoles. Proceedings from 2nd Symposium of the ISB Working Group on Functional Footwear, Cologne, Germany, 1995.
