Stiffer soles are making life more comfortable for some diabetic patient

New research, from Staffordshire University in the UK, provides the first scientific evidence to help healthcare professionals provide shoe-specific foot care to their diabetic patients.
According to the research, highlighted in an Annals of Biomedical Engineering article, the body mass index (BMI) of diabetics indicates how stiff or soft the cushioning material in shoes should be.

The research was led by Panagiotis Chatzistergos. Previous research has shown that the stiffness of the materials used to cushion diabetic patients' feet influences how well they respond to such treatment. However, there are currently no set guidelines that can inform healthcare professionals about which stiffness is optimal for which patients, according to the article. Practitioners currently fall back on empirical and anecdotal evidence when making such decisions, according to Chatzistergos.

As part of ongoing research into diabetic footwear, the team at Staffordshire along with their collaborators set out to find scientific evidence upon which to base such decisions. A range of different bespoke polyurethane (BPU) cushioning materials were manufactured, using standard footwear manufacturing techniques and commercially available chemical compounds. These materials produced had the same mechanical qualities but differed in how stiff they were. Various mechanical tests were then performed using a 3D-printed model of a heel, as well as the feet of ten healthy adult volunteers. Pressure measurements were taken of the entire area of the foot to assess the mechanical characteristics and especially the cushioning properties of the insole materials being tested.

The findings highlight the importance of considering a person's weight and body mass index (BMI) when choosing cushioning materials. People, who weigh more or have a higher BMI, need stiffer insole or footwear material to reduce pressure. Different materials might also be needed for a patient's left and right foot, because pressure is not normally distributed equally across a person's feet.

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