Vertical and shear forces and distributions in the diabetic foot

糖尿病足的垂直力和剪切力及其分布

• 批准号: 8239895
• 负责人: Scott Barnes
• 金额: $ 43.85万
• 依托单位: BERTEC CORPORATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-15 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8239895
• 关键词: Academia; Accounting; Address; Affect; Age; Amputation; Area; Biomechanics; Blindness; Centers for Disease Control and Prevention (U.S.); Clinic; Clinical; Clinical Trials; Communities; Complication; Complications of Diabetes Mellitus; Computer software; Data; Devices; Diabetes Mellitus; Diabetic Foot; Diabetic Foot Ulcer; Diagnosis; Engineering; Etiology; Evaluation; Event; Film; Finite Element Analysis; Foot Ulcer; Foundations; Goals; Health; Heart Diseases; Individual; Kidney Failure; Lead; Limb structure; Location; Lower Extremity; Maps; Marketing; Measurement; Measures; Metric; Modeling; Patients; Phase; Physicians; Plantar Ulcers; Play; Population; Positioning Attribute; Preventive Medicine; Questionnaires; Reaction; Reporting; Research; Research Personnel; Resolution; Role; Science; Solutions; Stress; Surface; System; Technology; Testing; Time; Ulcer; United States; Universities; Walking; base; cost; cost effective; data acquisition; diabetic; diabetic patient; digital; foot; foot sole; human subject; improved; innovation; insight; instrument; interest; lifetime risk; meetings; member; pressure; prototype; research facility; shear stress; tool; tool development

DESCRIPTION (provided by applicant): Foot ulcers are a prevalent complication in the diabetic population, and despite that, the exact causation of plantar ulcers is still unknown. Research suggests that vertical pressure and horizontal shear play an integral role, but the pressure and shear distributions must be precisely measured on the entire plantar surface. Unfortunately, only pressure distribution measurement systems are commercially available. Several shear stress distribution measurement systems have been developed in universities in the past, but the systems are limited in their resolution, accuracy, and size. To address this need, Bertec Corporation is proposing to collaborate with Innovative Scientific Solutions Inc. and the Cleveland Clinic Foundation to develop a measurement tool where the continuous distributions of pressure and shear over the entire plantar foot can be quantified for approximately the cost of existing commercially available tools that are capable of only measuring pressure. This tool will be a force plate developed by Bertec with an elastic surface stress sensitive film (S3F) coating the top developed by ISSI. The device will be tested with diabetics and age-matched controls at the Cleveland Clinic in order to better refine the system and its software. It will be capable of measuring the ground reaction forces and the continuous pressure and shear distributions as a subject walks across the plate. The final product will be of great interest to biomechanists, podiatrists, physical therapists, and doctors specializing in the treatment of diabetes and diabetic foot complications. But in order to reach that goal, the following specific aims must be accomplished: Aim 1, Phase I) Integrate an elastic polymeric film sensitive to pressure and shear with a 6-component force plate in order to obtain a prototype instrument that will yield ground reaction forces plus a true pressure and shear deformation distribution in the polymeric film, due to plantar loading; Aim 2, Phase II) Capture precise foot landmark positions on the prototype product of Aim 1, so that the measured quantities can be accurately mapped to the physical location on the foot; Aim 3, Phase II) Utilizing the finite element analysis model, as independently established by Innovative Science Solutions Inc., for the surface stress sensitive film, and the synchronously measured shear forces from the force plate, convert the shear deformation distribution of the prototype product to shear stress distribution. Then integrate this analysis module into Bertec's digital data acquisition software allowing auto-calculation of shear stresses; Aim 4, Phase II) Incorporate the pressure deformation distribution and foot marker position data from Phase I and Aim 2 into the data acquisition software. Using the finite element analysis model and the synchronously measured vertical force by the force plate, calibrate the pressure deformation model to auto-calculate true pressure distribution; and Aim 5, Phase II) Evaluate the clinical utility of the prototype system, including the acquisition software measuring shear stress and pressure distribution acting upon the plantar foot, from a functional as well as a research point of view through clinical trials of patients with and without diabetes.

描述（由申请人提供）：足部溃疡是糖尿病人群中常见的并发症，尽管如此，足底溃疡的确切原因仍然未知。研究表明，垂直压力和水平剪切在足底变形中起着不可或缺的作用，但必须精确测量足底整个表面的压力和剪切分布。不幸的是，只有压力分布测量系统是商用的。过去，高校已经开发了几种剪切应力分布测量系统，但这些系统在分辨率、精度和尺寸上都受到限制。为了满足这一需求，Bertec公司提议与创新科学解决方案公司和克利夫兰诊所基金会合作开发一种测量工具，可以量化整个足底的压力和剪切的连续分布，其成本大约是现有的商业工具，只能测量压力。该工具将是一个由Bertec开发的力板，顶部有ISSI开发的弹性表面应力敏感膜（S3F）涂层。该设备将在克利夫兰诊所的糖尿病患者和年龄匹配的对照组中进行测试，以更好地完善系统及其软件。它将能够测量地面反作用力和连续的压力和剪切分布，当一个人走过板块。最终产品将引起生物力学家、足病医生、物理治疗师和专门治疗糖尿病和糖尿病足并发症的医生的极大兴趣。但为了实现这一目标，必须实现以下具体目标：目标1，阶段1)将对压力和剪切敏感的弹性聚合物薄膜与6分量力板集成，以获得一个原型仪器，该仪器将产生地面反作用力以及聚合物薄膜中由于足底载荷而产生的真实压力和剪切变形分布；Aim 2, Phase II)在Aim 1的原型产品上捕获精确的足部地标位置，使测量量能够准确映射到足部的物理位置；Aim 3, Phase II)利用Innovative Science Solutions Inc.独立建立的表面应力敏感膜的有限元分析模型，并同步测量力板的剪切力，将原型产品的剪切变形分布转化为剪切应力分布。然后将该分析模块集成到Bertec的数字数据采集软件中，允许自动计算剪切应力；Aim 4, Phase II)将第一期和Aim 2的压力变形分布和足标位置数据整合到数据采集软件中。利用有限元分析模型和测力板同步测量的垂直力，标定压力变形模型，自动计算真实压力分布；和Aim 5， II期)通过对糖尿病患者和非糖尿病患者的临床试验，从功能和研究的角度评估原型系统的临床效用，包括测量作用于足底足的剪切应力和压力分布的采集软件。

项目成果

Expanded butterfly plots: A new method to analyze simultaneous pressure and shear on the plantar skin surface during gait.

• DOI: 10.1016/j.jbiomech.2015.03.025
• 发表时间: 2015-07-16
• 期刊: Journal of biomechanics
• 影响因子: 2.4
• 作者: Berki V;Boswell MA;Ciltea D;Guseila LM;Goss L;Barnes S;Berme N;McMillan GR;Davis BL
• 通讯作者: Davis BL

Spatial frequency content of plantar pressure and shear profiles for diabetic and non-diabetic subjects.

• DOI: 10.1016/j.jbiomech.2016.09.023
• 发表时间: 2016-11-07
• 期刊: JOURNAL OF BIOMECHANICS
• 影响因子: 2.4
• 作者: Berki, Visar;Davis, Brian L.
• 通讯作者: Davis, Brian L.