VISUALIZING DIABETIC FEET TO OPTIMIZE ORTHOTIC FITTING

糖尿病（DM）和周围神经病变患者的发病率很高， 皮肤破裂和随后下肢截肢的风险， 到足底未被注意到的反复创伤（足底压力） 在走路的时候。 目前的康复方法使用主观方法 制作矫形器以降低足底压力，但溃疡复发 高（30- 57%）。该项目的长期目标是减少 按目的划分皮肤破裂和随后截肢的发生率 根据脚的内部结构制作矫形器。 我们 已经开发出可视化和测量足部结构的方法， 螺旋X射线计算机断层扫描（SXCT）数据结合足底 压力测量。 本提案旨在将SXCT联合收割机 成像方法和足底压力分析来量化 内部结构和外部压力之间的关系 脚，以改善矫正设计。 我们将通过以下方式实现这一目标： 以下具体目标：目标1：SXCT容积成像 准确可靠的骨形态测量评估方法， 足部的软组织 目标2：衡量发生的结构变化 由于糖尿病并发症和外周血管疾病， 神经病变，并确定这些变化是如何与足底 加载时的压力。 目标3：生成并验证2D平面和 根据SXCT体积数据建立足部的3D数学实体模型。 确定糖尿病足和健康足之间的差异，以及 这些差异与足底压力的关系将有助于 了解和管理有助于皮肤的结构因素 崩溃 数学模型的建立将使我们能够 可视化和操纵的内部和外部的三维结构的 脚在计算机辅助设计环境从SXCT测量和 可能对矫形器的设计有直接的影响。 在今后的工作中， 我们将使用这个数学模型和计算力学 分析以优化矫正器设计。 预测的最佳矫正器 然后可以制造和评估用于给定足部结构的设计 在研究后期的临床试验中。

People with Diabetes Mellitus (DM) and peripheral neuropathy are at high risk for skin breakdown and subsequent lower extremity amputation due to unnoticed, repeated trauma (plantar pressures) to the plantar foot during walking. Current rehabilitation methods use subjective methods to fabricate orthotics to reduce plantar pressures, but ulcer recurrence is high (30-57 percent). The long term goal of this project is to reduce the incidence of skin breakdown and subsequent amputation by objective orthotic fabrication based on the internal structure of the foot. We have developed methods of visualizing and measuring foot structure from spiral x-ray computed tomography (SXCT) data in conjunction with plantar pressure measurements. The purpose of this proposal is to combine SXCT imaging methods and plantar pressure analysis to quantify the relationship between internal structures and external pressure on the foot to improve orthotic design. We will achieve this purpose through the following specific aims; Aim 1: Validate SXCT volumetric imaging methods for accurate and reliable morphometric assessment of bones and soft tissues in the foot. Aim 2: Measure structural changes which occur in the foot as a result of the complications of diabetes and peripheral neuropathy, and determine how these changes are related to plantar pressures during loading. Aim 3: Generate and validate 2D planar and 3D mathematical solid models of the foot from SXCT volumetric data. Determining the differences between the Diabetic and healthy foot, and how these differences relate to plantar pressures will help to understand and manage the structural factors that contribute to skin breakdown. Creation of the mathematical model will enable us to visualize and manipulate the internal and external 3D structure of the foot in a computer aided design environment from SXCT measurements and may have immediate implications for orthotic design. In future work, we will use this mathematical model and computational mechanical analysis to optimize orthotic design. The predicted optimal orthotic design for a given foot structure can then be manufactured and evaluated in a clinical trial during later phases of the research.