VISUALIZING DIABETIC FEET TO OPTIMIZE ORTHOTIC FITTING

患有糖尿病和周围神经病变的人处于兴奋状态 皮肤破裂和随后的下肢截肢的风险 对足底的反复创伤(足底压力) 在走路的时候。目前的康复方法使用的是主观方法 制作矫形器以降低足底压力，但溃疡复发 很高(30%-57%)。该项目的长期目标是减少 按目标分类的皮肤破裂和随后截肢的发生率 基于足部内部结构的矫形矫形术。我们 我开发了可视化和测量脚部结构的方法 螺旋X线计算机体层摄影(SXCT)数据与足底 压力测量。这项建议的目的是将SXCT 成像方法和足底压力分析来量化 内部结构与外部压力之间的关系 脚，以改进矫形设计。我们将通过以下方式实现这一目标 以下具体目标；目标1：验证SXCT体积成像 用于准确和可靠的骨骼和骨形态测量评估的方法 脚上的软组织。目标2：衡量发生的结构性变化 在足部因糖尿病和外周并发症所致 神经病，并确定这些变化与足底的关系 加载过程中的压力。目标3：生成并验证2D平面和 来自SXCT体积数据的足部三维数学实体模型。 确定糖尿病足和健康足之间的区别，以及 这些差异与足底压力之间的关系将有助于 了解和管理构成皮肤的结构性因素 崩溃了。数学模型的建立将使我们能够 可视化并操作的内部和外部3D结构 在计算机辅助设计环境中从SXCT测量和 可能会对矫形器设计产生直接的影响。在今后的工作中， 我们将使用这个数学模型和计算力学 分析以优化矫形器设计。最优矫形器的预测 然后，可以制造和评估给定脚部结构的设计 在研究的后期阶段进行临床试验。

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.