journal article·2024-06-19Open access

Pressure-Reducing Design of 3D-Printed Diabetic Shoe Midsole Utilizing Auxetic Lattice Structure

Jifa Zhang, Shizhu Lu, Yinyin Lin, Yang Wang, Xiaolie Yi, Wencheng Fang

Applied Sciences· Volume 14· Issue 12

Abstract

With the global rise in the prevalence of diabetes, diabetic patients need innovative footwear designs to reduce the risk of foot ulcers. This study examined the mechanical properties of diabetic shoe midsoles featuring auxetic lattice structures. Through the construction of finite element models and simulation, this research compared the biomechanical parameter differences in the plantar regions of the metatarsal head, midfoot, and hindfoot when wearing two types of auxetic midsoles with internal angles of 60° and 75° and a non-auxetic midsole with an internal angle of 90° under both walking and running conditions. Compared to the non-auxetic midsole, the auxetic midsoles significantly reduced the peak plantar pressure and optimized the pressure distribution across various plantar regions. Notably, the auxetic 60° midsole reduced the peak plantar pressure by 19.68–55.25% and 16.19–54.39% compared to the non-auxetic 90° midsole during walking and running, respectively. This study also verified that the auxetic midsoles exhibited greater adaptability and compliance to the plantar foot shape, contributing to reductions in plantar pressure in comparisons of deformation values and plantar contact areas across the different midsoles. Auxetic midsoles manufactured using 3D printing technology have significant potential to prevent diabetic foot ulcers and maintain human foot health. This research integrates insights and techniques from materials science and ergonomics, offering a new direction for footwear design.
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Research context

OpenAlex topics: Cellular and Composite Structures · Diabetic Foot Ulcer Assessment and Management · Wound Healing and Treatments

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Industrial Design & Engineering, School of Art & Design, Guangdong University of Technology, Guangzhou 510090, China

Department of Design, School of Advanced Manufacturing, Guangdong University of Technology, Jieyang 510006, China

Department of Product Design, College of Fine Arts, Guangdong Polytechnic Normal University, Guangzhou 510665, China

Funding

2022 Educational Science Planning Project

References (59)

Show source-provided references
1. Global Estimates of Diabetes Prevalence for 2013 and Projections for 203510.1016/j.diabres.2013.11.002 ↗
2. The Neuropathic Foot—A Management Scheme: A Case Report10.1093/ptj/69.4.287 ↗
3. Risk Factors for Plantar Foot Ulcer Recurrence in Neuropathic Diabetic Patients10.2337/dc13-2470 ↗
4. Are Arch-Conforming Insoles a Good Fit for Diabetic Foot? Insole Customized Design by Using Finite Element Analysis10.1002/hfm.20841 ↗
5. Pedorthic Management of the Diabetic Foot10.1177/0309364614535233 ↗
6. A Scientific Approach to Insole Design for the Diabetic Foot10.1016/0958-2592(93)90075-E ↗
7. Shear-Reducing Insoles to Prevent Foot Ulceration in High-Risk Diabetic Patients10.1097/01.ASW.0000422625.17407.93 ↗
8. Effects of Total Contact Insoles on the Plantar Stress Redistribution: A Finite Element Analysis10.1016/S0268-0033(03)00080-9 ↗
9. Multi-Plug Insole Design to Reduce Peak Plantar Pressure on the Diabetic Foot during Walking10.1007/s11517-008-0311-5 ↗
10. Zolfagharian, A., Lakhi, M., Ranjbar, S., and Bodaghi, M. (2021). Custom Shoe Sole Design and Modeling toward 3D Printing. Int. J. Bioprinting, 7.10.18063/ijb.v7i4.396 ↗
11. Plantar Pressure at Different Phases during Gait Cycle in Diabetic Patients and Midsole Structure Design
12. Effects of Individually Optimized Rocker Midsoles and Self-Adjusting Insoles on Plantar Pressure in Persons with Diabetes Mellitus and Loss of Protective Sensation10.1016/j.diabres.2023.111077 ↗
13. Seeing Auxetic Materials from the Mechanics Point of View: A Structural Review on the Negative Poisson’s Ratio10.1016/j.commatsci.2012.02.012 ↗
14. Design and Analysis of an Auxetic Metamaterial with Tuneable Stiffness10.1016/j.compstruct.2021.114997 ↗
15. Experimental and Numerical Studies on the Compressive Mechanical Properties of the Metallic Auxetic Reentrant Honeycomb10.1016/j.matdes.2019.108036 ↗
16. Leung, M.S.-H., Yick, K.-L., Sun, Y., Chow, L., and Ng, S.-P. (2022). 3D Printed Auxetic Heel Pads for Patients with Diabetic Mellitus. Comput. Biol. Med., 146.10.1016/j.compbiomed.2022.105582 ↗
17. Ford, R.R., Misra, M., Mohanty, A.K., and Brandon, S.C. (2022). Effect of Simulated Mass-Tunable Auxetic Midsole on Vertical Ground Reaction Force. J. Biomech. Eng., 144.10.1115/1.4054776 ↗
18. Nourani, A., Daei, M.D., and Honarmand, M. (2023). Comparison of Energy Absorption in Conventional and Auxetic Shoes: Gait Analysis and Finite Element Modeling. J. Des. Against Fatigue, 1.10.62676/jz62m929 ↗
19. Honarvar, S., Nourani, A., Yarandi, A., and Ghehi, F.F. (2022, January 21–22). Three-Dimensional Finite Element Modeling of the Shoe Sole to Investigate the Impact of Various Geometries on Foot Heel Stresses and Energy Absorption. Proceedings of the 2022 29th National and 7th International Iranian Conference on Biomedical Engineering (ICBME), Tehran, Iran.10.1109/ICBME57741.2022.10052813 ↗
20. Effects of Auxetic Shoe on Lumbar Spine Kinematics and Kinetics during Gait and Drop Vertical Jump by a Combined in Vivo and Modeling Investigation10.1038/s41598-022-21540-6 ↗
21. Emerson, R., and Rhee, J. (2024, January 20–23). Analyzing Auxetic Cellular Structures for Personal Protective Gear Designs. Proceedings of the International Textile and Apparel Association Annual Conference Proceedings, Long Beach, CA, USA.10.31274/itaa.17641 ↗
22. Cannata, F., Vadalà, G., Russo, F., Papalia, R., Napoli, N., and Pozzilli, P. (2020). Beneficial Effects of Physical Activity in Diabetic Patients. J. Funct. Morphol. Kinesiol., 5.10.3390/jfmk5030070 ↗
23. Fasting Plasma Glucose and Lipid Profiles of Diabetic Patients Improve with Aerobic Exercise Training10.4314/gmj.v51i3.5 ↗
24. Effects of Aerobic Exercise on the Expressions and Activities of Nitric Oxide Synthases in the Blood Vessel Endothelium in Prediabetes Mellitus
25. Effects of Running on the Development of Diabetes and Diabetes-Induced Complications10.1134/S0022093022010161 ↗
26. Exercise Prescription for Patients with Type 2 Diabetes and Pre-Diabetes: A Position Statement from Exercise and Sport Science Australia10.1016/j.jsams.2011.04.005 ↗
27. Auxetic Foams: Modelling Negative Poisson’s Ratios10.1016/0956-7151(94)90145-7 ↗
28. Analytical Solution and Finite Element Approach to the Dense Re-Entrant Unit Cells of Auxetic Structures10.1007/s00707-019-02387-x ↗
29. Auxetic Metamaterials and Structures: A Review10.1088/1361-665X/aaa61c ↗
30. (2009). Biological Evaluation of Medical Devices—Part 5: Tests for in Vitro Cytotoxicity (Standard No. ISO 10993-5:2009).
31. (2010). Biological Evaluation of Medical Devices—Part 10: Tests for Irritation and Skin Sensitization (Standard No. ISO 10993-10:2010).
32. Trending Applications of 3D Printing: A Study10.51983/ajeat-2020.9.1.1085 ↗
33. Center of Mass of the Human Body Helps in Analysis of Balance and Movement
34. (2014). Standard Test Method for Tensile Properties of Plastics (Standard No. ASTM Standard D638-14).
35. (2003). Standard Test Methods for Rubber Property-Compression Set (Standard No. ASTM D395-03).
36. Liao, C.J., Lu, H., Chang, X., Sun, H., Fan, S.Q., and Wu, H. (2018, January 22–24). Mechanical Properties of Silicone Elastomer Seals for Space Docking Vehicles. Proceedings of the IOP Conference Series: Materials Science and Engineering, Bangkok, Thailand.10.1088/1757-899X/408/1/012010 ↗
37. A Finite Element Analysis of a Human Foot Model to Simulate Neutral Standing on Ground10.1016/j.proeng.2016.06.240 ↗
38. Technology Construction and Finite Element Analysis of a Coupled Finite Element Model of Foot and Barefoot Running Footwear
39. Experiments, Hyperelastic Modeling and Finite Element Simulation of 3d-Printed Thermoplastic Polyurethane10.1002/pamm.202100229 ↗
40. Histomorphological Evaluation of Diabetic and Non-Diabetic Plantar Soft Tissue10.3113/FAI.2011.0802 ↗
41. Gait Changes in Persons with Diabetes: Early Risk Marker for Diabetic Foot Ulcer10.1016/j.fas.2019.01.005 ↗
42. Footbed Shapes for Enhanced Footwear Comfort10.1080/00140130802419503 ↗
43. Hip and Ankle Walking Strategies: Effect on Peak Plantar Pressures and Implications for Neuropathic Ulceration10.1016/0003-9993(94)90004-3 ↗
44. A Study on the Design of Auxetic Structure of Seat Skeleton10.7494/mech.2012.31.2.72 ↗
45. Structures Behavior of Auxetic Structures under Compression and Impact Forces10.1088/1361-665X/aaa3cf ↗
46. Lvov, V.A., Senatov, F.S., Veveris, A.A., Skrybykina, V.A., and Díaz Lantada, A.J.M. (2022). Auxetic Metamaterials for Biomedical Devices: Current Situation, Main Challenges, and Research Trends. Materials, 15.10.3390/ma15041439 ↗
47. Zwaferink, J.B., Custers, W., Paardekooper, I., Berendsen, H.A., and Bus, S.A. (2020). Optimizing Footwear for the Diabetic Foot: Data-Driven Custom-Made Footwear Concepts and Their Effect on Pressure Relief to Prevent Diabetic Foot Ulceration. PLoS ONE, 15.10.1371/journal.pone.0224010 ↗
48. Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using in-Shoe Plantar Pressure Analysis10.2337/dc10-2206 ↗
49. Perception of Footwear Comfort and Its Relationship with the Foot Structure among Youngest-Old Women and Men10.7717/peerj.12385 ↗
50. Lam, Y.N., Yick, K.L., Ng, S.P., Leung, D.M., and Yeung, K.L. (2014, January 6–8). Plantar Pressure Distribution and Perceived Comfort with Elevated Heel Heights during Standing and Walking. Proceedings of the 7th Textile Bioengineering and Informatics Symposium, TBIS 2014, in Conjunction with the 5th Asian Protective Clothing Conference (APCC 2014), Hong Kong, China.
51. Structures On the Design Workflow of Auxetic Metamaterials for Structural Applications10.1088/1361-665X/ac3f78 ↗
52. A 3D Printed Modular Soft Gripper Integrated with Metamaterials for Conformal Grasping10.3389/frobt.2021.799230 ↗
53. Comparison of Plantar Pressures and Contact Area between Normal and Cavus Foot10.1016/j.gaitpost.2013.10.018 ↗
54. Relationship between Plantar Pressure and Perceived Comfort in Military Boots10.1080/19424280902977129 ↗
55. Shirvani, H., Ghasemi, M.H., Shamsoddini, A., and Barati, K. (2024, June 13). Immediate Effects of Using Insoles with Various Wedges on Plantar Pressure Measurements and Comfort Level during Marching. Available online: https://www.researchsquare.com/article/rs-258589/v1.
56. Foot Examination for Older Adults10.1016/j.amjmed.2020.07.010 ↗
57. Orthotics An External Shoe Modification for Reducing Metatarsal Head Pressure in People with Metatarsalgia10.1097/JPO.0b013e3181ccc1f1 ↗
58. Effect of a Metatarsal Pad on the Forefoot During Gait10.7547/1020018 ↗
59. Cui, T. (2019). Disruption in Digital Fabrication: Exploring Fdm 3D Printing and 3D Cad for a Wearable Apparel Product, Auburn University.