Prototyping and Experimental Analysis of Active Offloading Footwear for Patients With Diabetes Using an Array of Magnetorheological Fluid-Based Modules.

BACKGROUND: Diabetic foot ulceration is a serious challenge worldwide which imposes an immense risk of lower extremity amputation and in many cases may lead to the death. The presented work focuses on the offloading requirements using an active approach and considers the use of magnetorheological fluid-based modules to redistribute high plantar pressures (PPs). METHODS & RESULTS: Experimentation validated a single module with a threshold peak pressure of 450 kPa, whereas an offloading test with a three-module array and complete footwear validated a maximum pressure reduction of 42.5% and 34.6%, respectively. CONCLUSION: To our knowledge, no such active and electrically controllable offloading footwear has been reported yet that has experimentally demonstrated PP reduction of more than 30% over the offloading site.

Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations.

The high prevalence of lower extremity ulceration and amputation in people with diabetes is strongly linked to difficulties in achieving and maintaining a reduction of high plantar pressures (PPs) which remains an important risk factor. The effectiveness of current offloading footwear is opposed in part by poor patient adherence to these interventions which have an impact on everyday living activities of patients. Moreover, the offloading devices currently available utilize primarily passive techniques, whereas PP distribution is a dynamically changing process with frequent shifts of high PP areas under different areas of the foot. Thus, there is a need for pressure offloading footwear capable of regularly and autonomously adapting to PPs of people with diabetes. The aim of this article is to summarize the concepts of intelligent pressure offloading footwear under development which will regulate PPs in people with diabetes to prevent and treat diabetic foot ulcers. Our team is creating this intelligent footwear with an auto-contouring insole which will continuously read PPs and adapt its shape in the forefoot and heel regions to redistribute high PP areas. The PP-redistribution process is to be performed consistently while the footwear is being worn. To improve adherence, the footwear is designed to resemble a conventional shoe worn by patients in everyday life. Preliminary pressure offloading and user perceptions assessments in people without and with diabetes, respectively, exhibit encouraging results for the future directions of the footwear. Overall, this intelligent footwear is designed to prevent and treat diabetic foot ulcers while enhancing patient usability for the ultimate prevention of lower limb amputations.

A Two-Axis Piezoresistive Force Sensing Tool for Microgripping.

Force sensing has always been an important necessity in making decisions for manipulation. It becomes more appealing in the micro-scale context, especially where the surface forces become predominant. In addition, the deformations happening at the very local level are often coupled, and therefore providing multi-axis force sensing capabilities to microgripper becomes an important necessity. The manufacturing of a multi-axis instrumented microgripper comprises several levels of complexity, especially when it comes to the single wafer fabrication of a sensing and actuation mechanism. To address these requirements, in this work, an instrumented two-axis force sensing tool is proposed, which can then be integrated with the appropriate actuators for microgripping. Indeed, based on the task, the gripper design and shape requirements may differ. To cover wide needs, a versatile manufacturing strategy comprising of the separate fabrication of the passive and sensing parts was especially investigated. At the microscale, signal processing brings additional challenges, especially when we are dealing with multi-axis sensing. Therefore, a proper device, with efficient and appropriate systems and signal processing integration, is highly important. To keep these requirements in consideration, a dedicated clean-room based micro-fabrication of the devices and corresponding electronics to effectively process the signals are presented in this work. The fabricated sensing part can be assembled with wide varieties of passive parts to have different sensing tools as well as grippers. This force sensing tool is based upon the piezoresistive principle, and is experimentally demonstrated with a sensing capability up to 9 mN along the two axes with a resolution of 20 µN. The experimental results validate the measurement error within 1%. This work explains the system design, its working principle, FEM analysis, its fabrication and assembly, followed by the experimental validation of its performance. Moreover, the use of the proposed sensing tool for an instrumented gripper was also discussed and demonstrated with a micrograsping and release task.