RESUMO
BACKGROUND: Accurate representation of the insole geometry is crucial for the development and performance evaluation of foot orthoses designed to redistribute plantar pressure, especially for diabetic patients. METHODS: Considering the limitations in the type of equipment and space available in clinical practices, this study adopted a simple portable three-dimensional (3-D) desktop scanner to evaluate the 3-D geometry of an orthotic insole and the corresponding deformities after the insole has been worn. The shape of the insole structure along horizontal cross sections is defined with 3-D scanning and image processing. Accompanied by an in-shoe pressure measurement system, plantar pressure distribution in four foot regions (hallux, metatarsal heads, midfoot, and heel) is analyzed and evaluated for insole deformity. RESULTS: Insole deformities are quantified across the four foot regions. The hallux region tends to show the greatest changes in shape geometry (17%-50%) compared with the other foot regions after 2 months of insole wear. As a result of insole deformities, plantar peak pressures change considerably (-4.3% to +69.5%) during the course of treatment. CONCLUSIONS: Changes in shape geometry of the insoles could be objectively quantified with 3-D scanning techniques and image processing. This investigation finds that, in general, the design of orthotic insoles may not be adequate for diabetic individuals with similar foot problems. The drastic changes in the insole shape geometry and cross-sectional areas during orthotic treatment may reduce insole fit and conformity. An inadequate insole design may also affect plantar pressure reduction. The approach proposed herein, therefore, allows for objective quantification of insole shape geometry, which results in effective and optimal orthotic treatment.
