Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2011

Open Access 01-12-2011 | Study protocol

Generation of subject-specific, dynamic, multisegment ankle and foot models to improve orthotic design: a feasibility study

Authors: Michiel Oosterwaal, Scott Telfer, Søren Tørholm, Sylvain Carbes, Lodewijk W van Rhijn, Ross Macduff, Kenneth Meijer, Jim Woodburn

Published in: BMC Musculoskeletal Disorders | Issue 1/2011

Login to get access

Abstract

Background

Currently, custom foot and ankle orthosis prescription and design tend to be based on traditional techniques, which can result in devices which vary greatly between clinicians and repeat prescription. The use of computational models of the foot may give further insight in the biomechanical effects of these devices and allow a more standardised approach to be taken to their design, however due to the complexity of the foot the models must be highly detailed and dynamic.

Methods/Design

Functional and anatomical datasets will be collected in a multicentre study from 10 healthy participants and 15 patients requiring orthotic devices. The patient group will include individuals with metarsalgia, flexible flat foot and drop foot.
Each participant will undergo a clinical foot function assessment, 3D surface scans of the foot under different loading conditions, and detailed gait analysis including kinematic, kinetic, muscle activity and plantar pressure measurements in both barefoot and shod conditions. Following this each participant will undergo computed tomography (CT) imaging of their foot and ankle under a range of loads and positions while plantar pressures are recorded. A further subgroup of participants will undergo magnetic resonance imaging (MRI) of the foot and ankle.
Imaging data will be segmented to derive the geometry of the bones and the orientation of the joint axes. Insertion points of muscles and ligaments will be determined from the MRI and CT-scans and soft tissue material properties computed from the loaded CT data in combination with the plantar pressure measurements. Gait analysis data will be used to drive the models and in combination with the 3D surface scans for scaling purposes. Predicted plantar pressures and muscle activation patterns predicted from the models will be compared to determine the validity of the models.

Discussion

This protocol will lead to the generation of unique datasets which will be used to develop linked inverse dynamic and forward dynamic biomechanical foot models. These models may be beneficial in predicting the effect of and thus improving the efficacy of orthotic devices for the foot and ankle.
Appendix
Available only for authorised users
Literature
1.
go back to reference Garrow AP, Silman AJ, Macfarlane GJ: The Cheshire Foot Pain and Disability Survey: a population survey assessing prevalence and associations. Pain. 2004, 110: 378-384. 10.1016/j.pain.2004.04.019.CrossRefPubMed Garrow AP, Silman AJ, Macfarlane GJ: The Cheshire Foot Pain and Disability Survey: a population survey assessing prevalence and associations. Pain. 2004, 110: 378-384. 10.1016/j.pain.2004.04.019.CrossRefPubMed
2.
go back to reference Barr EL, Browning C, Lord SR, Menz HB, Kendig H: Foot and leg problems are important determinants of functional status in community dwelling older people. Disabil Rehabil. 2005, 27: 917-923. 10.1080/09638280500030506.CrossRefPubMed Barr EL, Browning C, Lord SR, Menz HB, Kendig H: Foot and leg problems are important determinants of functional status in community dwelling older people. Disabil Rehabil. 2005, 27: 917-923. 10.1080/09638280500030506.CrossRefPubMed
3.
go back to reference Spahn G, Schiele R, Hell AK, Klinger HM, Jung R, Langlotz A: The prevalence of pain and deformities in the feet of adolescents. Results of a cross-sectional study. Z Orthop Ihre Grenzgeb. 2004, 142: 389-396. 10.1055/s-2004-822844.CrossRefPubMed Spahn G, Schiele R, Hell AK, Klinger HM, Jung R, Langlotz A: The prevalence of pain and deformities in the feet of adolescents. Results of a cross-sectional study. Z Orthop Ihre Grenzgeb. 2004, 142: 389-396. 10.1055/s-2004-822844.CrossRefPubMed
4.
go back to reference Brem H, Sheehan P, Rosenberg HJ, Schneider JS, Boulton AJ: Evidence-based protocol for diabetic foot ulcers. Plast Reconstr Surg. 2006, 117: 193S-209S. 10.1097/01.prs.0000225459.93750.29. discussion 210S-211SCrossRefPubMed Brem H, Sheehan P, Rosenberg HJ, Schneider JS, Boulton AJ: Evidence-based protocol for diabetic foot ulcers. Plast Reconstr Surg. 2006, 117: 193S-209S. 10.1097/01.prs.0000225459.93750.29. discussion 210S-211SCrossRefPubMed
5.
go back to reference Michelson J, Easley M, Wigley FM, Hellmann D: Foot and ankle problems in rheumatoid arthritis. Foot Ankle Int. 1994, 15: 608-613.CrossRefPubMed Michelson J, Easley M, Wigley FM, Hellmann D: Foot and ankle problems in rheumatoid arthritis. Foot Ankle Int. 1994, 15: 608-613.CrossRefPubMed
6.
go back to reference Cheng HY, Lin CL, Wang HW, Chou SW: Finite element analysis of plantar fascia under stretch-the relative contribution of windlass mechanism and Achilles tendon force. J Biomech. 2008, 41: 1937-1944. 10.1016/j.jbiomech.2008.03.028.CrossRefPubMed Cheng HY, Lin CL, Wang HW, Chou SW: Finite element analysis of plantar fascia under stretch-the relative contribution of windlass mechanism and Achilles tendon force. J Biomech. 2008, 41: 1937-1944. 10.1016/j.jbiomech.2008.03.028.CrossRefPubMed
7.
go back to reference Cheng HY, Lin CL, Chou SW, Wang HW: Nonlinear finite element analysis of the plantar fascia due to the windlass mechanism. Foot Ankle Int. 2008, 29: 845-851. 10.3113/FAI.2008.0845.CrossRefPubMed Cheng HY, Lin CL, Chou SW, Wang HW: Nonlinear finite element analysis of the plantar fascia due to the windlass mechanism. Foot Ankle Int. 2008, 29: 845-851. 10.3113/FAI.2008.0845.CrossRefPubMed
8.
go back to reference Commean PK, Mueller MJ, Smith KE, Hastings M, Klaesner J, Pilgram T, Robertson DD: Reliability and validity of combined imaging and pressures assessment methods for diabetic feet. Arch Phys Med Rehabil. 2002, 83: 497-505. 10.1053/apmr.2002.30923.CrossRefPubMed Commean PK, Mueller MJ, Smith KE, Hastings M, Klaesner J, Pilgram T, Robertson DD: Reliability and validity of combined imaging and pressures assessment methods for diabetic feet. Arch Phys Med Rehabil. 2002, 83: 497-505. 10.1053/apmr.2002.30923.CrossRefPubMed
9.
go back to reference Erdemir A, Saucerman JJ, Lemmon D, Loppnow B, Turso B, Ulbrecht JS, Cavanagh PR: Local plantar pressure relief in therapeutic footwear: design guidelines from finite element models. J Biomech. 2005, 38: 1798-1806. 10.1016/j.jbiomech.2004.09.009.CrossRefPubMed Erdemir A, Saucerman JJ, Lemmon D, Loppnow B, Turso B, Ulbrecht JS, Cavanagh PR: Local plantar pressure relief in therapeutic footwear: design guidelines from finite element models. J Biomech. 2005, 38: 1798-1806. 10.1016/j.jbiomech.2004.09.009.CrossRefPubMed
10.
go back to reference Chao EY, Armiger RS, Yoshida H, Lim J, Haraguchi N: Virtual Interactive Musculoskeletal System (VIMS) in orthopaedic research, education and clinical patient care. J Orthop Surg Res. 2007, 2: 2-10.1186/1749-799X-2-2.CrossRefPubMedPubMedCentral Chao EY, Armiger RS, Yoshida H, Lim J, Haraguchi N: Virtual Interactive Musculoskeletal System (VIMS) in orthopaedic research, education and clinical patient care. J Orthop Surg Res. 2007, 2: 2-10.1186/1749-799X-2-2.CrossRefPubMedPubMedCentral
11.
go back to reference Fang L, Jia X, Wang R: Modeling and simulation of muscle forces of trans-tibial amputee to study effect of prosthetic alignment. Clin Biomech (Bristol, Avon). 2007, 22: 1125-1131. 10.1016/j.clinbiomech.2007.07.017.CrossRef Fang L, Jia X, Wang R: Modeling and simulation of muscle forces of trans-tibial amputee to study effect of prosthetic alignment. Clin Biomech (Bristol, Avon). 2007, 22: 1125-1131. 10.1016/j.clinbiomech.2007.07.017.CrossRef
12.
go back to reference Blana D, Hincapie JG, Chadwick EK, Kirsch RF: A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems. J Biomech. 2008, 41: 1714-1721. 10.1016/j.jbiomech.2008.03.001.CrossRefPubMedPubMedCentral Blana D, Hincapie JG, Chadwick EK, Kirsch RF: A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems. J Biomech. 2008, 41: 1714-1721. 10.1016/j.jbiomech.2008.03.001.CrossRefPubMedPubMedCentral
13.
go back to reference Be'ery-Lipperman M, Gefen A: A method of quantification of stress shielding in the proximal femur using hierarchical computational modeling. Comput Methods Biomech Biomed Engin. 2006, 9: 35-44. 10.1080/10255840600564959.CrossRefPubMed Be'ery-Lipperman M, Gefen A: A method of quantification of stress shielding in the proximal femur using hierarchical computational modeling. Comput Methods Biomech Biomed Engin. 2006, 9: 35-44. 10.1080/10255840600564959.CrossRefPubMed
14.
go back to reference Saraswat P, Andersen MS, Macwilliams BA: A musculoskeletal foot model for clinical gait analysis. J Biomech. 2010, 43: 1645-1652. 10.1016/j.jbiomech.2010.03.005.CrossRefPubMed Saraswat P, Andersen MS, Macwilliams BA: A musculoskeletal foot model for clinical gait analysis. J Biomech. 2010, 43: 1645-1652. 10.1016/j.jbiomech.2010.03.005.CrossRefPubMed
15.
go back to reference Ruimerman R, Oosterwaal M, Guldemond NA: Optimalisatie van inlegzoolontwerp door gebruik van computer simulaties. Nederlands Tijdschrift voor Orthopaedie. 2009, 16: 47- Ruimerman R, Oosterwaal M, Guldemond NA: Optimalisatie van inlegzoolontwerp door gebruik van computer simulaties. Nederlands Tijdschrift voor Orthopaedie. 2009, 16: 47-
16.
go back to reference Garrow AP, Papageorgiou AC, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ: Development and validation of a questionnaire to assess disabling foot pain. Pain. 2000, 85: 107-113. 10.1016/S0304-3959(99)00263-8.CrossRefPubMed Garrow AP, Papageorgiou AC, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ: Development and validation of a questionnaire to assess disabling foot pain. Pain. 2000, 85: 107-113. 10.1016/S0304-3959(99)00263-8.CrossRefPubMed
17.
go back to reference Budiman-Mak E, Conrad KJ, Roach KE: The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991, 44: 561-570. 10.1016/0895-4356(91)90220-4.CrossRefPubMed Budiman-Mak E, Conrad KJ, Roach KE: The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991, 44: 561-570. 10.1016/0895-4356(91)90220-4.CrossRefPubMed
18.
go back to reference Kuyvenhoven MM, Gorter KJ, Zuithoff P, Budiman-Mak E, Conrad KJ, Post MW: The foot function index with verbal rating scales (FFI-5pt): A clinimetric evaluation and comparison with the original FFI. J Rheumatol. 2002, 29: 1023-1028.PubMed Kuyvenhoven MM, Gorter KJ, Zuithoff P, Budiman-Mak E, Conrad KJ, Post MW: The foot function index with verbal rating scales (FFI-5pt): A clinimetric evaluation and comparison with the original FFI. J Rheumatol. 2002, 29: 1023-1028.PubMed
19.
go back to reference Hyslop E, Woodburn J, McInnes IB, Semple R, Newcombe L, Hendry G, Rafferty D, De Mits S, Turner DE: A reliability study of biomechanical foot function in psoriatic arthritis based on a novel multi-segmented foot model. Gait Posture. 2010, 32: 619-626. 10.1016/j.gaitpost.2010.09.004.CrossRefPubMed Hyslop E, Woodburn J, McInnes IB, Semple R, Newcombe L, Hendry G, Rafferty D, De Mits S, Turner DE: A reliability study of biomechanical foot function in psoriatic arthritis based on a novel multi-segmented foot model. Gait Posture. 2010, 32: 619-626. 10.1016/j.gaitpost.2010.09.004.CrossRefPubMed
20.
go back to reference Hermens HJ: European Recommendations for Surface ElectroMyoGraphy, Results of the SENIAM project. 1999, Enschede: Roessingh Research and Development Hermens HJ: European Recommendations for Surface ElectroMyoGraphy, Results of the SENIAM project. 1999, Enschede: Roessingh Research and Development
21.
go back to reference Klein Horsman MD, Koopman HFJM, van der Helm FCT, Prosé LP, Veeger HEJ: Morphological muscle and joint parameters for musculoskeletal modelling of the lower extremity. Clinical Biomechanics. 2007, 22: 239-247. 10.1016/j.clinbiomech.2006.10.003.CrossRefPubMed Klein Horsman MD, Koopman HFJM, van der Helm FCT, Prosé LP, Veeger HEJ: Morphological muscle and joint parameters for musculoskeletal modelling of the lower extremity. Clinical Biomechanics. 2007, 22: 239-247. 10.1016/j.clinbiomech.2006.10.003.CrossRefPubMed
22.
go back to reference Cheung JT, Zhang M, An KN: Effects of plantar fascia stiffness on the biomechanical responses of the ankle-foot complex. Clinical Biomechanics. 2004, 19: 839-846. 10.1016/j.clinbiomech.2004.06.002.CrossRefPubMed Cheung JT, Zhang M, An KN: Effects of plantar fascia stiffness on the biomechanical responses of the ankle-foot complex. Clinical Biomechanics. 2004, 19: 839-846. 10.1016/j.clinbiomech.2004.06.002.CrossRefPubMed
23.
go back to reference Chen WP, Tang FT, Ju CW: Stress distribution of the foot during mid-stance to push-off in barefoot gait: a 3-D finite element analysis. Clinical Biomechanics. 2001, 16: 614-620. 10.1016/S0268-0033(01)00047-X.CrossRefPubMed Chen WP, Tang FT, Ju CW: Stress distribution of the foot during mid-stance to push-off in barefoot gait: a 3-D finite element analysis. Clinical Biomechanics. 2001, 16: 614-620. 10.1016/S0268-0033(01)00047-X.CrossRefPubMed
24.
go back to reference Cheung JTM, Vries G, de Nigg BM: Biomechanical effects of midfoot fusion - a finite element study. J Biomech. 2007, 40: S326-CrossRef Cheung JTM, Vries G, de Nigg BM: Biomechanical effects of midfoot fusion - a finite element study. J Biomech. 2007, 40: S326-CrossRef
25.
go back to reference Cheung JT, Zhang M: A 3-dimensional finite element model of the human foot and ankle for insole design. Arch Phys Med Rehabil. 2005, 86: 353-358. 10.1016/j.apmr.2004.03.031.CrossRefPubMed Cheung JT, Zhang M: A 3-dimensional finite element model of the human foot and ankle for insole design. Arch Phys Med Rehabil. 2005, 86: 353-358. 10.1016/j.apmr.2004.03.031.CrossRefPubMed
26.
go back to reference Lemmon D, Shiang TY, Hashmi A, Ulbrecht JS, Cavanagh PR: The effect of insoles in therapeutic footwear-a finite element approach. J Biomech. 1997, 30: 615-620. 10.1016/S0021-9290(97)00006-7.CrossRefPubMed Lemmon D, Shiang TY, Hashmi A, Ulbrecht JS, Cavanagh PR: The effect of insoles in therapeutic footwear-a finite element approach. J Biomech. 1997, 30: 615-620. 10.1016/S0021-9290(97)00006-7.CrossRefPubMed
27.
go back to reference Chen WP, Ju CW, Tang FT: Effects of total contact insoles on the plantar stress redistribution: a finite element analysis. Clin Biomech (Bristol, Avon). 2003, 18: S17-24. 10.1016/S0268-0033(03)00080-9.CrossRef Chen WP, Ju CW, Tang FT: Effects of total contact insoles on the plantar stress redistribution: a finite element analysis. Clin Biomech (Bristol, Avon). 2003, 18: S17-24. 10.1016/S0268-0033(03)00080-9.CrossRef
28.
go back to reference Actis RL, Ventura LB, Lott DJ, Smith KE, Commean PK, Hastings MK, Mueller MJ: Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking. Med Biol Eng Comput. 2008, 46: 363-371. 10.1007/s11517-008-0311-5.CrossRefPubMedPubMedCentral Actis RL, Ventura LB, Lott DJ, Smith KE, Commean PK, Hastings MK, Mueller MJ: Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking. Med Biol Eng Comput. 2008, 46: 363-371. 10.1007/s11517-008-0311-5.CrossRefPubMedPubMedCentral
29.
go back to reference Cheung JTM, Zhang M: Parametric design of pressure-relieving foot orthosis using statistics-based finite element method. Med Eng Phys. 2008, 30: 269-277. 10.1016/j.medengphy.2007.05.002.CrossRefPubMed Cheung JTM, Zhang M: Parametric design of pressure-relieving foot orthosis using statistics-based finite element method. Med Eng Phys. 2008, 30: 269-277. 10.1016/j.medengphy.2007.05.002.CrossRefPubMed
30.
go back to reference Goske S, Erdemir A, Petre M, Budhabhatti S, Cavanagh PR: Reduction of plantar heel pressures: Insole design using finite element analysis. J Biomech. 2006, 39: 2363-2370. 10.1016/j.jbiomech.2005.08.006.CrossRefPubMed Goske S, Erdemir A, Petre M, Budhabhatti S, Cavanagh PR: Reduction of plantar heel pressures: Insole design using finite element analysis. J Biomech. 2006, 39: 2363-2370. 10.1016/j.jbiomech.2005.08.006.CrossRefPubMed
31.
go back to reference Barani Z, Haghpanahi M, Katoozian H: Three dimensional stress analysis of diabetic insole: a finite element approach. Technol Health Care. 2005, 13: 185-192.PubMed Barani Z, Haghpanahi M, Katoozian H: Three dimensional stress analysis of diabetic insole: a finite element approach. Technol Health Care. 2005, 13: 185-192.PubMed
32.
go back to reference Hsu YC, Gung YW, Shih SL, Feng CK, Wei SH, Yu CH, Chen CS: Using an optimization approach to design an insole for lowering plantar fascia stress--a finite element study. Ann Biomed Eng. 2008, 36: 1345-1352. 10.1007/s10439-008-9516-x.CrossRefPubMed Hsu YC, Gung YW, Shih SL, Feng CK, Wei SH, Yu CH, Chen CS: Using an optimization approach to design an insole for lowering plantar fascia stress--a finite element study. Ann Biomed Eng. 2008, 36: 1345-1352. 10.1007/s10439-008-9516-x.CrossRefPubMed
33.
go back to reference Nester C, Jones RK, Liu A, Howard D, Lundberg A, Arndt A, Lundgren P, Stacoff A, Wolf P: Foot kinematics during walking measured using bone and surface mounted markers. J Biomech. 2007, 40: 3412-3423. 10.1016/j.jbiomech.2007.05.019.CrossRefPubMed Nester C, Jones RK, Liu A, Howard D, Lundberg A, Arndt A, Lundgren P, Stacoff A, Wolf P: Foot kinematics during walking measured using bone and surface mounted markers. J Biomech. 2007, 40: 3412-3423. 10.1016/j.jbiomech.2007.05.019.CrossRefPubMed
34.
go back to reference Chen S-J, Mukul M, Chou L-S: Soft-Tissue Movement at the Foot During the Stance Phase of Walking. J Am Podiatr Med Assoc. 2011, 101: 25-34.CrossRefPubMed Chen S-J, Mukul M, Chou L-S: Soft-Tissue Movement at the Foot During the Stance Phase of Walking. J Am Podiatr Med Assoc. 2011, 101: 25-34.CrossRefPubMed
35.
go back to reference Nester CJ, Liu AM, Ward E, Howard D, Cocheba J, Derrick T: Error in the description of foot kinematics due to violation of rigid body assumptions. J Biomech. 2010, 43: 666-672. 10.1016/j.jbiomech.2009.10.027.CrossRefPubMed Nester CJ, Liu AM, Ward E, Howard D, Cocheba J, Derrick T: Error in the description of foot kinematics due to violation of rigid body assumptions. J Biomech. 2010, 43: 666-672. 10.1016/j.jbiomech.2009.10.027.CrossRefPubMed
36.
go back to reference Weijers R, Walenkamp G, van Mameren H, van den Hout JAAM: Changes of the soft tissue of the forefoot during loading: a volumetric study. The Foot. 2003, 13: 70-75. 10.1016/S0958-2592(02)00147-5.CrossRef Weijers R, Walenkamp G, van Mameren H, van den Hout JAAM: Changes of the soft tissue of the forefoot during loading: a volumetric study. The Foot. 2003, 13: 70-75. 10.1016/S0958-2592(02)00147-5.CrossRef
Metadata
Title
Generation of subject-specific, dynamic, multisegment ankle and foot models to improve orthotic design: a feasibility study
Authors
Michiel Oosterwaal
Scott Telfer
Søren Tørholm
Sylvain Carbes
Lodewijk W van Rhijn
Ross Macduff
Kenneth Meijer
Jim Woodburn
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2011
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-12-256

Other articles of this Issue 1/2011

BMC Musculoskeletal Disorders 1/2011 Go to the issue