Effects of thickness and length of custom made insole on plantar pressure for diabetic foot with neuropathy: A finite element approach

Custom made insole (CMI) effectively reduces the incidence of foot ulceration and re-ulceration in the diabetic foot with neuropathy. Several factors influence the effectiveness of CMI, which can be studied using the finite element analysis (FEA). This study investigated the effect of varying CMI thickness and length on the peak plantar pressure using FEA. A subjectspecific 3D foot model was reconstructed with the CMI. The top surface of tibia and fibula were fixed and a displacement of 3 mm was exerted from the ground along with the upward Achilles tendon force. The peak contact pressure was reduced by 17.52% and 9.46% with an overall thickness of CMI of 9mm and 6mm compared to 3mm, respectively. Full-length CMI redistributed contact pressure at the midfoot better than half-length CMI. In conclusion, FEA provides more insight for the intervention of CMI on plantar pressure in the diabetic foot with neuropathy.