Project 6

Dynamic Ulcer Prevention Insole

People :
Project leader: Prof. dr. K. (Klaas) Postema
Second project leader: Prof. dr. ir. G.J. (Bart) Verkerke
Daily supervisor: dr. J.M. (Juha) Hijmans
Researcher: ir. R. (Roy) Reints

Companies/institutions involved:
University Medical Center Groningen
University of Groningen
Dr Comfort
VTEC – lasers & sensors

Brief summary:
In the Netherlands there are about 800.000 patients with Diabetes Mellitus. This number will increase till 1.300.000 in 2025. Around 3% of the Diabetic people develop a foot ulcer. Treatment of these ulcers is very intensive and costly. On average an ulcer needs 5 months to heal. In 15% of the patients with an ulcer an amputation of foot/lower leg is needed. Due to physiological changes high pressure spots occur, increasing the chance of developing ulcers. Diabetic neuropathy decreases the proprioceptive feedback. As an effect, patients do not feel these high pressures and are therefore at high risk of developing ulcers. One ulcer prevention strategy is to decrease the pressure at high pressure spots on the foot sole. Insole foot pressure measurements are used to indicate high pressure spots on the foot sole. These measurements are used by the orthopaedic shoe technician to adapt the individual insoles. Use of these insoles results in lower incidence of new ulcers. Plantar shear is known to affect blood supply in a negative way. Reduced blood supply contributes to the ulcer development. Therefore, both plantar pressure and shear need to be addressed when developing new devices to prevent diabetic foot ulcers. The Dynamic Ulcer Prevention Insole project is divided into two parts. In the first part a smart insole will be developed that continuously measures pressure and shear stress. A sensor that is small and flat enough to be used in insoles has recently been developed. The accuracy will be checked as well as the possibility to build several of them into an insole. This will be the first end-product. In the second part a dynamic changing insole surface will be developed. This insole automatically adapts to high pressure and shear spots.

The main goal of this project is to develop two insoles that will help in the prevention of diabetic foot ulcers. With the prevention of diabetic foot ulcers we aim to lower the number of long term hospitalizations and lower leg amputees. By doing so we aim to lower social and healthcare burden. Moreover, we aim to improve the quality of life for patients with Diabetic neuropathy.