Date of Award

8-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Bioengineering

Committee Chair/Advisor

Dr. John DesJardins

Committee Member

Dr. Jordon Gilmore

Committee Member

Dr. Joseph Singapogu

Committee Member

Dr. Joel Kidd

Abstract

Diabetes and its associated complications have seen their prevalence sharply rise in the United States over the past few decades. In fact, the prevalence of diagnosed diabetes has nearly doubled from 5.1% of the US population in 1988, to 9% in the most recent CDC report, which does not include the large percentage of the population with undiagnosed or prediabetes. Of this diabetic population, it is estimated that up to 34% will experience at least one foot ulcer during their lifetime. In worst case scenarios, these ulcers can become infected and eventually require amputation of a portion of, or the entire foot. Treatment methods for diabetic foot ulcers revolve around the redistribution of pressure away from the affected region. The current gold standard treatment for diabetic foot ulcers is the total contact cast, which has been proven to be effective. However, it has a strong negative impact on mobility and other daily activities. Previous research has attempted to increase the efficacy of less invasive treatment options, like custom fit foot orthoses, through the use of a novel 3D printed design. This 3D printed orthotic utilizes a variable meta-structure to augment the effective stiffness of certain regions of the orthotic. These lower stiffness regions can promote the redistribution of pressure away from areas that are at risk of, or have already experienced, ulceration. This dissertation builds upon this previous work by evaluating the comfort and effectiveness of the proposed 3D printed design when worn by an affected population. Following that study, the selection of materials used within the novel orthotic design was reassessed to improve the orthotic’s durability over time while retaining its variable 3 stiffness properties. Finally, a study was conducted to record and evaluate plantar pressure variation throughout the diabetic foot ulcer clinical cycle of care. These plantar pressure measurements have the potential to inform future orthotic design by highlighting the effect of wound healing on pressure distribution across the affected area.

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