Heel skin stiffness effect on the hind foot biomechanics during heel strike

Background: The human heel pad is a complex biological structure consisting of the fat pad and the skin. The mechanical properties of the skin layer are of significant importance to the load‐bearing function of the heel pad and human locomotion. The condition of the heel skin is also directly associated with some medical conditions such as heel ulcers that may become a site for the skin breakdown, which is the most common precursor to lower extremity amputation among persons with diabetes. It is essential to develop a detailed understanding of the properties of the heel skin layer and its effect on hind foot biomechanics during heel strike.

[1]  S. Carta,et al.  Pressure ulcer research issues in surgical patients. , 2000, Advances in skin & wound care.

[2]  T Y Shiang,et al.  The effect of insoles in therapeutic footwear--a finite element approach. , 1997, Journal of biomechanics.

[3]  Y. Itzchak,et al.  In vivo biomechanical behavior of the human heel pad during the stance phase of gait. , 2001, Journal of biomechanics.

[4]  F. Al-Mahroos,et al.  Diabetic neuropathy, foot ulceration, peripheral vascular disease and potential risk factors among patients with diabetes in bahrain: a nationwide primary care diabetes clinic-based study , 2007, Annals of Saudi medicine.

[5]  William R Ledoux,et al.  The compressive material properties of the plantar soft tissue. , 2007, Journal of biomechanics.

[6]  Y. Shau,et al.  Altered heel‐pad mechanical properties in patients with Type 2 diabetes mellitus , 2000, Diabetic medicine : a journal of the British Diabetic Association.

[7]  Kenneth E. Evans,et al.  Experimental and numerical investigations of the deformation of soft materials under tangential loading , 2006 .

[8]  G. Baroud,et al.  Material properties of the human calcaneal fat pad in compression: experiment and theory. , 2002, Journal of biomechanics.

[9]  J. Lagarde,et al.  In vivo model of the mechanical properties of the human skin under suction , 2000, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[10]  T. Koepsell,et al.  Risk Factors for Amputation in Patients with Diabetes Mellitus , 1992, Annals of Internal Medicine.

[11]  Ming Zhang,et al.  Three-dimensional finite element analysis of the foot during standing--a material sensitivity study. , 2005, Journal of biomechanics.

[12]  K. Harding,et al.  Plantar pressure in off‐loading devices used in diabetic ulcer treatment , 2005, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[13]  K. Rome.  Mechanical properties of the heel pad: current theory and review of the literature , 1998 .

[14]  C. I. Franks,et al.  Dynamic Foot Pressure and Other Studies as Diagnostic and Management Aids in Diabetic Neuropathy , 1983, Diabetes Care.

[15]  F. Tang,et al.  Comparison of the mechanical properties of the heel pad between young and elderly adults. , 1998, Archives of physical medicine and rehabilitation.

[16]  A F Mak,et al.  Biomechanical assessment of plantar foot tissue in diabetic patients using an ultrasound indentation system. , 2000, Ultrasound in medicine & biology.

[17]  Ahmet Erdemir,et al.  An inverse finite-element model of heel-pad indentation. , 2006, Journal of biomechanics.

[18]  S. Seber,et al.  The relationship of heel pad elasticity and plantar heel pain. , 1999, Clinical orthopaedics and related research.

[19]  A. Veves,et al.  Abnormal Foot Pressures Alone May not Cause Ulceration , 1989, Diabetic medicine : a journal of the British Diabetic Association.

[20]  Cwj Cees Oomens,et al.  A numerical‐experimental method to characterize the non‐linear mechanical behaviour of human skin , 2003, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[21]  A. Gefen,et al.  Utilization of the foot load monitor for evaluating deep plantar tissue stresses in patients with diabetes: proof-of-concept studies. , 2009, Gait & posture.

[22]  Wen-Chung Tsai,et al.  Microchambers and macrochambers in heel pads: are they functionally different? , 2007, Journal of applied physiology.

[23]  Dequan Zou,et al.  Plantar tissue stiffness in patients with diabetes mellitus and peripheral neuropathy. , 2002, Archives of physical medicine and rehabilitation.

[24]  Yaodong Gu,et al.  Characterisation of nonlinear material parameters of foams based on indentation tests , 2009 .

[25]  John L. Ricci,et al.  Histology and Histomorphometric Analysis of the Normal and Atrophic Heel Fat Pad , 1995, Foot & ankle international.