At present, there are several existing in-vivo indentation systems developed for the characterization of plantar soft tissue properties. Through using these devices, several studies have been conducted to investigate and quantify the relationship between plantar soft tissue properties and conditions that cause plantar soft tissue stiffening such as aging and diabetes mellitus.
Unfortunately, most of the in-vivo indentation techniques are limited by the lack of adequate indentation into the plantar soft tissue. Moreover, there is no consensus on the appropriate indentation depth, resulting in the inability to make unambiguous remarks from literature. Hence, the first study of this thesis assesses the effect of deformation depth on plantar soft tissue behavior and establishes a guideline for the minimum indentation depth that is sufficient to quantify critical plantar soft tissue behavior.
Apart from the indentation parameters, the management of plantar tissue stiffness data is also questionable. The second study of this thesis examines the influence of gender and physical attributes such as bodyweight (BW) and body mass index (BMI) on plantar soft tissue stiffness. It also evaluates the necessity to isolate the differences in terms of gender, BW and BMI in the data analysis of plantar tissue stiffness. From the experimental results, it can be deduced that BW and BMI are weakly associated with tissue stiffness and there is no significant difference in stiffness between male and female participants.
The results suggest that normalizing of plantar tissue stiffness by BW and BMI is not necessary. It is also found that the stiffness data can be pooled and treated equally regardless of gender.
In the third and forth study, the improved indentation procedure is practiced to investigate the effect of tissue glycation, both naturally and pathologically, on plantar tissue behavior. The indentation experiment successfully demonstrates the ability of the proposed indentation technique to quantify the positive relationship between tissue glycation and plantar soft tissue stiffness. It is concluded that both natural and accelerated tissue glycation stiffen plantar soft tissue, resulting in stiffer and weaker tissue property.
The proposed indentation technique is believed to be more realistic than most of the indentation systems available. With the improved indentation apparatus, plantar tissues tested are subjected to large tissue deformation and various metatarsophalangeal joint (MTPJ) dorsiflexion angles which better mimics the real gait condition. Hence, the indentation system developed in this study provides a more useful stiffness values in identification of abnormal and potentially wounded soft tissue. It can be used as a quick non invasive screening tool to massively examine a large population to identify vulnerable tissue and hence prevent foot problems in patients.
|School:||National University of Singapore (Singapore)|
|School Location:||Republic of Singapore|
|Source:||DAI-B 77/06(E), Dissertation Abstracts International|
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