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Gepubliceerd in: Journal of Foot and Ankle Research 1/2014

Open Access 01-04-2014 | Meeting abstract

Prediction of plantar soft tissue stiffness based on gender, age, bodyweight, height and body mass index

Auteurs: Jee Chin Teoh, Taeyong Lee

Gepubliceerd in: Journal of Foot and Ankle Research | bijlage 1/2014

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Introduction

Stiffened plantar soft tissues break down easily (Cheung et al., 2005) and these microscopic tears will heap together and develop into a large ulcer. In the USA, 85% of all non-traumatic amputations in diabetes patients arise from non-healing ulcers (Larsson, 1994). In fact, foot ulceration is one of the major causes of hospitalization among the DM patients. 15% of the DM population are threatened by high ulceration risk during their life time (Aziz nather’s book). These findings elucidate the need of early identification of degenerating plantar soft tissue to prevent problematic tissue rupture, especially to diabetic and elderly patients. Non-invasive in vivo assessment that enables direct measurement of tissue’s mechanical response is therefore required. In order to differentiate between normal and pathological tissue, a stiffness reference is needed.
The objective of this study is to conduct a multivariate analysis on the data of plantar tissue stiffness to a better understanding on the influences and the use of these parameters to predict the healthy tissue stiffness of these individuals.

Methods

100 healthy subjects were recruited from National Seoul University (SNU) hospital for the experiment.
During stiffness measurement [1], indentor tip probes the plantar soft tissue to obtain localized force response underneath the 2nd metatarsal head pad at 3 different dorsiflexion angles of 0°, 20°, 40° and the hallux and heel at 0°. Maximum tissue deformation is fixed at 5.6mm (close to literature data) [2].
Tissue behavior was characterized via K, stiffness constant.
https://static-content.springer.com/image/art%3A10.1186%2F1757-1146-7-S1-A128/MediaObjects/13047_2014_Article_733_Equa_HTML.gif
Multiple linear regression of soft tissue stiffness was performed on several plantar locations. The independent variables are gender (-1 for females and +1 for males), bodyweight, height, BMI and age. Multiple analysis was chosen to study the combined effects of the independent variables on tissue stiffness.

Results

However, moderately strong relationship was found on the combined effects of these independent variables as shown in Table 1.
Table 1
Linear regression equation: partial regression coefficients, p values, root mean square errors (RMSE) and number of participants.Y= b0 + b1 x gender + b2 x weight + b3 x height + b4 x bmi + b5 X age; b0 (n/mm); b1 (n/mm)/gender, female= -1, male = +1; b2 (n/mm)/weight; b3 (n/mm)/height; b4 (n/mm)/bmi; b5 (n/mm)/age
Plantar location
b0
Gender (b1)
p
Weight (b2)
p
Height (b3)
p
BMI (b4)
p
Age (b5)
p
RMSE
n
Left
              
Hallux
 
-1.8669817
-0.10225389
 
-0.0042387
 
0.01183471
 
-0.0133015
 
0.02399122
 
0.48578
99
Heel
 
12.3844196
-0.12954317
 
0.08095755
*
-0.0619824
*
-0.1717064
*
0.00629858
 
1.09547
100
2ndMTH
6.46521444
-0.2177458
 
0.06521518
**
-0.0443825
*
-0.152051
**
0.02342962
 
0.802866
96
 
20°
8.58233676
-0.37727232
 
0.11675474
**
-0.0669571
**
-0.2698104
**
0.05478136
 
0.989617
100
 
40°
12.5772582
-0.15231289
 
0.12385643
**
-0.0855753
*
-0.3131397
**
0.06469774
 
1.479414
98
Right
              
Hallux
 
0.66899629
0.087890718
 
-0.0165869
 
0.00670808
 
0.03648811
 
-0.0093199
 
0.409141
99
Heel
 
17.6691906
-0.54480677
*
0.14765975
**
-0.0882361
**
-0.3480107
**
-0.0132202
 
1.147579
100
2ndMTH
4.48332802
-0.17447007
 
0.04778213
*
-0.0271027
 
-0.1134243
*
0.01582428
 
0.821476
96
 
20°
14.2540307
-0.34137115
 
0.12512617
**
-0.0797136
**
-0.2852428
**
-0.0020648
 
1.126962
100
 
40°
16.389124
-0.20310698
 
0.13467015
**
-0.0842629
*
-0.2962142
**
-0.0117724
 
1.614592
98
This suggest that the decision to ignore the influence of gender, age, bodyweight, height and body mass index on plantar soft tissue stiffness should be carefully considered. The combined effect of these independent parameters may subtly influence the accuracy of the study analysis.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​4.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.
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Literatuur
1.
go back to reference Chen W, et al: An instrumented tissue tester for measuring soft tissue property under the metatarsal heads in relation to metatarsophalangeal joint angle. Journal of Biomechanics. 2011, 44: 1804-1804.CrossRef Chen W, et al: An instrumented tissue tester for measuring soft tissue property under the metatarsal heads in relation to metatarsophalangeal joint angle. Journal of Biomechanics. 2011, 44: 1804-1804.CrossRef
2.
go back to reference Cavanagh PR: Plantar soft tissue thickness during ground contact in walking. Journal of Biomechanics. 1999, 32 (6): 623-628. 10.1016/S0021-9290(99)00028-7.CrossRefPubMed Cavanagh PR: Plantar soft tissue thickness during ground contact in walking. Journal of Biomechanics. 1999, 32 (6): 623-628. 10.1016/S0021-9290(99)00028-7.CrossRefPubMed
Metagegevens
Titel
Prediction of plantar soft tissue stiffness based on gender, age, bodyweight, height and body mass index
Auteurs
Jee Chin Teoh
Taeyong Lee
Publicatiedatum
01-04-2014
Uitgeverij
BioMed Central
Gepubliceerd in
Journal of Foot and Ankle Research / Uitgave bijlage 1/2014
Elektronisch ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-7-S1-A128

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