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Peak Plantar Pressures While Wearing a Carbon Fiber Off Loading Orthoses

Carbon Fiber Off-Loading Orthosis

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03618628
Acronym
CFO
Enrollment
3
Registered
2018-08-07
Start date
2016-05-24
Completion date
2018-04-12
Last updated
2019-05-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes Mellitus, Orthotic Device, Peripheral Neuropathy

Brief summary

The purpose of this study is to determine the ability of carbon fiber off loading orthoses to reduce plantar pressure while providing an augmented plantarflexor power to improve walking and function. Results of this study could lead to increased use of carbon fiber off loading orthoses for patients with diabetes, peripheral neuropathy, and foot wounds as a way augmenting wound healing and preventing future recurrences of wounds.

Detailed description

The long term goal of this research is the successful incorporation of carbon fiber into an off loading device will provide protection to the insensate foot of people with diabetes by reducing localized peak pressures, and thus the risk of recurrence neuropathic foot wounds and fractures, while improving ankle power at push off that will allow individuals with loss of ankle muscle function to walk faster and return to dynamic activities required in their jobs and for full function in the community. The overall goal of this proposal is to determine effects of carbon fiber off loading orthoses (CFO) design characteristics (lay up and geometry of strut) on brace strength, weight, power return capacity, plantar off-loading and participant comfort using FE models, ex-vivo testing and human testing. First, a CFO will be fabricated using geometry consistent with the current clinical standard. This representative CFO will serve as a baseline from which a finite element (FE) model will be built. The model will be altered as desired to determine the effects of variable design characteristics. The FE model will estimate brace deflection and stress when the CFO is designed with various lay up designs and brace thicknesses. We will use results from the FE model to fabricate a new CFO for study participants. We will then measure peak plantar pressures during walking while the participants are barefoot, wearing the CFO consistent with current clinical standards, and wearing the new CFO fabricated based on the results of the FE model. We will also measure plantarflexor power during walking while the participants are wearing the CFO consistent with current clinical standards and while wearing the CFO designed based on the results of the FE model. It is believed that the FE model driven CFO design will lead to improved brace strength while reducing plantar pressure compared to barefoot and will have similar plantarflexor power as the CFO based on current clinical standards.

Interventions

DEVICECarbon Fiber Off Loading Orthosis (CFO)

A finite element (FE) model will be created to determine properties that will improve CFO strength while maintaining reduction of peak plantar pressures of the CFO and plantarflexor power. A new CFO will then be fabricated for the participant. Participants will be tested in while walking barefoot, wearing their current CFO, and wearing the FE model driven CFO.

Sponsors

Washington University School of Medicine
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Daily life includes a minimum of moderate activity level (variable cadence walking) 2. Have a Gillette or carbon off loading orthosis as a result of diabetes related foot impairments 3. Diagnosis of diabetes mellitus and peripheral neuropathy 4. Ability to ambulate in the community (K-level ≥ 2) 5. Age \> 21 years

Exclusion criteria

1. Unable to ambulate and complete testing required for study participation. 2. Severe foot deformity of the hindfoot or any deformity of the foot with a dislocation resulting in a bony prominence on the plantar/weightbearing surface of the foot. 3. Neurological diseases that affects walking

Design outcomes

Primary

MeasureTime frameDescription
Peak Plantar PressureParticipant was tested in new brace (based on FE model) after wearing for 1 week.Plantar pressure during walking while the participant wears the brace fabricated based on the finite element (FE) model compared to 1) the brace fabricated based on current clinical standards and 2) barefoot.

Countries

United States

Participant flow

Participants by arm

ArmCount
People Using a CFO
People who are currently wearing a carbon fiber off loading orthosis (CFO) will have a new CFO fabricated for them based on the results of our finite element (FE) model. We will then test both CFOs ability to reduce peak plantar compared to barefoot and the peak plantarflexor power of both braces. Carbon Fiber Off Loading Orthosis (CFO): A finite element (FE) model will be created to determine properties that will improve CFO strength while maintaining reduction of peak plantar pressures of the CFO and plantarflexor power. A new CFO will then be fabricated for the participant. Participants will be tested in while walking barefoot, wearing their current CFO, and wearing the FE model driven CFO.
3
Total3

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDeath1
Overall StudyLost to Follow-up1

Baseline characteristics

CharacteristicPeople Using a CFO
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
2 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
Age, Continuous66.3 years
STANDARD_DEVIATION 11.5
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
3 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
1 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
2 Participants
Region of Enrollment
United States
3 participants
Sex: Female, Male
Female
2 Participants
Sex: Female, Male
Male
1 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
1 / 3
other
Total, other adverse events
0 / 3
serious
Total, serious adverse events
0 / 3

Outcome results

Primary

Peak Plantar Pressure

Plantar pressure during walking while the participant wears the brace fabricated based on the finite element (FE) model compared to 1) the brace fabricated based on current clinical standards and 2) barefoot.

Time frame: Participant was tested in new brace (based on FE model) after wearing for 1 week.

ArmMeasureGroupValue (NUMBER)
People Using a CFOPeak Plantar PressureBarefoot (midfoot)75.3 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureCurrent CFO (midfoot)14.2 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureModel driven CFO (midfoot)14.5 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureBarefoot (Forefoot)22.8 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureCurrent CFO (Forefoot)3.5 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureModel driven CFO (Forefoot)6.6 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureBarefoot (Heel)60.0 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureCurrent CFO (Heel)23.4 Newtons per squared centimeters
People Using a CFOPeak Plantar PressureModel driven CFO (Heel)14.5 Newtons per squared centimeters

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026