On the design and evaluation of adjustable footwear for the prevention of diabetic foot ulcers

Worldwide there are over 422 million people with diabetes. Up to 34% of them will develop a diabetic foot ulcer. These ulcers are extremely dangerous and can result in amputation of the affected leg. Elevated pressures at the plantar surface of the foot are a major cause of diabetic foot ulcerations. Diabetic foot ulcers can be prevented by reducing plantar pressures that are too high. Special footwear such as custom-made insoles and rocker profile shoes are commonly used to reduce plantar pressure. However, the design of this footwear is mainly based on the experience of the prescribing specialist and orthopaedic shoe technician. This leads to a large variety of results and sometimes to insufficient offloading of the foot. Even when the insole or rocker profile shoe initially is effective, over time the location of the pressure spots can shift, resulting in poor offloading and putting the person at risk again of developing an ulcer. The work in this thesis aimed to overcome the problems with the current offloading footwear and includes the design and evaluation of an adjustable rocker profile and a self-adjusting insole

Firesides

Firesides mean sitting around the hearth, and watching the flames dance, talking of things past, meeting an ISU Forester (a fellow classmate at that!) that you never really knew, and spending a friendly evening with a professor in his home

Summer Jobs A Summer in the Backcountry

MT. Rainier, the towering God of Washington, gave me a lasting impression of power and beauty when at age thirteen I first saw it. ... THE MOUNTAIN. I had seen other mountains, but nothing like this, and the lush-green forest of Douglas-fir, Western Hemlock, and Western Red-cedar within Mt. Rainier National Park complimented the mountain\u27s beauty. After meeting THE MOUNTAIN and the park, I decided I would major in forestry in college and someday return here to work. We all have similar stories about love of the mountains and first interest in forestry, but in my case my dream came true

Insole for reducing peak pressures under a foot

The invention provides an insole (1) comprising a plurality of supporting elements (5A, 5B, 5C) distributed over the insole surface for resiliently supporting a foot. Each supporting element comprises a main supporting portion (9) having a narrowing outer shape, and a widening circumferential buckling wall (7) designed to have a buckling behaviour such that: (i) the buckling wall collapses in reaction to a condition in which an external compressive force exceeds a first force threshold (F1); and (ii) if thus being collapsed, the buckling wall resiliently expands in reaction to a condition in which said external compressive force falls below a second force threshold (F2), which is lower than the first force threshold. In use the insole provides a highly effective dynamically self-adjusting pressure distribution reducing peak pressures under a foot, dynamically when the patient walks. In addition, the insole is compact, non complex, easy to produce, durable and reliable

Effects of flexible and rigid rocker profiles on in-shoe pressure

Rocker profiles are commonly used in the prevention of diabetic foot ulcers. Rockers are mostly stiffened to restrict toe plantarflexion to ensure proper offloading. It is also described that toe dorsiflexion should be restricted. However, the difference in effect on plantar pressure between rigid rockers that restrict this motion and flexible rockers that do not is unknown. In-shoe plantar pressure data were collected for a control shoe and the same shoe with rigid and flexible rockers with the apex positioned at 50% and 60%. For 29 healthy female adults peak plantar pressure (PP), maximum mean pressure (MMP) and force-time integral (FTI) were determined for seven regions of the foot. Generalized estimate equation was used to analyse the effect of the different shoes on the outcome measures for these regions. Compared to the control shoe a significant increase of PP and FTI was found at the first toe for both rigid rockers and the flexible rocker with the apex positioned at 60%, while MMP was significantly increased in rockers with an apex position of 60% (p <0.001). PP at the first toe was significantly lower in flexible rockers when compared to rigid rockers (p <0.001). For both central and lateral forefoot PP and MMP were significantly more reduced in rigid rockers (p <0.001), while for the medial forefoot no differences were found. The use of rigid rockers results in larger reductions of forefoot plantar pressures, but in worse increase of plantar pressures at the first toe compared to rockers that allow toe dorsiflexion

Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy

Objective: To report the long-term outcome of nine dogs treated for caudal cervical spondylomyelopathy (CCSM) with surgical spinal fusion. Study design: Short case series. Animals: Nine large-breed dogs. Methods: Medical records of dogs treated for disc-associated CCSM (2013-2016) were reviewed. The surgery objective was spinal distraction by implantation of a SynCage and fixation with two Unilock plates. Follow-up included the Helsinki pain score questionnaire, neurological grading, radiography, computed tomography (CT), and micro-CT (μCT) with subsequent histopathology (two dogs). Results: Clinical follow-up was obtained between 9 and 51 months (27.4 ± 13.4 months). The Helsinki pain score and neurological Griffith score improved (P <.01) in all dogs and in eight of nine dogs, respectively. According to CT, the volume of bone (mean ± SD) through the cage was 79.5% ± 14.3%, including compact bone (53.0% ± 23.4%). Subsidence was seen in one of nine dogs. Implant failure was evident in four dogs, and plates were removed in two dogs. In seven of nine dogs, infraclinical pathology was observed in adjacent segment, associated with implants engaging adjacent intervertebral discs. Radiographic evidence of bony fusion between vertebral bodies was noted in all dogs. Spinal fusion was confirmed by μCT and histopathology in two cervical spine segments that became available at 22 and 40 months postoperatively. Conclusion: Instrumented spinal fusion in dogs with disc-associated CCSM resulted in owner satisfaction and radiographic evidence of interbody spinal fusion in all dogs. Clinical significance: The fusion distraction technique reported here can be used to achieve spinal fusion with a good long-term outcome

Auditory laterality in a nocturnal, fossorial marsupial (Lasiorhinus latifrons) in response to bilateral stimuli

Behavioural lateralisation is evident across most animal taxa, although few marsupial and no fossorial species have been studied. Twelve wombats (Lasiorhinus latifrons) were bilaterally presented with eight sounds from different contexts (threat, neutral, food) to test for auditory laterality. Head turns were recorded prior to and immediately following sound presentation. Behaviour was recorded for 150 seconds after presentation. Although sound differentiation was evident by the amount of exploration, vigilance and grooming performed after different sound types, this did not result in different patterns of head turn direction. Similarly, left-right proportions of head turns, walking events and food approaches in the post-sound period were comparable across sound types. A comparison of head turns performed before and after sound showed a significant change in turn direction (&chi;2 1 = 10.65, P = 0.001) from a left preference during the pre-sound period (mean 58% left head turns, CI 49-66%) to a right preference in the post-sound (mean 43% left head turns, CI 40-45%). This provides evidence of a right auditory bias in response to the presentation of the sound. This study therefore demonstrates that laterality is evident in southern hairy-nosed wombats in response to a sound stimulus, although side biases were not altered by sounds of varying context