Evidence map›Paper›PMID 40834496›Full record

ArticleClinical biomechanics (Bristol, Avon)2025

Pathways of load transfer in custom accommodative insoles for people with diabetes.

Dylan J Heino, Scott Telfer, Kimberly A Nickerson, Christina Carranza, Mathew Sunil Varre, Avocet Nagle-Christensen, William R Ledoux, Brittney C Muir

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical biomechanics (Bristol, Avon), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Durability and offloading performance of 3D-printed multilayer lattice for accommodative insoles.Journal of the mechanical behavior of biomedical materials · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Dylan J HeinoVA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, 1660 S Columbian Way, MS 151, Seattle, WA 98108, United States of America; Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, WA 98195, United States of America.
Scott TelferVA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, 1660 S Columbian Way, MS 151, Seattle, WA 98108, United States of America; Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, WA 98195, United States of America; Department of Orthopaedic Surgery and Sports Medicine, University of Washington, 1959 NE Pacific St., Box 356500, Seattle, WA 98195, United States of America.
Kimberly A NickersonVA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, 1660 S Columbian Way, MS 151, Seattle, WA 98108, United States of America; Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, WA 98195, United States of America.
Christina CarranzaDepartment of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, WA 98195, United States of America.
Mathew Sunil VarreVA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, 1660 S Columbian Way, MS 151, Seattle, WA 98108, United States of America; Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, WA 98195, United States of America.
Avocet Nagle-ChristensenVA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, 1660 S Columbian Way, MS 151, Seattle, WA 98108, United States of America.
William R LedouxVA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, 1660 S Columbian Way, MS 151, Seattle, WA 98108, United States of America; Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, WA 98195, United States of America; Department of Orthopaedic Surgery and Sports Medicine, University of Washington, 1959 NE Pacific St., Box 356500, Seattle, WA 98195, United States of America.
Brittney C MuirVA RR&D Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, 1660 S Columbian Way, MS 151, Seattle, WA 98108, United States of America; Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, WA 98195, United States of America. Electronic address: bcmuir@uw.edu.

Funding

RRD VA I01 RX003539RRD VA IK6 RX002970
6 · The paper itself

Abstract

backgroundCustom accommodative insoles help reduce plantar pressures in people with diabetes who are at risk of developing foot ulcers. We have developed 3D printed custom accommodative insoles with patient-specific geometry and material properties that improve offloading performance compared to traditional insoles. While effective at offloading forefoot pressure, their load redistribution mechanisms across the full foot remain unclear. The purpose of this study is to compare the load redistribution mechanisms and pathways across nine plantar regions between standard and 3D printed insoles using a load transfer algorithm.

methodsTwenty-six feet from 17 individuals with diabetes and high forefoot plantar pressure were included. Each participant received three pairs of custom accommodative insoles: standard of care, finite element optimized 3D printed, and pressure-based 3D printed. Peak plantar pressure and force-time-integral were recorded during walking, and a load transfer algorithm was used to map redistribution.

findingsThe main pathway of load transfer across all insoles was from the metatarsal heads to the midfoot, particularly from the first metatarsal head to the medial midfoot. The finite element optimized 3D printed custom accommodative insoles had the largest load transfers away from the metatarsal heads compared to the other insole conditions.

interpretationDesign elements like arch height, metatarsal bars, and offloading zones influenced load transfer pathways. These results underscore the potential of custom accommodative insole designs to offload high-risk areas and adds an additional perspective to quantify insole performance, though subject-specific variability remains an important factor.

Indexed as

Diabetes MellitusDiabetic FootFoot OrthosesShoesAdultAgedAlgorithmsBiomechanical PhenomenaEquipment DesignFemaleFinite Element AnalysisFootHumansMaleMiddle AgedPressure3D printingCustom accommodative insolesDiabetesLoad transfer

Identifiers

PMID40834496
PMCPMC12931951

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.