ArticleScientific reports2025
Validation and reliability of mechanical stiffness assessment tools in multilayered polyurethane phantom models of healthy and diabetic plantar soft tissues.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Plantar soft tissue stiffness plays a crucial role in the development of diabetic foot complications, but in vivo assessments are constrained by anatomical variability and probe-induced measurement artifacts. To develop anatomically layered polyurethane phantom models mimicking healthy and diabetic plantar soft tissues and evaluate the reliability and concurrent validity of four mechanical stiffness assessment tools, [MyotonPRO, Shore Durometer, IndentoPRO, and Tissue Compliance Meter (TCM)] against Shear Wave Elastography (SWE). Six regional phantom models (calcaneus, midfoot, forefoot) with skin, fat pad, fascia, and muscle layers were fabricated. SWE was performed in no-contact mode to eliminate surface compression, improving measurement consistency. A total of 162 configurations were tested under blinded and randomized conditions. Intra- and inter-rater reliability was assessed using ICCs; concurrent validity was evaluated via correlation and regression analyses with SWE. All devices demonstrated excellent reliability (ICC range: 0.88-0.99). SWE-derived stiffness was significantly higher in diabetic models, especially in the calcaneal and midfoot regions (p < 0.001). IndentoPRO showed the highest correlation with SWE (r = 0.91), followed by MyotonPRO (r = 0.87), TCM (r = 0.85), and Durometer (r = 0.78). TCM exhibited the highest predictive value (R
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