Over-the-Counter Customised Insoles for Offloading Foot Focal Pressure

Yajie Zhang , Jane E. A. Lewis

Journal of Science in Sport and Exercise ›› : 1 -14.

PDF
Journal of Science in Sport and Exercise ›› :1 -14. DOI: 10.1007/s42978-026-00372-0
Original Article
research-article
Over-the-Counter Customised Insoles for Offloading Foot Focal Pressure
Author information +
History +
PDF

Abstract

Purpose

Over-the-counter prefabricated offloading relief insoles with removable modular cells for customisation have not been extensively studied in literature, and no studies have examined designs specifically intended for calluses and corns. This study examined the immediate effects of such insole prototype on the users.

Methods

Foot pressure distribution was measured by in-shoe F-Scan system during normal walking cycles under four conditions: walking with normal footwear (C1), with prototype insoles inside the footwear (C2), with a cavity under the second metatarsal-phalangeal joint on the left or right side of the prototype insole (C3), and with cavities on both sides on the prototype insoles (C4). Subjective data were also collected in terms of insole fitting, comfort rating and balance feeling.

Results

Overall, the prototype insoles designed to offload focal pressure via removing modular cells showed significant immediate effects (all P ≤ 0.002). Averaged across both sides, average peak pressure (PP) of C2, C3 and C4 reduced from C1 by 19%, 25% and 28%, respectively; maximum PP of C2, C3 and C4 was reduced from C1 by 16%, 18% and 19%, respectively. With bilateral cavities, average PP at the second cavity side significantly decreased by a further 11% (C4 vs. C2, P = 0.003). These findings suggest that creating cavities alters the loading response during the gait cycle, as the metatarsal and heel peak pressures decreased. No imbalance was observed for C3 and C4. Participants reported satisfactory comfort and provided insights for future design development.

Conclusion

This over-the-counter prototype shows potential for individuals to customise cavities in their insoles to manage excessive focal pressure.

Keywords

Modular insole / Offloading / Plantar pressure / Callus / Walking

Cite this article

Download citation ▾
Yajie Zhang, Jane E. A. Lewis. Over-the-Counter Customised Insoles for Offloading Foot Focal Pressure. Journal of Science in Sport and Exercise 1-14 DOI:10.1007/s42978-026-00372-0

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Farndon L, Concannon M, Stephenson J. A survey to investigate the association of pain, foot disability and quality of life with corns. J Foot Ankle Res, 2015, 8: 70

[2]

Menz HB, Zammit GV, Munteanu SE. Plantar pressures are higher under callused regions of the foot in older people. Clin Exp Dermatol, 2007, 32(4): 375-380

[3]

Bousie JA, Blanch P, McPoil TG, Vicenzino B. Hardness and posting of foot orthoses modify plantar contact area, plantar pressure, and perceived comfort when cycling. J Sci Med Sport, 2018, 21(7): 691-6

[4]

Pérez Pico AM, Villar Rodríguez J, Belo J, Cáceres-Madrid MV, Fontán-Jiménez M, Mayordomo R. The effects of terrestrial and aquatic activities on foot health: a comparative analysis of podiatric disorders. Healthc, 2025, 13(7): 695

[5]

Ciaffi J, Brognara L, Gangemi G, Vanni E, Assirelli E, Neri S, et al.. Prevalence and characteristics of fibromyalgia in patients with foot and ankle pain: the experience of an academic podiatry clinic. Medicina (Kaunas), 2022, 59(1): 58

[6]

Freeman DB. Corns and calluses resulting from mechanical hyperkeratosis. Am Fam Physician, 2002, 65(11): 2277-80

[7]

Singh D, Bentley G, Trevino SG. Callosities, corns, and calluses. BMJ, 1996, 312: 1403-6

[8]

Murray HJ, Young MJ, Hollis S, Boulton AJ. The association between callus formation, high pressures and neuropathy in diabetic foot ulceration. Diabet Med, 1996, 13(11): 979-82

[9]

National Health Service. Corns and calluses. 2025. https://www.nhs.uk/conditions/corns-and-calluses/. Accessed 23 Nov 2022.

[10]

Mrdjenovich DE. Off-loading practices for the wounded foot : concepts and choices. J Am Col Certif Wound Spec, 2010, 2(4): 73-8

[11]

Beuker BJ, Van Deursen RW, Price P, et al.. Plantar pressure in off-loading devices used in diabetic ulcer treatment. Wound Repair Regen, 2005, 13(6): 537-542

[12]

Dumont I. Do windows in removable casts increase local pressure. Diabet Foot J, 2012, 16: 24-8

[13]

Withers RV, Perrin BM, Landorf KB, Raspovic A. Offloading effects of a removable cast walker with and without modification for diabetes – related foot ulceration: a plantar pressure study. J Foot Ankle Res, 2023, 16(1): 27

[14]

Actis RL, Ventura LB, Lott DJ, et al.. Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking. Med Biol Eng Comput, 2008, 46(4): 363-371

[15]

Hemler SL, Ntella SL, Jeanmonod K, Kochli C, Tiwari B, Civet Y, et al.. Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations. Front Endocrinol (Lausanne), 2023, 14: 1166513

[16]

Shuang J, Haron A, Crosby D, Mansoubi M, Massey GJ, Lin C, et al.. An active insole to normalise plantar pressure loading: using pre dictive real time finite element driven soft hydraulic actuators to minimise plantar pressure and the pressure time integral for diabetic foot ulceration. IEEE Trans Biomed Eng, 2025, 72: 2882-92

[17]

Lin TL, Sheen HM, Chung CT, Yang SW, Lin SY, Luo HJ, et al.. The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy. J Foot Ankle Res, 2013, 6(1): 29

[18]

Penny H, Tran S, Sansosti L, Pettineo S, Bloom A, Qureshi R, et al.. Comparison of two pixelated insoles using in-shoe pressure sensors to determine percent offloading: case studies. J Wound Care, 2020, 29: S18-S26

[19]

Raspovic A, Landorf KB, Gazarek J, Stark M. Reduction of peak plantar pressure in people with diabetes-related peripheral neuropathy: an evaluation of the DH pressure relief shoe ™. J Foot Ankle Res, 2012, 5(4): 1-8

[20]

Shaulian H, Gefen A, Solomonow-avnon D, Wolf A. Finite element-based method for determining an optimal offloading design for treating and preventing heel ulcers. Comput Biol Med, 2021, 131 Article ID: 104261

[21]

Lung CW, Liau BY, Peters JA, He L, Townsend R, Jan YK, et al.. Effects of various walking intensities on leg muscle fatigue and plantar pressure distributions. BMC Musculoskelet Disord, 2021, 22(1): 831

[22]

Putti AB, Arnold GP, Cochrane LA, Abboud RJ. Normal pressure values and repeatability of the Emed® st4 system. Gait Posture, 2008, 27: 25

[23]

Xu C, Wen XX, Huang LY, Shang L, Cheng XX, Yan YB, et al.. Normal foot loading parameters and repeatability of the Footscan® platform system. J Foot Ankle Res, 2017, 10: 30

[24]

Kase R, Amemiya A, Okonogi R, Yamakawa H, Sugawara H, Tanaka YL, et al.. Examination of the effect of suitable size of shoes under the second metatarsal head and width of shoes under the fifth metatarsal head for the prevention of callus formation in healthy young women. Sensors, 2018, 18(10): 3269

[25]

Robison RO, Herzog W, Nigg BM. Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry. J Manipulative Physiol Ther, 1987, 10: 172-6

[26]

Pataky TC. Generalized n -dimensional biomechanical field analysis using statistical parametric mapping. J Biomech, 2010, 43: 1976-1982

[27]

Armstrong DG, Athanasiou KA. The edge effect: how and why wounds grow in size and depth. Clin Podiatr Med Surg, 1998, 15(1): 105-8

[28]

Chanda A, Unnikrishnan V. Novel insole design for diabetic foot ulcer management. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 2018, 232(12): 1182-1195

[29]

Shuang J, Haron A, Massey G, Mansoubi M, Dawes H, Bowling FL, et al.. The effect of calcaneus and metatarsal head offloading insoles on healthy subjects ’ gait kinematics, kinetics, asymmetry, and the implications for plantar pressure management: a pilot study. PLoS ONE, 2024, 19(5): e0303826

[30]

Shaulian H, Gefen A, Biton H, Wolf A. Gait & posture graded stiffness offloading insoles better redistribute heel plantar pressure to protect the diabetic neuropathic foot. Gait Posture, 2023, 101: 28-34

[31]

Gupta S, Saviour CM, Pal B, Chanda S, Mukherjee K. Biomechanics of joints and implants: concepts to applications. Singapore: Springer Nature Singapore; 2025. pp. 121–49.

[32]

Herbert-copley AG, Sinitski EH, Lemaire ED, Baddour N. Temperature and easurement changes over time for F-Scan sensors. 2013 IEEE Int Symp Med Meas Appl. 2013;265–7. https://doi.org/10.1109/MeMeA.2013.6549749.

[33]

Açıkgöz T, Kakilli N, Çiftdemir M, Ekuklu G Tastekin N. Paradoxical effect of body mass index ranges on pedobarographic evaluation. J Biomech. 2024. https://doi.org/10.1016/j.jbiomech.2024.112419.

[34]

Hotfiel T, Carl HD, Wendler F, Heiß R, Swoboda B. Plantar pressures increase with raising body weight: a standardised approach with paired sample using neutral shoes. J Back Musculoskelet Rehabil, 2017, 30(3): 583-9

[35]

Hofmann UK, Götze M, Wiesenreiter K, Muller O, Wunschel M, Mittag F. Transfer of plantar pressure from the medial to the central forefoot in patients with hallux valgus. BMC Musculoskelet Disord, 2019, 20(1): 1-8

[36]

Haris F, Liau BY, Jan YK, Akbari VBH, Primanda Y, Lin KH, et al.. A review of the plantar pressure distribution effects from insole materials and at different walking speeds. Appl Sci, 2021, 11(24): 11851

[37]

Nouman M, Chong DYR, Srewaradachpisal S, Chatpun S. The effect of customized insole pads on plantar pressure distribution in a diabetic foot with neuropathy: material and design study using finite element analysis approach. Appl Sci, 2023, 13(1): 399

[38]

Shi QQ, Li PL, Yick KL, Li NW, Jiao J. Effects of contoured insoles with different materials on plantar pressure offloading in diabetic elderly during gait. Sci Rep, 2022, 12(1): 15395

[39]

Mori T, Hamatani M, Noguchi H, Oe M, Sanada H. Insole-type simultaneous measurement system of plantar pressure and shear force during gait for diabetic patients. J Robot Mechatron, 2012, 24(5): 766-772

[40]

Tang J, Bader DL, Parker DJ, Forghany S, Nester CJ, Moser D, et al.. Evaluation of in-shoe plantar pressure and shear during walking for diabetic foot ulcer prevention. J Wound Care, 2023, 32(9): 587-96

Funding

European Regional Development Fund(81844 and 81845)

RIGHTS & PERMISSIONS

The Author(s)

PDF

10

Accesses

0

Citation

Detail

Sections
Recommended

/