title: A 3-dimensional finite element model of the human foot and ankle for insole design.
abstract: OBJECTIVE
  To investigate the effect of material stiffness of flat and custom-molded insoles on plantar pressures and stress distribution in the bony and ligamentous structures during balanced standing.
  
  
  METHODS
  A 3-dimensional (3-D) finite element model of the human ankle-foot complex and a custom-molded insole were developed from 3-D reconstruction of magnetic resonance images and surface digitization. The distal tibia and fibula, together with 26 foot bones and 72 major ligaments and the plantar fascia, were embedded in a volume of soft tissues.
  
  
  METHODS
  Computational laboratory in a rehabilitation engineering center.
  
  
  METHODS
  A healthy man in his mid twenties (weight, 70 kg).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Foot-support interfacial pressure, von Mises stress in bony structures, and strain of the plantar fascia were predicted using the finite element model.
  
  
  RESULTS
  A custom-molded, soft (Young modulus, E=0.3 MPa) insole reduced the peak plantar pressure by 40.7% and 31.6% at the metatarsal and heel region, respectively, compared with those under a flat, rigid (E=1000 MPa) insole. Meanwhile, a 59.7% increase in the contact area of the plantar foot was predicted with a corresponding peak plantar pressure increase of 22.2% in the midfoot.
  
  
  CONCLUSIONS
  The finite element analysis implies that the custom-molded shape is more important in reducing peak plantar pressure than the stiffness of the insole material.
authors.affiliation: Jockey Club Rehabilitation Engineering Centre, The Hong Kong Polytechnic University, Kowloon, China.
authors.forename: Jason Tak-Man
authors.initials: JT
authors.lastname: Cheung
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000842:Ankle / Q000502:physiology*; D020342:Finite Element Analysis; D005528:Foot / Q000502:physiology*; D006801:Humans; D008297:Male; D011312:Pressure; D012775:Shoes; D013314:Stress, Mechanical