NCT02895139

Brief Summary

This study will assess the ability of different orthotic insole treatments to reduce pressure under the ball of the foot. This is important for people who have diabetes because their feet are at higher risk of foot problems in this area. This study will involve the participants wearing a a range of insoles produced by milling, handmade processes and additive manufacture along with normal orthotic footwear. A researcher will measure the pressures under the feet while the participants walk wearing the orthotic insoles.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
25

participants targeted

Target at below P25 for not_applicable diabetes

Timeline
Completed

Started Jul 2016

Shorter than P25 for not_applicable diabetes

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 2016

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

August 26, 2016

Completed
14 days until next milestone

First Posted

Study publicly available on registry

September 9, 2016

Completed
4 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2017

Completed
Last Updated

February 28, 2017

Status Verified

February 1, 2017

Enrollment Period

6 months

First QC Date

August 26, 2016

Last Update Submit

February 27, 2017

Conditions

Keywords

Additive ManufactureOrthotic Insole

Outcome Measures

Primary Outcomes (1)

  • Reduction of forefoot pressure to below safety threshold

    Number of participants with all forefoot plantar pressure \< 200kPa when wearing the orthotic compared to without the orthotic. This will be measured over 6 months of trial to assess if product performance is maintained over duration of use.

    6 months

Secondary Outcomes (13)

  • Change in forefoot pressure

    6 months

  • Patient Outcomes - Quality of Life

    6 months

  • Patient Outcomes - Capability

    6 months

  • Patient Outcomes - Foot Health

    6 months

  • Patient Outcomes - Orthotic Fit

    6 months

  • +8 more secondary outcomes

Study Arms (3)

Additive Manufactured Orthotic Device

EXPERIMENTAL

Device will be produced via additive manufacture to the specification of a Health and Care Professions Council (HCPC) registered orthotist based on a digital foot scan.

Device: Additive Manufactured Orthotic Device

Moulded Orthotic Device

OTHER

Historic control collected using same protocol. Intervention was a moulded orthotic device produced from an impression box of the foot shape.

Device: Moulded orthotic

Milled Orthotic Device

OTHER

Historic control collected using same protocol. Device will be produced via Computer Aided Design/Computer Aided Manufacture (CAD/CAM) milling to the specification of a HCPC registered orthotist based on a digital foot scan.

Device: Milled orthotic

Interventions

The 3D foot scan data will be used to generate a 3D model of the foot orthotic which will then be adapted to be suitable for solid printing. The final model will be saved in .stl format for use in the printing software. The additive manufactured orthotic insoles and all features or additions will be produced in a single build from additive materials matched for hardness to medium density EVA. Post production the orthotic will be cleaned to remove support material and a top cover will be attached to the final additive manufactured orthotic insole.

Additive Manufactured Orthotic Device

The foam impression box and prescription will be sent to an external company for production of the handmade moulded orthotics. Handmade moulded orthotics will be produced by heating and wrapping medium density Ethylene-vinyl acetate (EVA) around plaster casts of the impression boxes. The orthotic insoles may be manually adapted to meet the requirements of the prescription, this could include cut out sections designed to offload regions of the foot or the addition of features such as metatarsal bars which provide varied support. Features and additions will be added in post manually by cutting and gluing onto the moulded orthotic insole. A top cover will be attached to the final moulded orthotic insole.

Moulded Orthotic Device

The 3D foot scan data will be used to generate a 3D model of the foot orthotic. This will then be saved in .pan format for use in a CNC milling software. Orthotics and all features will be milled in a single mill from a block of medium density EVA. Post milling the orthotics will be cleaned. The orthotic insoles may be manually adapted to meet the requirements of the prescription, this could include cut out sections designed to offload regions of the foot or the addition of features such as metatarsal bars which provide varied support. Features and additions will be added in post manually by cutting and gluing onto the milled orthotic insole. A top cover will be attached to the final milled orthotic insole.

Milled Orthotic Device

Eligibility Criteria

Age40 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Are aged between 40 and 85
  • Have diabetes
  • Have all normal foot structures
  • Have sensory neuropathy
  • Have detectable pulses in feet
  • Have non-standard footwear provided by the orthotics department
  • Able to walk 50 meters unaided without stopping

You may not qualify if:

  • Pregnant or Nursing
  • Had prior major injuries to the lower limb (eg. Fractures, skin graft)
  • Have active persistent foot or leg ulceration within last 2 years.
  • The participant may also not be suitable to participate if they have any of the following conditions:
  • Ischemia or poor blood supply to your feet
  • Charcot Arthropathy
  • Connective tissue diseases (for example scleroderma, systemic lupus erythematosus).
  • Autoimmune diseases (e.g. rheumatoid arthritis).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Royal Blackburn Hospital

Blackburn, Lancashire, BB2 3HH, United Kingdom

Location

MeSH Terms

Conditions

Diabetes Mellitus

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principle Investigator

Study Record Dates

First Submitted

August 26, 2016

First Posted

September 9, 2016

Study Start

July 1, 2016

Primary Completion

January 1, 2017

Study Completion

January 1, 2017

Last Updated

February 28, 2017

Record last verified: 2017-02

Data Sharing

IPD Sharing
Will not share

Locations