Assessing Plantar Skin Epidermal Layer in Response to Various Insole Hardness via Deep Learning Enabled Optical...

Area of Science:

• Biomechanics
• Dermatology
• Medical Imaging

Background:

• Plantar tissue health is crucial for preventing diabetic foot ulcers (DFU).
• Understanding how walking interventions affect foot tissues can inform DFU prevention strategies.

Purpose of the Study:

• To investigate the effects of walking interventions with varying insole hardness and durations on plantar skin thickness.
• To assess the potential of optical coherence tomography (OCT) and deep learning in evaluating these changes for DFU prevention.

Main Methods:

• Walking interventions were performed using adjustable air-insoles with hardness levels of 80, 160, and 240 mmHg for 10 and 20 minutes.
• Optical coherence tomography (OCT) measured stratum corneum (SC) and living epidermis (ED) thickness at the big toe (T1), first metatarsal head (M1), and second metatarsal head (M2).
• Deep learning algorithms analyzed the differences in SC and ED thickness.

Main Results:

• A statistically significant increase in SC thickness was observed at M1 after 20 minutes of walking with 80 mmHg insole hardness.
• A statistically significant decrease in SC thickness was noted at T1 and M1 after 20 minutes of walking with 160 mmHg insole hardness.
• Changes in SC and ED thickness varied based on insole hardness and walking duration.

Conclusions:

• Walking interventions can induce measurable changes in plantar skin thickness, specifically the stratum corneum.
• OCT combined with deep learning shows promise for monitoring plantar tissue adaptations relevant to DFU prevention.
• Further research is warranted to optimize walking interventions for maintaining plantar tissue health and preventing DFU.