Tools for design and validation of shoe lasts for diabetic patients

Background: It is common practice to prescribe customised footwear to people with diabetes to reduce the risk of foot ulceration. Although shoe customising systems have been proposed, effective tools for designing shoe lasts for diabetic patients are lacking. The shape of the lasts must meet certain biomechanical objectives, while maintaining the style of the shoe. Method: The main contributions of this work are as follows: the creation of an artificial-neural-network-based framework to correlate foot measurements and medical data to required footwear features; the definition of repeatable geometrical procedures to measure foot and last scans; and the definition of geometrical operators to modify the last shape according to its original aesthetic and specific footwear parameters. These parameters are computed by a knowledge-based system on the basis of the patient's pathology and best practices of experienced technicians. Results: Dedicated software systems integrated in a common platform are implemented to support the last design process. Test case studies and a survey show the advantages provided by the proposed approach in terms of achieved quality and shoe developing time (72% time savings). Conclusions: A design framework with dedicated tools is proposed for the customisation of shoe lasts for diabetic patients. Further research should be focused on tools to design the insole, outsole and other shoe components.