Reducing the burden of diabetic foot disease by utilising biomechanical knowledge for evidence-based foot assessment and insole prescription

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Diabetic foot ulcers are the world’s most common cause of lower-limb amputations. They lead to around one million amputations annually worldwide. Between 19% and 34% of people with diabetes develop foot ulcers, and these ulcers increase the risk of death after 5 years to 70%. This risk is 2.5 times the risk of death for a non-ulcerous patient with diabetes. Centre for Biomechanics and Rehabilitation Technologies (CBRT) research, led by Professor Roozbeh Naemi, focused on new ways to address these problems.


Research at the Centre for Biomechanics and Rehabilitation Technologies (CBRT) has focused on preventing and treating diabetic foot ulcers. CBRT researchers developed a new, unique approach to using ultrasound elastography to investigate the mechanical properties of the sole of the foot, including its stiffness and thickness. The research has produced impact with new biomechanical assessment protocols for at-risk patients and with new technologies for prescribing biomechanically informed insoles. Impacts include:

  • New clinical practice: contributed expertise to establish foot-specific labs at AR Hospitals (India) and Koç University Hospital (Turkey). Implemented new patient assessment protocols and achieved improved patient outcomes at AR Hospitals, Koç University Hospital, Hospital Militar Geriatrico (Peru), and Abbas Medical Centre (Tanzania).
  • New prescription technologies: improved, individualised, insole manufacturing at Technofootbed (Spain), Cadscan (UK) and Podiatry Foot Clinic (Malta). Achieved cost savings and improved financial positions for these organisations.
Picture showing ultrasound elastography in process

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