A major cause of illness and disability in diabetic patients are complications affecting the lower limbs, in particular, the feet. It is believed that elevated plantar pressure plays a major role in foot problems in diabetic patients. It is proposed that high foot pressure concentrations may be avoided by developing a novel shoe insert based on the mechanics of smart materials. This paper describes the conceptual design of an automatic system that continuously monitors and controls the pressure levels in diabetic patients' feet. The scheme is based on the constant measurement of pressure levels and an active change in the shape of the shoe insert so as to decrease high-pressure levels. Sensing and actuation is done by the use of smart materials powered by a battery pack in the insert. All of the circuitry is envisioned to be on a single VLSI chip embedded in the shoe insert, hence making the shoe insert completely autonomous. Genetic algorithms will be used to select the optimal shapes and hence provide the smart materials with the correct voltage inputs so as to alter the shape of the insert. The greatest strength of the system is that it will be an active real-time system that will adapt to changes in the locations of high stress points, hence being superior to currently used passive shoe inserts and other forms of diabetic foot care. The focus of this paper is to show the preliminary use of genetic algorithms to quickly select an optimal shape that can be created by discretely placed actuators so as to reduce the high levels of plantar pressures.
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