The Effect of Customized Insole Pads on Plantar Pressure Distribution in a Diabetic Foot with Neuropathy: Material and Design Study Using Finite Element Analysis Approach

Round 1

Reviewer 1 Report

This manuscript entitled “The effect of custom-made insole pads on plantar pressure distribution towards diabetic foot with neuropathy: Material and design study using finite element approach” primarily aimed to use finite element analysis to explore the effect of pad design and material stiffness on plantar pressure reduction and distribution in diabetic foot with neuropathy. The authors bring an interesting study, but there are still some problems that cannot up this review to a publishing level. Suggestions are listed in the specific comments below.

 

Specific comments:

1.     In the abstract part, line 27-28, “Appropriate selection of material and pad designs plays a major role in reduction of peak plantar pressure under the bony prominences in diabetic foot with neuropathy.” This conclusion is unclear. What does the appropriate selection mean? More specific suggestions should be mentioned.

2.     In the introduction part, line 57-59, “Reduction of peak plantar pressure, foot stability, arch support, foot comfort, and shock absorption are some of the key criteria to design and prescribe custom-made insole (CMI)for people with different needs.” Please cite some relevant references here.

3.     In the introduction part, line 72-75, “However, limited studies have been focused on design parameters that provide a better reduction of peak plantar pressure at the forefoot and hindfoot in combi-nation with the materials which are best suit to reduce the peak plantar pressure in diabetic foot with neuropathy”. It is recommended to add some references to support this sentence.

4.     In the introduction part, in my opinion, the research gap and the highlight of this this manuscript are not well presented. Please provide relevant description.

5.     In the opinion of the reviewer, the overall quality of figures is too blurred, please replace clearer figures.

6.     In the discussion part, it is recommended to add the aim of this study in the first paragraph of the discussion part (before presenting the main findings).

7.     In the conclusion part, line 133, “Our results suggests that”, please check the grammar mistake.

8.     Some recently studies could be added in the discussion, such as:

Artificial Intelligence Methodologies Applied to Technologies for Screening, Diagnosis and Care of the Diabetic Foot: A Narrative Review. Biosensors 2022, 12, 985. https://doi.org/10.3390/bios12110985

A Current Review of Foot Disorder and Plantar Pressure Alternation in the Elderly. Physical Activity and Health, 4(1), 95–106. DOI: http://doi.org/10.5334/paah.57

Development and Validation of a Subject-Specific Coupled Model for Foot and Sports Shoe Complex: A Pilot Computational Study. Bioengineering 2022, 9, 553. https://doi.org/10.3390/bioengineering9100553

9.     Please do check the language and grammar mistakes throughout the whole article to further improve clarity.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

Manuscript entitled 'effect of custom-made insole pads on plantar pressure distribution towards diabetic foot with neuropathy: Material and design study using finite element approach' presents a very interesting and informative study on the development of custom-made insole pads towards diabetic foot with neuropathy. The manuscript figures are beautifully presented and explained well in the text. Afew comments need to be rectified as indicated in the attached PDF. 

Comments for author File: Comments.pdf

Author Response

Please see the attachemnt.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

All my questions have been well addressed, so I recommend to accept it.