1. Despina Gherman, Ana- Maria Vasilescu, Corina Oancea
21st EUMASS Congress & 4th International Congress of Medical Assessors
Ljubljana, Slovenia, 2016
PROMOTING ACTIVE AGING BY INNOVATIVE TECHNOLOGIES IN DEVELOPING AND MANUFACTURING OF CUSTOMIZED ASSISTIVE PRODUCTS FOR ELDERLY
Despina Gherman, Ana- Maria Vasilescu, Corina Oancea

2. AKNOWLEDGEMENTS and FINANCIAL DISCLOURE
This paper, as featured in the Project
MOBILITY – “Preventing gait deficiencies and improving biomechanical parameters for the elderly population by designing and developing customized footwear”
was financed by the Romanian Ministry for Education and Research, intended for Partnership in Priority Domains.
 (PN-II- PT-PCCA )

3. DEMOGRAPHIC CHALLENGE
Population aging is a global phenomenon
Projected Changes in Age Composition of Romanian
Society
Old–age-dependency rate
2014→22%
2020→33%
2050→55%
Studies
Programmes
Policies
Legislation
Source: Inputs for the Preparation of a Draft National Strategy and Action Plan on Social Inclusion and Poverty Reduction (2014–2020).

4. ACTIVE AGING
“Active aging refers to the situation where people continue to participate in the formal labour market, as well as engage in other unpaid productive activities (such as care provision for family members and volunteering),and live healthy, independent and secure lives as they age” * MULTIDIMENSIONAL CONCEPT
* European Centre for Social Welfare Policy and Research in Vienna in close collaboration with, and advice from, the European Commission's Directorate General for Employment Social Affairs and Inclusion and the UNECE.
Active aging index(AAI) COMPOSITE INDEX
Four domains
i. employment
ii. participation in society actual experiences
iii. independent, healthy and secure living
iv. capacity and enabling environment for active aging
- individual characteristics
- environmental factors(ICF,WHO, 2001)
FOCUS

5. ENVIRONMENTAL FACTORS PROMOTING ACTIVE AGING: barriers vs. facilitators
In 2003, ISO 9999, taking over the terminology of the ICF (The International Classification of Functioning, Disability and Health, WHO 2001) defined the concept of assistive product “any product (including devices, equipments, instruments, technologies and software) produced or generally available, preventing, compensating, monitoring, relieving or neutralizing disability, activity limitation and participation restriction”.
It is recognized that any product or technology can be assistive*.
(*ISO 9999: Technical aids for disabled persons – Classification (second version); ISO/TC 173/SC 2; ISO/DIS 9999 (rev.)
AGING = DISABILITY ?!
„Disability is an umbrella term for impairments, activity limitations and participation restrictions, denoting a negative aspect of the interaction between a person’s health condition and the individual’s contextual factors: personal and environment factors” (ICF,WHO, 2001)

6. GAIT and BALANCE DISORDERS in ELDERLY
Strong predictors of functional decline:
disability
loss of independence
limited quality of life
Multiple causes:
the aging process itself
“essential senile gait disorder”
age-related underlying diseases
non-neurologic (e.g.,deformities, arthritis, etc.)
neurologic (e.g., strokes)
multiple (chronic lung disease, angina pectoris, cardiac failure, peripheral vascular disease, vision impairment,etc.)

7. THE PROJECT
Aims at scientifically design and develop footwear for older people in Romania→ age-related foot disorders (size, shape, function),abnormal gait, comorbidities;
3 phases:
Research- common feet and gait disorders in elderly; the footwear characteristics of the market, to meet older people needs;
Development -anthropometric and biomechanical parameters measurement→ prototypes ←3D last modelling techniques, 3D foot scanning and shoe design in CAD/CAM system;
Comfort will be tested by wearing sample footwear and making the necessary adjustments.
Expected results : optimising footwear for older people, maximising safe shoe use, promoting active aging

8. Figure1. INFOOT USB 3D Scanner
ANTHROPOMETRIC MEASUREMENTS by 3D SCANNING of ELDERLY FEET
3D Foot scanning system
Monochrome board camera
Scan area : 400(L) x 200 (l) x 150 (h)
Scan time: 30 mm/sec
Data Processing: 10sec/foot
Max weight: 200 kg
Figure1. INFOOT USB 3D Scanner

9. FOLLOWING PLACEMENT OF ANATOMICAL POINTS, FOOT-SPECIFIC SIZES ARE AUTOMATICALLY CALCULATED
Anthropometric parameters
Lp - Foot length (mm) Pd - Ball girth circumference (mm)
Ld - Foot breadth (mm) Pr - Instep circumference (mm)
Lc - Heel breadth (mm) Lr - Instep length (mm)
Hd - Toe height (mm) Hr - Height of instep (mm)
Ud1 - Toe 1 angle (°) Ud5 - Toe 5 angle (°)
Ha1 - Toe 1 height (mm)
Ha5 - Toe 5 height (mm)
Hme - Height of the most lateral point of lateral malleolus (mm)
Hmi - Height of the most medial point of medial malleolus (mm)
Uc - Heel angle (°)
Pc - Heel girth (mm)
Size number
Figure 2. Anthropometric parameters

10. 3D FOOT SHAPE IS OBTAINED USING THE INFOOT SCANNER AND THE DEDICATED SOFTWARE APPLICATION MEASURE 2.8
Figure D shape of scanned foot
Figure 4. Anthropometric chart after placing anatomical points

11. BIOMECHANICAL STUDY OF ELDERLY GAIT BY MEASURING GROUND REACTION FORCE UNDER STATIC AND DYNAMIC CONDITIONS
Figure 5. Platforme AMTI´s AccuGait System
Figure 6. Components of the ground
reaction force

12. Figure 7. Graphical representation of component Fz
Figure 8. Evolution of vertical component Fz of the ground reaction force in normal gait without shoes. Each persons responds differently to loading

13. THANK YOU FOR YOUR ATTENTION !