Dr Daniel Parker

Ultrasound in the Diabetic Foot
2023 - 2025

Recognition Type Internal funding award

Description This project seeks to establish ultrasound assessment for early detection of tissue damage enabling improved decision-making pathways for prevention and management of ulceration in diabetes.

At present the tolerance of the tissue on the sole of the foot to load is not effectively considered with risk assessed based on systemic clinical factors like vascular and neurological status. Research has established ultrasound for early detection of pressure injury within both deep and superficial tissue layers and shown that it can be used to monitor structural changes during tissue healing. However, while ultrasound is used clinically to assess musculoskeletal function it is not currently used for assessment of tissue injury in the diabetic foot. Standardised protocols are needed to allow clear detection of risk. The proposed work builds on Dr Parker’s pilot protocol developed for imaging of the diabetic foot and prior work to characterise foot tissue using ultrasound

Affiliated Organisations - The University of Salford

Research Centres/Groups Centre for Human Movement and Rehabilitation

Org Units School of Health & Society

Recognition Type	Internal funding award
Description	This project seeks to establish ultrasound assessment for early detection of tissue damage enabling improved decision-making pathways for prevention and management of ulceration in diabetes. At present the tolerance of the tissue on the sole of the foot to load is not effectively considered with risk assessed based on systemic clinical factors like vascular and neurological status. Research has established ultrasound for early detection of pressure injury within both deep and superficial tissue layers and shown that it can be used to monitor structural changes during tissue healing. However, while ultrasound is used clinically to assess musculoskeletal function it is not currently used for assessment of tissue injury in the diabetic foot. Standardised protocols are needed to allow clear detection of risk. The proposed work builds on Dr Parker’s pilot protocol developed for imaging of the diabetic foot and prior work to characterise foot tissue using ultrasound
Affiliated Organisations	- The University of Salford
Research Centres/Groups	Centre for Human Movement and Rehabilitation
Org Units	School of Health & Society

Person-Powered Loading for Ultrasound Tissue Observation
2025 - 2025

Recognition Type Internal funding award

Description School of Health and Society Pump Prime

This project will deliver an early-stage experimental validation of a conceptual design for a novel person powered assessment of foot tissue.

Background and hypothesis: Footwear and orthotics reduce surface pressure by varying the material properties of the sole/orthotic, however the effect on internal stresses and tissue behavior is largely unknown. Loadbearing tissues vary in composition, compressibility and stiffness which can affect their response and capacity to manage applied load, yet this is not currently assessed in clinical practice. Using ultrasound to image tissue change when loaded across interface materials matched to orthotic materials will allow tissue behavior and capacity to be assessed.

Experimental validation: A soft (pressure reducing), medium and high stiffness silicone interface material will be produced with support from the makerspace. Five participants will have their feet scanned using ultrasound and plantar pressure while performing a simple sit to stand activity onto the materials. Measures will include peak compression (mm), time to peak compression (s), peak pressure (kPa) and pressure time integral (kPa/s) for each material. Data will be used to establish differences in tissue loading behavior between materials, which will form the basis of funding application for subsequent diagnostic device development.

Affiliated Organisations - The University of Salford

Research Centres/Groups Centre for Human Movement and Rehabilitation

Org Units School of Health & Society

Recognition Type	Internal funding award
Description	School of Health and Society Pump Prime This project will deliver an early-stage experimental validation of a conceptual design for a novel person powered assessment of foot tissue. Background and hypothesis: Footwear and orthotics reduce surface pressure by varying the material properties of the sole/orthotic, however the effect on internal stresses and tissue behavior is largely unknown. Loadbearing tissues vary in composition, compressibility and stiffness which can affect their response and capacity to manage applied load, yet this is not currently assessed in clinical practice. Using ultrasound to image tissue change when loaded across interface materials matched to orthotic materials will allow tissue behavior and capacity to be assessed. Experimental validation: A soft (pressure reducing), medium and high stiffness silicone interface material will be produced with support from the makerspace. Five participants will have their feet scanned using ultrasound and plantar pressure while performing a simple sit to stand activity onto the materials. Measures will include peak compression (mm), time to peak compression (s), peak pressure (kPa) and pressure time integral (kPa/s) for each material. Data will be used to establish differences in tissue loading behavior between materials, which will form the basis of funding application for subsequent diagnostic device development.
Affiliated Organisations	- The University of Salford
Research Centres/Groups	Centre for Human Movement and Rehabilitation
Org Units	School of Health & Society

Pilot digital orthotics supply chain to offload the diabetic foot in low- and middle-income settings
2023 - 2023

Recognition Type Internal funding award

Description This work aligns to a Burdett Trust funded project to establish diabetic foot health education and treatment pathways for care in low and middle income settings. To date this work has established an offloading clinic and provided training to local clinicians on design and production of foot orthotics using 3D foot scanning. Our pilot has used a distributed digital supply chain where clinical assessment and foot scanning are conducted locally in Uganda then computerised design and automated manufacture are delivered at Salford. We have worked with ALGEOS an industry leader in the foot care sector to identify sustainable material and manufacture approaches. As we refine this process and better understand the elements of the supply chain which are most critical, we will support a transition to an independent locally managed service.

Aims
1)Train researchers in use of low-cost foot scanning tools used within the UK orthotics industry.
2)Apply evidence-based protocols to ensure effective capture and design remotely.
3)Pilot a digital orthotics supply chain and produce orthotics for clinical use.

Achievements under these aims
1. Two clinical scientists were trained in the use of the foot scanner within the UK and then provided training in Uganda to technicians within Fort Portal hospital. Additional training and education provided to wider team. This was supported by Algeos as an industry partner.

2. A standard operating procedure has been established to allow effective foot shape capture for use in clinical practice. This follows guidance by the manufacturer and evidence base for design of orthotics for patients with diabetes. This is being used in Fort Portal clinic as standard practice for moderate and high-risk patients.

3. A foot scanner was selected to meet the requirements of digital design and as appropriate for the clinical setting. The digital pilot has been undertaken where foot shape and prescription is captured by clinical teams in Uganda, footwear and fitting requirements are managed locally. Digital design is conducted in the UK along with manufacture. While disconnected this enables the clinic to integrate bespoke foot orthotics into practice in advance of the local specialist skills or manufacture equipment.

Research Centres/Groups Centre for Human Movement and Rehabilitation

Org Units School of Health & Society

Recognition Type	Internal funding award
Description	This work aligns to a Burdett Trust funded project to establish diabetic foot health education and treatment pathways for care in low and middle income settings. To date this work has established an offloading clinic and provided training to local clinicians on design and production of foot orthotics using 3D foot scanning. Our pilot has used a distributed digital supply chain where clinical assessment and foot scanning are conducted locally in Uganda then computerised design and automated manufacture are delivered at Salford. We have worked with ALGEOS an industry leader in the foot care sector to identify sustainable material and manufacture approaches. As we refine this process and better understand the elements of the supply chain which are most critical, we will support a transition to an independent locally managed service. Aims 1)Train researchers in use of low-cost foot scanning tools used within the UK orthotics industry. 2)Apply evidence-based protocols to ensure effective capture and design remotely. 3)Pilot a digital orthotics supply chain and produce orthotics for clinical use. Achievements under these aims 1. Two clinical scientists were trained in the use of the foot scanner within the UK and then provided training in Uganda to technicians within Fort Portal hospital. Additional training and education provided to wider team. This was supported by Algeos as an industry partner. 2. A standard operating procedure has been established to allow effective foot shape capture for use in clinical practice. This follows guidance by the manufacturer and evidence base for design of orthotics for patients with diabetes. This is being used in Fort Portal clinic as standard practice for moderate and high-risk patients. 3. A foot scanner was selected to meet the requirements of digital design and as appropriate for the clinical setting. The digital pilot has been undertaken where foot shape and prescription is captured by clinical teams in Uganda, footwear and fitting requirements are managed locally. Digital design is conducted in the UK along with manufacture. While disconnected this enables the clinic to integrate bespoke foot orthotics into practice in advance of the local specialist skills or manufacture equipment.
Research Centres/Groups	Centre for Human Movement and Rehabilitation
Org Units	School of Health & Society

Best poster presentation iFAB Bordeaux, 2023 (Supervised Student's Work)
2023 - 2023

Recognition Type Awards and prizes (external)

Description First author Atefeh Rahimi Toudeshki

Research Centres/Groups Centre for Human Movement and Rehabilitation

Recognition Type	Awards and prizes (external)
Description	First author Atefeh Rahimi Toudeshki
Research Centres/Groups	Centre for Human Movement and Rehabilitation

Peer Reviewer - Swiss National Science Foundation
2024 - 2024

Recognition Type Peer reviewer for funding body

Description Theme - Custom foot orthoses

Recognition Type	Peer reviewer for funding body
Description	Theme - Custom foot orthoses

Mitacs - Accelerate
2024 - 2024

Recognition Type Peer reviewer for funding body

Description Mitacs Accelerate connects Canadian companies and not-for-profit organizations with the high quality research expertise in academic institutions.

Recognition Type	Peer reviewer for funding body
Description	Mitacs Accelerate connects Canadian companies and not-for-profit organizations with the high quality research expertise in academic institutions.

Peer Reviewer - Tidal N+ Network
2022 - 2023

Recognition Type Peer reviewer for funding body

Description Review for Tidal N+ Calls 2 and 3 under DMS, Physical Devices and Sensors and Data themes.

Affiliated Organisations #1 ORGANISATION NOT LISTED

Dr Daniel Parker's Recognition (7)