Novel Combination of Plantar Pressure and Lower Limb Rotation Measurements Towards Monitoring and Early Detection of Diabetic Foot Ulcers

IRC-SET 2020 ◽  
2021 ◽  
pp. 401-412
Author(s):  
Yuan Zhe Wen ◽  
Jovan Liau Yi Jun
2017 ◽  
Vol 107 (6) ◽  
pp. 475-482 ◽  
Author(s):  
Ryan T. Crews ◽  
Steven R. Smith ◽  
Ramin Ghazizadeh ◽  
Sai V. Yalla ◽  
Stephanie C. Wu

Background: Offloading devices for diabetic foot ulcers (DFU) generally restrict exercise. In addition to traditional health benefits, exercise could benefit DFU by increasing blood flow and acting as thermotherapy. This study functionally evaluated a cycling cleat designed for forefoot DFU. Methods: Fifteen individuals at risk of developing a DFU used a recumbent stationary bicycle to complete one 5-minute cycling bout with the DFU cleat on their study foot and one 5-minute bout without it. Foot stress was evaluated by plantar pressure insoles during cycling. Laser Doppler perfusion monitored blood flow to the hallux. Infrared photographs measured foot temperature before and after each cycling bout. Results: The specialized cleat significantly reduced forefoot plantar pressure (9.9 kPa versus 62.6 kPa, P < .05) and pressure time integral (15.4 versus 76.4 kPa*sec, P < .05). Irrespective of footwear condition, perfusion to the hallux increased (3.97 ± 1.2 versus 6.9 ± 1.4 tissue perfusion units, P < .05) after exercise. Infrared images revealed no changes in foot temperature. Conclusions: The specialized cleat allowed participants to exercise with minimal forefoot stress. The observed increase in perfusion suggests that healing might improve if patients with active DFU were to use the cleat. Potential thermotherapy for DFU was not supported by this study. Evaluation of the device among individuals with active DFU is now warranted.


Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2261
Author(s):  
Mariyam J. Ghazali ◽  
Xu Ren ◽  
Armin Rajabi ◽  
Wan Fathul Hakim W. Zamri ◽  
Nadia Mohd Mustafah ◽  
...  

With the development of societies, diabetic foot ulcers have become one of the most common diseases requiring lower extremity amputation. The early treatment and prevention of diabetic foot ulcers can considerably reduce the possibility of amputation. Using footwear to redistribute and relieve plantar pressure is one of the important measures for the treatment and prevention of diabetic foot ulcers. Thus, the evaluation and prediction of the distribution of plantar pressure play an important role in designing footwears. Herein, the finite element method was used to study plantar pressure under two kinds of foot models, namely, the skeletal structure foot model and the whole foot model, to explore the influence of human bones on the pressure of the soles of the feet and obtain accurate foot pressure. Simulation results showed that under the two models, the plantar pressure and the pressure from the footwear with ethylene vinyl acetate were all reduced. The total deformation demonstrated a slight increase. These stresses are very useful as they enable the design of suitable orthotic footwear that reduces the amount of stress in individuals with diabetic foot ulcers.


Author(s):  
Hilman Ibrahim ◽  
Willy Muljono ◽  
Aria Kekalih

Introduction: Diabetic foot ulcer is one of the most severe complications in a patient with diabetes mellitus because it will lead to with amputation, which results in disability and death. Doppler ultrasound is an easily available and non-invasive modality for evaluating lower limb arteries and can detect the severity of blood flow disorders or peripheral arterial disease (PAD). WHO recommends the classification of perfusion, extent/size, depth/tissue loss, infection, and sensation (PEDIS) as a tool for establishing the diagnosis and helping determine the management of diabetic foot. This study aims to see the correlation of PEDIS scores in assessing impaired lower limb arterial flow with Doppler ultrasound in patients with diabetic foot ulcers. Method: This was a cross-sectional study with subjects who has diabetic foot ulcer treated in the Division of Vascular and Endovascular Surgery, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The data of PEDIS scores and spectral ultrasound in the femoral artery, popliteal artery, dorsalis pedis artery, and posterior tibial artery were taken. Results: As many as 81 subjects participated in this study, with 52 people (64%) were male, 29 people (36%) were female, and an average age of 59.8 ± 10.5 years. Pedis cut-off scores were obtained using ROC (receiver operating characteristic) curves, with popliteal arteries scores of >10, dorsalis pedis arteries, and posterior tibial arteries scores of >8 had the best values as diagnostic tools compared to USG as reference standards. Conclusion: PEDIS score could be use as assessment for impaired lower limb arterial flow, compare to Doppler ultrasound. Keywords: PEDIS score, Doppler ultrasound spectral, diabetic foot ulcer


Author(s):  
Berna Cüreklibatır Encan ◽  
Arzu Marmaralı ◽  
Dilek Bayraktar ◽  
Şevki Çetinkalp ◽  
Ilgın Yıldırım Şimşir

Diabetes mellitus (DM) is a chronic disease that has become a global health problem. As the population of people with diabetes is growing worldwide, the prevalence of complications associated with DM, such as diabetic foot, also increases. Neuropathy and high plantar pressure are the two most frequent causes of foot ulceration. Since diabetic wounds tend to heal slowly, it is crucial to prevent diabetic foot ulcers before they occur. In this study, the efficacy of a sock developed for diabetes in the previous research of the authors was investigated in a clinical study with the participation of patients with diabetes over a 6-month period. At the end of the study, it was observed that none of the participants had experienced any new ulcers, bacterial or fungal infections, or callus formation during this research. Moreover, a slight decrease in pressure was observed for the first, second, and third metatarsal bones when the socks were worn on day 1. On the other hand, pressure reduction was identified for the fourth and fifth metatarsal bones in all following measurements. However, analyses revealed that duration of usage did not have a statistically significant effect on overall plantar pressure. It was also found that pressure on the fourth and fifth metatarsal bones significantly decreased. Assessment of wearing comfort revealed the satisfaction of the patients, as well. Based on the promising outcomes of this clinical evaluation, these socks developed for people with diabetes can be strongly expected to help avoid diabetic foot ulcers.


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