scholarly journals Effect of selected exercises on in-shoe plantar pressures in people with diabetes and peripheral neuropathy

The Foot ◽  
2012 ◽  
Vol 22 (3) ◽  
pp. 130-134 ◽  
Author(s):  
Kshamata M. Shah ◽  
Michael J. Mueller
Keyword(s):  
Peripheral Neuropathy ◽  
Plantar Pressures

Severe peripheral neuropathy and elevated plantar pressures causing foot ulceration in pituitary gigantism

1993 ◽  
Vol 39 (1) ◽  
pp. 113-118 ◽  
Author(s):  
A. M. Jennings ◽  
A. Robinson ◽  
R. H. Kandler ◽  
R. P. Betts ◽  
R. E. J. Ryder ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Foot Ulceration ◽  
Plantar Pressures

Redistribution of Foot Pressure in Healthy Adults During Sideslope Walking

2002 ◽  
Vol 23 (12) ◽  
pp. 1112-1118 ◽  
Author(s):  
Stephen R. Urry
Keyword(s):  
Peripheral Neuropathy ◽  
Relative Position ◽  
Healthy Adults ◽  
Daily Activities ◽  
Normal Adult ◽  
Foot Pressure ◽  
First Metatarsal ◽  
Plantar Pressures ◽  
Pressure Changes

Normal adult plantar pressures were measured during both level and sideslope walking. Sideslope pressures increased, depending on the relative position of the foot on the slope. With upslope placement, pressures increased significantly at the midfoot (≈20%) and fifth metatarsal (≈16%). With downslope placement, pressure increased predominantly beneath the first metatarsal (≈11%). Pressure changes were relatively small at the heel (≈3%) and central metatarsals (≈4%). Significant increases occurred on sideslopes as small as 2°. Since gradients of this size are likely to be encountered commonly in outdoor daily activities, this finding may have substantial implications for individuals with peripheral neuropathy.

scholarly journals Insoles to ease plantar pressure in people with diabetes and peripheral neuropathy: a feasibility randomised controlled trial with an embedded qualitative study

2021 ◽  
Author(s):  
Richard Collings ◽  
Jennifer Freeman ◽  
Jos M Latour ◽  
Joanne Paton
Keyword(s):  
Peripheral Neuropathy ◽  
Qualitative Study ◽  
Active Control ◽  
Thematic Analysis ◽  
Plantar Pressure ◽  
Diabetic Peripheral Neuropathy ◽  
Controlled Trial ◽  
Plantar Pressures ◽  
Patient Reported ◽  
Feasibility Rct

Abstract Background: Therapeutic footwear and insoles are preventative strategies to reduce elevated plantar pressures associated with diabetic foot ulcer risk. An insole intervention appropriate for chairside delivery optimizing plantar foot pressure reduction in people with diabetes has been developed. Aim: To explore the feasibility and acceptability of testing an optimized insole compared with an active control insole to reduce plantar pressures for people with diabetic peripheral neuropathy.Methods: A double-blinded multicentre feasibility RCT with an embedded qualitative study. In addition to usual care, participants were randomized to either an optimized insole group (Intervention) or a standard cushioned insole group (Active control). Participants were assessed at baseline, 3, 6 and 12 months with clinical outcome of mean peak plantar pressure (MPPP) reduction. An embedded qualitative study involved semi-structured interviews with 12 study participants and three podiatrists to explore their experiences of the intervention and trial procedures. Data were analyzed using descriptive statistics (quantitative data) and thematic analysis (qualitative data).Results: Screened were142 patients from which 61 were recruited; 30 participants were randomized to the Intervention group and 31 to the Active control group. Forty-two participants completed the study. At 12-months, 69% of the patient-reported questionnaires were returned and 68% of the clinical outcomes were collected. Mean difference in MPPP between the Intervention and Active control groups for all regions-of-interest combined favoured the Intervention, with increases from 87kPa at post-randomization to 255kPa at 12-months. Thematic analysis revealed three themes; accepting the study, behaviour and support during study procedures, and impact from study participation. Conclusion: The results of the feasibility RCT suggest that the optimized insole holds promise as an intervention, and that a full RCT to evaluate the clinical and cost-effectiveness of this intervention is feasible and warranted for people with diabetic peripheral neuropathy. Trial registration: International Standard Randomized Controlled Trial Number: ISRCTN16011830. Registered 9th October 2017, https://www.isrctn.com/ISRCTN16011830

scholarly journals Diabetic footwear: is it an assistive technology capable of reducing peak plantar pressures in elderly patients with neuropathy?

2016 ◽  
Vol 29 (3) ◽  
pp. 469-476 ◽  
Author(s):  
Alexandre Faraco de Oliveira ◽  
Ana Carolina Bertoletti De Marchi ◽  
Camila Pereira Leguisamo
Keyword(s):  
Peripheral Neuropathy ◽  
Assistive Technology ◽  
Plantar Pressure ◽  
The Elderly ◽  
Test Results ◽  
Paired Sample ◽  
Plantar Pressures ◽  
Therapeutic Footwear ◽  
High Prevalence ◽  
Peak Plantar Pressure

Abstract Introduction: Diabetes Mellitus is a chronic disease with high prevalence in the population in particular among the elderly. The longer time of diabetes, increased the chances of developing complications such as peripheral neuropathy, which is an important factor in the genesis of plantar lesions by changing the distribution and formation of plantar pressure peaks. Objective: Evaluate the influence of an Assistive Technology, therapeutic footwear for diabetics, in the peaks of plantar pressure of elderly. Methods: This was an experimental study of transversal type, composed by 10 elderly, diabetic, with peripheral neuropathy, using as an instrument to measure a baropodometry platform. Were measured peaks of plantar pressure, static and dynamic in three situations: barefoot, the participants' own standard footwear and with therapeutic footwear for diabetics. Data analysis by normal distribution as a single paired sample, applying the ANOVA test. Results: The use of therapeutic footwear for diabetics promoted a reduction in media of peak plantar pressure in the order of 22% in static analysis, and 31% in dynamic analysis. Conclusion: The therapeutic footwear for diabetics was able to produce significant reductions in peak plantar pressure, being more efficient than a common footwear. This effect may contribute to the prevention of injuries associated with the diabetic foot.

Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy

2003 ◽  
Vol 36 (7) ◽  
pp. 1009-1017 ◽  
Author(s):  
Michael J. Mueller ◽  
Mary Hastings ◽  
Paul K. Commean ◽  
Kirk E. Smith ◽  
Thomas K. Pilgram ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Plantar Pressures

scholarly journals Efficacy and Mechanism of Orthotic Devices to Unload Metatarsal Heads in People With Diabetes and a History of Plantar Ulcers

2006 ◽  
Vol 86 (6) ◽  
pp. 833-842 ◽  
Author(s):  
Michael J Mueller ◽  
Donovan J Lott ◽  
Mary K Hastings ◽  
Paul K Commean ◽  
Kirk E Smith ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Contact Area ◽  
Weight Bearing ◽  
Orthotic Devices ◽  
Shoe Condition ◽  
Plantar Pressures ◽  
Skin Breakdown ◽  
Second Metatarsal ◽  
Plantar Ulcers ◽  
History Of

Abstract Background and Purpose. Total-contact inserts (TCIs) and metatarsal pads (MPs) frequently are prescribed to reduce excessive plantar stresses to help prevent skin breakdown in people with diabetes mellitus (DM) and peripheral neuropathy. The first purpose of this study was to determine the effect of a TCI and an MP on metatarsal head peak plantar pressures (PPP) and pressure-time integrals (PTI). The second purpose of this study was to determine a possible mechanism of pressure reduction by measuring contact area and loaded soft-tissue thickness (STT) under the metatarsal heads and second metatarsal shaft. Subjects. Twenty subjects (12 men and 8 women; age [mean±SD]=57±9 years) with DM (duration [mean±SD]=16±11 years), peripheral neuropathy, and a history of plantar ulcers participated. Methods. A repeated-measures research design was used, and outcome measures are reported for 3 footwear conditions: shoe, shoe with TCI, and shoe with TCI and MP. In-shoe plantar pressures were collected during walking and during spiral x-ray computed tomography (SXCT). The STT and identification of the pressure sensor and location of the MP in relationship to the metatarsal heads were determined by use of SXCT. Results. The PPP and the PTI were 16% to 24% lower at the metatarsal heads in the TCI condition than in the shoe condition. The PPP and the PTI decreased an additional 15% to 28% (for a total reduction of 29% to 47%) with the addition of the MP. The contact area increased 27% with the TCI but not with the MP. The STT did not increase under the metatarsal heads in the TCI condition (compared with the shoe condition) but did increase 8% to 22% at metatarsal heads 2 to 5 with the addition of the MP. The PPP increased substantially (308%) and the STT decreased 14% under the shaft of the second metatarsal with the addition of the MP to the TCI-plus-shoe condition. Discussion and Conclusion. The TCI and the MP caused substantial and additive reductions of pressures under the metatarsal heads. The TCI reduces excessive pressures at the metatarsal heads by increasing the contact area of weight-bearing forces. Conversely, the MP acts by compressing the soft tissues proximal to the metatarsal heads and relieving compression at the metatarsal heads. These findings can assist in the design of effective orthotic devices to relieve excessive plantar stresses that contribute to skin breakdown and subsequent amputation in people with DM and peripheral neuropathy. [Mueller MJ, Lott DJ, Hastings MK, et al. Efficacy and mechanism of orthotic devices to unload metatarsal heads in people with diabetes and a history of plantar ulcers. Phys Ther. 2006;86:833–842.]

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