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.

The Distribution of Plantar Pressures in American Indians with Diabetes Mellitus

2001 ◽  
Vol 91 (6) ◽  
pp. 280-287 ◽  
Author(s):  
Thomas G. McPoil ◽  
Wesley Yamada ◽  
Wayne Smith ◽  
Mark Cornwall
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Range Of Motion ◽  
American Indians ◽  
Plantar Pressure ◽  
Metatarsophalangeal Joint ◽  
Control Group ◽  
First Metatarsophalangeal Joint ◽  
Plantar Pressures ◽  
Peak Plantar Pressure

The primary purpose of this study was to determine the magnitude and duration of plantar pressures acting on the feet of American Indians with diabetes mellitus. A secondary purpose was to determine whether differences in the range of motion of the ankle and first metatarsophalangeal joints existed between American Indians with and without diabetes. Three groups of American Indian subjects were tested: a control group (n = 20); a group with diabetes but no peripheral neuropathy (n = 24); and a group with diabetes and peripheral neuropathy (n = 21). A floor-mounted pressure sensor platform was used to collect plantar pressure data while subjects walked barefoot. The results indicated that American Indians with diabetes have 1) a pattern of peak plantar pressure similar to patterns previously reported for non–American Indians with diabetes and 2) a reduction in ankle and first metatarsophalangeal joint range of motion in comparison with nondiabetic American Indians. (J Am Podiatr Med Assoc 91(6): 280-287, 2001)

The Relationship of the Position of the Metatarsal Heads and Peak Plantar Pressure

2003 ◽  
Vol 24 (4) ◽  
pp. 349-353 ◽  
Author(s):  
René E. Weijers ◽  
Geert H.I.M. Walenkamp ◽  
Henk van Mameren ◽  
Alphons G.H. Kessels
Keyword(s):  
Plantar Pressure ◽  
Lateral Side ◽  
Ct Scanner ◽  
Plantar Pressures ◽  
Medial Side ◽  
Plantar Pressure Distribution ◽  
Peak Plantar Pressure ◽  
The Right ◽  
Relationship Of ◽  
The Relationship

We test the premise that peak plantar pressure is located directly under the bony prominences in the forefoot region. The right foot of standing volunteers was examined in three different postures by a CT-scanner. The plantar pressure distribution was simultaneously recorded. The position of the metatarsal heads and the sesamoids could be related to the corresponding local peak plantar pressures. The metatarsal heads 1, 4, and 5 had a significantly different position than the local peak plantar pressures. The average difference in distance between the position of the metatarsal heads and the peak plantar pressure showed a significant correlation: on the medial side the head was located more distally to the local peak plantar pressure, on the lateral side more proximally. The findings suggest that normal plantar soft tissue is able to deflect a load. The observations might improve insight into the function of the normal forefoot and might direct further research on the pathological forefoot and on the design of footwear.

Foot Function in Diabetic Patients after Partial Amputation

1996 ◽  
Vol 17 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Juan Carlos Garbalosa ◽  
Peter R. Cavanagh ◽  
Ge Wu ◽  
Jan S. Ulbrecht ◽  
Mary B. Becker ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Plantar Pressure ◽  
Three Dimensional ◽  
Diabetic Patients ◽  
Plantar Pressures ◽  
Plantar Pressure Distribution ◽  
Patients With Diabetes ◽  
Peak Plantar Pressure ◽  
Partial Amputation ◽  
Foot Function

The function of partially amputated feet in 10 patients with diabetes mellitus was studied. First-step bilateral barefoot plantar pressure distribution and three-dimensional kinematic data were collected using a Novel EMED platform and three video cameras. Analysis of the plantar pressure data revealed a significantly greater mean peak plantar pressure in the feet with transmetatarsal amputation (TMA) than in the intact feet of the same patients. The heels of the amputated feet had significantly lower mean peak plantar pressures than all the forefoot regions. A significantly greater maximum dynamic dorsiflexion range of motion was seen in the intact compared with the TMA feet. However, no difference was noted in the static dorsiflexion range of motion between the two feet and there was, therefore, a trend for the TMA feet to use less of the available range of motion. Given the altered kinematics and elevated plantar pressures noted in this study, careful postsurgical footwear management of feet with TMA would appear to be essential if ulceration is to be prevented.

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

Static and Dynamic Plantar Pressure and Normalized Plantar Pressure Characteristics among Children, Adults, and the Elderly

2021 ◽  
Vol 104 (12) ◽  
pp. 1881-1887
Keyword(s):  
Young Adults ◽  
Plantar Pressure ◽  
Center Of Pressure ◽  
The Elderly ◽  
Quiet Standing ◽  
Foot Pressure ◽  
Gait Performance ◽  
Plantar Pressures ◽  
Balance Ability ◽  
Pressure Characteristics

Background: A better understanding of plantar pressure while standing and walking would help in improving balance and gait performance across different age ranges. Objective: To clarify the differences of plantar pressure while standing and walking among children, adults, and the elderly. Materials and Methods: Fifty-three participants including eleven aged 3 to 8 years, thirty aged 20 to 40 years, and twelve aged 60 to 90 years were included in the present study. Plantar pressure and related parameters while quiet standing and walking with self-selected speed were assessed. Results: In static plantar pressure, no significant differences were observed of mean different pressure and mean different contact area between dominant and non-dominant limbs among the three groups, while center of pressure (COP) displacement was shown as significantly greater between children and adults (p<0.05). For dynamic plantar pressure, no significant differences in COP velocity were found among the three groups. The elderly showed significant lower normalized maximum plantar pressure in areas of the second and third metatarsal, and internal heel compared with the young adults (p<0.05). Additionally, normalized maximum plantar pressures among children seemed to differ from adults. Conclusion: Plantar pressure characteristics could indicate that children develop gait ability in braking and propulsion phases with greater heel and toe function, while the ability of braking and propulsion declined with aging. These could reflect balance ability while standing or walking. Keywords: Foot pressure; Children; Elderly; Normalization

Vertical forces and plantar pressures in selected aerobic movements versus walking

1993 ◽  
Vol 83 (9) ◽  
pp. 504-508 ◽  
Author(s):  
DL Thompson ◽  
MR Hatley ◽  
TG McPoil ◽  
MW Cornwall
Keyword(s):  
Plantar Pressure ◽  
Lower Extremities ◽  
High Impact ◽  
Vertical Force ◽  
Plantar Pressures ◽  
Peak Plantar Pressure ◽  
Force Data

Ten subjects between the ages of 19 and 29 years walked and performed four aerobic movements over a force and pressure platform. Peak plantar pressure and peak vertical force data were collected three times on the dominant leg as each subject performed all of the five activities. Peak vertical forces acting on the lower extremities for the low impact aerobic movements were significantly less when compared with the high impact movements. As was expected, no differences were found in peak vertical forces between walking and the low impact aerobic movements. Peak plantar pressures for walking were not significantly different when compared with any of the four aerobic movements studied.

Patellar tendon bearing brace: Combined effect of heel clearance and ankle status on foot plantar pressure

2013 ◽  
Vol 38 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Farnaz Alimerzaloo ◽  
Reza V Kashani ◽  
Hassan Saeedi ◽  
Marjan Farzi ◽  
Nader Fallahian
Keyword(s):  
Patellar Tendon ◽  
Contact Area ◽  
Plantar Pressure ◽  
Combined Effect ◽  
Repeated Measure ◽  
Effective Parameters ◽  
Plantar Pressures ◽  
Peak Plantar Pressure ◽  
Measure Analysis ◽  
Repeated Measure Analysis

Background: Heel clearance and ankle status (free or locked) are of major determinants affecting peak plantar pressures and contact area in patellar tendon bearing brace and have been separately studied by many researchers. This study investigated the combined effect of ankle status and heel clearance on contact area and peak plantar pressure in different areas of foot (hindfoot, midfoot, and forefoot). Study design: Before–after repeated measurement trial. Methods: Nine healthy male volunteers walked 8 m with normal shoe and four conditions of patellar tendon bearing brace wear. Repeated-measure analysis of variance test was used to compare contact area and plantar pressure changes in three areas of the foot. Results: Application of patellar tendon bearing brace significantly reduced overall plantar pressure and contact area ( p < 0.01). Although both contact area and plantar pressure significantly decreased in hindfoot and midfoot, plantar pressure increased in forefoot area ( p < 0.05). Conclusions: Application of the patellar tendon bearing brace can reduce the overall peak plantar pressure in the foot but increases focal plantar pressure in forefoot. Excessive lifting of the heel seems to minimize the contact area, thus increase focal pressure in forefoot. Overall, plantar pressure seems to be more effectively off-loaded by combining maximum heel clearance and restriction of the ankle joint. Clinical relevance Although effective parameters of patellar tendon bearing brace have been separately addressed in previous studies, no study was found that investigated the combined effect of ankle status and heel clearance. This study investigates the combined effect of these parameters and provides detailed information on clinical application of the patellar tendon bearing brace.

Computerized Analysis of Plantar Pressure Variation in Flip-Flops, Athletic Shoes, and Bare Feet

2008 ◽  
Vol 98 (5) ◽  
pp. 374-378 ◽  
Author(s):  
Tanya J. Carl ◽  
Stephen L. Barrett
Keyword(s):  
Plantar Pressure ◽  
Gait Cycle ◽  
Computer Software ◽  
Protective Role ◽  
Plantar Pressures ◽  
Peak Plantar Pressure ◽  
Foot Problems ◽  
Athletic Shoes ◽  
A Minor ◽  
Pressure Measurement System

Background: High peak plantar pressures predispose to foot problems and may exacerbate existing conditions. For podiatric physicians to make educated recommendations to their patients, it is important and necessary to begin to look at different shoes and how they affect peak plantar pressure. Methods: To determine how flip-flops change peak plantar pressure while walking, we compared peak plantar pressures in the same test subjects wearing flip-flops, wearing athletic shoes, and in bare feet. Ten women with size 7 feet and a body mass index less than 25 kg/m2 were tested with an in-shoe pressure-measurement system. These data were collected and analyzed by one-way analysis of variance and computer software. Results: Statistically significant results were obtained for nine of the 18 comparisons. In each of these comparisons, flip-flops always demonstrated higher peak plantar pressures than athletic shoes but lower pressures than bare feet. Conclusion: Although these data demonstrate that flip-flops have a minor protective role as a shock absorber during the gait cycle compared with pressures measured while barefoot, compared with athletic shoes, they increase peak plantar pressures, placing the foot at greater risk for pathologic abnormalities. (J Am Podiatr Med Assoc 98(5): 374–378, 2008)

Plantar Pressure Distribution in Patients with Diabetic Peripheral Neuropathy and a First-Ray Amputation

2018 ◽  
Vol 108 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Iona Borg ◽  
Stephen Mizzi ◽  
Cynthia Formosa
Keyword(s):  
Peripheral Neuropathy ◽  
Plantar Pressure ◽  
Diabetic Peripheral Neuropathy ◽  
Metatarsophalangeal Joint ◽  
Plantar Pressures ◽  
Plantar Pressure Distribution ◽  
Pressure Time ◽  
First Ray ◽  
Metatarsophalangeal Joints ◽  
Ray Amputation

Background: Elevated dynamic plantar pressures are a consistent finding in diabetic patients with peripheral neuropathy, with implications for plantar foot ulceration. This study aimed to investigate whether a first-ray amputation affects plantar pressures and plantar pressure distribution patterns in individuals living with diabetes and peripheral neuropathy. Methods: A nonexperimental matched-subject design was conducted. Twenty patients living with diabetes and peripheral neuropathy were recruited. Group 1 (n = 10) had a first-ray amputation and group 2 (n = 10) had an intact foot with no history of ulceration. Plantar foot pressures and pressure-time integrals were measured under the second to fourth metatarsophalangeal joints, fifth metatarsophalangeal joint, and heel using a pressure platform. Results: Peak plantar pressures under the second to fourth metatarsophalangeal joints were significantly higher in participants with a first-ray amputation (P = .008). However, differences under the fifth metatarsophalangeal joint (P = .734) and heel (P = .273) were nonsignificant. Pressure-time integrals were significantly higher under the second to fourth metatarsophalangeal joints in participants with a first-ray amputation (P = .016) and in the heel in the control group (P = .046). Conclusions: Plantar pressures and pressure-time integrals seem to be significantly higher in patients with diabetic peripheral neuropathy and a first-ray amputation compared with those with diabetic neuropathy and an intact foot. Routine plantar pressure screening, orthotic prescription, and education should be recommended in patients with a first-ray amputation.

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