Diabetic foot ulcer incidence in relation to plantar pressure magnitude

NewsBot · Sep 6, 2013

Members do not see these Ads. Sign Up.
Diabetic foot ulcer incidence in relation to plantar pressure magnitude and measurement location
William R. Ledoux , Jane B. Shofer , Matthew S. Cowley , Jessie H. Ahroni , Victoria Cohen , Edward J. Boyko
Journal of Diabetes and Its Complications; Article in Press

Aims
We prospectively examined the relationship between site-specific peak plantar pressure (PPP) and ulcer risk. Researchers have previously reported associations between diabetic foot ulcer and elevated plantar foot pressure, but the effect of location-specific pressures has not been studied.

Methods
Diabetic subjects (n=591) were enrolled from a single VA hospital. Five measurements of in-shoe plantar pressure were collected using F-Scan. Pressures were measured at 8 areas: heel, lateral midfoot, medial midfoot, first metatarsal, second through fourth metatarsal, fifth metatarsal, hallux, and other toes. The relationship between incident plantar foot ulcer and PPP or pressure–time integral (PTI) was assessed using Cox regression.

Results
During follow-up (2.4years), 47 subjects developed plantar ulcers (10 heel, 12 metatarsal, 19 hallux, 6 other). Overall mean PPP was higher for ulcer subjects (219 vs. 194kPa), but the relationship differed by site (the metatarsals with ulcers had higher pressure, while the opposite was true for the hallux and heel). A statistical analysis was not performed on the means, but hazard ratios from a Cox survival analysis were nonsignificant for PPP across all sites and when adjusted for location. However, when the metatarsals were considered separately, higher baseline PPP was significantly associated with greater ulcer risk; at other sites, this relationship was nonsignificant. Hazard ratios for all PTI data were nonsignificant.

Conclusions
Location must be considered when assessing the relationship between PPP and plantar ulceration.
Click to expand...

Admin2 · Sep 6, 2013

Related Threads:
Other threads tagged with diabetic foot biomechanics or plantar pressures
Plantar pressures in diabetic patients with foot ulcers which have remained healed
Plantar pressures in diabetes with no known neuropathy
How good are you at locating areas of high pressure?
Changes in skin stiffness preceed ulcer formation
Value of reporting pressure-time integral data in addition to peak pressure data in studies on the diabetic foot
Prediction of peak pressure from clinical and radiological measurements in patients with diabetes.

NewsBot · Jun 17, 2022

Characteristics of Plantar Pressure Distribution in Diabetes with or without Diabetic Peripheral Neuropathy and Peripheral Arterial Disease
Zijun Cao et al
J Healthc Eng. 2022 Jun 6

Background: Excessive plantar pressure leads to increased risk of diabetic foot ulcers. Diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD) have been considered to be associated with alterations in gait and plantar pressure in diabetic patients. However, few studies have differentiated the effects with each of them.

Objective: To investigate the plantar pressure distribution in diabetic patients, with DPN and PAD as independent or combined factors.

Methods: 112 subjects were recruited: 24 diabetic patients with both DPN and PAD (DPN-PAD group), 12 diabetic patients with DPN without PAD (DPN group), 10 diabetic patients with PAD without DPN (PAD group), 23 diabetic patients without DPN or PAD, and 43 nondiabetic healthy controls (HC group). The in-shoe plantar pressure during natural walking was measured. Differences in peak pressure, contact area, proportion of high pressure area (%HP), and anterior/posterior position of centre of pressure (COP) were analysed.

Results: Compared with HC group, in DPN-PAD group and DPN group, the peak pressures in all three forefoot regions increased significantly; in PAD group, the peak pressure in lateral forefoot increased significantly. The contact area of midfoot in the DPN-PAD group decreased significantly. PAD group had larger HP% of lateral forefoot, DPN group had larger HP% of inner forefoot, and DPN-PAD group had larger HP% of total plantar area. There was a significant tendency of the anterior displacement of COP in the DPN-PAD group and DPN group. No significant differences were observed between the D group and HC group.

Conclusion: DPN or PAD could affect the plantar pressure distribution in diabetic patients independently or synergistically, resulting in increased forefoot pressure and the area at risk of ulcers. DPN has a more pronounced effect on peak pressure than PAD. The synergistic effect of them could significantly reduce the plantar contact area of midfoot.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

Homeopathy for Diabetic Foot Ulcers

Low Plasma Arginine among Patients with Diabetic Foot Ulcer

Pranic Healing for Diabetic Foot Ulcer Management

The role of programmed cell death in diabetic foot ulcers

Efficacy of LL-37 cream in enhancing healing of diabetic foot ulcer

Topical Medications for Treating Diabetic Foot Ulcers - A Systematic Review

Boron based gel for the treatment of diabetic foot ulcers

Share This Page