Foot pressure measurements in diabetic and nondiabetic amputees.
OBJECTIVE
Foot problems are common in the remaining foot of diabetic amputees. Because high foot pressures are associated with foot ulceration, we studied foot pressures of the remaining foot of diabetic and nondiabetic unilateral amputees.


METHODS
Four age-matched groups of 11 subjects were studied. The groups were comprised of diabetic subjects with previous major amputation, nondiabetic nonneuropathic amputees, diabetic nonamputee patients with similar peripheral nerve involvement as the diabetic amputees, and nondiabetic control subjects. Vibration perception threshold (VPT) was assessed by biothesiometry and foot pressures with an optical pedobarograph.


RESULTS
Mean +/- SE VPT in the diabetic amputees was significantly higher than the nondiabetic amputees (40.2 +/- 3.7 vs. 17.7 +/- 2.8 V, P less than 0.002) and similar to diabetic nonamputees (43.4 +/- 3.3 V, NS). VPT was abnormal in 9 (82%) diabetic amputees, 2 (18%) nondiabetic amputees, and 10 (91%) nonamputee diabetic patients. The mean peak foot pressure in the diabetic amputees was higher compared with nondiabetic amputees (18.3 +/- 2.2 vs. 11.3 +/- 1.4 kg/cm2, P less than 0.05) and control subjects (10.0 +/- 1.5 kg/m2, P less than 0.01), but no difference existed with diabetic nonamputees. Abnormally high foot pressures (greater than 12.3 kg/cm2) were present in 8 (73%) diabetic amputees, 3 (27%) nondiabetic amputees, 8 (73%) diabetic nonamputees, and 4 (36%) healthy subjects.


CONCLUSIONS
We conclude that high pressures are present under the remaining foot in diabetic amputees, and that these pressures are associated with diabetic neuropathy. Prosthetic usage does not increase the pressures under the remaining foot in nondiabetic amputees.
Veves
A
A
Diabetes Centre, Manchester Royal Infirmary, United Kingdom.
Van Ross
E R
ER
Boulton
A J
AJ
D000368:Aged; D000672:Amputation Stumps / Q000503:physiopathology*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000209:etiology; D005528:Foot / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure / Q000009:adverse effects; D012684:Sensory Thresholds / Q000502:physiology; D014732:Vibration