Effectiveness of diabetic insoles to reduce foot pressures.
The F-Scan system was used to measure peak plantar pressures in 11 diabetics each with a unilateral great toe amputation and an intact contralateral extremity (nonamputated), to evaluate the effectiveness of five footwear-insole strategies: 1) extra-depth shoes without an insole, 2) extra-depth shoes with a Plastizote insole, 3) extra-depth shoes with a Plastizote insole and a metatarsal pad, 4) extra-depth shoes with a Plastizote insole and a medial longitudinal arch pad, and 5) extra-depth shoes with a Plastizote insole and a combination of metatarsal pad and arch pad. When we compared extra-depth shoes with and without insoles, peak pressures were significantly reduced with insoles under the first metatarsal, the lesser metatarsals, and the heel (p < 0.001) in feet with and without an amputation, as well as under the great toe on the contralateral foot (nonamputated, p < 0.001), but not under the lesser toes (giant toe, p = 0.088; nonamputated, p = 0.763). There was no significant difference between the different insole modifications.
Ashry
H R
HR
Acor Orthopaedics, Cleveland, OH, USA.
Lavery
L A
LA
Murdoch
D P
DP
Frolich
M
M
Lavery
D C
DC
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D017719:Diabetic Foot / Q000517:prevention & control*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D005069:Evaluation Studies as Topic; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006214:Hallux / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices / Q000592:standards*; D011312:Pressure; D012775:Shoes