Effects of preventative footwear on foot pressure as determined by pedobarography in diabetic patients: a prospective study.
OBJECTIVE
This study analysed the effects of specially manufactured insoles on foot pressures in diabetic patients during a 1-year prospective observation period.


METHODS
We studied 81 type 2 diabetic patients without foot lesions. Using pedobarography three different regions of interest were examined: maximum peak pressure (MPP) of the total foot area, heel region and head of metatarsal bone I-III. Eighteen patients with high risk pressure (MPP of total foot 474 +/- 183 kPa; heel region 278 +/- 147 kPa, metatarsal 389 +/- 222 kPa) received optimal insole support. Sixty-three patients as a control group (MMP of total foot 367.7 +/- 157 kPa; heel 263.1 +/- 127 kPa, metatarsal 339.9 +/- 171 kPa) received conventional footwear.


RESULTS
After insole support a 30% pressure reduction of total foot MMP (474 +/- 183 kPa vs. 290 +/- 106 kPa) was achieved in the treatment group. After 6 months (324 +/- 127 kPa) and 1 year (380 +/- 190 kPa) a pressure reduction was found. Between the 6- and 12-month controls plantar pressures again increased. In the control group a significant increase of all peak pressures occurred.


CONCLUSIONS
Early insole support is successful in reducing plantar pressure. A repeated adjustment should be performed every 6 months to prevent foot pressure increases. The comparison of foot pressure development between the two groups showed constant levels in the treatment group. In the control group a marked increase of the pressure values was found. Identification and subsequent support of patients with high ulceration risk may help to reduce the high amputation rate.
Lobmann
R
R
Department of Endocrinology and Metabolism, University Medical School of Magdeburg, Germany.
Kayser
R
R
Kasten
G
G
Kasten
U
U
Kluge
K
K
Neumann
W
W
Lehnert
H
H
D000368:Aged; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D017719:Diabetic Foot / Q000517:prevention & control*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D011312:Pressure; D011859:Radiography; D012307:Risk Factors; D012775:Shoes; D013997:Time Factors
D006442:Glycated Hemoglobin