title: Daily-life activities and in-shoe forefoot plantar pressure in patients with diabetes.
abstract: OBJECTIVE
  To assess differences regarding in-shoe forefoot plantar pressure (PP) in patients with diabetes during various daily-life activities.
  
  
  METHODS
  In-shoe PP was measured in 93 patients during: level walking, ramp and stair walking, turning in different settings and while performing the Up & Go test. Separate PPs were determined for the big toe and metatarsal (mt) regions one to five.
  
  
  RESULTS
  Across all activities, similar PPs were measured in the big toe and mt-1 to mt-3 region. Lower PPs were measured in mt-4 and mt-5 region. PPs during level walking were mostly higher when compared to the other activities (p</=.030). Turning while level walking resulted in higher PPs than turning while performing the other activities (p</=.033). Higher PPs were measured for both ramp and stair ascending when compared to descending (p</=.001). In the big toe region, stair descending resulted in higher PPs than ascending (p</=.001). Across all activities, patients with neuropathy had lower PPs (overall mean 28kPa) than patients without neuropathy.
  
  
  CONCLUSIONS
  Level walking resulted in the highest forefoot PPs during daily-life activities. Patients with neuropathy had lower PPs than patients without neuropathy.
authors.affiliation: Department Orthopaedic Surgery, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. ngu@orthop.unimaas.nl
authors.forename: Nick A
authors.initials: NA
authors.lastname: Guldemond
authors.forename: Pieter
authors.initials: P
authors.lastname: Leffers
authors.forename: Antal P
authors.initials: AP
authors.lastname: Sanders
authors.forename: Nicolaas C
authors.initials: NC
authors.lastname: Schaper
authors.forename: Fred
authors.initials: F
authors.lastname: Nieman
authors.forename: Geert H I M
authors.initials: GH
authors.lastname: Walenkamp
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000534:rehabilitation*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005528:Foot; D005545:Forefoot, Human / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011187:Posture; D011312:Pressure; D012775:Shoes / Q000592:standards*; D014732:Vibration; D016138:Walking / Q000502:physiology*
chemical_list: D006442:Glycated Hemoglobin