title: Increased plantar foot pressure in persons affected by leprosy.
abstract: Although foot pressure has been reported to be increased in people affected by leprosy, studies on foot pressure and its determinants are limited. Therefore, the aim was to assess barefoot plantar foot pressure and to identify clinical determinants of increased plantar foot pressure in leprosy affected persons. Plantar pressure in both feet was assessed using the Novel EMED-X platform in 39 persons affected by leprosy. Peak pressure was determined for the total foot and four regions: hallux, metatarsal heads, midfoot and heel. Potential determinants were: age, weight, nerve function (Neuropathy Disability Score, Pressure Perception Threshold and Vibration Perception Threshold), toe and foot deformities, joint mobility, ankle muscle strength and callus. Increased peak pressure (>600kPa) was observed in 46% of the participants. The highest peak pressure (mean) was found in the metatarsal heads region (right 549 (SD 321)kPa; left 530 (SD 298)kPa). Multilevel regression analysis showed that Neuropathy Disability Score, amputation/absorption of toes and hallux valgus independently contributed to metatarsal heads peak pressure in persons affected with leprosy. To conclude, peak pressure is increased in people affected by leprosy. The highest peak pressure is found in the forefoot region and is significantly associated to Neuropathy Disability Score, toe amputation/absorption and hallux valgus. Screening for clinical characteristics can be used to identify individual persons affected by leprosy at risk of excessive pressure.
authors.affiliation: Department of Rehabilitation, Academic Medical Center, Amsterdam, The Netherlands. f.j.slim@amc.uva.nl
authors.forename: Frederik J
authors.initials: FJ
authors.lastname: Slim
authors.forename: Carine H
authors.initials: CH
authors.lastname: van Schie
authors.forename: Renske
authors.initials: R
authors.lastname: Keukenkamp
authors.forename: William R
authors.initials: WR
authors.lastname: Faber
authors.forename: Frans
authors.initials: F
authors.lastname: Nollet
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005545:Forefoot, Human / Q000503:physiopathology; D006801:Humans; D007918:Leprosy / Q000150:complications / Q000175:diagnosis*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053580:Muscle Strength / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D011312:Pressure; D012720:Severity of Illness Index; D013314:Stress, Mechanical; D016474:Weight-Bearing / Q000502:physiology