title: The role of a total contact insole in diminishing foot pressures following partial first ray amputation in diabetic patients.
abstract: BACKGROUND
  In diabetic subjects, reulcerations following first ray amputations are particularly frequent. Treatment usually includes an in-shoe intervention to reduce plantar pressure.
  
  
  OBJECTIVE
  To investigate the effects of a total contact insole on the plantar pressure reduction in patients with partial first ray amputations.
  
  
  METHODS
  Twenty diabetic subjects (mean age 60 years, mean body mass index 27kg/m(2)) with partial first ray amputation of one foot. Plantar pressure data was recorded using Matscan system (Tekscan vers. 6.34, Boston, USA) while standing and taking a step for three conditions (shoe, shoe with total contact insole, and shoe with flat insole). Plantar pressures were determined at the five metatarsal areas, mid foot area and medial and lateral heel areas.
  
  
  RESULTS
  Pressures diminished significantly (P<0.05) in tested areas using the total contact insole while standing and walking. While using the flat insole, significant pressure changes were only seen while walking (P<0.05) (P<0.05). A highly significant change in pressures with the total contact insoles during walking in all areas except for the M1 area (P<0.001) as compared to that of flat insole.
  
  
  CONCLUSIONS
  The conforming total contact insole showed significant reduction in plantar pressures in patients with first ray amputation.
authors.affiliation: Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University Hospitals, Egypt. relhilaly@yahoo.com
authors.forename: Rana
authors.initials: R
authors.lastname: El-Hilaly
authors.forename: Ossama
authors.initials: O
authors.lastname: Elshazly
authors.forename: Ayman
authors.initials: A
authors.lastname: Amer
mesh_terms: D000671:Amputation, Surgical; D015331:Cohort Studies; D017719:Diabetic Foot / Q000503:physiopathology* / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006214:Hallux; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012775:Shoes; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology