title: Elevated plantar pressure in diabetic patients and its relationship with their gait features.
abstract: OBJECTIVE
  High plantar pressure is a major risk factor for diabetic foot ulcers. The relationship between plantar pressure and foot mobility has been investigated in some studies. However, when the foot is in motion, foot mobility is only a small feature of the gait. Therefore, we investigated relationship between high plantar pressure and gait and also studied the motion of the trunk. In addition, we investigated the relationship between gait and patient characteristics to identify patients at high-risk of developing diabetic foot ulcers.
  
  
  METHODS
  The relationships between elevated plantar pressure, gait features, and patient characteristics were analyzed. Plantar pressure distribution in the stance phase was divided on the four plantar segments. Elevated plantar pressure was defined as being more than the mean plus one standard deviation of the corresponding segment in non-diabetic subjects. Plantar pressure distribution was measured by an F-scan system, and gait features were measured using wireless motion sensors attached to the sacrum and feet. Patient characteristics were obtained from medical records or by interview.
  
  
  RESULTS
  Small roll and yaw motions of the body and yaw motion of the foot during the mid-stance phase were related to the elevated plantar pressure in 57 diabetic patients. Furthermore, these gait features were related to sensory neuropathy, diabetes duration, patient weight, toe-gap force, and ankle range of motion.
  
  
  CONCLUSIONS
  Given our findings, it may be possible to prevent diabetic foot ulcers by increasing foot motion during the mid-stance phase. Passive exercise aimed at expanding ankle range of motion in patients with sensory neuropathy or long-standing diabetes may assist in achieving this.
authors: The University of Tokyo, Department of Wound Care Management, Graduate School of Medicine, Japan.
authors: Ayumi
authors: A
authors: Amemiya
authors: The University of Tokyo, Department of Life Support Technology (Molten), Graduate School of Medicine, Japan.
authors: Hiroshi
authors: H
authors: Noguchi
authors: The University of Tokyo, Department of Advanced Nursing Technology, Graduate School of Medicine, Japan.
authors: Makoto
authors: M
authors: Oe
authors: The University of Tokyo Hospital, Department of Nursing, Japan.
authors: Yumiko
authors: Y
authors: Ohashi
authors: The University of Tokyo, Department of Diabetes and Metabolic Diseases, Japan.
authors: Kohjiro
authors: K
authors: Ueki
authors: The University of Tokyo, Department of Diabetes and Metabolic Diseases, Japan.
authors: Takashi
authors: T
authors: Kadowaki
authors: The University of Tokyo, Department of Life Support Technology (Molten), Graduate School of Medicine, Japan. Electronic address: tmoriics-tky@umin.ac.jp.
authors: Taketoshi
authors: T
authors: Mori
authors: The University of Tokyo, Department of Wound Care Management, Graduate School of Medicine, Japan.
authors: Hiromi
authors: H
authors: Sanada
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D017719:Diabetic Foot / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D016059:Range of Motion, Articular / Q000502:physiology; D012307:Risk Factors