title: Comparative Clustering of Plantar Pressure Distributions in Diabetics with Polyneuropathy May Be Applied to Reveal Inappropriate Biomechanical Stress.
abstract: In diabetic patients, excessive peak plantar pressure has been identified as major risk factor for ulceration. Analyzing plantar pressure distributions potentially improves the identification of patients with a high risk for foot ulceration development. The goal of this study was to classify regional plantar pressure distributions. By means of a sensor-equipped insole, pressure recordings of healthy controls (n = 18) and diabetics with severe polyneuropathy (n = 25) were captured across eight foot regions. The study involved a controlled experimental protocol with multiple sessions, where a session contained several cycles of pressure exposure. Clustering was used to identify subgroups of study participants that are characterized by similar pressure distributions. For both analyzed groups, the number of clusters to best describe the pressure profiles was four. When both groups were combined, analysis again led to four distinct clusters. While three clusters did not separate between healthy and diabetic volunteers the fourth cluster was only represented by diabetics. Here the pressure distribution pattern is characterized by a focal point of pressure application on the forefoot and low pressure on the lateral region. Our data suggest that pressure clustering is a feasible means to identify inappropriate biomechanical plantar stress.
authors.affiliation: Faculty of Computer Science, Otto-von-Guericke University, Magdeburg, Germany.|ifak system GmbH, Magdeburg, Germany.
authors.forename: Uli
authors.initials: U
authors.lastname: Niemann
authors.affiliation: Faculty of Computer Science, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Myra
authors.initials: M
authors.lastname: Spiliopoulou
authors.affiliation: ifak system GmbH, Magdeburg, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Szczepanski
authors.affiliation: mediXmind GmbH, Magdeburg, Germany.
authors.forename: Fred
authors.initials: F
authors.lastname: Samland
authors.affiliation: ifak system GmbH, Magdeburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Grützner
authors.affiliation: Clinic for Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Senk
authors.affiliation: Clinic for Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Antao
authors.initials: A
authors.lastname: Ming
authors.affiliation: Clinic for Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Juliane
authors.initials: J
authors.lastname: Kellersmann
authors.affiliation: Clinic for Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Malanowski
authors.affiliation: Clinic for Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Klose
authors.affiliation: Clinic for Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mertens
mesh_terms: D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D016000:Cluster Analysis; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D013314:Stress, Mechanical