title: Novel dynamic peak and distribution plantar pressure measures on diabetic patients during walking.
abstract: Diabetic peripheral neuropathy (DPN) is a common complication leading to foot ulceration and amputation. Several kinematic, kinetic and plantar pressure measures have been proposed for DPN detection, however findings have been inconsistent. In this work, we present new shape features that capture variations in the plantar pressure using shape and entropy measures to the study of patients with retinopathy, DPN and nephropathy, and a control diabetic group with no complications. The change in the peak plantar pressure (PPP) position with each step for both feet was represented as a convex polygon, asymmetry index, area of the convex polygon, 2nd wavelet moment (WM2) and sample entropy (SamEn). WM2 and the SamEn were more sensitive in capturing variations due to presence of complications than the area and asymmetry measures. WM2 of the left heel (median: 1st IQ, 3rd IQ): 8.27 (4.6,14.8) and left forefoot: 9.2 (2.4,16) were significantly lower for the DPN group compared to the control (CONT) group (heel 11.9 (5.0,16.4); forefoot: 10.3 (4.4,21.3), p < 0.05). SamEn for the DPN group was significantly lower in the right foot compared to the left foot (1.3 (1.26, 1.37) and 1.33 (1.26,1.4), p < 0.01) compared to CONT (right foot: 1.37 (1.24,1.45) and left foot: 1.34 (1.25,1.42), P < 0.05). These new shape and regularity features have shown promising results in detecting diabetic peripheral neuropathy and warrant further investigation.
authors.affiliation: Khalifa University Center of Biotechnology, Abu Dhabi, United Arab Emirates.
authors.forename: Haitham M
authors.initials: HM
authors.lastname: Al-Angari
authors.affiliation: Department of Biomedical Engineering, Khalifa University, Po Box 127788, Abu Dhabi, United Arab Emirates.
authors.forename: Ahsan H
authors.initials: AH
authors.lastname: Khandoker
authors.affiliation: Khalifa University Center of Biotechnology, Abu Dhabi, United Arab Emirates.
authors.forename: Sungmun
authors.initials: S
authors.lastname: Lee
authors.affiliation: Institute of Cardiac Science, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
authors.forename: Wael
authors.initials: W
authors.lastname: Almahmeed
authors.affiliation: Khalifa University Center of Biotechnology, Abu Dhabi, United Arab Emirates; Department of Biomedical Engineering, Khalifa University, Po Box 127788, Abu Dhabi, United Arab Emirates.
authors.forename: Habiba S
authors.initials: HS
authors.lastname: Al Safar
authors.affiliation: School of Community Health, Charles Sturt University, Albury, NSW and Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.
authors.forename: Herbert F
authors.initials: HF
authors.lastname: Jelinek
authors.affiliation: Department of Biomedical Engineering, Khalifa University, Po Box 127788, Abu Dhabi, United Arab Emirates. Electronic address: kinda.khalaf@kustar.ac.ae.
authors.forename: Kinda
authors.initials: K
authors.lastname: Khalaf
mesh_terms: D001696:Biomechanical Phenomena; D003924:Diabetes Mellitus, Type 2; D017719:Diabetic Foot / Q000503:physiopathology*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D016138:Walking
keywords: Diabetes; Diabetes complications; Diabetic peripheral neuropathy; Plantar pressure; Sample entropy; Shape analysis; Wavelet moment