Plantar Pressures are Higher in Cases with Diabetic Foot Ulcers Compared to Controls Despite a Longer Stance Phase Duration
The aim of this study was to assess whether plantar pressures were higher in patients with active unilateral plantar diabetic foot ulcers (DFUs) of greater than 3 months duration (cases) compared to patients without a foot ulcer history (diabetes control), and patients without diabetes or foot ulcer history (healthy controls).
Cases with type-2 diabetes mellitus and DFUs, type-2 diabetes controls and healthy controls were recruited for this study.
A Footscan pressure plate was used for plantar pressure assessment. The three step approach to capturing data was chosen. This method involves each participant taking two steps before landing on the pressure plate.
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To test the main hypothesis, the plantar pressure data for the ulcerated foot in cases, were compared to the average plantar pressures from the left and right foot in the appropriate control group.
Paired analyses were carried out between the relevant descriptive factors and outcome measures of the ulcerated and non-ulcerated feet of the DFU group.
Primary results of the study show the mpp (magnitudes of plantar pressure) and the pti (duration and magnitude of plantar pressure) at toes 2-5 and the midfoot were significantly higher in cases with DFUs compared to both control groups.
Secondary results show the maximum sensor pressure at the toes and the contact area of the mid-foot were also significantly higher in cases with DFUs compared to both controls.
This study highlighted the importance of offloading feet during active ulceration to overcome the mechanical impact of elevated plantar pressures on ulcerated tissue.
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References:
- Malindu E. Fernando, Robert G. Crowther, Peter A. Lazzarini, Kunwarjit S. Sangla, Scott Wearing, Petra Buttner, Jonathan Golledge (2016) Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration. BMC Endocrine Disorders BMC series: doi: 10.1186/s12902-016-0131-9.
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