Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis
OBJECTIVE: Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure anal...
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| Veröffentlicht in: | Diabetes care 2011-07, Vol.34 (7), p.1595-1600 |
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| creator | Bus, Sicco A Haspels, Rob Busch-Westbroek, Tessa E |
| description | OBJECTIVE: Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to evaluate and optimize the pressure-reducing effects of diabetic therapeutic footwear. RESEARCH DESIGN AND METHODS: Dynamic in-shoe plantar pressure distribution was measured in 23 neuropathic diabetic foot patients wearing fully customized footwear. Regions of interest (with peak pressure >200 kPa) were selected and targeted for pressure optimization by modifying the shoe or insole. After each of a maximum of three rounds of modifications, the effect on in-shoe plantar pressure was measured. Successful optimization was achieved with a peak pressure reduction of >25% (criterion A) or below an absolute level of 200 kPa (criterion B). RESULTS: In 35 defined regions, mean peak pressure was significantly reduced from 303 (SD 77) to 208 (46) kPa after an average 1.6 rounds of footwear modifications (P < 0.001). This result constitutes a 30.2% pressure relief (range 18-50% across regions). All regions were successfully optimized: 16 according to criterion A, 7 to criterion B, and 12 to criterion A and B. Footwear optimization lasted on average 53 min. CONCLUSIONS: These findings suggest that in-shoe plantar pressure analysis is an effective and efficient tool to evaluate and guide footwear modifications that significantly reduce pressure in the neuropathic diabetic foot. This result provides an objective approach to instantly improve footwear quality, which should reduce the risk for pressure-related plantar foot ulcers. |
| doi_str_mv | 10.2337/dc10-2206 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3120171</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A262143403</galeid><sourcerecordid>A262143403</sourcerecordid><originalsourceid>FETCH-LOGICAL-c626t-6e5bca1cd462f1284ff150bbe51de0fb808d68953285f407e207f98767802a783</originalsourceid><addsrcrecordid>eNpt0l9v0zAQAPAIgVgZPPAFIAIhxEOG_ybOC1I1Npg0sUpbny3HObeeUjuzk6HxyCfHUbvBUBVFkezfneO7y7LXGB0RSqvPrcaoIASVT7IZrikvOGfiaTZDmNUFr2tykL2I8RohxJgQz7MDgkuMMOGz7PfJrepGNVjvcuXa_KIf7Mb-2i54k1-tIagexsHq_NT74SeokBsf8h8wBt-rYZ02vlrVwL3IFykY3BDzZbRulZ-54nLtIV90yg0peBEgxjFAPnequ4s2vsyeGdVFeLX7HmbL05Or4-_F-cW3s-P5eaFLUg5FCbzRCuuWlcRgIpgxmKOmAY5bQKYRSLSlqDklghuGKiCoMrWoykogoipBD7Mv27z92Gyg1ekfg-pkH-xGhTvplZWPd5xdy5W_lRQThCucEnzcJQj-ZoQ4yI2NGrp0MfBjlKJiuBapskm--09e-zGk-06oqlKnOE_o_RatVAfSOuPTqXpKKeekJJhRhmhSxR61Apf60nkHxqblR_5oj09PCxur9wZ82gbo4GMMYB4qgpGcxktO4yWn8Ur2zb8lfJD385TAhx1QUavOBOW0jX8do7REeOrF260zyku1CsksL1OVGUpvOpTTP-l4394</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>877720655</pqid></control><display><type>article</type><title>Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis</title><source>Journals@Ovid Ovid Autoload</source><source>MEDLINE</source><source>EZB Electronic Journals Library</source><creator>Bus, Sicco A ; Haspels, Rob ; Busch-Westbroek, Tessa E</creator><creatorcontrib>Bus, Sicco A ; Haspels, Rob ; Busch-Westbroek, Tessa E</creatorcontrib><description>OBJECTIVE: Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to evaluate and optimize the pressure-reducing effects of diabetic therapeutic footwear. RESEARCH DESIGN AND METHODS: Dynamic in-shoe plantar pressure distribution was measured in 23 neuropathic diabetic foot patients wearing fully customized footwear. Regions of interest (with peak pressure >200 kPa) were selected and targeted for pressure optimization by modifying the shoe or insole. After each of a maximum of three rounds of modifications, the effect on in-shoe plantar pressure was measured. Successful optimization was achieved with a peak pressure reduction of >25% (criterion A) or below an absolute level of 200 kPa (criterion B). RESULTS: In 35 defined regions, mean peak pressure was significantly reduced from 303 (SD 77) to 208 (46) kPa after an average 1.6 rounds of footwear modifications (P < 0.001). This result constitutes a 30.2% pressure relief (range 18-50% across regions). All regions were successfully optimized: 16 according to criterion A, 7 to criterion B, and 12 to criterion A and B. Footwear optimization lasted on average 53 min. CONCLUSIONS: These findings suggest that in-shoe plantar pressure analysis is an effective and efficient tool to evaluate and guide footwear modifications that significantly reduce pressure in the neuropathic diabetic foot. This result provides an objective approach to instantly improve footwear quality, which should reduce the risk for pressure-related plantar foot ulcers.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc10-2206</identifier><identifier>PMID: 21610125</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Aged ; Associated diseases and complications ; Biological and medical sciences ; Clinical medicine ; Clinics ; Diabetes ; Diabetes Mellitus - physiopathology ; Diabetes. Impaired glucose tolerance ; Diabetic foot ; Diabetic Foot - physiopathology ; Diabetic Foot - therapy ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; feet ; Female ; Foot - physiopathology ; Foot diseases ; Footwear ; Health aspects ; Health care ; Humans ; Male ; Medical sciences ; Metabolic diseases ; Middle Aged ; Miscellaneous ; nervous system diseases ; Optimization algorithms ; Original Research ; patients ; Pressure ; Pressure distribution ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; risk ; Shoes ; Studies</subject><ispartof>Diabetes care, 2011-07, Vol.34 (7), p.1595-1600</ispartof><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 American Diabetes Association</rights><rights>Copyright American Diabetes Association Jul 2011</rights><rights>2011 by the American Diabetes Association. 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c626t-6e5bca1cd462f1284ff150bbe51de0fb808d68953285f407e207f98767802a783</citedby><cites>FETCH-LOGICAL-c626t-6e5bca1cd462f1284ff150bbe51de0fb808d68953285f407e207f98767802a783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24336018$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21610125$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bus, Sicco A</creatorcontrib><creatorcontrib>Haspels, Rob</creatorcontrib><creatorcontrib>Busch-Westbroek, Tessa E</creatorcontrib><title>Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE: Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to evaluate and optimize the pressure-reducing effects of diabetic therapeutic footwear. RESEARCH DESIGN AND METHODS: Dynamic in-shoe plantar pressure distribution was measured in 23 neuropathic diabetic foot patients wearing fully customized footwear. Regions of interest (with peak pressure >200 kPa) were selected and targeted for pressure optimization by modifying the shoe or insole. After each of a maximum of three rounds of modifications, the effect on in-shoe plantar pressure was measured. Successful optimization was achieved with a peak pressure reduction of >25% (criterion A) or below an absolute level of 200 kPa (criterion B). RESULTS: In 35 defined regions, mean peak pressure was significantly reduced from 303 (SD 77) to 208 (46) kPa after an average 1.6 rounds of footwear modifications (P < 0.001). This result constitutes a 30.2% pressure relief (range 18-50% across regions). All regions were successfully optimized: 16 according to criterion A, 7 to criterion B, and 12 to criterion A and B. Footwear optimization lasted on average 53 min. CONCLUSIONS: These findings suggest that in-shoe plantar pressure analysis is an effective and efficient tool to evaluate and guide footwear modifications that significantly reduce pressure in the neuropathic diabetic foot. This result provides an objective approach to instantly improve footwear quality, which should reduce the risk for pressure-related plantar foot ulcers.</description><subject>Aged</subject><subject>Associated diseases and complications</subject><subject>Biological and medical sciences</subject><subject>Clinical medicine</subject><subject>Clinics</subject><subject>Diabetes</subject><subject>Diabetes Mellitus - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic foot</subject><subject>Diabetic Foot - physiopathology</subject><subject>Diabetic Foot - therapy</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>feet</subject><subject>Female</subject><subject>Foot - physiopathology</subject><subject>Foot diseases</subject><subject>Footwear</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>nervous system diseases</subject><subject>Optimization algorithms</subject><subject>Original Research</subject><subject>patients</subject><subject>Pressure</subject><subject>Pressure distribution</subject><subject>Public health. Hygiene</subject><subject>Public health. 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Impaired glucose tolerance</topic><topic>Diabetic foot</topic><topic>Diabetic Foot - physiopathology</topic><topic>Diabetic Foot - therapy</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>feet</topic><topic>Female</topic><topic>Foot - physiopathology</topic><topic>Foot diseases</topic><topic>Footwear</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>nervous system diseases</topic><topic>Optimization algorithms</topic><topic>Original Research</topic><topic>patients</topic><topic>Pressure</topic><topic>Pressure distribution</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>risk</topic><topic>Shoes</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bus, Sicco A</creatorcontrib><creatorcontrib>Haspels, Rob</creatorcontrib><creatorcontrib>Busch-Westbroek, Tessa E</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>Agricultural Science Collection</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (ProQuest)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Agriculture Science Database</collection><collection>Family Health Database (ProQuest Medical & Health Databases)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>ProQuest Science Journals</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bus, Sicco A</au><au>Haspels, Rob</au><au>Busch-Westbroek, Tessa E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2011-07-01</date><risdate>2011</risdate><volume>34</volume><issue>7</issue><spage>1595</spage><epage>1600</epage><pages>1595-1600</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>OBJECTIVE: Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to evaluate and optimize the pressure-reducing effects of diabetic therapeutic footwear. RESEARCH DESIGN AND METHODS: Dynamic in-shoe plantar pressure distribution was measured in 23 neuropathic diabetic foot patients wearing fully customized footwear. Regions of interest (with peak pressure >200 kPa) were selected and targeted for pressure optimization by modifying the shoe or insole. After each of a maximum of three rounds of modifications, the effect on in-shoe plantar pressure was measured. Successful optimization was achieved with a peak pressure reduction of >25% (criterion A) or below an absolute level of 200 kPa (criterion B). RESULTS: In 35 defined regions, mean peak pressure was significantly reduced from 303 (SD 77) to 208 (46) kPa after an average 1.6 rounds of footwear modifications (P < 0.001). This result constitutes a 30.2% pressure relief (range 18-50% across regions). All regions were successfully optimized: 16 according to criterion A, 7 to criterion B, and 12 to criterion A and B. Footwear optimization lasted on average 53 min. CONCLUSIONS: These findings suggest that in-shoe plantar pressure analysis is an effective and efficient tool to evaluate and guide footwear modifications that significantly reduce pressure in the neuropathic diabetic foot. This result provides an objective approach to instantly improve footwear quality, which should reduce the risk for pressure-related plantar foot ulcers.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>21610125</pmid><doi>10.2337/dc10-2206</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2011-07, Vol.34 (7), p.1595-1600 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3120171 |
| source | Journals@Ovid Ovid Autoload; MEDLINE; EZB Electronic Journals Library |
| subjects | Aged Associated diseases and complications Biological and medical sciences Clinical medicine Clinics Diabetes Diabetes Mellitus - physiopathology Diabetes. Impaired glucose tolerance Diabetic foot Diabetic Foot - physiopathology Diabetic Foot - therapy Endocrine pancreas. Apud cells (diseases) Endocrinopathies feet Female Foot - physiopathology Foot diseases Footwear Health aspects Health care Humans Male Medical sciences Metabolic diseases Middle Aged Miscellaneous nervous system diseases Optimization algorithms Original Research patients Pressure Pressure distribution Public health. Hygiene Public health. Hygiene-occupational medicine risk Shoes Studies |
| title | Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis |
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