Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes
Abstract Background High plantar pressures are associated with increased foot ulcer risk in people with diabetes. Identification of high plantar pressures in people with diabetes is clinically challenging due to time and cost constraints of plantar pressure testing. Factors affecting foot biomechani...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-021-00494-4 |
| _version_ | 1797321337894600704 |
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| author | Vivienne H. Chuter Martin J. Spink Michael David Sean Lanting Angela Searle |
| author_facet | Vivienne H. Chuter Martin J. Spink Michael David Sean Lanting Angela Searle |
| author_sort | Vivienne H. Chuter |
| collection | DOAJ |
| description | Abstract Background High plantar pressures are associated with increased foot ulcer risk in people with diabetes. Identification of high plantar pressures in people with diabetes is clinically challenging due to time and cost constraints of plantar pressure testing. Factors affecting foot biomechanics, including reduced joint range of motion and foot deformity, are implicated in the development of high plantar pressures and may provide a method to clinically identify those at risk of pressure related complications. The aim of this study was to investigate the contribution of joint range of motion and foot deformity measures on plantar pressures in a community dwelling group with diabetes. Methods Barefoot (Tekscan HR Mat™) and in‐shoe (Novel Pedar‐X®) plantar pressure variables, weight bearing ankle dorsiflexion, hallux range of motion, lesser toe deformities and hallux abductus (HAV) scale were assessed in 136 adults with diabetes (52.2% male; mean age 68.4 years). Multivariate multiple linear regression was used to assess the effect of the four biomechanical factors plus neuropathy and body mass index on plantar pressure variables. Non‐parametric bootstrapping was employed to determine the difference in plantar pressure variables for participants with two or more foot biomechanical pathologies compared to those with less than two pathologies. Results Almost one third (32%) of the cohort had two or more foot biomechanical pathologies. Participants with two or more foot biomechanical pathologies displayed significant increases in all barefoot plantar pressure regions (except forefoot), compared to those with less than two pathologies. No significant changes were found for the in‐shoe plantar pressure variables. The regression model explains between 9.9% (95%CI: 8.4 to 11.4%) and 29.6% (95% CI: 28.2 to 31%), and between 2.5% (1.0 to 4.0%) and 43.8% (95% CI: 42.5–44.9%), of the variance in the barefoot and in‐shoe plantar pressure variables respectively. Conclusions Participants presenting with two or more factors affecting foot biomechanics displayed higher peak pressures and pressure time integrals in all foot regions compared to those with less than two factors. The tests used in this study could help clinicians detect elevated plantar pressures in people with diabetes and present an opportunity for early preventative interventions. |
| first_indexed | 2024-03-08T04:56:11Z |
| format | Article |
| id | doaj.art-13899aa473344c28ae554fdb2a817b70 |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:56:11Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-13899aa473344c28ae554fdb2a817b702024-02-07T15:10:48ZengWileyJournal of Foot and Ankle Research1757-11462021-01-01141n/an/a10.1186/s13047-021-00494-4Clinical foot measurements as a proxy for plantar pressure testing in people with diabetesVivienne H. Chuter0Martin J. Spink1Michael David2Sean Lanting3Angela Searle4School of Health SciencesFaculty of Health and MedicineUniversity of NewcastlePO Box 127, 2258OurimbahNSWAustraliaSchool of Health SciencesFaculty of Health and MedicineUniversity of NewcastlePO Box 127, 2258OurimbahNSWAustraliaSchool of MedicineGriffith UniversityBrisbaneQueenslandAustraliaSchool of Health SciencesFaculty of Health and MedicineUniversity of NewcastlePO Box 127, 2258OurimbahNSWAustraliaSchool of Health SciencesFaculty of Health and MedicineUniversity of NewcastlePO Box 127, 2258OurimbahNSWAustraliaAbstract Background High plantar pressures are associated with increased foot ulcer risk in people with diabetes. Identification of high plantar pressures in people with diabetes is clinically challenging due to time and cost constraints of plantar pressure testing. Factors affecting foot biomechanics, including reduced joint range of motion and foot deformity, are implicated in the development of high plantar pressures and may provide a method to clinically identify those at risk of pressure related complications. The aim of this study was to investigate the contribution of joint range of motion and foot deformity measures on plantar pressures in a community dwelling group with diabetes. Methods Barefoot (Tekscan HR Mat™) and in‐shoe (Novel Pedar‐X®) plantar pressure variables, weight bearing ankle dorsiflexion, hallux range of motion, lesser toe deformities and hallux abductus (HAV) scale were assessed in 136 adults with diabetes (52.2% male; mean age 68.4 years). Multivariate multiple linear regression was used to assess the effect of the four biomechanical factors plus neuropathy and body mass index on plantar pressure variables. Non‐parametric bootstrapping was employed to determine the difference in plantar pressure variables for participants with two or more foot biomechanical pathologies compared to those with less than two pathologies. Results Almost one third (32%) of the cohort had two or more foot biomechanical pathologies. Participants with two or more foot biomechanical pathologies displayed significant increases in all barefoot plantar pressure regions (except forefoot), compared to those with less than two pathologies. No significant changes were found for the in‐shoe plantar pressure variables. The regression model explains between 9.9% (95%CI: 8.4 to 11.4%) and 29.6% (95% CI: 28.2 to 31%), and between 2.5% (1.0 to 4.0%) and 43.8% (95% CI: 42.5–44.9%), of the variance in the barefoot and in‐shoe plantar pressure variables respectively. Conclusions Participants presenting with two or more factors affecting foot biomechanics displayed higher peak pressures and pressure time integrals in all foot regions compared to those with less than two factors. The tests used in this study could help clinicians detect elevated plantar pressures in people with diabetes and present an opportunity for early preventative interventions.https://doi.org/10.1186/s13047-021-00494-4DiabetesPlantar pressureBiomechanical |
| spellingShingle | Vivienne H. Chuter Martin J. Spink Michael David Sean Lanting Angela Searle Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes Journal of Foot and Ankle Research Diabetes Plantar pressure Biomechanical |
| title | Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes |
| title_full | Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes |
| title_fullStr | Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes |
| title_full_unstemmed | Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes |
| title_short | Clinical foot measurements as a proxy for plantar pressure testing in people with diabetes |
| title_sort | clinical foot measurements as a proxy for plantar pressure testing in people with diabetes |
| topic | Diabetes Plantar pressure Biomechanical |
| url | https://doi.org/10.1186/s13047-021-00494-4 |
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