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Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers.

Bacarin TA, Sacco IC, Hennig EM - Clinics (Sao Paulo) (2009)

Bottom Line: The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3+/-11.4 kPa.s; DN: 43.3+/-9.1 kPa.s; DNU: 68.7+/-36.5 kPa.s; p=0.002) and rearfoot (CG: 83.3+/-21.2 kPa.s; DN: 94.9+/-29.4 kPa.s; DNU: 102.5+/-37.9 kPa.s; p=0.048).A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait.The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Biomechanics of the Human Movement and Posture, Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo/SP, Brazil. tbacarin@usp.br

ABSTRACT

Objective: To investigate and compare the influence of a previous history of foot ulcers on plantar pressure variables during gait of patients with diabetic neuropathy.

Introduction: Foot ulcers may be an indicator of worsening diabetic neuropathy. However, the behavior of plantar pressure patterns over time and during the progression of neuropathy, especially in patients who have a clinical history of foot ulcers, is still unclear.

Methods: Subjects were divided into the following groups: control group, 20 subjects; diabetic neuropathy patients without foot ulcers, 17 subjects; and diabetic neuropathy patients with at least one healed foot ulcer within the last year, 10 subjects. Plantar pressure distribution was recorded during barefoot gait using the Pedar-X system.

Results: Neuropathic subjects from both the diabetic neuropathy and DNU groups showed higher plantar pressure than control subjects. At midfoot, the peak pressure was significantly different among all groups: control group (139.4+/-76.4 kPa), diabetic neuropathy (205.3+/-118.6 kPa) and DNU (290.7+/-151.5 kPa) (p=0.008). The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3+/-11.4 kPa.s; DN: 43.3+/-9.1 kPa.s; DNU: 68.7+/-36.5 kPa.s; p=0.002) and rearfoot (CG: 83.3+/-21.2 kPa.s; DN: 94.9+/-29.4 kPa.s; DNU: 102.5+/-37.9 kPa.s; p=0.048).

Conclusion: A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait. The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

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Summary of differences in pressure-time integral according to its tendency. Upper panel presentation: comparison between DN and CG (black arrows), showing higher values for DN. Lower panel: comparison between DNU and CG (black arrows) and to DN (white arrows). Black stars represent significant differences (p<0.05) between groups.
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f2-08-oa-0176: Summary of differences in pressure-time integral according to its tendency. Upper panel presentation: comparison between DN and CG (black arrows), showing higher values for DN. Lower panel: comparison between DNU and CG (black arrows) and to DN (white arrows). Black stars represent significant differences (p<0.05) between groups.

Mentions: Regarding the plantar-pressure integral, neuropathic subjects presented higher values than control subjects, mainly at the lateral forefoot (M3), midfoot (M2) and rearfoot (M1). Figure 2 represents a summary of the differences observed among groups in the pressure-time integral variable.


Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers.

Bacarin TA, Sacco IC, Hennig EM - Clinics (Sao Paulo) (2009)

Summary of differences in pressure-time integral according to its tendency. Upper panel presentation: comparison between DN and CG (black arrows), showing higher values for DN. Lower panel: comparison between DNU and CG (black arrows) and to DN (white arrows). Black stars represent significant differences (p<0.05) between groups.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2666475&req=5

f2-08-oa-0176: Summary of differences in pressure-time integral according to its tendency. Upper panel presentation: comparison between DN and CG (black arrows), showing higher values for DN. Lower panel: comparison between DNU and CG (black arrows) and to DN (white arrows). Black stars represent significant differences (p<0.05) between groups.
Mentions: Regarding the plantar-pressure integral, neuropathic subjects presented higher values than control subjects, mainly at the lateral forefoot (M3), midfoot (M2) and rearfoot (M1). Figure 2 represents a summary of the differences observed among groups in the pressure-time integral variable.

Bottom Line: The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3+/-11.4 kPa.s; DN: 43.3+/-9.1 kPa.s; DNU: 68.7+/-36.5 kPa.s; p=0.002) and rearfoot (CG: 83.3+/-21.2 kPa.s; DN: 94.9+/-29.4 kPa.s; DNU: 102.5+/-37.9 kPa.s; p=0.048).A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait.The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Biomechanics of the Human Movement and Posture, Physical Therapy, Speech and Occupational Therapy Department, Faculdade de Medicina, Universidade de São Paulo/SP, Brazil. tbacarin@usp.br

ABSTRACT

Objective: To investigate and compare the influence of a previous history of foot ulcers on plantar pressure variables during gait of patients with diabetic neuropathy.

Introduction: Foot ulcers may be an indicator of worsening diabetic neuropathy. However, the behavior of plantar pressure patterns over time and during the progression of neuropathy, especially in patients who have a clinical history of foot ulcers, is still unclear.

Methods: Subjects were divided into the following groups: control group, 20 subjects; diabetic neuropathy patients without foot ulcers, 17 subjects; and diabetic neuropathy patients with at least one healed foot ulcer within the last year, 10 subjects. Plantar pressure distribution was recorded during barefoot gait using the Pedar-X system.

Results: Neuropathic subjects from both the diabetic neuropathy and DNU groups showed higher plantar pressure than control subjects. At midfoot, the peak pressure was significantly different among all groups: control group (139.4+/-76.4 kPa), diabetic neuropathy (205.3+/-118.6 kPa) and DNU (290.7+/-151.5 kPa) (p=0.008). The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3+/-11.4 kPa.s; DN: 43.3+/-9.1 kPa.s; DNU: 68.7+/-36.5 kPa.s; p=0.002) and rearfoot (CG: 83.3+/-21.2 kPa.s; DN: 94.9+/-29.4 kPa.s; DNU: 102.5+/-37.9 kPa.s; p=0.048).

Conclusion: A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait. The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

Show MeSH
Related in: MedlinePlus