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The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy.

Lin TL, Sheen HM, Chung CT, Yang SW, Lin SY, Luo HJ, Chen CY, Chan IC, Shih HS, Sheu WH - J Foot Ankle Res (2013)

Bottom Line: Among the 26 ROIs, a significant reduction in MPP (32.3%, P<0.001) was found after removing the insole plugs.With an arch support added, the pressure was further reduced (9.5%, P<0.001).These findings suggest that forefoot plantar pressure can be reduced by removing plugs and adding arch support to foam-based insoles.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sec, 4, Taichung 407, Taiwan, Republic of China. whhsheu@vghtc.gov.tw.

ABSTRACT

Background: Removable plug insoles appear to be beneficial for patients with diabetic neuropathic feet to offload local plantar pressure. However, quantitative evidence of pressure reduction by means of plug removal is limited. The value of additional insole accessories, such as arch additions, has not been tested. The purpose of this study was to evaluate the effect of removing plugs from foam based insoles, and subsequently adding extra arch support, on plantar pressures.

Methods: In-shoe plantar pressure measurements were performed on 26 patients with diabetic neuropathic feet at a baseline condition, in order to identify the forefoot region with the highest mean peak pressure (MPP). This was defined as the region of interest (ROI) for plug removal.The primary outcome was measurement of MPP using the pedar® system in the baseline and another three insole conditions (pre-plug removal, post-plug removal, and post-plug removal plus arch support).

Results: Among the 26 ROIs, a significant reduction in MPP (32.3%, P<0.001) was found after removing the insole plugs. With an arch support added, the pressure was further reduced (9.5%, P<0.001). There were no significant differences in MPP at non-ROIs between pre- and post-plug removal conditions.

Conclusions: These findings suggest that forefoot plantar pressure can be reduced by removing plugs and adding arch support to foam-based insoles. This style of insole may therefore be clinically useful in managing patients with diabetic peripheral neuropathy.

No MeSH data available.


Related in: MedlinePlus

Mean peak plantar pressure (MPP), maximum force, and contact area in the four insoles conditions.
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Figure 5: Mean peak plantar pressure (MPP), maximum force, and contact area in the four insoles conditions.

Mentions: Figure 5 and Table 3 provide data related to MPP changes in the four insole conditions. The adjusted MPPs at ROIs for the baseline condition, pre-plug removal condition, post-plug removal condition, and post-plug removal plus arch support condition were 262.5 ± 64.9, 221.4 ± 50.3, 149.9 ± 34.8, and 135.6 ± 31.9 (kPa), respectively. A significant difference at ROIs between conditions was found (p <0.001). The comparison between the post-plug removal and the pre-plug removal conditions showed a significant reduction in MPP (32.3%, p <0.001) at ROIs. With an arch support added, the values were further reduced (MPP: 9.5%, p <0.001). For the region of non-ROIs, a significant difference in MPP was found between conditions (p =0.002), but there were no significant differences when the pre-plug removal condition was compared with the post-plug removal condition (159.2 ± 26.8 kPa vs. 162.7 ± 30.2 kPa; p = 0.408). A significant difference was found when the baseline condition was compared with each of the rest 3 conditions (comparison between the pre-plug removal and the baseline condition: 8.7% reduction, p <0.001; comparison between the post-plug removal and the baseline condition: 6.7% reduction, p =0.03 ; and comparison between the post-plug removal plus arch support and the baseline condition: 9% reduction, p =0.01). For the midfoot area, there were no significant differences in MPP between conditions (p =0.052).


The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy.

Lin TL, Sheen HM, Chung CT, Yang SW, Lin SY, Luo HJ, Chen CY, Chan IC, Shih HS, Sheu WH - J Foot Ankle Res (2013)

Mean peak plantar pressure (MPP), maximum force, and contact area in the four insoles conditions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750449&req=5

Figure 5: Mean peak plantar pressure (MPP), maximum force, and contact area in the four insoles conditions.
Mentions: Figure 5 and Table 3 provide data related to MPP changes in the four insole conditions. The adjusted MPPs at ROIs for the baseline condition, pre-plug removal condition, post-plug removal condition, and post-plug removal plus arch support condition were 262.5 ± 64.9, 221.4 ± 50.3, 149.9 ± 34.8, and 135.6 ± 31.9 (kPa), respectively. A significant difference at ROIs between conditions was found (p <0.001). The comparison between the post-plug removal and the pre-plug removal conditions showed a significant reduction in MPP (32.3%, p <0.001) at ROIs. With an arch support added, the values were further reduced (MPP: 9.5%, p <0.001). For the region of non-ROIs, a significant difference in MPP was found between conditions (p =0.002), but there were no significant differences when the pre-plug removal condition was compared with the post-plug removal condition (159.2 ± 26.8 kPa vs. 162.7 ± 30.2 kPa; p = 0.408). A significant difference was found when the baseline condition was compared with each of the rest 3 conditions (comparison between the pre-plug removal and the baseline condition: 8.7% reduction, p <0.001; comparison between the post-plug removal and the baseline condition: 6.7% reduction, p =0.03 ; and comparison between the post-plug removal plus arch support and the baseline condition: 9% reduction, p =0.01). For the midfoot area, there were no significant differences in MPP between conditions (p =0.052).

Bottom Line: Among the 26 ROIs, a significant reduction in MPP (32.3%, P<0.001) was found after removing the insole plugs.With an arch support added, the pressure was further reduced (9.5%, P<0.001).These findings suggest that forefoot plantar pressure can be reduced by removing plugs and adding arch support to foam-based insoles.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sec, 4, Taichung 407, Taiwan, Republic of China. whhsheu@vghtc.gov.tw.

ABSTRACT

Background: Removable plug insoles appear to be beneficial for patients with diabetic neuropathic feet to offload local plantar pressure. However, quantitative evidence of pressure reduction by means of plug removal is limited. The value of additional insole accessories, such as arch additions, has not been tested. The purpose of this study was to evaluate the effect of removing plugs from foam based insoles, and subsequently adding extra arch support, on plantar pressures.

Methods: In-shoe plantar pressure measurements were performed on 26 patients with diabetic neuropathic feet at a baseline condition, in order to identify the forefoot region with the highest mean peak pressure (MPP). This was defined as the region of interest (ROI) for plug removal.The primary outcome was measurement of MPP using the pedar® system in the baseline and another three insole conditions (pre-plug removal, post-plug removal, and post-plug removal plus arch support).

Results: Among the 26 ROIs, a significant reduction in MPP (32.3%, P<0.001) was found after removing the insole plugs. With an arch support added, the pressure was further reduced (9.5%, P<0.001). There were no significant differences in MPP at non-ROIs between pre- and post-plug removal conditions.

Conclusions: These findings suggest that forefoot plantar pressure can be reduced by removing plugs and adding arch support to foam-based insoles. This style of insole may therefore be clinically useful in managing patients with diabetic peripheral neuropathy.

No MeSH data available.


Related in: MedlinePlus