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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

The graphs of mean peak plantar pressure of a patient with ROI located in the MT2-3 area in the four experimental insole conditions. (i) baseline; (ii) pre-plug removal; (iii) post-plug removal; and (iv) post-plug removal plus arch support. Note the mean peak plantar pressure value of ROI is reduced gradually following removal of the plugs and addition of an arch support.
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Figure 6: The graphs of mean peak plantar pressure of a patient with ROI located in the MT2-3 area in the four experimental insole conditions. (i) baseline; (ii) pre-plug removal; (iii) post-plug removal; and (iv) post-plug removal plus arch support. Note the mean peak plantar pressure value of ROI is reduced gradually following removal of the plugs and addition of an arch support.

Mentions: Insole configuration is also important for plantar pressure redistribution. An arch pad is often used in clinical practice for support of the medial midfoot area, which is thought to be capable of bearing a load safely and relieving the excess pressure from the remaining plantar foot area [6]. However, it has seldom been used in combination with a removable plug insole and the level of efficiency has not been previously reported. In this study, significant reductions of MPP in ROIs (9.5%) after addition of an arch support to the post-plug removal insoles were observed (Figure 6). The contact area and maximum force in the midfoot region increased significantly (51.5% and 42.6%, respectively). These results showed that an arch support can share the mechanical load and may explain its effect on further offloading.


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)

The graphs of mean peak plantar pressure of a patient with ROI located in the MT2-3 area in the four experimental insole conditions. (i) baseline; (ii) pre-plug removal; (iii) post-plug removal; and (iv) post-plug removal plus arch support. Note the mean peak plantar pressure value of ROI is reduced gradually following removal of the plugs and addition of an arch support.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: The graphs of mean peak plantar pressure of a patient with ROI located in the MT2-3 area in the four experimental insole conditions. (i) baseline; (ii) pre-plug removal; (iii) post-plug removal; and (iv) post-plug removal plus arch support. Note the mean peak plantar pressure value of ROI is reduced gradually following removal of the plugs and addition of an arch support.
Mentions: Insole configuration is also important for plantar pressure redistribution. An arch pad is often used in clinical practice for support of the medial midfoot area, which is thought to be capable of bearing a load safely and relieving the excess pressure from the remaining plantar foot area [6]. However, it has seldom been used in combination with a removable plug insole and the level of efficiency has not been previously reported. In this study, significant reductions of MPP in ROIs (9.5%) after addition of an arch support to the post-plug removal insoles were observed (Figure 6). The contact area and maximum force in the midfoot region increased significantly (51.5% and 42.6%, respectively). These results showed that an arch support can share the mechanical load and may explain its effect on further offloading.

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