Abstract-Temperature of the plantar foot surface is an important feature in type II diabetes as abnormal temperature variations can be an early sign of foot diseases. In this paper, automatic way to analyze these temperature variations is presented by using an infrared camera. A robust acquisition protocol is proposed and an image processing software is developed. Three types of analysis are performed. First, the mean plantar foot temperature of both feet results from a segmentation procedure based on the Chan and Vese active contour method. Second, the point-to-point absolute mean difference between the 2 feet is assessed by using a rigid registration method. Third, significant hyperthermia regions such that the point-to-point absolute difference is greater than 2.2°C are highlighted. All these measures are fully automatic and do not need manual intervention. 82 type II diabetic subjects in a preulcerative state were recruited in the Dos de Mayo hospital (HNDM) in Lima, Peru. These persons were classified in two risk groups of developing an ulcer based on a medical exam: a medium risk group, and a high risk group. Results show that the mean temperature of the plantar foot surface is higher of 1ºC in the high risk group compared to the medium risk group. The mean point-to-point absolute difference shows identical values in the 2 groups. Finally, 9 subjects out of the 82 ones show significant hyperthermia of one foot compared to the other (6 in the medium risk group and 3 in the high risk group). It is expected that the new opportunity to automatically analyze foot temperature in hospitals or in diabetic health centers will help in reducing foot ulcer occurrence for type II diabetic persons.

In diabetic foot, the occurrence of an ulcer is often associated with hyperthermia. Hyperthermia is defined as a temperature greater than 2.2°C in a given region of one of the foot compared to the temperature of the same region of the contralateral foot. Unfortunately, hyperthermia is not yet assessed in current diabetic foot therapy. In this paper, we propose an easy way to detect a possible hyperthermia by using an infrared camera. A specific acquisition protocol of the thermal images is proposed. A dedicated image analysis is developed: it is composed of a contour detection of the 2 feet using the Chan and Vese active contour method associated to the ICP rigid registration technique. Among 85 type II diabetes persons recruited in the Dos de Mayo hospital in Lima, Peru, 9 individuals show significant hyperthermia. It is expected that the new possibility of detecting hyperthermia in hospitals or in diabetic health centers which is now available, thanks to the proposed method, will help in reducing foot ulcer occurrence for diabetic persons.

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This study was designed to assess the effect of time on the repeatability of the LorAn pressure distribution measurement system, and evaluate the variability of plantar pressure and postural balance, during barefoot standing in diabetic and non-diabetic subjects, for future diabetic foot clinical evaluation. Fourteen subjects were evaluated (8 females, 6 males, 8 non-diabetics and 6 diabetics, age range 30-70 years) and had no musculoskeletal symptoms. Four variables were measured with the platform in the barefoot standing position. Ten measurements were taken using two different techniques for feet and posture positioning, during three sessions, once a week. The MANOVA test confirmed that the platform measurements are reproducible for variables body baricenter (x) and foot baricenter (x) through time, being the coefficients of variation, with a 99% confidence interval, lower than 1.6% for body baricenter (x), and lower than 2.06% for foot baricenter (x), for all studied conditions. For the remaining variables, the results were not stabilized through time, which makes necessary to standardize the measurement protocol that guarantees the repeatability in all variables.