Analysis of plantar pressure in diabetic type 2 subjects with and without neuropathy

Rahman, Muhammad Afiq; Aziz, Zulkarnain; Acharya, U. Rajendra; Ha, Tan Peck; Kannathal, N.; Ng, E. Y. K.; Law, Chelsea; Tavintharan, Subramaniam; Shuen, Wong Yue; Fang, Sum Chee

doi:10.1016/j.rbmret.2006.03.001

Cited by 29 publications

(25 citation statements)

References 26 publications

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“…However, mean peak pressure within the former group was 23% higher. Ctercteko et al (1981), Pitei et al (1999) and Rahman et al (2006) reported similarly lower rates of peak pressure increase (8%, 32% and 15%, respectively) in diabetic subjects.…”

Section: Discussionmentioning

confidence: 76%

Temporal characteristics of plantar shear distribution: Relevance to diabetic patients

Yavuz¹,

Tajaddini²,

Botek³

et al. 2008

Journal of Biomechanics

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Diabetic foot ulcers are known to have a biomechanical etiology. Among the mechanical factors that cause foot lesions, shear stresses have been either neglected or underestimated. The purpose of this study was to determine various plantar pressure and shear variables in the diabetic and control groups and compare them. Fifteen diabetic patients with neuropathy and 20 non-diabetic subjects without foot symptoms were recruited. Subjects walked on a custom-built platform capable of measuring local normal and tangential forces simultaneously. Pressure-time integral quantities were increased by 54% (p=0.013) in the diabetic group. Peak AP and resultant shear magnitudes were found to be about 32% larger (p<0.05), even though diabetic subjects walked at a slower velocity. Lower AP and ML stress range (peak-to-peak) values were observed in the control subjects (p<0.05). Shear-time integral values were increased in the diabetic group by 61% and 132% for AP and resultant shear cases, respectively (p<0.05). Plantar shear is known to be a factor in callus formation and has previously been associated with higher ulcer incidence. During gait, shear stresses are induced with twice the frequency of pressure characteristically. Therefore, plantar shear should be investigated further from a broader perspective including the temporal specifications and fatigue failure characteristics of the affected plantar tissue.

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Section: Discussionmentioning

confidence: 76%

Temporal characteristics of plantar shear distribution: Relevance to diabetic patients

Yavuz¹,

Tajaddini²,

Botek³

et al. 2008

Journal of Biomechanics

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show abstract

“…Therefore, computer aided diagnostic techniques were developed to utilize this relationship alone for the detection of diabetes. In one such study, pressure distribution techniques were used for analyzing the mechanical behavior of the human foot during static and dynamic loading situations in normal subjects, and subjects with Type 2 diabetes and diabetes with neuropathy [15]. They used static parameters and the power ratio features with neural network classifier for automatic classification, and obtained an accuracy of 90%.…”

Section: Introductionmentioning

confidence: 99%

Computer-Based Identification of Type 2 Diabetic Subjects with and Without Neuropathy Using Dynamic Planter Pressure and Principal Component Analysis

et al. 2011

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Diabetes is a chronic disease that is characterized by an increased blood glucose level due to insulin resistance. Type 2 diabetes is common in middle aged and old people. In this work, we present a technique to analyze dynamic foot pressures images and classify them into normal, diabetes type 2 with and without neuropathy classes. Plantar pressure images were obtained using the F-Scan (Tekscan, USA) in-shoe measurement system. We used Principal Component Analysis (PCA) and extracted the eigenvalues from different regions of the foot image. The features extracted from region 1 of the foot pressure image, which were found to be clinically significant, were fed into the Fuzzy classifier (Sugeno model) for automatic classification. Our results show that the proposed method is able to identify the unknown class with an accuracy of 93.7%, sensitivity of 100%, and specificity of 83.3%. Moreover, in this work, we have proposed an integrated index using the eigenvalues to differentiate the normal subjects from diabetes with and without neuropathy subjects using just one number. This index will help the clinicians in easy and objective daily screening, and it can also be used as an adjunct tool to cross check their diagnosis.

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“…Damaged motor nerves cannot innervate muscles, and consequently, muscles will atrophy. In the foot, this results in a high arch with progression toward prominent MH and hammering of the toes with both conditions causing increased pressures at the MH and toe regions (Bus, Maas, de Lange, Michels, & Levi, 2005; Rahman et al, 2006; van Schie, 2005). It appears that both groups in this investigation may have been at some risk for developing an ulcer based on possible structural changes of the feet.…”

Section: Discussionmentioning

confidence: 99%

Weight-Bearing Exercise and Foot Health in Native Americans

Cuaderes

DeShea

Lamb

2014

Care Management Journals

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Diabetes contributes to sensory peripheral neuropathy, which has been linked to lower limb abnormalities that raise the risk for foot ulcers and amputations. Because amputations are a reason for pain and hospitalization in those with diabetes, it is of critical importance to gain insight about prevention of ulcer development in this population. Although the American Diabetes Association (ADA) now recommends that individuals with neuropathy can engage in moderate-intensity weight-bearing activity (WBA), they must wear appropriate footwear and inspect their feet daily. The physical forces and inflammatory processes from WBA may contribute to plantar characteristics that lead to ulcers. The purpose of this study was to compare neuropathic status and foot characteristics in Native Americans according to WBA classification. The t tests for unequal sample sizes found that exercisers had more difficulty sensing baseline temperature than nonexercisers, except at the right foot (all p values < .05). By dividing groups into no/low risk and high risk for ulcer, a majority showed no/low risk according to touch and vibration sense. Exercisers demonstrated higher surface skin temperature gradients at the first metatarsal head, a plantar site where wounds tend to form. The more consistently exercisers performed, the higher the plan-tar pressures were at the right second (r = .24, p = .02) and third metatarsal heads (r = .26, p = .01). Findings from this investigation do not refute current ADA recommendations and further intervention studies are needed that are longitudinal and measures WBA more accurately.

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Analysis of plantar pressure in diabetic type 2 subjects with and without neuropathy

Cited by 29 publications

References 26 publications

Temporal characteristics of plantar shear distribution: Relevance to diabetic patients

Temporal characteristics of plantar shear distribution: Relevance to diabetic patients

Computer-Based Identification of Type 2 Diabetic Subjects with and Without Neuropathy Using Dynamic Planter Pressure and Principal Component Analysis

Weight-Bearing Exercise and Foot Health in Native Americans

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