Determinants of plantar pressures in the diabetic foot

Indicators of Future Ulceration in Diabetes Patients of Low-Moderate Foot Risk

“…The metatarsal region and the heel observed significantly increased pressure values compared to the control group. This phenomenon was previously reported in relation to determinants of DFU [7,8,21,26]. The hallux has been determined as a chief pressure point in patients within a high risk category of ulceration [21,22].…”

“…However, this study recorded similar pressures at the hallux in both groups; this was a novel finding. Deformation and reduced ankle flexion are considered causative factors for increased pressure at the hallux [47]. Since patients involved in this study did not present with any of these triggers it is understandable why elevated pressure was not detected here.…”

“…Numerous determinants of ulceration exist, but often it is a presence of more than one determinant that will lead to ulcer development. Payne et al [8] conducted a study in relation to the determinants of elevated plantar pressure. The main causation factors discussed are increased body weight, neuropathy, foot structure/deformity, limited joint mobility, muscle strength and changes to plantar soft tissue.…”

“…A substantial number of authors have investigated the plantar pressure values of DM and neuropathic patients with the notion of high pressure areas to be linked to ulcer sites. Many studies concluded that the presence of neuropathy was responsible for a major increase in plantar pressure across all findings [8,19,20]. Armstrong et al [21] and Ctercteko et al [22] along with others [23][24][25] have concluded that the hallux, heel and mid-metatarsal regions are those most inclined to develop calluses and ulceration.…”

Effect of 850 nm He-Ne Laser Therapy on Nerve Conduction and Foot Planter Pressures Distribution of Painful Diabetic Neuropathy: A Randomized Controlled Trial

“…In neuropathy, there is a progressive degeneration of the peripheral nerves in the lower limbs especially, that leads to sensory and motor deficits [2]. This affects the biomechanics of the foot, that seen in the ankle kinematics [3], gait kinetics [4] and plantar pressure distribution [5]. According to literature review, there is a strong association between diabetic neuropathy and higher plantar loads that could be responsible for foot ulceration [6] and re-ulceration [7].…”