Optical Pedobarography for Assessing Neuropathic Feet in Diabetic Patients—A Review

Abstract

The use of optical pedobarography is presented in this article. The limitations of the analytical methods using peak pressures as a parameter for assessment of foot at risk of plantar ulcers are indicated. A new method, which takes into consideration the actual plantar pressure distribution using the power ratio PR (the ratio of high-frequency power to the total power in the walking foot pressure image distribution)and relates it to 3 levels of sensation loss is described. PR is able to detect early loss of foot sensation characterized by a loss of sensation level of 4.5 gm. The methods available in the literature for management of foot ulcers by proper footwear design, and their limitations, are discussed. A new method of individualized footwear based on matching the softness of the footwear insole with the softness of normal foot sole soft tissue (having durometer reading of 20 degrees Shore) and optimum insole thickness (12 mm) is helpful in the prevention of plantar ulcers.

Three-dimensional finite element analysis of the foot during standing—a material sensitivity study

“…The pressure distributions between the foot and different supports were measured experimentally with the use of in-shoe pressure sensors and pedobarograph (Cavanagh et al, 1987;Lavery et al, 1997;Patil et al, 2002;Raspovic et al, 2000;Lord and Hosein, 2000;Lord et al, 1986). Due to the difficulties and lack of better technology for the experimental measurement, the load transfer mechanism and internal stress states within the soft tissues and the bony structures were not well addressed.…”

The Role of Skin Hardness, Thickness, and Sensory Loss on Standing Foot Power in the Development of Plantar Ulcers in Patients with Diabetes Mellitus—A Preliminary Study

“…4 This article presents the re-sults of a study aimed to identify relationships between standing foot pressure and (i) hardness and (ii) thickness at different levels of sensation loss. Standing foot pressure was characterized by power ratio (PR) as previously defined by Patil et al 5 Shore measurements of hardness were used to characterize plantar tissue hardness. Thickness was measured from duplex ultrasound imaging of the plantar surface.…”

Diabetic Foot Risk Assessment and Foot Care Among Patients Attending Tertiary Care Hospital in Central India

“…The softness of the footwear insole is helpful in the prevention of plantar ulcers. 13 The final value of the hardness depends on the depth of the indenter after it has been applied for 15 seconds on the material. 14 A value between 8 and 15 Shore Units is desirable for diabetic footwear.…”