Orthotic treatment for refractory plantar ulcers using distribution assessments of sensory disturbance and dynamic plantar pressure in patients with Hansen's disease: A case series

Relationship between Plantar Pressure and Sensory Disturbance in Patients with Hansen’s Disease—Preliminary Research and Review of the Literature

“…All participants received conventional dermatological care for treatment or prevention of plantar ulceration. Data of three out of 10 patients (Cases A-C) were partly published previously as a small case series in the Journal of Dermatology [19]. The protocol was in complete compliance with the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Ethics Committee in Tamazenshoen (No.…”

“…Although it is only an observatory result, our precision orthotic approach successfully treated or prevented plantar ulcerations. The treatment courses of Cases A-C were previously described as a case series in detail [19]. We further assessed the dynamic pressure of this foot while wearing the orthosis with the F-scan system.…”

“…The clinical application of plantar pressure assessment is still limited in the clinics of Hansen's disease [16,19,24,45]. Instead of assessing dynamic pressure, clinicians typically assess sensory function in addition to the ordinal checkpoints, such as deformity, bone process, paresis, balance and gait pattern [11][12][13].…”

“…However, since only a few reports utilize multi-modalities including both assessment types, the relationship between plantar pressure and sensory disturbance is still not wholly delineated. Subsequently, it is difficult for clinicians to decide which parameter or both should be referred to in orthotic treatment of Hansen's disease [19,21]. On these grounds, the purpose of the present study was to evaluate whether a relationship exists between dynamic pressure and sensory disturbance in Hansen's disease upon the knowledge reported in previous literature.…”

“…Neither study conveys the idea of detailed evaluation for plantar pressure or sensory assessment, while some researchers state the necessity of assessing sensory loss for shoes or orthosis design [11]. There is increasing evidence emphasizing the importance of dynamic pressure assessment [16][17][18] or a combination of both assessment types [19]. Thus, researchers are reaching a consensus on utilizing sensors in the precise treatment of plantar ulceration [6,20].…”