Quantifying Dynamic Changes in Plantar Pressure Gradient in Diabetics with Peripheral Neuropathy

Lung, Chi-Wen; Hsiao-Wecksler, Elizabeth T.; Burns, Stephanie; Lin, Fang; Jan, Yih‐Kuen

doi:10.3389/fbioe.2016.00054

Cited by 37 publications

(68 citation statements)

References 50 publications

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“…Other work has also identified that an increase in the viscoelasticity of plantar soft tissues, especially at the first metatarsophalangeal joint may be a crucial factor for elevated peak plantar pressures in people with DPN [ 51 ]. More recent work has outlined that new measures of plantar pressure such as the pressure gradient angle which quantifies the time-varying directions of plantar pressure may provide more valuable information regarding the plantar stressors experienced by people with DPN [ 52 ]. Whether measuring the viscoelasticity of plantar tissue and pressure gradient angles in people with active DFUs provides more insight on the biomechanical mechanisms underlying delayed wound healing is uncertain.…”

Section: Discussionmentioning

confidence: 99%

Plantar pressures are elevated in people with longstanding diabetes-related foot ulcers during follow-up

et al. 2017

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ObjectiveHigh plantar pressures are implicated in the development of diabetes-related foot ulcers. Whether plantar pressures remain high in patients with chronic diabetes-related foot ulcers over time is uncertain. The primary aim of this study was to compare plantar pressures at baseline and three and six months later in participants with chronic diabetes-related foot ulcers (cases) to participants without foot ulcers (controls).MethodsStandardised protocols were used to measure mean peak plantar pressure and pressure-time integral at 10 plantar foot sites (the hallux, toes, metatarsals 1 to 5, mid-foot, medial heel and lateral heel) during barefoot walking. Measurements were performed at three study visits: baseline, three and six months. Linear mixed effects random-intercept models were utilised to assess whether plantar pressures differed between cases and controls after adjusting for age, sex, body mass index, neuropathy status and follow-up time. Standardised mean differences (Cohen’s d) were used to measure effect size.ResultsTwenty-one cases and 69 controls started the study and 16 cases and 63 controls completed the study. Cases had a higher mean peak plantar pressure at several foot sites including the toes (p = 0.005, Cohen’s d = 0.36) and mid-foot (p = 0.01, d = 0.36) and a higher pressure-time integral at the hallux (p<0.001, d = 0.42), metatarsal 1 (p = 0.02, d = 0.33) and mid-foot (p = 0.04, d = 0.64) compared to controls throughout follow-up. A reduction in pressure-time integral at multiple plantar sites over time was detected in all participants (p<0.05, respectively).ConclusionsPlantar pressures assessed during gait are higher in diabetes patients with chronic foot ulcers than controls at several plantar sites throughout prolonged follow-up. Long term offloading is needed in diabetes patients with diabetes-related foot ulcers to facilitate ulcer healing.

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Section: Discussionmentioning

confidence: 99%

Plantar pressures are elevated in people with longstanding diabetes-related foot ulcers during follow-up

et al. 2017

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“…An F-scan system (Tekscan, South Boston, MA) was used to measure the plantar pressure data of the right foot in standardized shoes [ 33 ] during walking on the treadmill. Each F-scan in-shoe sensor contains 960 sensing pixels (sensels).…”

Section: Methodsmentioning

confidence: 99%

Complexity-Based Measures of Postural Sway during Walking at Different Speeds and Durations Using Multiscale Entropy

Liau

Lung

et al. 2019

Entropy

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: Participation in various physical activities requires successful postural control in response to the changes in position of our body. It is important to assess postural control for early detection of falls and foot injuries. Walking at various speeds and for various durations is essential in daily physical activities. The purpose of this study was to evaluate the changes in complexity of the center of pressure (COP) during walking at different speeds and for different durations. In this study, a total of 12 participants were recruited for walking at two speeds (slow at 3 km/h and moderate at 6 km/h) for two durations (10 and 20 minutes). An insole-type plantar pressure measurement system was used to measure and calculate COP as participants walked on a treadmill. Multiscale entropy (MSE) was used to quantify the complexity of COP. Our results showed that the complexity of COP significantly decreased (p < 0.05) after 20 min of walking (complexity index, CI = −3.51) compared to 10 min of walking (CI = −3.20) while walking at 3 km/h, but not at 6 km/h. Our results also showed that the complexity index of COP indicated a significant difference (p < 0.05) between walking at speeds of 3 km/h (CI = −3.2) and 6 km/h (CI = −3.6) at the walking duration of 10 minutes, but not at 20 minutes. This study demonstrated an interaction between walking speeds and walking durations on the complexity of COP.

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“…In-shoe pressure, unfortunately, is a difficult and expensive parameter to measure. Pressure-sensing devices are available such as the Tekscan F-scan [15], however, these are expensive, have a relatively short product life span and are not be suitable for everyday use [16].…”

Section: Devices For Diagnosismentioning

confidence: 99%

A Holistic Technology-Based Solution for Prevention and Management of Diabetic Foot Complications

Cleland

Rafferty

Synnott

et al. 2017

Ubiquitous Computing and Ambient Intelligence

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It has been estimated, on a global scale, that a limb is lost every 20 seconds due to diabetes. Effective treatment has, however, been shown to reduce the risk of amputations and foot ulcers. Self-management and the provision of effective foot care in the clinic and at home, is viewed as instrumental in providing appropriate care for people with diabetes. This in turn can reduce the costs associated with treating and managing diabetes and its associated complications. This paper presents a usability evaluation of a smartphone based solution for the management of diabetic foot disease. The solution combines novel thermal imaging with tailored educational content and gamification elements in an attempt to improve self-management of the condition. The solution was evaluated in a workshop setting by 7 participants. Overall, the participants felt the proposed solution would be a very worthwhile endeavor. They rated the usability and utility at an acceptable level (SUS 69.1/100). Notable suggested improvements focused on how educational content was formatted and searched in addition to the physical support provided to facilitate imaging of the feet.

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Quantifying Dynamic Changes in Plantar Pressure Gradient in Diabetics with Peripheral Neuropathy

Cited by 37 publications

References 50 publications

Plantar pressures are elevated in people with longstanding diabetes-related foot ulcers during follow-up

Plantar pressures are elevated in people with longstanding diabetes-related foot ulcers during follow-up

Complexity-Based Measures of Postural Sway during Walking at Different Speeds and Durations Using Multiscale Entropy

A Holistic Technology-Based Solution for Prevention and Management of Diabetic Foot Complications

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