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Plantar pressure in off-loading devices used in diabetic ulcer treatment

Beuker, Benn J., Van Deursen, Robert William Martin ORCID:, Price, Patricia Elaine, Manning, Erik A., Van Baal, Jeff G. and Harding, Keith Gordon 2005. Plantar pressure in off-loading devices used in diabetic ulcer treatment. Wound Repair and Regeneration 13 (6) , pp. 537-542. 10.1111/j.1524-475X.2005.00075.x

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Four off-loading devices used for the treatment of diabetic forefoot ulcers were compared: a custom-molded insole shoe, a cast MABAL shoe, a prefabricated pneumatic walking brace, and a bivalved total contact cast (BTCC). It was anticipated that all devices would significantly reduce forefoot plantar pressure compared with a control shoe. Sixteen healthy volunteers participated. Plantar pressures were evaluated using the Pedar system, while walking speed was determined using an optoelectric timer. Peak pressure (PP) of ten plantar areas and pressure–time integral for the first metatarsal area were analyzed statistically using a repeated measures analysis of variance. Forefoot pressures were significantly reduced compared with the control shoe for all devices (p<0.001). PP was most reduced (by 65.8%) for the BTCC, and pressure–time integral was most reduced for the BTCC and cast MABAL shoe. Small but significant differences between devices in walking speed (p<0.05) could not explain the substantial PP differences between the different devices. Although all off-loading devices resulted in a significant reduction of forefoot plantar pressure, devices differed significantly in the magnitude of pressure reduction. Further research will have to reveal the level of off-loading sufficient for effective treatment of diabetic ulcers.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Subjects: R Medicine > R Medicine (General)
Publisher: Wiley
ISSN: 1067-1927
Last Modified: 17 Oct 2022 10:09

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