Pressure relief and load redistribution by custom-made insoles in diabetic patients with neuropathy and foot deformity

Clinical Biomechanics
Sicco A BusPeter R Cavanagh

Abstract

To study the effects of custom-made insoles on plantar pressures and load redistribution in neuropathic diabetic patients with foot deformity. Cross-sectional. Although custom-made insoles are commonly prescribed to diabetic patients, little quantitative data on their mechanical action exists. Regional in-shoe peak pressures and force-time integrals were measured during walking in the feet of 20 neuropathic diabetic subjects with foot deformity who wore flat or custom-made insoles. Twenty-one feet with elevated risk for ulceration at the first metatarsal head were analysed. Load redistribution resulting from custom-made insoles was assessed using a new load-transfer algorithm. Custom-made insoles significantly reduced peak pressures and force-time integrals in the heel and first metatarsal head regions; pressures and integrals were significantly increased in the medial midfoot region compared with flat insoles. Custom-made insoles successfully reduced pressures in and integrals at the first metatarsal head in 7/21 feet, were moderately successful in another seven, but failed in the remaining seven. Load transfer was greatest from the lateral heel to the medial midfoot regions. Custom-made insoles were more effective than flat i...Continue Reading

References

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