Assessment of plantar pressure and balance in patients with diabetes

Daniela M C Anjos, Luciana P O Gomes, Luciana M M Sampaio, João C F Correa, Claudia S Oliveira, Daniela M C Anjos, Luciana P O Gomes, Luciana M M Sampaio, João C F Correa, Claudia S Oliveira

Abstract

Introduction: Patients with diabetes for more than 10 years may have an increase in peak plantar pressure, considerable postural oscillation, balance deficit, alterations in gait pattern and an increased risk of falls. The aim of the present study was to assess the correlation between plantar pressure distribution and balance in patients with diabetes using a pressure platform (Footwork).

Material and methods: The study was carried out at the Human Movement Clinic of the Centro Universitário de Belo Horizonte (Brazil). The sample was made up of 18 right-handed individuals with type 2 diabetes - 14 females and 4 males - with an average age of 58.72 ±9.54 and an average of 18.56 ±6.61 years since diagnosis.

Result: Data analysis revealed that greater peak plantar pressure on the right hindfoot led to greater radial displacement (Rd) (r = 0.2022) and greater displacement velocity (r = 0.2240). Greater peak plantar pressure on the left hindfoot also led to greater displacement velocity (P) (r = 0.5728) and radial displacement (RD) (r = 0.1972). A positive correlation was found between time elapsed since diagnosis and peak midfoot pressure (r = 0.3752) on the right and left side as well as between BMI and plantar pressure on all regions of the foot.

Conclusions: The data reveal a correlation between postural oscillation and peak plantar pressure on the hindfoot.

Keywords: balance; baropodometry; diabetes; diabetic neuropathy; plantar pressure; stabilometry.

Figures

Figure 1
Figure 1
Correlation between BMI and time since diagnosis and between BMI and glycaemia values
Figure 2
Figure 2
Mean peak plantar pressure values in the right foot (*,**p < 0.05)
Figure 3
Figure 3
Mean peak plantar pressure values in the left foot (*p < 0.05)
Figure 4
Figure 4
Mean displacement speed values in barycentre of the body as well as right and left feet (*p < 0.05)
Figure 5
Figure 5
Correlation between mean plantar pressure and time since diagnosis

References

    1. Boulton AJ, Malik RA, Arezzo JC, Sosenko JM. Diabetic somatic neuropathies: a technical review. Diabetes Care. 2004;27:1458–86.
    1. Dasilva MA, Muñoz MP, González LT. Perspectiva familiar alrededor del paciente diabético. Ver Neurol. Neurocirugía y Psiquiatria. 2005;38:63–8.
    1. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20:1183–97.
    1. Veves A, Murray HJ, Young MJ, Boulton AJ. The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia. 1992;15:660–3.
    1. Fernando DJ, Masson EA, Veves A, Boulton AJ. Relationship of limited joint mobility to abnormal foot pressures and diabetic ulceration. Diabetes Care. 1991;14:8–11.
    1. Gooding GW, Stess RM, Graf PM. Sonography of the sole of the foot- evidence for loss of foot pad thickness in diabetics and it relationship to ulceration of the foot. Invest Radiol. 1986;21:45–8.
    1. Payne CB. Biomechanics of the diabetic foot- some theoretical considerations. J Am Podiatr Med Assoc. 1998;88:285–9.
    1. Sarnow MR, Veves A, Giurini JM, Rosenblum BI, Chrzan JS, Habershaw GM. In –shoe foot pressure measurements in diabetic patients with at-risk feet and in healthy subjects. Diabetes Care. 1994;17:1002–6.
    1. Veves A, Fernando DJ, Walewski P, Boulton AJ. A study of plantar pressure in a diabetic clinic population. Foot. 1991;2:89–92.
    1. Wooden MJ. The biomecnics of the foot and ankle. Philadelphia: Davis Company; 1996. Biomechanical evaluation for functional orthotics. Donatelli RA.
    1. Chamlian TR. São Paulo: EDUSP; 1999. Medicina Física e Reabilitação: parte 1; p. 41.
    1. Libotte M. Podospie Electronique. Encyclopêdie Médico-Chirurgicale: Kinésithérapie eeducation fonctionelle. Paris: Edition Scientifíques et médicales Elsevier; 2001.
    1. Gutierrez E, Helber M, Dealva D, Ashton-Miller J, Richardson J. Mild diabetic neuropathy affects ankle motor function. Clin Biomech (Briston Avon) 2001;16:522–8.
    1. Richardson JK. The clinical identification of peripheral neuropathy among older person. Arch Phys Med Rehabil. 2002;83:1553–8.
    1. Stokes IA, Faris IB, Hulton WC. The neuropathic ulcer and loads on the foot in diabetic patients. Acta Orthop Sand. 1975;46:839–47.
    1. Boulton AJ, Gries FA, Jervell JA. Guidelines for the diagnosis and outpatient management of diabetic peripheral neuropathy. Diabet Med. 1998;15:508–14.
    1. Middleton J, Sinclair P, Patton R. Accuracy of centre of pressure measurement using a piezoelectric force platform. Clin Biomech. 1999;14:357–60.
    1. Mayfield JA, Reiber GE, Sanders LF, et al. Preventive foot care in people with diabetes. Diabetes Care. 1998;21:2161–77.
    1. Lavery LA, Armstrong DG, Vela SA, et al. Pratical criteria for screening patient at high risk for diabetic foot ulceration. Arch Intern Medicine. 1998;158:157–62.
    1. D'ambrogi E, Giurato L, D'agostinho MA, et al. Contribution of plantar fascia to the increased fore-foot pressure in diabetic patient. Diabetes Care. 2003;26:1525–9.
    1. Pataky Z, Assal JP, Conne P, et al. Plantar pressure distribution in type 2 diabetic patients without peripheral neuropathy and vascular disease. Diabet Med. 2005;22:762–7.
    1. Cavanagh PR, Rodgers MM, Liboshi A. Pressure distribution under symptom-free feet during barefoot standing. Foot Ankle. 1987;15:262–7.
    1. Caselli A, Pham H, Giurini JM, Armstrong DG, Veves A. The Forefoot-to-Rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. Diabetes Care. 2002;25:1066–71.
    1. Masson EA. What causes high foot pressures in diabetes: how can they be relived? Foot. 1992;2:212–7.
    1. Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4.400 patients observed between 1947 and 1973. Diabetes Care. 1978;1:168–88.
    1. Lord S, Clark R, Webster L. Postural stability and associated physiological factors in a population of aged persons. J Gerontol. 1991;46:69–76.

Source: PubMed

3
Iratkozz fel