Plantar pressure distribution in Type 2 diabetic patients without peripheral neuropathy and peripheral vascular disease

Abstract

We observed an anterior displacement of weight-bearing during walking on a level gradient as well as a reduced static contact plantar surface in diabetic patients without evidence of any complications compared with the non-diabetic control group. This could be a premature sign of peripheral neuropathy, which is not evaluated on clinical examination or quantitative sensory testing used in clinics.

Gait alterations of diabetic patients while walking on different surfaces

“…Patients' height or the short disease duration of the non-neuropathic group could have positively influenced gait velocity in these patients. Another article [21], not actually evaluating spatio-temporal gait parameters but the distribution of plantar pressure during walking on a level gradient, revealed other significant alterations in type 2 diabetic patients without either peripheral neuropathy or peripheral vascular disease (PVD). The non-neuropathic population showed a significant increase in peak plantar pressure at the level of the big toe and 5th metatarsal head as well as significantly prolonged duration of plantar pressure compared to healthy controls.…”

The influence of stride-length on plantar foot-pressures and joint moments

“…The PTI displayed a mixed pattern: in some foot sole areas PTI decreased with decreasing SL (heel, 2nd, 3rd and 4th metatarsals, medial toes), in other areas they remained unaffected or increased (midfoot, 1st metatarsal and lateral toes). Interestingly, the clinically relevant [20,21] forefoot-to-rearfoot pressure ratio (MT2/heel, data not explicitly presented) increased for peak pressures and for PTI with decreasing SL. Thus, if SF was increased and SL decreased, the load of the foot sole shifted from the rearfoot to the forefoot.…”

“…Thus, if SF was increased and SL decreased, the load of the foot sole shifted from the rearfoot to the forefoot. In previous studies, forward displacement of the loading of the foot sole has been associated with diabetes [2,20,21]. In diabetic neuropathy studies, gait velocity has seldom been controlled [22].…”

Computer-Based Identification of Type 2 Diabetic Subjects with and Without Neuropathy Using Dynamic Planter Pressure and Principal Component Analysis

“…In a study by Pataky et al, the distribution of plantar pressure during walking on a level gradient in patients with Type 2 diabetes mellitus without any microvascular and macrovascular complications were compared with control subjects [10]. They observed an anterior displacement of weight-bearing during walking on a level gradient as well as a reduced static contact plantar surface in diabetic patients without evidence of any complications compared with the non-diabetic control group.…”