The Potential of Color Doppler Ultrasound Efficiency in Monitoring Diabetic Nonulcerated Neuroarthropathic (Charcot) Foot

Abstract

Objective: Potential pain relief from foot pain can come from a shoe insert foot orthotic. This study assessed foot pressure distribution and balance in off the shelf foot orthotics versus a custom made foot orthotic compared to no orthotic. Methods:The subjects (8) were both men and women. The average age was 25.1 ± 2.8 years, the average weight was 68.8 ± 13.7 kg, and BMI 24.5 ± 6.4. Each patient was fit for both off the shelf and custom shoe insert foot orthotics and needed orthotics to reduce pain. Once fit, they were evaluated by standing and then walking 12 meters on a level surface while being monitored by a Tactilus Pressure Mapping system. Balance was also evaluated with a pressure platform during 8 balance tests. Results:With the subjects accomplishing quiet standing, the average pressure and peak pressure was shifted from the hind foot and forefoot to the mid foot when wearing foot inserts (p<0.05). During walking, the average pressure was significantly shifted from the forefoot and hind foot to the mid foot in both orthotic groups with the greatest reduction in forefoot pressure in the off the shelf orthotic group (p<0.05). This is especially seen when measuring the peak pressures on the foot, where, during standing the peak pressures on the fore foot were 20% higher with no orthotic than seen for the 2 orthotics tested here. Balance was best in the custom orthotic group while both orthotic groups had better balance than the no orthotic studies for the most difficult balance tests. Conclusion: At least in this small group of subjects, off the shelf foot orthotics help gait or balance but custom orthotics are better.