Automated Identification of Diabetic Type 2 Subjects with and without Neuropathy Using Wavelet Transform on Pedobarograph

Diabetes is a disorder of metabolism—the way our bodies use digested food for growth and energy. The most common form of diabetes is Type 2 diabetes. Abnormal plantar pressures are considered to play a major role in the pathologies of neuropathic ulcers in the diabetic foot. The purpose of this study was to examine the plantar pressure distribution in normal, diabetic Type 2 with and without neuropathy subjects. Foot scans were obtained using the F-scan (Tekscan USA) pressure measurement system. Various discrete wavelet coefficients were evaluated from the foot images. These extracted parameters were extracted using the discrete wavelet transform (DWT) and presented to the Gaussian mixture model (GMM) and a four-layer feed forward neural network for classification. We demonstrated a sensitivity of 100% and a specificity of more than 85% for the classifiers.

[1]  G. Reaven.  Role of Insulin Resistance in Human Disease , 1988, Diabetes.

[2]  A. Veves,et al.  Abnormal Foot Pressures Alone May not Cause Ulceration , 1989, Diabetic medicine : a journal of the British Diabetic Association.

[3]  P. Cavanagh,et al.  Body Mass is a Poor Predictor of Peak Plantar Pressure in Diabetic Men , 1991, Diabetes Care.

[4]  S. Weinstein.  Fifty years of somatosensory research: from the Semmes-Weinstein monofilaments to the Weinstein Enhanced Sensory Test. , 1993, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[5]  J. M. DeLeo,et al.  Receiver operating characteristic laboratory (ROCLAB): Software for developing decision strategies that account for uncertainty , 1993, 1993 (2nd) International Symposium on Uncertainty Modeling and Analysis.

[6]  S. Weinstein.  Fifty years of somatosensory research , 1993 .

[7]  S. Albert,et al.  Effect of custom orthotics on plantar pressure distribution in the pronated diabetic foot. , 1994, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[8]  M. Cornwall,et al.  Effect of foot orthotics on the initiation of plantar surface loading , 1997 .

[9]  D. Armstrong,et al.  Diabetic foot ulcers: prevention, diagnosis and classification. , 1998, American family physician.

[10]  A. Veves,et al.  Role of Neuropathy and High Foot Pressures in Diabetic Foot Ulceration , 1998, Diabetes Care.

[11]  S. Mallat.  A wavelet tour of signal processing , 1998 .

[12]  S. Sauseng,et al.  Estimation of risk for plantar foot ulceration in diabetic patients with neuropathy. , 1999, Diabetes, nutrition & metabolism.

[13]  Bhatia Mm,et al.  New on-line parameters for analysis of dynamic foot pressures in neuropathic feet of Hansen's disease subjects. , 1999 .

[14]  Thomas J. Downey,et al.  Using the receiver operating characteristic to asses the performance of neural classifiers , 1999, IJCNN'99. International Joint Conference on Neural Networks. Proceedings (Cat. No.99CH36339).

[15]  K. M. Patil,et al.  New on-line parameters for analysis of dynamic foot pressures in neuropathic feet of Hansen's disease subjects. , 1999, Journal of rehabilitation research and development.

[16]  A. Redmond,et al.  Effect of cast and noncast foot orthoses on plantar pressure and force during normal gait. , 2000, Journal of the American Podiatric Medical Association.

[17]  T. McPoil,et al.  Plantar pressure assessment. , 2000, Physical therapy.

[18]  F. Abouaesha,et al.  Plantar tissue thickness is related to peak plantar pressure in the high-risk diabetic foot. , 2001, Diabetes care.

[19]  L. Reed,et al.  Changes in foot function with the use of Root and Blake orthoses. , 2001, Journal of the American Podiatric Medical Association.

[20]  D. Armstrong,et al.  The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. , 2002, Diabetes care.

[21]  D. Yach,et al.  Life Course Perspectives on Coronary Heart Disease, Stroke and Diabetes: Key issues and implications for policy and research , 2002 .

[22]  K. M. Patil,et al.  The Role of Skin Hardness, Thickness, and Sensory Loss on Standing Foot Power in the Development of Plantar Ulcers in Patients with Diabetes Mellitus—A Preliminary Study , 2003, The international journal of lower extremity wounds.

[23]  A. Gefen.  Plantar soft tissue loading under the medial metatarsals in the standing diabetic foot. , 2003, Medical engineering & physics.

[24]  A. Veves,et al.  The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study , 1992, Diabetologia.

[25]  B. Yegnanarayana,et al.  Artificial Neural Networks , 2004 .

[26]  K. M. Patil,et al.  Effect of foot sole hardness, thickness and footwear on foot pressure distribution parameters in diabetic neuropathy , 2004, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[27]  D. Armstrong,et al.  Plantar soft-tissue thickness predicts high peak plantar pressure in the diabetic foot. , 2004, Journal of the American Podiatric Medical Association.

[28]  S. Sauseng,et al.  Progression and distribution of plantar pressure in Type 2 diabetic patients. , 2004, Diabetes, nutrition & metabolism.

[29]  W. Jeffcoate,et al.  Validation of a system of foot ulcer classification in diabetes mellitus , 2004, Diabetic medicine : a journal of the British Diabetic Association.

[30]  J. Assal,et al.  Plantar pressure distribution in Type 2 diabetic patients without peripheral neuropathy and peripheral vascular disease , 2005, Diabetic medicine : a journal of the British Diabetic Association.

[31]  M. A. Rahman,et al.  Analysis of plantar pressure in diabetic type 2 subjects with and without neuropathy , 2006 .

[32]  K. M. Patil,et al.  Diabetic feet at risk: A new method of analysis of walking foot pressure images at different levels of neuropathy for early detection of plantar ulcers , 2001, Medical and Biological Engineering and Computing.

[33]  P. Cavanagh,et al.  THE BIOMECHANICS OF THE FOOT IN DIABETES MELLITUS , 2008 .