Effectiveness of diabetic insoles to reduce foot pressures.

The F-Scan system was used to measure peak plantar pressures in 11 diabetics each with a unilateral great toe amputation and an intact contralateral extremity (nonamputated), to evaluate the effectiveness of five footwear-insole strategies: 1) extra-depth shoes without an insole, 2) extra-depth shoes with a Plastizote insole, 3) extra-depth shoes with a Plastizote insole and a metatarsal pad, 4) extra-depth shoes with a Plastizote insole and a medial longitudinal arch pad, and 5) extra-depth shoes with a Plastizote insole and a combination of metatarsal pad and arch pad. When we compared extra-depth shoes with and without insoles, peak pressures were significantly reduced with insoles under the first metatarsal, the lesser metatarsals, and the heel (p < 0.001) in feet with and without an amputation, as well as under the great toe on the contralateral foot (nonamputated, p < 0.001), but not under the lesser toes (giant toe, p = 0.088; nonamputated, p = 0.763). There was no significant difference between the different insole modifications.

[1]  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.

[2]  S. Siegel,et al.  Nonparametric Statistics for the Behavioral Sciences , 2022, The SAGE Encyclopedia of Research Design.

[3]  Kent K. Wu.  Foot Orthoses: Principles and Clinical Applications , 1990 .

[4]  G F Harris,et al.  Multistep Measurement of Plantar Pressure Alterations Using Metatarsal Pads , 1994, Foot & ankle international.

[5]  B. Greteman,et al.  Digital amputations in neuropathic feet. , 1990, Journal of the American Podiatric Medical Association (Print).

[6]  F. Wheelock,et al.  Digital amputations in diabetic patients. , 1972, Surgery.

[7]  D. Sims,et al.  Plantar sensory threshold in the ulcerative foot. , 1986, Leprosy review.

[8]  J. Giurini,et al.  In-Shoe Foot Pressure Measurements in Diabetic Patients With At-Risk Feet and in Healthy Subjects , 1994, Diabetes Care.

[9]  C. Grunfeld,et al.  Aesthesiometry: quantification of cutaneous pressure sensation in diabetic peripheral neuropathy. , 1988, Journal of rehabilitation research and development.

[10]  Hodge Mj,et al.  Amputation of the distal portion of the foot. , 1989 .

[11]  J. Rice,et al.  Sequelae of limited amputation. , 1988, Surgery.

[12]  C. I. Franks,et al.  The natural history of foot pressure abnormalities in neuropathic diabetic subjects. , 1987, Diabetes research.

[13]  Young Cr,et al.  The F-SCAN system of foot pressure analysis. , 1993 .

[14]  G. Reiber,et al.  Pathways to Diabetic Limb Amputation: Basis for Prevention , 1990, Diabetes Care.

[15]  Paul W. Brand,et al.  PLANTAR PRESSURES AND TROPHIC ULCERATION , 1963 .

[16]  N. Couch,et al.  Natural history of the leg amputee. , 1977, American journal of surgery.

[17]  D. Knighton,et al.  Amputation in the diabetic population: Incidence, causes, cost, treatment, and prevention , 1989, Journal of enterostomal therapy.