Effect of foot orthoses on plantar pressure distribution of patients with diabetic neuropathy

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Effect of foot orthoses on plantar pressure distribution of patients with diabetic neuropathy


Author: Lau, See-wai Sylvia
Title: Effect of foot orthoses on plantar pressure distribution of patients with diabetic neuropathy
Degree: M.Sc.
Year: 2010
Subject: Hong Kong Polytechnic University -- Dissertations
Foot -- Abnormalities -- Treatment
Diabetic neuropathies -- Patients
Department: Dept. of Health Technology and Informatics
Pages: ix, 67 leaves : ill. (some col.) ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2352679
URI: http://theses.lib.polyu.edu.hk/handle/200/5625
Abstract: The prevention of diabetic foot ulcer will contribute to reduction in the rate of infection and lower limb amputation. Reduction in elevated plantar pressure is important in preventing from plantar foot ulceration of patients with diabetic neuropathy. Total contact foot orthoses were shown in many research studies that they could significantly reduce plantar pressure. There were little research on computer-aided design and computer-aided manufacturing (CAD-CAM) method. The purpose of this study was to find out the suitable casting method between CAD-CAM and foam impression methods for the total contact foot orthoses of diabetic patients with neuropathy. The F-Scan insole sensing system was used in this study to measure in-shoe dynamic pressures. Plantar pressure parameters including peak pressure, maximum force, pressure-time integral and contact area were analyzed. Seven subjects with diabetic neuropathy were recruited. Peripheral neuropathy was confirmed by vibration perception threshold > 25V. The subjects were all free of existing foot ulcer, lower limb amputation and gross foot deformity. Plantar pressure parameters of walking with three types of foot orthoses were compared. The three types of foot orthoses included total contact foot orthoses generated using CAD-CAM method by the Swiss Comfort CAD-CAM Foot Orthotics System, total contact foot orthoses generated using foam impression method and flat insole. The pressure data were divided into thirteen regions including total foot, medial heel, lateral heel, mid foot, first metatarsal head, second metatarsal head, third metatarsal head, fourth metatarsal head, fifth metatarsal head, first toe, second toe, third toe and fourth and fifth toes. The result showed that maximum force for foam impression method was statistically significant lower than flat insole at medial heel (p = 0.047) and lateral heel region (p = 0.011) during heel strike to mid-stance. The foot orthoses by CAD-CAM (p = 0.003) and foam impression methods (p = 0.002) had a significantly larger contact area than flat insole at mid foot region. The greatest load transfer from heel to mid foot regions.

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