A comparison of two total contact cast constructs with variable body mass

Area of Science:

• Podiatry
• Biomechanics
• Diabetology

Background:

• Obesity is increasingly linked to adverse outcomes in diabetic foot disease.
• Understanding how obesity affects foot function under therapeutic interventions is crucial.

Purpose of the Study:

• To investigate the impact of obesity on foot function, specifically peak plantar pressures within a total contact cast (TCC).
• To compare the efficacy of two distinct TCC designs in managing plantar pressures across a spectrum of body mass indexes (BMIs).

Main Methods:

• Utilized an in-shoe pressure measurement system to assess mean peak plantar pressures in the heel, midfoot, and forefoot.
• Compared a standard TCC (gold standard for off-loading) with an alternate TCC design featuring a novel load-transferring foam.
• Evaluated outcomes across different BMI categories: normal, overweight, obese, and morbidly obese.

Main Results:

• No statistically significant differences in mean peak plantar pressures were observed between the two TCC designs across any foot region.
• The observed plantar pressures remained consistent regardless of the patient's body mass index when using either TCC design.

Conclusions:

• The alternate TCC design presents a practical alternative for clinicians managing neuropathic feet.
• This research offers valuable data on peak plantar pressure variations in total contact casts across different body mass indexes, aiding clinical decision-making.