Pressure redistribution by molded inserts in diabetic footwear: a pilot study

Area of Science:

• Podiatry
• Biomechanical Engineering
• Diabetic Foot Care

Background:

• Diabetic patients are at high risk of plantar ulceration due to neuropathy and poor circulation.
• Plantar pressure distribution is a critical factor in ulcer development.
• Custom-molded inserts may offer a solution for redistributing pressure in diabetic footwear.

Purpose of the Study:

• To evaluate the effectiveness of custom-molded inserts in redistributing plantar pressure.
• To compare pressure distribution with custom-molded inserts versus standard flat inserts in diabetic patients.
• To assess the potential of these inserts in preventing plantar ulceration.

Main Methods:

• A small-scale trial involving six diabetic patients at risk of ulceration.
• Utilized a pressure-measuring insole with force-sensitive resistor technology.
• Compared plantar pressure under metatarsal heads using custom-molded inserts and flat inserts in orthopedic shoes.

Main Results:

• A statistically significant reduction in peak plantar pressure was observed with custom-molded inserts (216 +/- 70 kPa) compared to flat inserts (305 +/- 79 kPa).
• The analysis focused on 12 pressure peaks under discrete metatarsal heads.
• The findings suggest a beneficial redistribution of load.

Conclusions:

• Custom-molded inserts show promise in reducing plantar pressure in diabetic patients.
• Further research is needed due to technical limitations and comparison challenges.
• These inserts could be a valuable tool in diabetic foot ulcer prevention strategies.