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Reduction of Abnormal Foot Pressures in Diabetic Neuropathy Using a New Polymer Insole Material

  1. Andrew J M Boulton, M.B. M.R.C.P,
  2. Christopher I Franks, Ph.D. C.Eng.,
  3. Roderic P Betts, Ph.D. C.Eng.,
  4. Thomas Duckworth, M.B. F.R.C.S. and
  5. John D Ward, M.D. F.R.C.P.
  1. Departments of Medicine, Royal Hallamshire Hospital Sheffield, United Kingdom
  2. Medical Physics and Clinical Engineering, Royal Hallamshire Hospital Sheffield, United Kingdom
  3. Orthopaedic Surgery, Royal Hallamshire Hospital Sheffield, United Kingdom
  1. Address reprint requests to Dr. A. J. M. Boulton, Department of Diabetes, University of Miami (D-1), P.O. Box 016960, Miami, Florida 33101.

Abstract

The precise pressures and loads under 69 neuropathic feet have been measured during walking using a modified microprocessor-controlled optical system. Abnormally high pressures were demonstrated in 94% of feet with a history of foot ulceration, with pressures as high as 20–30 kg × cm−2 under the forefoot. All subjects were also studied using a new visco-elastic polymer material recently used for insole manufacture. A reduction in pressure was demonstrated that was proportional to peak pressure (linear regression line correlation coefficient of 0.91; P < 0.001). We conclude that this material causes a significant reduction in the abnormally high pressures recorded under neuropathic feet, and should provide a useful insole for the management of patients at risk of neuropathic foot ulceration.

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