Topic:	Diabetes (DM)
Title:	Influence of Shoe Design on Plantar Pressures in Neuropathic Feet.
Author:	Praet, S.F.; Louwekens, J.K.
Source:	Diabetes Care. 26(2): 441-445. February 2003.
Availability:	Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org.
Abstract:	This article reports on a study undertaken to investigate the effect of shoe design on the plantar pressure dynamics of patients with diabetic neuropathy (nerve disease associated with diabetes) during walking. Three shoe design categories were tested. Total contact area and biomechanical variables in multiple areas under the foot were measured. Shoes with a rocker bottom principle reduced pressure 35 to 65 percent underneath the heel and the central metatarsal heads. Increased contact area did not result in significant pressure reductions underneath the forefoot. Pressure dynamics underneath the heel and medial forefoot (first metatarsal head and hallus) on average showed no significant differences among the different shoes with a cushioning insole. The authors conclude that the most effective way to offload the forefoot of patients with neuropathic feet is through the use of the rocker sole principle. In general, the effect of an insole depends on the design characteristics of a shoe. Predicting the effect of therapeutic footwear on an individual scale, however, remains difficult. Therefore, in-shoe pressure measurements seem to be necessary to evaluate a therapeutic shoe prescription in certain individuals cases. 2 figures. 1 table. 18 references.
Format:	Journal Article
Language:	English.
Major Keywords:	Diabetes Mellitus. Footwear. Diabetic Neuropathy. Complications. Equipment and Supplies.
Minor Keywords:	Prevention. Quality of Care. Diagnostic Tests. Monitoring. Ulcer. Foot.
Publication Number:	DMJA10722
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