LONGITUDINAL IN-SHOE FOOT PRESSURE RELIEF ACHIEVED BY SPECIALLY DESIGNED FOOTWEAR IN HIGH-RISK DIABETIC-PATIENTS

Specially designed Thor-Lo footwear has been shown to reduce the in-sh oe fool pressures in diabetic patients at risk of foot ulceration when compared to their own footwear. Fifty al high risk patients 32 (64%) males, 17 (34%) type 1 diabetes) have been provided with this foot wea r and have been followed up for 6 months. Mean age was 57.6 (range, 34 -78) years, duration of diabetes 22.4 (range, 4-50) years, Neuropathy Symptom Score 3.36 +/- 2.96 (mean +/- S.D.), Neuropathy Disability Sco re 16.8 +/- 6.83, VPT 43.4 +/- 11.8 Volts while 43 (86%) could not fee l a 5.07 or smaller Semmes-Weinstein monofilament. Forty-two (84%) pat ients were re-examined at an interim visit 3 months after baseline, wh ile 37 (74%) completed the study. In-shoe peak forces and pressures we re measured using the F-Scan system. No difference was found among the peak force among baseline (95.5 +/- 26 kg), interim (96.5 +/- 33) and final visit (97.7 +/- 25.2, P = NS). There was no difference in peak pressures at the baseline (3.98 +/- 1.42 kg . cm(-2)), second visit (4 .13 +/- 2.30) and the final visit (4.25 +/- 1.51). Nine (18%) patients developed foot problems and one died during the study. We conclude th at no changes in fool pressures were found over a period of 6 months o f continuous usage of the specially designed footwear in a group of di abetic patients at risk of foot ulceration. Further prospective studie s are required to evaluate the impact of specially designed foot ear i n reducing the rate of foot ulceration.