IN-SHOE FOOT PRESSURE MEASUREMENTS IN DIABETIC-PATIENTS WITH AT-RISK FEET AND IN HEALTHY-SUBJECTS

OBJECTIVE- To measure in-shoe foot pressures in diabetic patients and healthy subjects and compare them with the foot pressures when they wa lked without their shoes. RESEARCH DESIGN AND METHODS- Forty-four diab etic patients at risk of foot ulceration and 65 healthy subjects were matched for age, sex, race, and weight. Neuropathy was evaluated clini cally, and the F-Scan program was used to measure the foot pressures. Foot pressures were measured with the sensors placed in the shoes (S m easurements), between the foot and the sock with shoes (H measurements ) or with their socks alone (B measurements). RESULTS- In the control group, significant differences were found between S (4.77 +/- 1.87 kg/ cm(2)) and H measurements (5.12 +/- 1.87 kg/cm(2), P < 0.001),between S and B (7.23 +/- 2.95 kg/cm(2), P < 0.0001), and between H and B (P < 0.0001). In the diabetic group, no difference was found between S and H measurements (5.28 +/- 2.22 vs. 5.27 +/- 2.39 kg/cm(2), NS). In con trast, the B pressure was significantly higher when compared with both (8.77 +/- 4.67 kg/cm(2), P < 0.02). When compared with the control gr oup, the S and H pressures did not differ significantly, but the B pre ssure in the diabetic group was significantly higher (P < 0.02). The p eak S pressure was above the normal limit in 24 (27%) diabetic and 21 (16%) control feet (P < 0.05), the H pressure in 17 (19%) diabetic fee t and 22 (17%) control feet (NS), and the B pressure in 24 (27%) diabe tic and 21 (16%) control feet (P < 0.05). CONCLUSIONS- In-shoe foot pr essure measurements are significantly lower than the ones measured whe n walking with the socks only in both diabetic patients and healthy su bjects. The shoes of diabetic patients provided a higher pressure redu ction than did those of the control group, but the number of feet with abnormally high pressures did not change. The F-Scan system may be pa rticularly helpful in designing footwear suitable for diabetic patient s with at-risk feel.