A comparative study of the Podotrack, a simple semiquantitative plantar pressure measuring device, and the optical pedobarograph in the assessment ofpressures under the diabetic foot

Aims To test the Podotrack, a simple inexpensive semiquantitative footprint mat, for potential use as a screening tool for high plantar pressures, aga inst the optical pedobarograph (a computerized device). Methods The Podotrack was superimposed on the pedobarograph for simultaneou s measurement of pressures from both systems. Three independent observers q uantified the pressures of Podotrack footprints from healthy controls and d iabetic patients, both before (n = 164) and after (n = 183) training. The s ensitivity of the Podotrack to identify high pressure areas measured by the pedobarograph (> 12.3 kg/cm(2)) was 78.7%, 45.8% and 44.3% (observer A, B and C) before training, but improved to 96.2%, 92.4% and 91.1% after traini ng (P<0.01). Specificity for all three observers was more than 90% before a nd after training. Inter-observer agreement improved significantly after tr aining (P<0.001). Conclusion After a simple training of the observers, the Podotrack identifi ed approximately all high pressure areas, suggesting that the Podotrack cou ld be a useful screening tool to identify areas at risk of ulceration in di abetic patients. We recommend a standard training package for new Podotrack users, to optimize identification of diabetic patients at risk of foot ulc eration.