RUNNING SHOES FOR RELIEF OF PLANTAR PRESSURE IN DIABETIC-PATIENTS

There is a causal relationship between diabetic foot ulceration, eleva ted plantar pressure, and severe sensory neuropathy. Cushioned footwea r intended to relieve plantar pressure is well established for prevent ion and healing of planter ulcers. The aim of the present study was to investigate whether pressure relief by means of a running shoe with o ptimized forefoot pressure damping is comparable to that of a custom-m ade soft insole placed into an in-depth shoe. The in-shoe pressures we re compared to an in-depth shoe with the original cork insole and with a leather-soled Oxford shoe. The maximum reduction of plantar pressur e in the running shoe was 47% under the 2nd and 3rd metatarsal heads, 29% at the first metatarsal head, and 32% at the great toe in comparis on to the Oxford shoe. This was surpassed only by the custom-made inso le, which reduced pressures at the metatarsal heads by 50%. The specia lly designed running shoe yielded the same pressure relief at the cent ral metatarsal heads as the custom-made insole. Such shoes are likely to be very useful in preventing diabetic foot ulceration in high-risk patients as a comparatively affordable and immediately available devic e. (C) 1998 John Wiley & Sons, Ltd.