Daily-life activities and in-shoe forefoot plantar pressure in patients with diabetes

Abstract

Objective To assess differences regarding in-shoe forefoot plantar pressure (PP) in patients with diabetes during various daily-life activities. Research design and methods In-shoe PP was measured in 93 patients during: level walking, ramp and stair walking, turning in different settings and while performing the Up & Go test. Separate PPs were determined for the big toe and metatarsal (mt) regions one to five. Results Across all activities, similar PPs were measured in the big toe and mt-1 to mt-3 region. Lower PPs were measured in mt-4 and mt-5 region. PPs during level walking were mostly higher when compared to the other activities ( p ≤ .030). Turning while level walking resulted in higher PPs than turning while performing the other activities ( p ≤ .033). Higher PPs were measured for both ramp and stair ascending when compared to descending ( p ≤ .001). In the big toe region, stair descending resulted in higher PPs than ascending ( p ≤ .001). Across all activities, patients with neuropathy had lower PPs (overall mean 28 kPa) than patients without neuropathy. Conclusions Level walking resulted in the highest forefoot PPs during daily-life activities. Patients with neuropathy had lower PPs than patients without neuropathy.