Effect of Offloading Plantar Pressure on Peak Pressure in Ten Plantar Regions and Gait Speed in Men With Diabetes and Active Diabetic Foot Ulcers, and Healthy Men

Abstract

Background and Aims Diabetes is associated with dysfunction and damage in various organs due to abnormal pressure on ten plantar regions. This study aims to compare the effect of offloading plantar pressure on peak pressure of ten plantar regions and gait speed in men with diabetes and active diabetic foot ulcers, and healthy men. Methods This is a causal-comparative study. Participants were 30 healthy men, 30 diabetic men and 30 men with active diabetic foot ulcers who needed no leg amputation according to their physicians. Sampling was done using random and convenience methods. Diabetic foot ulcers were classified based on the Meggitt-Wagner classification criteria, according to which grade 1 indicates grade 1 indicates a superficial ulcer and was used as a criterion for selecting people with diabetic foot ulcers. Plantar pressure variables were recorded using RSscan software (RSscan International, Belgium; 0.5×0.5×0.02 m, 4363 sensors) at a sampling frequency of 300 Hz and the gait speed was measured using a digital stopwatch. Correct walking considered as the full impact of the foot on the middle of the foot scan machine. Data were analyzed using independent t-test in SPSS software, version 24. Results The peak pressure in the metatarsal 3 (P<0.001), metatarsal 4 (P= 0.020), medial heel (P= 0.004) and lateral heel (P= 0.007) in the diabetic foot ulcer group significantly increased compared to the diabetic group. In addition, the peak pressure in the medial heel (P= 0.013) and lateral heel (P= 0.019) in the diabetic group significantly decreased compared to the healthy group. Conclusion Men with diabetic foot ulcers are more exposed to abnormal peak pressures in different plantar regions, which can cause irreversible clinical injuries. Diabetic men have a lower gait speed than healthy men which can be important in their rehabilitation.