Longitudinal in-shoe foot pressure relief achieved by specially designed footwear in high risk diabetic patients

Abstract

Specially designed Thor-Lo footwear has been shown to reduce the in-shoe foot pressures in diabetic patients at risk of foot ulceration when compared to their own footwear. Fifty at high risk patients 32 (64%) males, 17 (34%) type 1 diabetes) have been provided with this foot wear and have been followed up for 6 months. Mean age was 57.6 (range, 34–78) years, duration of diabetes 22.4 (range, 4–50) years, Neuropathy Symptom Score 3.36 ± 2.96 (mean ± S.D.), Neuropathy Disability Score 16.8 ± 6.83, VPT 43.4 ± 11.8 Volts while 43 (86%) could not feel a 5.07 or smaller Semmes-Weinstein monofilament. Forty-two (84%) patients were re-examined at an interim visit 3 months after baseline, while 37 (74%) completed the study. In-shoe peak forces and pressures were measured using the F-Scan system. No difference was found among the peak force among baseline (95.5 ± 26 kg), interim (96.5 ± 33) and final visit (97.7 ± 25.2, P = NS). There was no difference in peak pressures at the baseline (3.98 ± 1.42 kg·cm −2), second visit (4.13 ± 2.30) and the final visit (4.25 ± 1.51). Nine (18%) patients developed foot problems and one died during the study. We conclude that no changes in foot pressures were found over a period of 6 months of continuous usage of the specially designed footwear in a group of diabetic patients at risk of foot ulceration. Further prospective studies are required to evaluate the impact of specially designed footwear in reducing the rate of foot ulceration.