The insole materials influence the plantar pressure distributions in diabetic foot with neuropathy during different walking activities

• Published in: Gait & posture 2019-10, Vol.74, p.154-161
• Main Authors: Nouman, Muhammad, Dissaneewate, Tulaya, Leelasamran, Wipawan, Chatpun, Surapong
• Format: Article
• Language: English
• Subjects: Adult; Custom made insole; Daily walking activities; Diabetes Mellitus - physiopathology; Diabetic foot; Diabetic Foot - physiopathology; Female; Foot - physiopathology; Foot Orthoses; Humans; Insole material; Male; Middle Aged; Plantar pressure; Pressure; Shoes; Walking - physiology; Weight-Bearing - physiology
• ISSN: 0966-6362; 1879-2219
• DOI: 10.1016/j.gaitpost.2019.08.023

•The energy return is higher with CMI-B, especially at the midfoot and hindfoot.•The maximum peak plantar pressure with CMI-B decreased, especially at the forefoot.•The effective reduction occurred at the forefoot region when using CMI-B.•The hallux showed a maximum increase in the contact area with CMI-B.•The COP is lessened to the forefoot region and more centered to the midfoot with CMI-B. Abnormal peak plantar pressure in neuropathic diabetic foot during walking activities is well managed through the use of appropriate design and material selection for the fabrication of custom made insoles (CMI). The redistribution of plantar pressure is possible by selecting an appropriate material for the fabrication of CMI. The walking activities may alter the plantar pressure distribution; which may differ while using CMI with different materials. The objective of the study was to evaluate the effectiveness of CMI’s materials on plantar pressure distribution during different walking activities, in diabetic feet with neuropathy. The study was conducted on sixteen diabetic neuropathic subjects. The subjects were provided with two types of CMI; CMI-A (Plastazote® and microcellular rubber) and CMI-B (Multifoam, Plastazote® and microcellular rubber). Maximum peak plantar pressure and plantar pressure distribution were determined by Pedar-X® sensor insole during level walking, ramp walking and stair walking. The CMI-B lessened the maximum peak plantar pressure from the forefoot throughout the walking activities compared to CMI-A. The contact area was observed as lower using CMI-A compared to CMI-B, while performing walking activities. CMI-B, with multifoam as an additional top layer, provided more effective peak plantar pressure reduction at forefoot and it had better plantar pressure distribution compared to CMI-A during level walking and ramp ascending in diabetic foot with neuropathy.