Using a total contact orthosis is an effective method for foot offloading among patients with diabetes-related foot neuropathy. However, the redistribution of peak plantar pressure is mostly observed during level walking, which may differ from other walking activities. A study of patients with neuropathy and diabetes investigated the plantar pressure from four regions of the foot during different walking activities (level walking, ramp ascending, ramp descending, stair ascending, and stair descending) with and without a total contact orthosis. The results indicated that the total contact orthosis significantly reduced and redistributed the peak plantar pressure from the sites where the ulceration rate is higher, at the toes and forefoot, compared with the other regions of the foot.
Sixteen participants with neuropathy and diabetes who ranged in age from 40 to 60 years old and had calluses and hallux valgus were provided with total contact orthoses made of multifoam, Plastazote, and microcellular rubber. The plantar pressure and contact area were recorded using a pedar®-x system during different walking activities when the participants used the orthotic and without the orthotic.
According to the study, a significant reduction of plantar pressure at the toes and forefoot regions was observed during different walking activities while participants walked with the orthotic compared with walking without the orthotic (control condition). Plantar pressure increased at the midfoot region when walking with the orthotic, and no significant difference was observed at the hindfoot region between the control and total contact orthosis conditions. Furthermore, maximum contact area was observed during level walking with the total contact orthosis compared with other walking activities, according to the researchers.
The study was published online April 29 in Foot & Ankle International.
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