COMPARATIVE ANALYSIS OF THREE TYPES OF THERAPEUTIC OFFLOADING DIABETIC SHOES WITH CUSTOM MADE INSOLE ON PLANTAR PRESSURE DISTRIBUTION IN SEVERE DIABETIC CHARCOT FOOT
Issued Date
2024-01-01
Resource Type
eISSN
2561987X
Scopus ID
2-s2.0-85209739322
Journal Title
Canadian Prosthetics and Orthotics Journal
Volume
7
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Canadian Prosthetics and Orthotics Journal Vol.7 No.1 (2024)
Suggested Citation
Nouman M., Apiputhanayut R., Narungsri T., Tipchatyotin S., Dissaneewate T. COMPARATIVE ANALYSIS OF THREE TYPES OF THERAPEUTIC OFFLOADING DIABETIC SHOES WITH CUSTOM MADE INSOLE ON PLANTAR PRESSURE DISTRIBUTION IN SEVERE DIABETIC CHARCOT FOOT. Canadian Prosthetics and Orthotics Journal Vol.7 No.1 (2024). doi:10.33137/cpoj.v7i1.41780 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/102209
Title
COMPARATIVE ANALYSIS OF THREE TYPES OF THERAPEUTIC OFFLOADING DIABETIC SHOES WITH CUSTOM MADE INSOLE ON PLANTAR PRESSURE DISTRIBUTION IN SEVERE DIABETIC CHARCOT FOOT
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Corresponding Author(s)
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Abstract
BACKGROUND: Charcot foot deformity, a severe complication of diabetes, involves neuropathy and abnormal peak plantar pressure in the midfoot and forefoot. However, orthotic interventions and shoe modifications are used to address the sequelae of Charcot neuroarthropathy, offering different approaches to managing abnormal peak plantar pressure. OBJECTIVE: To compare the effects of three types of therapeutic offloading diabetic shoes; prefabricated, relasting, and double rocker-modified shoes on peak plantar pressure in the midfoot and forefoot of nonulcerated chronic Charcot foot during walking. METHODOLOGY: A repeated measure design involved 15 participants (40% males and 60% females) with a mean age of 60.73 years (SD=10.50), with Charcot neuropathy. Participants were provided with three types of shoes; prefabricated, relasting, and double rocker-modified shoes, each equipped with the same custom-made insole (CMI). Plantar pressure was recorded while walking on level ground, focusing on the forefoot, midfoot, and hindfoot. The study also investigated additional variables affecting plantar pressure distribution, including the pressure-time integral and contact area. FINDINGS: The type of shoe had distinct effects on the distribution of plantar pressure. The double rocker-modified shoe particularly impacted forefoot pressure during the terminal stance phase of the gait cycle. Peak plantar pressure at the forefoot increased by 5.37% with double rocker-modified shoes compared to relasting shoes. Both double rocker-modified and prefabricated shoes reduced midfoot peak plantar pressure by 8.73% and 11.97%, respectively. Similar trends were observed at the hindfoot, with reductions in peak plantar pressure. However, there were no significant differences in regional peak plantar pressure between the types of shoes except for the central forefoot (F (1.61, 22.5) = 5.69, p = 0.014). CONCLUSION: There were no significant differences in the effectiveness of prefabricated, relasting, and double rocker-modified shoes in reducing and redistributing peak plantar pressure in high-risk areas of chronic Charcot foot.