Ulcer-risk classification and plantar pressure distribution in patients with diabetic polyneuropathy: exploring the factors that can lead to foot ulceration

Claudia Giacomozzi, Cristina D. Sartor, Rafael Telles, Luigi Uccioli, Isabel C.N. Sacco

Research output: Contribution to journalArticlepeer-review

Abstract

Plantar pressure is critical in the onset of neuropathic foot ulcers. However, risk classifications do not consider it as a stratification parameter. Whether plantar pressure distribution affects ulcer-risk was investigated. Patients from a research study (n. 134) and from a clinical environment (n. 83) were classified into ulcer-risk groups according to the International Working Group on the Diabetic Foot guidelines. Pressure distribution was acquired during gait (Pedar-X System), and assessed for hindfoot, midfoot, forefoot and toes (1way- and 2way-ANOVAs, p < 0.05). Pressure distribution changed with polyneuropathy even in the low-risk groups: median p = 0.048 (0.001-0.223). Risk classification correlated poorly with pressure distribution: median p = 0.686 (0.374-0.828). BMI, age and walking speed influenced most parameters and rendered the studies almost impossible to compare (2-way ANOVA factor A > 0.05). Pressure-time integral, the only comparable parameter between the two studies, may increase the predictive capacity of ulcer-risk stratification models.

Original languageEnglish
Pages (from-to)284-293
Number of pages10
JournalAnnali dell'Istituto Superiore di Sanita
Volume54
Issue number4
DOIs
Publication statusPublished - Oct 1 2018

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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