The role of a total contact insole in diminishing foot pressures following partial first ray amputation in diabetic patients

摘要

Background: In diabetic subjects, reulcerations following first ray amputations are particularly frequent. Treatment usually includes an in-shoe intervention to reduce plantar pressure. Objective: To investigate the effects of a total contact insole on the plantar pressure reduction in patients with partial first ray amputations. Material and methods: Twenty diabetic subjects (mean age 60 years, mean body mass index 27kg/m2) with partial first ray amputation of one foot. Plantar pressure data was recorded using Matscan system (Tekscan vers. 6.34, Boston, USA) while standing and taking a step for three conditions (shoe, shoe with total contact insole, and shoe with flat insole). Plantar pressures were determined at the five metatarsal areas, mid foot area and medial and lateral heel areas. Results: Pressures diminished significantly (P0.05) in tested areas using the total contact insole while standing and walking. While using the flat insole, significant pressure changes were only seen while walking (P0.05) (P0.05). A highly significant change in pressures with the total contact insoles during walking in all areas except for the M1 area (P0.001) as compared to that of flat insole. Conclusion: The conforming total contact insole showed significant reduction in plantar pressures in patients with first ray amputation.