Effects of Total Contact Orthosis on the Plantar Pressure during Walking Activities for Diabetic Foot

Abstract

Abnormal plantar pressures during different walking activities cause an adverse effect on the plantar load distribution in people with diabetic foot complications. However, limited data are available to examine the plantar peak pressure during different walking activities in diabetic people. The aim of this study was to investigate the plantar pressure from four regions of the foot during different walking activities (ie., level walking, ramp ascending, ramp descending, stair ascending and stair descending) in neuropathic diabetic subjects without and with a total-contact orthosis (TCO). Sixteen neuropathic diabetic subjects aged 40-60 years with calluses and foot deformities were included in this study and were provided with a TCO made up of multifoam, PlastazoteR and microcellular rubber. Peak plantar pressure and contact area without a TCO and with a TCO were recorded using the Pedar X® system during different walking activities. With the TCO significant reduction of peak plantar pressure at toes and forefoot when compared without TCO during different walking activities. Peak plantar pressure increased at the midfoot region when walking with a TCO and no significant difference was observed at the hindfoot region between two conditions. Furthermore, contact area was increased during level walking with a TCO compared to other walking activities. The reduction and redistribution of the peak plantar pressure occur with the use of TCO from the site where the ulceration rate is higher as at the toes and forefoot compared to the other regions of the foot.