The importance of plantar pressure in the prevention of ulcers in Portuguese patients with diabetic foot
DOI:
https://doi.org/10.25758/set.2101Keywords:
Diabetic foot, Plantar pressure, Prevention, Ulcer, Baropodometric platformAbstract
Objectives – To understand the relationship between plantar pressures and the ulcers’ occurrence in individuals with neuropathic diabetic feet, using this factor as a possible method of risk assessment and identification. To investigate the association between the epidemiological data and ulcer occurrence. To identify an indicative value for its occurrence. Methods – A quantitative cross-sectional, correlational, and epidemiological study was carried out by collecting sociodemographic and clinical information from the participants and conducting sensitivity tests to identify neuropathy. The sample (N = 60) was divided into two groups: neuropathic diabetics and non-neuropathic diabetics. Podological evaluations were performed using a baropodometric platform, and later statistical analyses were made with the results obtained. Results – There is an association between age, gender, and increased BMI with the occurrence of neuropathy. More than half of the diabetic population in the study has associated peripheral neuropathy. The presence of deformities in the feet of the individuals in the sample was shown to have an influence on the occurrence of ulcers, as well as PPP and IPT values. It can be assumed that the value 88.06 kPa is a reference value for the development of an ulcer. Conclusions – There is a relationship between PP and the occurrence of ulcers. Podological analysis on a baropodometric platform allows us to understand whether or not the patient is at risk of developing an ulcer. This study shows a possible PPP value that serves as an indicator of the development of an ulcer on a diabetic foot.
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References
Ministério da Saúde. Retrato da saúde 2018. Lisboa: MS; 2018. ISBN 9789899948013
Armstrong DG, Nguyen HC, Lavery LA, Van Schie CHM, Boulton AJM, Harkless LB. Off-loading the diabetic foot wound: a randomized clinical trial. Diabetes Care. 2001;24(6):1019-22.
Anichini R, Zecchini F, Cerretini I, Meucci G, Fusilli D, Alviggi L, et al. Improvement of diabetic foot care after the implementation of the International Consensus on the Diabetic Foot (ICDF): results of a 5-year prospective study. Diabetes Res Clin Pract. 2007;75(2):153-8.
Leite FE. Pé diabético [dissertation]. Porto: Faculdade de Medicina da Universidade do Porto; 2010.
Schaper NC, Van Netten JJ, Apelqvist J, Lipsky BA, Bakker K. Prevention and management of foot problems in diabetes: a summary guidance for daily practice 2015, based on the IWGDF guidance documents. Diabetes Metab Res Rev. 2016;32(Suppl 1):7-15.
Caiafa JS, Castro AA, Fidelis C, Santos VP, Silva ES, Sitrângulo Jr CJ. Atenção integral ao portador de pé diabético. J Vasc Bras. 2011;10(4 Suppl 2):1–32.
Fernando M, Crowther R, Lazzarini P, Sangla K, Cunningham M, Buttner P, et al. Biomechanical characteristics of peripheral diabetic neuropathy: a systematic review and meta-analysis of findings from the gait cycle, muscle activity and dynamic barefoot plantar pressure. Clin Biomech. 2013;28(8):831-45.
Mudalige AS, Jayasundere ND, De Silva KG, Mithila MP, Weerarathna TP. Plantar pressure profiler for medical diagnostics. In: 2016 IEEE International Conference on Information and Automation for Sustainability (ICIAfS) [homepage]. 2017 Jun 15. Available from: https://ieeexplore.ieee.org/abstract/document/7946561
Bus SA, De Lange A. A comparison of the 1-step, 2-step, and 3-step protocols for obtaining barefoot plantar pressure data in the diabetic neuropathic foot. Clin Biomech. 2005;20(9):892-9.
Bus SA, Waaijman R. The value of reporting pressure-time integral data in addition to peak pressure data in studies on the diabetic foot: a systematic review. Clin Biomech. 2012;28(2):117-21.
Serra LM. Pé diabético: manual para a prevenção da catástrofe. 2ª ed. Lisboa: Lidel; 2008. ISBN 9789727575091
Ko M, Hughes L, Lewis H. Walking speed and peak plantar pressure distribution during barefoot walking in persons with diabetes. Physiother Res Int. 2012;17(1):29-35.
Bacarin TA, Sacco ICN, Hennig EM. Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers. Clinics. 2009;64(2):113-20.
Silva CA, Pereira DS, Almeida DS, Venâncio MI. Pé diabético e avaliação do risco de ulceração [Diabetic foot and assessment of the risk of ulceration]. Rev Enferm Ref. 2014;4(1):153-61. Portuguese
Bus SA, van Netten JJ, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev. 2016;32(1):16-24.
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2017;40(Suppl 1):S33-43.
Al-Angari HM, Khandoker AH, Lee S, Almahmeed W, Al Safar HS, Jelinek HF, et al. Novel dynamic peak and distribution plantar pressure measures on diabetic patients during walking. Gait Posture. 2017;51:261-7.
Rahman MA, Aziz Z, Rajendra Acharya U, Ha TP, Kannathal N, Ng EYK, et al. Analysis of plantar pressure in diabetic type 2 subjects with and without neuropathy. ITBM-RBM. 2006;27(2):46-55.
Macedo A, Campos C, Correia J, Gomes P. Pé em risco aumentado de ulceração em doentes com diabetes mellitus tipo 2 [Increased risk of foot ulcers in patients with type 2 diabetes mellitus]. Rev Port Clin Geral. 2010;26(2):159-68. Portuguese
Lung CW, Hsiao-Wecksler ET, Burns S, Lin F, Jan YK. Quantifying dynamic changes in plantar pressure gradient in diabetics with peripheral neuropathy. Front Bioeng Biotechnol. 2016;4:54.
Sacco ICN, Hamamoto AN, Gomes AA, Onodera AN, Hirata RP, Hennig EM. Role of ankle mobility in foot rollover during gait in individuals with diabetic neuropathy. Clin Biomech. 2009;24(8):687-92.
Filippin N, Barbosa V, Sacco I, Costa PL. Effects of obesity on plantar pressure distribution in children. Rev Bras Fisioter. 2007;11(6):495-501.
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