MEASUREMENT OF DYNAMIC PLANTAR PRESSURE IN DIABETIC AND NONDIABETIC PATIENTS

A new method known as pedography enables the measurement of plantar pressure while walking. Different areas on the sole can be separately analyzed by means of a personal computer. We studied plantar pressure in 20 patients walking normally on a horizontal platform. Four different stages of weight bearing were investigated, namely 0, 10, 20, and 30 kg, in the ten diabetics and ten non-diabetics. All diabetic suffered from peripheral neuropathy, which was clinically proven as well as a reduction in nerve conduction velocity in the peroneal nerve. Non-diabetics showed no abnormal clinical findings on the lower extremities and nerve conduction velocity was within the normal range. The mean age and size differed between the diabetics and non-diabetics 52 +/- 5 versus 37 +/- 7 and 178 +/- 5 versus 185 +/- 4. Body weight was equal (84 +/- 6 versus 85 +/- 5 kg). We found no significant difference in maximum pressure on the heel, though there were differences on the fore-foot. Diabetics showed a higher maximum pressure already without weight bearing and reached a plateau at the 10 kg level, which was not exceeded at the higher stages of weight bearing. In summary, diabetic patients with neuropathy are subjected to very high plantar pressures at relatively low stages of weight bearing. Pedography enables preventive measures to be undertaken in time, e.g. prescription of orthopaedic insoles.