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Hellstrand Tang U, Zügner R, Lisovskaja V, et al. Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers - A two-year, randomized trial. J Clin Transl Endocrinol. 2014;1(4):121-132doi: 10.1016/j.jcte.2014.06.002.
Hellstrand Tang, U., Zügner, R., Lisovskaja, V., Karlsson, J., Hagberg, K., & Tranberg, R. (2014). Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers - A two-year, randomized trial. Journal of clinical & translational endocrinology, 1(4), 121-132. https://doi.org/10.1016/j.jcte.2014.06.002
Hellstrand Tang, Ulla, et al. "Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers - A two-year, randomized trial." Journal of clinical & translational endocrinology vol. 1,4 (2014): 121-132. doi: https://doi.org/10.1016/j.jcte.2014.06.002
Hellstrand Tang U, Zügner R, Lisovskaja V, Karlsson J, Hagberg K, Tranberg R. Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers - A two-year, randomized trial. J Clin Transl Endocrinol. 2014 Jul 24;1(4):121-132. doi: 10.1016/j.jcte.2014.06.002. eCollection 2014 Dec. PMID: 29159093; PMCID: PMC5685010.
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J Clin Transl Endocrinol. 2014 Jul 24;1(4):121-132. doi: 10.1016/j.jcte.2014.06.002. eCollection 2014 Dec.

Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers - A two-year, randomized trial.

Journal of clinical & translational endocrinology

Ulla Hellstrand Tang, Roland Zügner, Vera Lisovskaja, Jon Karlsson, Kerstin Hagberg, Roy Tranberg

Affiliations

  1. Department of Orthopaedics, Institute of Clinical Sciences, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
  2. Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
  3. Department of Mathematical Science/Mathematical Statistics, Chalmers University of Technology and University of Gothenburg, Sweden.

PMID: 29159093 PMCID: PMC5685010 DOI: 10.1016/j.jcte.2014.06.002

Abstract

BACKGROUND: Special insoles and shoes designed to prevent foot ulcers caused by repetitive high pressures are recommended for patients with diabetes who have any of the following risk factors: neuropathy; peripheral vascular disease; foot deformities; previous ulcers; amputation; and skin pathologies. However, there is a need for increased knowledge regarding: a) differences in the peak pressure (PP) and pressure time integral (PTI) for different types of insoles; and b) the properties of the pressure distribution for insoles used over a period of several months. We present the results of a randomized trial to compare the plantar pressures of three commonly used insoles.

OBJECTIVES: The primary objective was to compare the PP and PTI between three types of insoles. The secondary objective was to explore the long-term pattern of peak plantar pressure distribution and variations in specific regions of interest (ROI). The tertiary objective was to investigate the impacts of insole adjustments, how much the insoles were used, and the levels of patient satisfaction.

METHODS: In a 2-year trial, 114 patients with type 1 (

RESULTS: A mixed model analysis estimated lower PP values in the heel regions for the 35 EVA and 55 EVA insoles (171 ± 13 and 161 ± 13 kPa, respectively) than for the prefabricated insoles (234 ± 10 kPa) (

CONCLUSIONS: Custom-made insoles used in combination with stable walking shoes gave lower pressures at the heel region. The variation makes it difficult to detect a systematic difference in plantar pressure for the 6 ROI, if such a difference indeed exists. The levels of satisfaction and usage for all the insoles tested were high. The insoles maintained their pressure redistribution properties over long periods, and few adjustments were needed.

Keywords: 35 EVA, 35 shore EVA insoles; 55 EVA, 55 shore EVA insoles; Clinical trial; Diabetes; EVA, ethylene vinyl acetate; Foot ulcer; Insoles; MTH1, metatarsal head 1; MTH2, metatarsal head 2; MTH4, metatarsal head 4; MTH5, metatarsal head 5; Offloading; PP, peak pressure; PTI, pressure time integral; Prevention; ROI, region of interest

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