Daily-life activities and in-shoe forefoot plantar pressure in patients with diabetes

Objective: To assess differences regarding in-shoe forefoot plantar pressure (PP) in patients with diabetes during various daily-life activities. Research design and methods: In-shoe PP was measured in 93 patients during: level walking, ramp and stair walking, turning in different settings and while performing the Up & Go test. Separate PPs were determined for the big toe and metatarsal (mt) regions one to five. Results: Across all activities, similar PPs were measured in the big toe and mt-1 to mt-3 region. Lower PPs were measured in mt-4 and mt-5 region. PPs during level walking were mostly higher when compared to the other activities (p <= .030). Turning while level and mt walking resulted in higher PPs than turning while performing the other activities (p <= .033). Higher PPs were measured for both ramp and stair ascending when compared to descending (p <= .001). In the big toe region, stair descending resulted in higher PPs than ascending (p <= .001). Across all activities, patients with neuropathy had lower PPs (overall mean 28 kPa) than patients without neuropathy. Conclusions: Level walking resulted in the highest forefoot PPs during daily-life activities. Patients with neuropathy had lower PPs than patients without neuropathy. (C) 2006 Elsevier Ireland Ltd. All rights reserved.