Plantar pressure and gait changes in type 2 diabetic patients with peripheral neuropathy
LI Wen-xia
LUO Xiang-rong
CAO Ying
ZOU Meng-chen
HU Ping
JIANG Ya
XUE Yao-ming
GAO Fang
Abstract：Objective To investigate the plantar pressure distribution and gait changes in type 2 diabetic patients with peripheral neuropathy.Methods A total of 303 patients with type 2 diabetes hospitalized were enrolled and divided into diabetic peripheral neuropathy (DPN) group (n =137) or diabetic control (DC,without DPN) group (n =166).Demographic characteristics and related biochemical indexes were recorded.Parameters of Plantar pressure and gait were recorded with the FootScan system.Independent t-test or Mann Whaitney U test and Spearman rank correlation analysis were applied in the data analysis.Results Compared with DC group,plantar peak pressures in third metatarsal [(13.15 ± 4.22) N/cm2 vs.(11.96 ± 3.94) N/ema2,P ＜ 0.05] or forth metatarsal [(10.21 ± 4.22) N/cm2 vs.(9.14 ± 3.66) N/cm2,P ＜ 0.05] on the left foot and in the first [(6.02 ± 2.79) N/cm2 vs.(5.04 ± 2.87) N/cm2,P ＜ 0.05],the second [(9.95 ±2.69) N/cm2 vs.(9.18 ±2.77) N/cm2,P ＜0.05],the third [(10.90 ±3.23) N/cm2 vs.(9.93 ± 3.09) N/cm2,P ＜ 0.05] metatarsal on the right foot were significantly decreased.There was no significant difference in pressure-time intergrals in each region,total force,total force-time intergrals,or total contact area between the two groups (P ＞0.05).In comparison with those in DC group,foot flat phase extended [56.8％ (50.22％-62.45％) vs.59.5％ (54.25％-64.15％),P ＜ 0.05],forefoot push off phase shorten [31.25％ (25.475％-35.775％) vs.29％ (24.95％-33.65％),P＜0.05] in stance phase,and total contact time [(858 ± 12)ms vs.(900 ± 127)ms,P＜ 0.05] were increased significantly,while walking speed was significantly decreased [(2.58 ± 0.67) km/h vs.(2.28 ± 0.66)km/h,P ＜0.05] in DPN group.Walking speed and forefoot push off phase changes were positively correlated with peak pressure changes,while foot fiat phase changes was negative correlated with peak pressure.Conclusion In DPN patients,walking speed decreases,foot flat phase is extended,and forefoot push off phase is shorten in stance phase;however,peak pressure and pressure-time intergrals does not increase significantly.While evaluating plantar pressure in diabetic patients,walking speed and gait should be controlled and pressure-time intergral may be better reflecting the plantar loading.
Keywords：diabeticperipheral neuropathyplantar pressuregait
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 859-863 )