Title

APWCA2009 - Apr 04, 2009

Author(s)
  with Meegan Van Straaten, PT; Krista Coleman-Wood, PT, Ph.D.; Kenton R. Kaufman, Ph.D., P.E.

Presented at: Philadelphia, PA

Background
Foot ulceration is one of the leading causes of hospitalization for patients with diabetes mellitus. This study was intended to evaluate offloading of the neuropathic forefoot comparing a rocker sole design verses the flat sole with and without a Plastizote insert.

Methods
Fifteen subjects with a history of open wounds were recruited for this study. Foot pressures were measured only on the foot with the healing or healed wound. Peak pressures were obtained in four regions of the foot: hallux, metatarsal head, midfoot and heel. A two factor repeated  measures ANOVA was performed to test for statistical significance at p=0.05.

Results
Offloading of all four foot regions was better with the use of the rocker sole and rocker sole shoe with Plastizote insert. The results show significant (p

Conclusion
Offloading the neuropathic foot is better accomplished with use of a rocker sole shoe with a Plastizote insert. This combination reduces the peak plantar pressure significantly under the hallux, metatarsal heads and heel as compared to a flat soled shoe. The reduction in the plantar pressure below the threshold of ulceration in the neuropathic foot is complementary in the care of patients with neuropathic ulcerations of the feet.