Title: Efficacy of Multilayered Hosiery in Reducing In-shoe Plantar Foot Pressure in High-Risk Patients with Diabetes
Authors: Adam P. Garrow, PHD., Carine Van Schie, PHD, Andrews J.M Boulton, MD
Source: Diabetes Care 2005, 28:2001-2006.
PODIATRIC RELEVANCE:
As podiatric physicians specialized in the care of lower extremity disorders we are well aware that diabetes has a devastating impact on the foot. A significant number of diabetic patients will develop some type of foot ulceration in their lifetime which can lead to foot infection and amputation. Any preventive measure that can decrease the risk of lower extremity amputation should be taken into consideration. This article evaluates the efficacy of a new Multilayered Hosiery in reducing In-Shoe plantar pressure in high risk patients with diabetes.
METHODS:
A total of nineteen subjects of the Manchester Diabetes Center were used in the study. Fifteen of the nineteen participants were male ranging from age thirty-nine to eighty years old. They all demonstrated moderate to severe signs of peripheral neuropathy. Sixty-three percent had long standing diabetes type II with a mean duration of twenty years. The subjects were overweight or obese and ulcer free at the time of recruitment. All subjects had at least one area on the sole of the foot with a pressure greater than six kilograms per centimeter squared. The Pressure Stat system was used for pressure measurements and in shoe plantar pressure measurements were recorded using the F-scan (Tek-scan, Boston, MA). The Preventive Foot Care (PFC) socks consisted of an outer layer combined with a low friction fiber inner layer to reduce friction at the sock-foot interface. Each participant underwent a standardized clinical examination where the foot length, girth and deformity were assessed.
RESULTS:
The average total foot contact area increased from 138 cm² in supermarket socks to 149 cm² in the PFC socks with an 8.9% reduction in total contact pressure. Larger changes were observed in the forefoot. The foot contact area increased by 14.2% with a 10.2% reduction in peak pressure. It was observed that a 9.7% increase in total contact area corresponds to 8.9% reduction in contact pressure, very close to the value determined by the F-Scan. The results show that the PFC socks can provide a 9% reduction of In-Shoe total foot pressure and 14% reduction of peak forefoot pressure due to and 8% increase in foot contact area.
COMMENTS:
Numerous preventive measures are now available to prevent foot ulcerations in the diabetic neuropathic patient however new products and concepts that can reduce mechanical stress on the foot and can be cost saving will continue to be introduced. Altering the kind of socks for our diabetic patient is a simple and cost effective method that can protect the at risk foot in diabetes. This article shows the efficacy of the PFC Multilayered socks in reducing In-Shoe plantar pressure in high risk patients with diabetes. Previous studies have demonstrated a correlation between decreasing plantar pressure and prevention of foot ulcers in high risk diabetic patient. The PFC socks may have some usefulness in the prevention of diabetic foot ulcers.
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Disclaimer:
Scientific Abstract Monthly postings are submitted by podiatric surgical residents. The ideas presented are not the opinions of the American College of Foot and Ankle Surgeons (ACFAS), nor are they presented as facts. ACFAS presents this information without any warranty of any kind, expressed or implied, and is not liable for its accuracy nor for any loss or damage caused by the user's reliance on information obtained in these areas.