An examination of plantar pressure measurements to identify the location of diabetic forefoot ulceration

Susan Stacpoole-Shea, Graeme Shea, Lawrence Lavery

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to evaluate pressure-time parameters on the sole of the foot in order to predict sites of pathology in diabetics. Mid-gait walking steps from 36 subjects diagnosed with diabetes and ulceration to the forefoot were analyzed using the Pedar in-shoe pressure analysis system. The time that weight was loaded on the hallux and lesser digits was found to be significantly shorter on the feet with ulceration compared to those without. A combination of five pressure measure reports could significantly differentiate between the three common locations of forefoot ulcerations. The significant pressure measure reports were the pressure-time integral measured over the whole foot and pressure-time integral and peak pressure measured separately at the first and combined lesser metatarsophalangeal joint regions. A preliminary model was developed using discriminate analysis that was accurate to 72.7% in identifying the location of the subjects' ulceration. Sensitivity and specificity formulas were calculated to demonstrate the diagnostic value of the model. The model accurately identified ulceration locations to a sensitivity of 83% and a specificity of 69%. Further refinement and testing is underway to refine the model to develop a screening tool to identify the site of potential foot ulceration and to prevent it and its sequelae of lower limb ulceration in the diabetic population.

Original languageEnglish (US)
Pages (from-to)109-115
Number of pages7
JournalJournal of Foot and Ankle Surgery
Volume38
Issue number2
StatePublished - Mar 1999

Fingerprint

Pressure
Foot
Hallux
Metatarsophalangeal Joint
Shoes
Gait
Walking
Lower Extremity
Pathology
Weights and Measures
Sensitivity and Specificity
Population

Keywords

  • Diabetes
  • Foot
  • Pressure
  • Ulceration

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

An examination of plantar pressure measurements to identify the location of diabetic forefoot ulceration. / Stacpoole-Shea, Susan; Shea, Graeme; Lavery, Lawrence.

In: Journal of Foot and Ankle Surgery, Vol. 38, No. 2, 03.1999, p. 109-115.

Research output: Contribution to journalArticle

@article{ed553635acc649119b54ca4a698e1587,
title = "An examination of plantar pressure measurements to identify the location of diabetic forefoot ulceration",
abstract = "The purpose of this study was to evaluate pressure-time parameters on the sole of the foot in order to predict sites of pathology in diabetics. Mid-gait walking steps from 36 subjects diagnosed with diabetes and ulceration to the forefoot were analyzed using the Pedar in-shoe pressure analysis system. The time that weight was loaded on the hallux and lesser digits was found to be significantly shorter on the feet with ulceration compared to those without. A combination of five pressure measure reports could significantly differentiate between the three common locations of forefoot ulcerations. The significant pressure measure reports were the pressure-time integral measured over the whole foot and pressure-time integral and peak pressure measured separately at the first and combined lesser metatarsophalangeal joint regions. A preliminary model was developed using discriminate analysis that was accurate to 72.7{\%} in identifying the location of the subjects' ulceration. Sensitivity and specificity formulas were calculated to demonstrate the diagnostic value of the model. The model accurately identified ulceration locations to a sensitivity of 83{\%} and a specificity of 69{\%}. Further refinement and testing is underway to refine the model to develop a screening tool to identify the site of potential foot ulceration and to prevent it and its sequelae of lower limb ulceration in the diabetic population.",
keywords = "Diabetes, Foot, Pressure, Ulceration",
author = "Susan Stacpoole-Shea and Graeme Shea and Lawrence Lavery",
year = "1999",
month = "3",
language = "English (US)",
volume = "38",
pages = "109--115",
journal = "Journal of Foot and Ankle Surgery",
issn = "1067-2516",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - An examination of plantar pressure measurements to identify the location of diabetic forefoot ulceration

AU - Stacpoole-Shea, Susan

AU - Shea, Graeme

AU - Lavery, Lawrence

PY - 1999/3

Y1 - 1999/3

N2 - The purpose of this study was to evaluate pressure-time parameters on the sole of the foot in order to predict sites of pathology in diabetics. Mid-gait walking steps from 36 subjects diagnosed with diabetes and ulceration to the forefoot were analyzed using the Pedar in-shoe pressure analysis system. The time that weight was loaded on the hallux and lesser digits was found to be significantly shorter on the feet with ulceration compared to those without. A combination of five pressure measure reports could significantly differentiate between the three common locations of forefoot ulcerations. The significant pressure measure reports were the pressure-time integral measured over the whole foot and pressure-time integral and peak pressure measured separately at the first and combined lesser metatarsophalangeal joint regions. A preliminary model was developed using discriminate analysis that was accurate to 72.7% in identifying the location of the subjects' ulceration. Sensitivity and specificity formulas were calculated to demonstrate the diagnostic value of the model. The model accurately identified ulceration locations to a sensitivity of 83% and a specificity of 69%. Further refinement and testing is underway to refine the model to develop a screening tool to identify the site of potential foot ulceration and to prevent it and its sequelae of lower limb ulceration in the diabetic population.

AB - The purpose of this study was to evaluate pressure-time parameters on the sole of the foot in order to predict sites of pathology in diabetics. Mid-gait walking steps from 36 subjects diagnosed with diabetes and ulceration to the forefoot were analyzed using the Pedar in-shoe pressure analysis system. The time that weight was loaded on the hallux and lesser digits was found to be significantly shorter on the feet with ulceration compared to those without. A combination of five pressure measure reports could significantly differentiate between the three common locations of forefoot ulcerations. The significant pressure measure reports were the pressure-time integral measured over the whole foot and pressure-time integral and peak pressure measured separately at the first and combined lesser metatarsophalangeal joint regions. A preliminary model was developed using discriminate analysis that was accurate to 72.7% in identifying the location of the subjects' ulceration. Sensitivity and specificity formulas were calculated to demonstrate the diagnostic value of the model. The model accurately identified ulceration locations to a sensitivity of 83% and a specificity of 69%. Further refinement and testing is underway to refine the model to develop a screening tool to identify the site of potential foot ulceration and to prevent it and its sequelae of lower limb ulceration in the diabetic population.

KW - Diabetes

KW - Foot

KW - Pressure

KW - Ulceration

UR - http://www.scopus.com/inward/record.url?scp=0032938908&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032938908&partnerID=8YFLogxK

M3 - Article

VL - 38

SP - 109

EP - 115

JO - Journal of Foot and Ankle Surgery

JF - Journal of Foot and Ankle Surgery

SN - 1067-2516

IS - 2

ER -