The Effects of Metatarsal Pad on Plantar Pressure of the Forefoot in Individuals with Diabetic Peripheral Neuropathy: A Randomized Crossover Study

Jafarpisheh, Mohammad; Sadeghi-Demneh, Ebrahim; Fereshtenejad, Niloufar

doi:10.22122/jrrs.v11i6.2561

The Effects of Metatarsal Pad on Plantar Pressure of the Forefoot in Individuals with Diabetic Peripheral Neuropathy: A Randomized Crossover Study

Document Type : Original Articles

Authors

Mohammad Jafarpisheh ¹

Ebrahim Sadeghi-Demneh ²

Niloufar Fereshtenejad ³

¹ MSc Student, Department of Prosthetics and Orthotics, School of Rehabilitation Sciences, Student Research Committee of Rehabilitation Students (TREATA), Isfahan University of Medical Sciences, Isfahan, Iran

² Assistant Professor, Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

³ Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

10.22122/jrrs.v11i6.2561

Abstract

Introduction: Foot insoles are widely used to reduce excessive pressure exerted on the plantar surface of the foot and prevent diabetic foot ulceration. The objective of this study was to investigate the effects of the metatarsal pad on pressure on the forefoot area.Materials and Methods: This randomized crossover clinical trial was conducted on 18 volunteers (5 women and 13 men) with diabetic peripheral neuropathy. Plantar pressure was recorded while participants walked over a plantar pressure platform in three random conditions of barefoot, with a placebo intervention, and with a metatarsal pad. The processed variables were statistically analyzed using repeated measure one-way ANOVA.Results: The metatarsal pad caused a significant reduction in mean pressure on the forefoot compared to the barefoot and placebo conditions (P < 0.001). The metatarsal pad also significantly reduced the time-pressure integral in the forefoot compared to the barefoot and placebo conditions (P < 0.001). There was no significant difference in the time-pressure integral of the total plantar surface between the three conditions.Conclusion: The metatarsal pad transfers the forefoot load to the midfoot area, thereby, reducing the pressure exerted on the forefoot. This finding implies that using a metatarsal pad can be an effective intervention to prevent diabetic foot ulceration.

Keywords

Diabetic foot

Peripheral neuropathy

Plantar pressure

Metatarsal pad