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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Pressure-relieving footwear helps prevent foot ulcers in people with diabetes. The footwear design contributes to this effect and includes the insole top cover. We aimed to assess the offloading effect of materials commonly used as insole top cover. We measured 20 participants with diabetes and peripheral neuropathy for in-shoe peak pressures while walking in their prescribed footwear with the insole covered with eight different materials, tested in randomized order. Top covers were a 3 mm or 6 mm thick open or closed-cell foam or a 6 mm thick combination of open- and closed-cell foams. We re-assessed pressures after one month of using the top cover. Peak pressures were assessed per anatomical foot region and a region of interest (i.e., previous ulceration or high barefoot pressure). Walking comfort was assessed using a 10-point Likert scale. Mean peak pressure at the region of interest varied between 167 (SD:56) and 186 (SD:65) kPa across top covers (p < 0.001) and was significantly higher for the 3 mm thick PPT than for four of the seven 6 mm thick top covers. Across 6 mm thick top covers, only two showed a significant peak pressure difference between them. Over time, peak pressures changed non-significantly from −2.7 to +47.8 kPa across top cover conditions. Comfort ratings were 8.0 to 8.4 across top covers (p = 0.863). The 6 mm thick foams provided more pressure relief than the 3 mm thick foam during walking in high-risk people with diabetes. Between the 6 mm thick foams and over time, only small differences exist. The choice of which 6 mm thick insole top cover to use may be determined more by availability, durability, ease of use, costs, or hygienic properties than by superiority in pressure-relief capacity.

Details

Title
Pressure-Relieving Effect of Different Insole Top Covers in People with Diabetes at High Risk of Foot Ulceration
Author
Bus, Sicco A 1   VIAFID ORCID Logo  ; Busch-Westbroek, Tessa E 1   VIAFID ORCID Logo  ; Pulles, Jan 2 ; Tim van Dun 3 ; Szabo, Ghizella 2 ; Lacorte, Dario H 4 ; Dannick Luckson 4 ; van Netten, Jaap J 1   VIAFID ORCID Logo 

 Department of Rehabilitation Medicine, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands[email protected] (J.J.v.N.); Program Rehabilitation & Development, Amsterdam Movement Sciences Research Institute, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands 
 Livit OttoBock Care, Kabelweg 40, 1060 JA Amsterdam, The Netherlands 
 Voetencentrum Wender, Sabina Klinkhamerweg 10, 7555 SK Hengelo, The Netherlands 
 Department of Human Movement Sciences, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands 
First page
5549
Publication year
2024
Publication date
2024
Publisher
MDPI AG
e-ISSN
14248220
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3104086392
Copyright
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.