Clinical plantar pressure measurement in diabetes: rationale and methodology

This article discusses the methodology and rationale for the application of plantar pressure measurement (PPM) to patients with diabetes mellitus in a clinical setting. PPM is often the only dynamic component of the examination and it provides data on the foot-ground interaction during the specific activity (walking) in which plantar ulceration usually occurs. Elevated plantar pressure has been linked both prospectively and retrospectively with plantar ulceration and it is likely that future studies will show PPM to be predictive of both the site of ulceration and the risk of ulceration. The principles of operation of a number of platforms and in-shoe devices together with methods of analysis and display are disscussed. Biomechanical factors which may lead to elevated pressure are briefly discussed and 8 case studies illustrating different facets of the use of PPM in a clinical setting are presented.