Effective and clinically relevant optimisation of cushioning stiffness to maximise the offloading capacity of diabetic footwear

Chatzistergos, Panagiotis E., Gatt, Alfred, Formosa, Cynthia, Sinclair, Jonathan K. and CHOCKALINGAM, Nachiappan (2023) Effective and clinically relevant optimisation of cushioning stiffness to maximise the offloading capacity of diabetic footwear. Diabetes Research and Clinical Practice. p. 110914. ISSN 01688227

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Abstract or description

Introduction: Optimising the cushioning stiffness of diabetic footwear/orthoses can significantly enhance their offloading capacity. This study explores whether optimum cushioning stiffness can be predicted using simple demographic and anthropometric parameters.
Methods: Sixty-nine adults with diabetes and loss of protective sensation in their feet were recruited for this cross-sectional observational study. In-shoe plantar pressure was measured using Pedar® for a neutral diabetic shoe (baseline) and after adding cushioning footbeds of varying stiffness. The cushioning stiffness that achieved maximum offloading was identified for each participant. The link between optimum cushioning stiffness and plantar loading or demographic/anthropometric parameters was assessed using multinomial regression.
Results: People with higher baseline plantar loading required stiffer cushioning materials for maximum offloading. Using sex, age, weight, height, and shoe-size as covariates correctly predicted the cushioning stiffness that minimised peak pressure across the entire foot, or specifically in the metatarsal heads, midfoot and heel regions in 70%, 72%, 83% and 66% of participants respectively.
Conclusions: Increased plantar loading is associated with the need for stiffer cushioning materials for maximum offloading. Patient-specific optimum cushioning stiffness can be predicted using five simple demographic/anthropometric parameters. These results open the way for methods to optimise cushioning stiffness as part of clinical practice.

Item Type:	Article
Faculty:	School of Life Sciences and Education > Sport and Exercise
Depositing User:	Panagiotis CHATZISTERGOS
Date Deposited:	25 Sep 2023 13:00
Last Modified:	23 Oct 2023 10:52
URI:	https://eprints.staffs.ac.uk/id/eprint/7916

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