Biofeedback can reduce foot pressure to a safe level and without causing new at‐risk zones in patients with diabetes and peripheral neuropathy. Issue 2 (5th February 2013)

• Record Type: Journal Article
• Authors: De León Rodriguez, D.; Allet, L.; Golay, A.; Philippe, J.; Assal, J.‐Ph.; Hauert, C.‐A.; Pataky, Z.
• Is Part Of: Diabetes/metabolism research and reviews. Volume 29:Issue 2(2013:Feb.)
• Page Start: 139
• Page End: 144
• Publication Date: 2013-02-05
• Subjects: Diabetes -- Periodicals; Metabolism -- Periodicals; 616.642
• DOI: 10.1002/dmrr.2366
• Languages: English
• ISSNs: 1520-7552

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="dmrr2366-sec-0001" sec-type="section"> <title>Background</title> <p>Plantar pressure reduction is mandatory for diabetic foot ulcer healing. Our aim was to evaluate the impact of a new walking strategy learned by biofeedback on plantar pressure distribution under both feet in patients with diabetic peripheral neuropathy.</p> </sec> <sec id="dmrr2366-sec-0002" sec-type="section"> <title>Methods</title> <p>Terminally augmented biofeedback has been used for foot off‐loading training in 21 patients with diabetic peripheral sensory neuropathy. The biofeedback technique was based on a subjective estimation of performance and objective visual feedback following walking sequences. The patient was considered to have learned a new walking strategy as soon as the peak plantar pressure (PPP) under the previously defined at‐risk zone was within a range of 40–80% of baseline PPP in 70% of the totality of steps and during three consecutive walking sequences. The PPP was measured by a portable in‐shoe foot pressure measurement system (PEDAR®) at baseline (T0), directly after learning (T1) and at 10‐day retention test (T2).</p> </sec> <sec id="dmrr2366-sec-0003" sec-type="section"> <title>Results</title> <p>The PPP under at‐risk zones decreased significantly at T1 (165 ± 9 kPa, <italic>p</italic> < 0.0001) and T2 (167 ± 11, <italic>p</italic> = 0.001), as compared with T0 (242 ± 12 kPa) without any increase of the PPP elsewhere.</p> <p>At the contralateral foot (not concerned by off‐loading), the PPP was slightly higher under the lateral midfoot at T1 (68 ± 8 kPa, <italic>p</italic> = 0.01) and T2 (65 ± 8 kPa, <italic>p</italic> = 0.01), as compared with T0 (58 ± 6 kPa).</p> </sec> <sec id="dmrr2366-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The foot off‐loading by biofeedback leads to a safe and regular plantar pressure distribution without inducing any new 'at‐risk' area under both feet. Copyright © 2012 John Wiley & Sons, Ltd.</p> </sec> </abstract>