J Korean Diabetes.  2022 Dec;23(4):266-277. 10.4093/jkd.2022.23.4.266.

Validation of Foot Pressure Variables during Walking according to Glycated Hemoglobin Levels

• Yi KO
• Kang YH
• Hong YS
• Kwon O
• Kim JW
• Jin YZ

• KMID: 2538098
• DOI: http://doi.org/10.4093/jkd.2022.23.4.266

Abstract

The purpose of this study was to explore the variables of foot pressure according to glycated hemoglobin level during walking in diabetic patients with pes rectus. The subjects of this study were 39 people (78 feet) in their 40s and 60s, and they were divided into 11 pre-diabetic patients (22 feet) and 14 diabetic patients (28 feet) based on glycated hemoglobin; 14 patients without diabetes (28 feet) was used as a control. Foot pressure was measured using the EMED-LE Measurement system. The sole of the foot was divided into 12 parts, each of which was analyzed for pressure, force, contact area, and grounding time. For statistics, nonparametric Kruskal–Wallis and Wilcoxon signed rank test were used. Prediabetic and diabetic patients had lower hindfoot and second and third metatarsal foot pressure but higher first and third toe pressure compared to those without diabetes. In addition, the maximum and minimum force were high in all parts of the sole, and the contact time was long, signifying strong downward force for a long duration. Measurement of foot pressure by parts allowed detailed analysis of abnormal foot pressure and is valuable as basic data for diagnosis, prediction, and treatment of diabetic foot. Based on these data, maximum and minimum pressure better explain the problem of plantar pressure distribution rather than mean maximum pressure.

Keyword

Diabetes; Foot pressure; Gait; HbA1c level

Figure

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  Fig. 1. EMED-LE Measurement system (Novel, Germany).

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  Fig. 2. Twelve areas of the sole of the foot masking.

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  Fig. 3. Gait measurement.

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  Fig. 4. RCSP (resting calcaneal stance position) measurement [24].

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  Fig. 5. Mean maximum pressure for each of the 12 foot areas according to the glycated hemoglobin level (HbA1c). *P < 0.05, **P < 0.01.

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  Fig. 6. Peak pressure for each of the 12 foot areas according to the glycated hemoglobin level (HbA1c). *P < 0.05, **P < 0.01.

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  Fig. 7. Mean minimum pressure for each of the 12 foot areas according to the glycated hemoglobin level (HbA1c). *P < 0.05, **P < 0.01.

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  Fig. 8. Mean maximum force for each of the 12 foot areas according to the glycated hemoglobin level (HbA1c). *P < 0.05, **P < 0.01.

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  Fig. 9. Contact area for each of the 12 foot areas according to the glycated hemoglobin level (HbA1c). *P < 0.05, **P < 0.01.

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  Fig. 10. Contact time for each of the 12 foot areas according to the glycated hemoglobin level (HbA1c). *P < 0.05, **P < 0.01.

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