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Abnormalities of Foot Pressure in Early Diabetic Neuropathy
Author(s) -
Boulton A. J. M.,
Betts R. P.,
Franks C. I.,
Newrick P. G.,
Ward J. D.,
Duckworth T.
Publication year - 1987
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1987.tb00867.x
Subject(s) - medicine , diabetic neuropathy , diabetic foot , foot (prosody) , diabetes mellitus , peripheral neuropathy , nerve conduction velocity , surgery , endocrinology , philosophy , linguistics
Dynamic foot pressure has been studied in 44 diabetic subjects of mean age 52 years with no clinical evidence of neuropathy and in an age and sex matched non‐diabetic control group. Vibration perception threshold (VPT), sensory (SCV), and motor conduction velocities (MCV) were also measured in the diabetic subjects. Sixteen diabetic subjects (Group A) had abnormally high pressures under the metatarsal heads (>10 kg/cm 2 ), whereas the remaining 28 diabetic subjects had normal results (Group B). The ratio of toe to metatarsal head loading (normal 0.112) was significantly reduced in Group A (0.077) compared to Group B (0.127: p <0.05). VPT and sural nerve SCV were also significantly abnormal in Group A subjects compared with Group B ( p <0.005 and p <0.02, respectively), though there were no differences in MCV. A significant inverse correlation was obtained between toe loading and VPT. It is concluded that abnormalities of foot pressure occur in early sensory neuropathy and may precede clinical abnormalities. Assessment of the toe‐loading ratio may provide a sensitive measure of motor dysfunction in early diabetic neuropathy.