Comparison of two pixelated insoles using in-shoe pressure sensors to determine percent offloading: case studies.
Publication/Presentation Date
2-1-2020
Abstract
OBJECTIVE: The gold standard for offloading neuropathic forefoot and midfoot wounds is the total contact cast (TCC). However, in practice TCC is rarely used and is contraindicated in patients with fluctuating oedema, poor perfusion, lack of adequate tissue oxygenation and morbid obesity. It can also be too restrictive for patients, inevitably resulting in treatment rejection and delayed healing. This paper examines the role of shoe-based offloading devices as an alternative in reducing plantar pressure and optimising the healing of neuropathic ulcers.
METHOD: Healthy subjects were recruited and fitted for two types of pixelated insoles: PegAssist (PA) insole system (Darco International, US) and FORS-15 (FORS) offloading insole (Saluber, Italy). An area of discreet, elevated high pressure was created by adding a 1/4-inch-thick felt pad to the plantar skin under the first metatarsal head. Subjects walked barefoot in surgical shoes with standard insoles (Condition 1), barefoot in pixelated insoles (Condition 2), barefoot with pixels removed (Condition 3). Dynamic plantar pressures were measured using F-Scan and the results were analysed to determine plantar pressure changes in each condition.
RESULTS: Using PA, the percentage reduction of plantar pressure (kPa) under the first metatarsal between Condition 1 and Condition 2 was 10.54±15.81% (p=0.022), between Condition 2 and Condition 3 was 40.13±11.11% (p
CONCLUSION: Our current analysis shows that pixelated insoles exhibit potential for supplemental offloading in surgical shoes. These devices could provide an alternative way for physicians to offload plantar wounds and expedite closure for patients that cannot tolerate a TCC or other restrictive devices.
Volume
29
Issue
Sup2c
First Page
18
Last Page
18
ISSN
0969-0700
Published In/Presented At
Penny, H., Tran, S., Sansosti, L., Pettineo, S., Bloom, A., Qureshi, R., Bickers, D., Kreuz, E., Zaki, P., & McGuire, J. (2020). Comparison of two pixelated insoles using in-shoe pressure sensors to determine percent offloading: case studies. Journal of wound care, 29(Sup2c), S18–S26. https://doi.org/10.12968/jowc.2020.29.Sup2c.S18
Disciplines
Medicine and Health Sciences
PubMedID
32058841
Department(s)
Fellows and Residents
Document Type
Article