Document Detail

Biofeedback can reduce foot pressure to a safe level and without causing new at-risk zones in patients with diabetes and peripheral neuropathy.
MedLine Citation:
PMID:  23081857     Owner:  NLM     Status:  Publisher    
BACKGROUND: 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. METHODS: 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 3 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). RESULTS: The PPP under at-risk zones decreased significantly at T1 (165 ± 9 kPa, p < 0.0001) and T2 (167 ± 11, p = 0.001), as compared to T0 (242 ± 12 kPa) without any increase of the PPP elsewhere. At the contra-lateral foot (not concerned by off-loading), the PPP was slightly higher under the lateral midfoot at T1 (68 ± 8 kPa, p = 0.01) and T2 (65 ± 8 kPa, p = 0.01), as compared to T0 (58 ± 6 kPa). CONCLUSIONS: The foot off-loading by biofeedback lead to a safe and regular plantar pressure distribution without inducing any new "at-risk" area under both feet. Copyright © 2012 John Wiley & Sons, Ltd.
D De León Rodriguez; L Allet; A Golay; J Philippe; J-Ph Assal; C-A Hauert; Z Pataky
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-18
Journal Detail:
Title:  Diabetes/metabolism research and reviews     Volume:  -     ISSN:  1520-7560     ISO Abbreviation:  Diabetes Metab. Res. Rev.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883450     Medline TA:  Diabetes Metab Res Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 John Wiley & Sons, Ltd.
Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
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