Factors Associated With Callus in Patients with Diabetes, Focused on Plantar
Shear Stress During Gait
#MMPMID27162193
Hamatani M
; Mori T
; Oe M
; Noguchi H
; Takehara K
; Amemiya A
; Ohashi Y
; Ueki K
; Kadowaki T
; Sanada H
J Diabetes Sci Technol
2016[Nov]; 10
(6
): 1353-1359
PMID27162193
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BACKGROUND: The aim of this study is to identify whether plantar shear stress in
neuropathic patients with diabetes with callus is increased compared with those
without callus. METHOD: The differences in foot deformity, limited joint
mobility, repetitive stress of walking, and ill-fitting shoes between patients
with callus and those without callus were also determined. Subjects were
recruited from the Diabetic Foot Outpatient Clinic. A newly developed in-shoe
measurement system, which has flexible and thin insoles, enabled measurement of
both plantar pressure and shear stress simultaneously when subjects walked as
usual on a 10 m walkway. RESULTS: It was found that plantar shear stress adjusted
for weight during the push-off phase was increased by 1.32 times in patients with
callus compared with those without callus (mean ± SD: 0.0500 ± 0.0160 vs 0.0380 ±
0.0144, P = .031). Moreover, hallux valgus deformity, reduction in dorsiflexion
of the ankle joint and increase in plantar flexion were showed in feet with
callus. Increased plantar shear stress may be caused by gait change that patients
having callus push off with the metatarsal head instead of the toe as a result of
foot deformity and limited joint mobility. CONCLUSIONS: It was found that plantar
shear stress adjusted for weight during the push-off phase was increased in
patients with callus compared with those without callus by using the newly
developed measurement system. These results suggest that reduction of plantar
shear stress during the push-off phase can prevent callus formation in
neuropathic patients with diabetes.
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