• 1

    Riu FR, Vert IS, Martin AL, et al.: A prospective study of cardiovascular disease in patients with type 2 diabetes. 6.3 years of follow-up. J Diabetes Complications 17: 235, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2

    Guariguata L, Whiting DR, Hambleton I, et al.: Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 103: 137, 2014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3

    Lim JZ, Ng NS, Thomas C: Prevention and treatment of diabetic foot ulcers. J R Soc Med 110: 104, 2017.

  • 4

    Mills JL: Lower limb ischaemia in patients with diabetic foot ulcers and gangrene: recognition, anatomic patterns and revascularization strategies. Diabetes Metab Res Rev 32(suppl 1): 239, 2016.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5

    Armstrong DG, Boulton AJM, Bus SA: Diabetic foot ulcers and their recurrence. N Engl J Med 376: 2367, 2017.

  • 6

    Rice JB, Desai U, Cummings AK, et al.: Burden of diabetic foot ulcers for Medicare and private insurers. Diabetes Care 37: 651, 2014.

  • 7

    Jan YK, Liao FY, Cheing GLY, et al.. Differences in skin blood flow oscillations between the plantar and dorsal foot in people with diabetes mellitus and peripheral neuropathy. Microvasc Res 122: 45, 2019.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8

    van Netten JJ, Price PE, Lavery LA, et al.: Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes Metab Res Rev 32(suppl 1): 84, 2016.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9

    Laughlin MH: Physical activity-induced remodeling of vasculature in skeletal muscle: role in treatment of type 2 diabetes. J Appl Physiol (1985) 120: 1, 2016.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10

    Liao F, An R, Pu F, et al.: Effect of exercise on risk factors of diabetic foot ulcers: a systematic review and meta-analysis. Am J Phys Med Rehabil 98: 103, 2019.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11

    Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus: Abbreviated Report of a WHO Consultation, World Health Organization, Geneva, 2011.

    • Search Google Scholar
    • Export Citation
  • 12

    Alves-Cabratosa L, Comas-Cufi M, Ponjoan A, et al.: Levels of ankle-brachial index and the risk of diabetes mellitus complications. BMJ Open Diabetes Res Care 8: e000977, 2020.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13

    Colberg SR, Sigal RJ, Yardley JE, et al.: Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care 39: 2065, 2016.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14

    Fritz T, Rosenqvist U: Walking for exercise—immediate effect on blood glucose levels in type 2 diabetes. Scand J Prim Health Care 19: 31, 2001.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15

    Wu FL, Wang WTJ, Liao F, et al.: Effects of walking speeds and durations on plantar skin blood flow responses. Microvasc Res 128: 103936, 2020.

  • 16

    Chatwin KE, Abbott CA, Boulton AJM, et al.: The role of foot pressure measurement in the prediction and prevention of diabetic foot ulceration—a comprehensive review. Diabetes Metab Res Rev 36: e3258, 2019.

    • Search Google Scholar
    • Export Citation
  • 17

    Lavery LA, Armstrong DG, Wunderlich RP, et al.: Predictive value of foot pressure assessment as part of a population-based diabetes disease management program. Diabetes Care 26: 1069, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18

    Mueller MJ, Zou D, Lott DJ: “Pressure gradient” as an indicator of plantar skin injury. Diabetes Care 28: 2908, 2005.

  • 19

    Jan YK, Lung CW, Cuaderes E, et al.: Effect of viscoelastic properties of plantar soft tissues on plantar pressures at the first metatarsal head in diabetics with peripheral neuropathy. Physiol Meas 34: 53, 2013.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20

    Pu F, Ren WY, Fu HY, et al.: Plantar blood flow response to accumulated pressure stimulus in diabetic people with different peak plantar pressure: a non-randomized clinical trial. Med Biol Eng Comput 56: 1127, 2018.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21

    Caselli A, Pham H, Giurini JM, et al.: The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. Diabetes Care 25: 1066, 2002.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22

    Bus SA, Maas M, de Lange A, et al.: Elevated plantar pressures in neuropathic diabetic patients with claw/hammer toe deformity. J Biomech 38: 1918, 2005.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23

    Fawzy OA, Arafa AI, El Wakeel MA, et al.: Plantar pressure as a risk assessment tool for diabetic foot ulceration in Egyptian patients with diabetes. Clin Med Insights Endocrinol Diabetes 7: 31, 2014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24

    Hazari A, Maiya A, Agouris I, et al.: Prediction of peak plantar pressure for diabetic foot: the regressional model. Foot (Edinb) 40: 87, 2019.

  • 25

    Koo S, Park MS, Chung CY, et al.: Effects of walking speed and slope on pedobarographic findings in young healthy adults. PLoS One 14: e0220073, 2019.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26

    Segal A, Rohr E, Orendurff M, et al.: The effect of walking speed on peak plantar pressure. Foot Ankle Int 25: 926, 2004.

  • 27

    Rosenbaum D, Hautmann S, Gold M, et al.: Effects of walking speed on plantar pressure patterns and hindfoot angular motion. Gait Posture 2: 191, 1994.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28

    Kottner J, Dobos G, Andruck A, et al.: Skin response to sustained loading: a clinical explorative study. J Tissue Viability 24: 114, 2015.

  • 29

    Nixon J, Cranny G, Bond S: Pathology, diagnosis, and classification of pressure ulcers: comparing clinical and imaging techniques. Wound Repair Regen 13: 365, 2005.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30

    Bhattacharya S, Mishra RK: Pressure ulcers: current understanding and newer modalities of treatment. Indian J Plast Surg 48: 4, 2015.

  • 31

    Piercy KL, Troiano RP, Ballard RM, et al.: The Physical Activity Guidelines for Americans. JAMA 320: 2020, 2018.

  • 32

    Hsi WL, Chai HM, Lai JS: Comparison of pressure and time parameters in evaluating diabetic footwear. Am J Phys Med Rehabil 81: 822, 2002.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33

    Waaijman R, Bus SA: The interdependency of peak pressure and pressure-time integral in pressure studies on diabetic footwear: no need to report both parameters. Gait Posture 35: 1, 2012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34

    Bus SA, Waaijman R: The value of reporting pressure-time integral data in addition to peak pressure data in studies on the diabetic foot: a systematic review. Clin Biomech (Bristol, Avon) 28: 117, 2013.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35

    Syed N, Karvannan H, Maiya AG, et al.: Plantar pressure distribution among asymptomatic individuals: a cross-sectional study. Foot Ankle Spec 5: 102, 2012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36

    Buldt AK, Forghany S, Landorf KB, et al.: Foot posture is associated with plantar pressure during gait: a comparison of normal, planus and cavus feet. Gait Posture 62: 235, 2018.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37

    Bohannon RW, Andrews AW: Normal walking speed: a descriptive meta-analysis. Physiotherapy 97: 182, 2011.

  • 38

    Lung CW, Hsiao-Wecksler ET, Burns S, et al.: Quantifying dynamic changes in plantar pressure gradient in diabetics with peripheral neuropathy. Front Bioeng Biotechnol 4: 54, 2016.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39

    Hasegawa H, Yamauchi T, Kraemer WJ: Foot strike patterns of runners at the 15-km point during an elite-level half marathon. J Strength Cond Res 21: 888, 2007.

    • Search Google Scholar
    • Export Citation
  • 40

    Nuesch C, Overberg JA, Schwameder H, et al.: Repeatability of spatiotemporal, plantar pressure and force parameters during treadmill walking and running. Gait Posture 62: 117, 2018.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41

    van Netten JJ, Raspovic A, Lavery LA, et al.: Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes Metab Res Rev 36(suppl 1):e3270, 2020.

    • Search Google Scholar
    • Export Citation
  • 42

    Maluf KS, Mueller MJ: Novel Award 2002. Comparison of physical activity and cumulative plantar tissue stress among subjects with and without diabetes mellitus and a history of recurrent plantar ulcers. Clin Biomech (Bristol, Avon) 18: 567, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43

    Duan Y, Ren W, Xu L, et al.: The effects of different accumulated pressure-time integral stimuli on plantar blood flow in people with diabetes mellitus. BMC Musculosket Disord 22: 554, 2021.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44

    Piercy KL, Troiano RP, Ballard RM, et al.: The Physical Activity Guidelines for Americans. 320: 2020, 2018.

  • 45

    Mueller MJ, Maluf KS: Tissue adaptation to physical stress: a proposed “physical stress theory” to guide physical therapist practice, education, and research. Phys Ther 82: 383, 2002.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46

    Kluding PM, Bareiss SK, Hastings M, et al.: Physical training and activity in people with diabetic peripheral neuropathy: paradigm shift. Phys Ther 97: 31, 2017.

    • Search Google Scholar
    • Export Citation

Effects of Walking Speeds and Durations on Peak Plantar Pressures

Fu-Lien WuDepartment of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL.

Search for other papers by Fu-Lien Wu in
Current site
Google Scholar
PubMed
Close
 PT, PhD
,
Chi-Wen LungDepartment of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL.
Department of Creative Product Design, Asia University, Taichung, Taiwan.

Search for other papers by Chi-Wen Lung in
Current site
Google Scholar
PubMed
Close
 PhD
,
Wendy Tzyy-Jiuan WangDepartment of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.

Search for other papers by Wendy Tzyy-Jiuan Wang in
Current site
Google Scholar
PubMed
Close
 PT, PhD
,
Jeannette ElliottDisability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL.

Search for other papers by Jeannette Elliott in
Current site
Google Scholar
PubMed
Close
 DPT
,
Sanjiv JainDepartment Physical Medicine and Rehabilitation, Carle Foundation Hospital, Urbana, IL.

Search for other papers by Sanjiv Jain in
Current site
Google Scholar
PubMed
Close
 MD
, and
Yih-Kuen JanDepartment of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL.
Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, People’s Republic of China.

Search for other papers by Yih-Kuen Jan in
Current site
Google Scholar
PubMed
Close
 PhD
Restricted access

Background: Walking at various speeds and durations may result in different peak plantar pressure (PPP). However, there is no study comparing the effect of walking speeds and durations on PPP. The purpose of this study was to explore whether different walking speeds and durations significantly change PPP and establish a normal response in healthy people.

Methods: An in-shoe plantar pressure system was used to measure PPP under the first toe, first metatarsal, second metatarsal, and heel regions in 12 healthy, young people. All participants performed six walking trials at three speeds (3, 6, and 9 km/h) and for two durations (10 and 20 min). The 3 × 2 two-way analysis of variance was used to examine the main effects of speeds and durations and their interaction.

Results: The results showed that walking speeds significantly affected PPP and that walking duration did not. No interaction between the walking speed and duration was observed. Peak plantar pressure values under the first toe and the first metatarsal head were significantly higher (P < .05) at 9 km/h (509.1 ± 314.2 kPa and 591.4 ± 302.4 kPa, respectively) than at 3 km/h (275.4 ± 168.7 kPa and 369.4 ± 205.4 kPa, respectively) after 10-min walking.

Conclusions: People at risk for foot ulcers may use slow and brisk walking for exercise to reduce PPP, thus reducing risk for foot ulcers. Our study demonstrated that slow running at 9 km/h significantly increases PPP.

Corresponding author: Yih-Kuen Jan, PhD, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL. (E-mail: yjan@illinois.edu)