• 1

    Sinnock P: “Hospital Utilization for Diabetes,” in Diabetes in America, ed by MI Harris, RF Hammon, p 1468, National Institutes of Health, Bethesda, MD, 1985..

  • 2

    Stahn RM, Gohdes D, Valway SE: Diabetes and its complications among selected tribes in North Dakota, South Dakota, and Nebraska. .Diabetes Care 16::244. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Farrell MA, Quiggens PA, Eller JD, et al: Prevalence of diabetes and its complications in the Eastern Band of Cherokee Indians. .Diabetes Care 16::253. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Acton K, Rogers B, Campbell G, et al: Prevalence of diagnosed diabetes and selected related conditions of six reservations in Montana and Wyoming. .Diabetes Care 16::263. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Sugarman J, Percy C: Prevalence of diabetes in a Navajo Indian community. .Am J Public Health 79::511. ,1989. .

  • 6

    Muneta B, Newman J, Wetterall S, et al: Diabetes and associated risk factors among Native Americans. .Diabetes Care 16::1619. ,1993. .

  • 7

    Knowler WC, Bennett PH, Hamman RF, et al: Diabetes incidence and prevalence in Pima Indians: a 19-fold greater incidence than in Rochester, Minnesota. .Am J Epidemiol 108::497. ,1978. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Nelson RG, Gohdes DM, Everhart JE, et al: Lower-extremity amputations in NIDDM: 12-year follow-up study in Pima Indians. .Diabetes Care 11::8. ,1988. .

  • 9

    Delbridge L, Ctercteko G, Fowler C, et al: The aetiology of diabetic neuropathic ulceration of the foot. .Br J Surg 72::1. ,1985. .

  • 10

    Stokes IAF, Faris IB, Hutton WC: The neuropathic ulcer and the loads on the foot in diabetic patients. .Acta Orthop Scand 46::839. ,1975. .

  • 11

    Ctercteko GC, Dhanendran M, Hutton WC, et al: Vertical forces acting on the foot of diabetic patients with neuropathic ulceration. .Br J Surg 68::608. ,1981. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Boulton AJM, Hardisty CA, Betts RP, et al: Dynamic foot pressure and other studies as diagnostic and management aids in diabetic neuropathy. .Diabetes Care 6::26. ,1983. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Masson EA, Hay EM, Stockley I, et al: Abnormal foot pressures alone may not cause ulceration. .Diabetic Med 6::426. ,1989. .

  • 14

    Veves A, Murray HJ, Young MJ, et al: The risk of foot ulceration in diabetic patients with high foot pressures: a prospective study. .Diabetologia 35::660. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Duckworth T, Boulton AJM, Betts RP, et al: Plantar pressure measurements and the prevention of ulceration in the diabetic foot. .J Bone Joint Surg Br 67::79. ,1985. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Cavanagh PR, Ulbrecht JS: Clinical plantar pressure measurement in diabetes: rationale and methodology. .Foot 4::123. ,1994. .

  • 17

    Armstrong DG, Peters EJ, Athanasiou KA, et al: Is there a critical level of plantar foot pressure to identify patients at risk for neuropathic foot ulceration. ?J Foot Ankle Surg 37::303. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Cavanagh PR, Ulbrecht JS: “Biomechanics of the Diabetic Foot: A Quantitative Approach to Assessment of Neuropathy, Deformity, and Plantar Pressure,” in Disorders of the Foot and Ankle, ed by JH Jahss, p 1864, CV Mosby, St Louis, MO, 1990..

  • 19

    Fernando DJ, Masson EA, Veves A, et al: Relationship of limited joint mobility to abnormal foot pressures and diabetic foot ulceration. .Diabetes Care 14::8. ,1991. .

    • Search Google Scholar
    • Export Citation
  • 20

    Mueller MJ, Diamond JE, Delitto A, et al: Insensitivity, limited joint mobility, and plantar ulcers in patients with diabetes mellitus. .Phys Ther 69::453. ,1989. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Birke JA, Cornwall MW, Jackson M: Relationship between hallux limitus and ulceration of the great toe. .J Orthop Sport Phys Ther 10::172. ,1988. .

    • Search Google Scholar
    • Export Citation
  • 22

    Frykberg RG, Lavery LA, Pham H, et al: Role of neuropathy and high foot pressures in diabetic foot ulceration. .Diabetes Care 21::1714. ,1998. .

  • 23

    McPoil TG, Brocato RS: “The Foot and Ankle: Biomechanical Evaluation and Treatment,” in Orthopedic and Sports Physical Therapy, ed by JA Gould, GA Davies, p 313, CV Mosby, St Louis, MO, 1985..

  • 24

    Meyers-Rice B, Sugars L, McPoil TG, et al: Comparison of three methods for obtaining plantar pressures in nonpathologic subjects. .JAPMA 84::499. ,1994. .

    • Search Google Scholar
    • Export Citation
  • 25

    McPoil TG, Cornwall MW, DuPuis L, et al: Variability of plantar pressure data: a comparison of the two-step and midgait methods. .JAPMA 89::495. ,1999. .

    • Search Google Scholar
    • Export Citation
  • 26

    Young MJ, Cavanagh PR, Thomas G, et al: The effect of callus removal on dynamic plantar foot pressures in diabetic patients. .Diabetic Med 9::55. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Cavanagh PR, Sims DS, Sanders LJ: Body mass is a poor predictor of peak plantar pressure in diabetic men. .Diabetes Care 14::750. ,1991. .

  • 28

    Landis JR, Koch GG: The measurement of observer agreement for categorical data. .Biometrics 33::159. ,1977. .

  • 29

    Gronley JK, Perry J: Gait analysis techniques. .Phys Ther 64::1831. ,1984. .

  • 30

    Murray MP, Mollinger F, Gardner GM, et al: Comparison of free and fast speed walking patterns in men. .Am J Phys Med 45::8. ,1966. .

  • 31

    Kadaba MP, Wooten ME, Gainey J, et al: Repeatability of phasic muscle activity: performance of surface and intramuscular wire electrodes in gait analysis. .J Orthop Res 3::350. ,1985. .

    • PubMed
    • Search Google Scholar
    • Export Citation

The Distribution of Plantar Pressures in American Indians with Diabetes Mellitus

Thomas G. McPoil PhD, PT, ATC1, Wesley Yamada DPM2, Wayne Smith MEd, PT, ATC, SCS3, and Mark Cornwall PhD, PT, CPed1
View More View Less
  • 1 Professor and Co-director, Gait Research Laboratory, Department of Physical Therapy, PO Box 15105, Northern Arizona University, Flagstaff, AZ 86011.
  • | 2 Chief of Podiatric Services, Hu Hu Kam Medical Center, Gila River Indian Community, Sacaton, AZ.
  • | 3 Assistant Professor of Physical Therapy, Arizona School of Health Sciences, Phoenix, AZ.
Restricted access

The primary purpose of this study was to determine the magnitude and duration of plantar pressures acting on the feet of American Indians with diabetes mellitus. A secondary purpose was to determine whether differences in the range of motion of the ankle and first metatarsophalangeal joints existed between American Indians with and without diabetes. Three groups of American Indian subjects were tested: a control group (n = 20); a group with diabetes but no peripheral neuropathy (n = 24); and a group with diabetes and peripheral neuropathy (n = 21). A floor-mounted pressure sensor platform was used to collect plantar pressure data while subjects walked barefoot. The results indicated that American Indians with diabetes have 1) a pattern of peak plantar pressure similar to patterns previously reported for non–American Indians with diabetes and 2) a reduction in ankle and first metatarsophalangeal joint range of motion in comparison with nondiabetic American Indians. (J Am Podiatr Med Assoc 91(6): 280-287, 2001)