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 Surg37::303. ,1998. .9710782)| false
Roy H. LidtkeDirector of the Gait Analysis Laboratory, Acting Director of Research, and Assistant Professor of Orthopedics, Dr. William M. Scholl College of Podiatric Medicine at Finch University, Chicago, IL; Visiting Professor, Department of Orthopedic Surgery, Rush-Presbyterian-St. Lukes Medical Center, Chicago, IL. Mailing address:Dr. William M. Scholl College of Podiatric Medicine at Finch University, 1001 N Dearborn St, Chicago, IL 60610.
A randomized controlled study of 19 patients with diabetes mellitus (10 men, 9 women) was undertaken to determine the effects of home exercise therapy on joint mobility and plantar pressures. Of the 19 subjects, 9 subjects performed unsupervised active and passive range-of-motion exercises of the joints in their feet. Each subject was evaluated for joint stiffness and peak plantar pressures at the beginning and conclusion of the study. After only 1 month of therapy, a statistically significant average decrease of 4.2% in peak plantar pressures was noted in the subjects performing the range-of-motion exercises. In the control group, an average increase of 4.4% in peak plantar pressures was noted. Although the joint mobility data revealed no statistically significant differences between the groups, there was a trend for a decrease in joint stiffness in the treatment group. The results of this study demonstrate that an unsupervised range-of-motion exercise program can reduce peak plantar pressures in the diabetic foot. Given that high plantar pressures have been linked to diabetic neuropathic ulceration, it may be possible to reduce the risk of such ulceration with this therapy. (J Am Podiatr Med Assoc 92(9): 483-490, 2002)