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Plantar blood flow response to accumulated pressure stimulus in diabetic people with different peak plantar pressure: a non-randomized clinical trial

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Abstract

The aim of this study was to investigate the plantar blood flow response to the same accumulated pressure stimulus in diabetic patients with different peak plantar pressure (PPP), which is important for assessing the risk of diabetic foot ulcer. Eleven diabetic subjects with high PPP (PPP ≥ 207 kPa) and 8 diabetic subjects with low PPP (PPP < 207 kPa) were asked to walk naturally on a treadmill so as to induce an accumulated stimulus of 73,000 kPa·s on their first metatarsal head, which was monitored with a sensorized insole. Blood perfusion (BP) in the first metatarsal head was measured before and after walking. Results showed that blood flow after applying the same walking stimulus was significantly decreased in comparison to the basal BP before walking in both high PPP and low PPP groups (p < 0.05), but no significant differences were found between the two groups in terms of BP parameters and its percentage change (p > 0.05). Moreover, BP parameters were not significantly correlated to PPP and the pressure-time integral (PTI) of the subjects’ gait (p > 0.05). This indicated that, besides PPP and PTI, the accumulated mechanical stimulus should be taken into consideration when assessing the risk of diabetic patients developing foot ulcers.

Plantar blood flow response to a walking stimulus

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Funding

This work was supported by the National Natural Science Foundation of China [grant number 11672027] and Beijing Municipal Science & Technology Commission [grant number Z171100000517010].

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Authors and Affiliations

  1. Key Laboratory of Rehabilitation Technical Aids of Ministry of Civil Affair, School of Biological Science and Medical Engineering, Beihang University, No.37 Xueyuan Road, Haidian District, Beijing, 100191, People’s Republic of China

    Fang Pu, Weiyan Ren, Hongyuan Fu, Xuan Zheng & Yubo Fan

  2. State Key Laboratory of Virtual Reality Technology and Systems, Beihang University, Beijing, People’s Republic of China

    Fang Pu

  3. Affiliated Hospital of National Research Center for Rehabilitation Technical Aids, Beijing, People’s Republic of China

    Min Yang & Yubo Fan

  4. Rehabilitation Engineering Laboratory, Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 1206 South Fourth Street, Champaign, IL, 61820, USA

    Yih-Kuen Jan

Authors
  1. Fang Pu
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  2. Weiyan Ren
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  3. Hongyuan Fu
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  4. Xuan Zheng
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  5. Min Yang
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  6. Yih-Kuen Jan
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Corresponding authors

Correspondence to Yih-Kuen Jan or Yubo Fan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of Beihang University and with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Pu, F., Ren, W., Fu, H. 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, 1127–1134 (2018). https://doi.org/10.1007/s11517-018-1836-x

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