The Effect of the Diabetic Ulcer on the Load-Bearing Function of the Foot

Summary

The relationship between the loading imposed on areas of the foot in walking and the formation of diabetic ulcers has been investigated using the apparatus described by Stokes et al. (1994). This ap-paratus enables the distribution of load across and along the foot to be recorded during walking. Twenty-two diabetic patients were studied. The patients were put into two groups according to the severity of their clinical condition. Comparisons were made between the groups, and with a group of 60 healthy subjects. Trends were found relating the severity of the clinical condition of the foot to a lateral shift of the maximum load on the forefoot and to a reduction of load carried by the toes. In all cases the position of an ulcer was found to coincide with an area of highest vertical load in walking. The apparatus has also been used to assess a special shoe designed to redistribute the load on the foot.