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Preventive Foot Care Socks Reduce In-Shoe Plantar Foot Pressure

Posted: Thursday, August 18, 2005

Preventive foot care socks can reduce in-shoe plantar pressure in high-risk diabetic patients, the results of a small study published in the August issue of Diabetes Care suggest.

"High plantar pressure is an acknowledged risk factor in the development of plantar ulcers in the diabetic neuropathic foot," Dr. Adam P. Garrow, of Withington Hospital, Manchester, UK, and colleagues write.

They examined whether preventive foot care socks reduce plantar foot pressures in a group of 19 diabetics with peripheral neuropathy. Fifteen were male with a mean age of 65.5 years. The subjects were ulcer-free at enrollment.

The preventive foot care socks had a double-layer construction consisting of a padded outer layer to cushion the feet, as well as a low-friction fiber inner layer to reduce friction at the sock/foot interface. Differences in maximum foot contact area and plantar pressure for the whole foot, forefoot, and peak plantar pressure areas were measured. The effects of the preventive foot care socks were compared with those of conventional supermarket socks.

When subjects wore the preventive foot care socks, a significant increase in maximum foot contact area of 11 cm squared (7.9%) was observed (p < 0.01). This was accompanied by a reduction of 5.4 kg (8.9%) in total foot pressure (p < 0.01). At the forefoot, the contact area was increased by 14.2%, which was accompanied by a 10.2% reduction in peak forefoot pressure.

"Compared with the supermarket socks which were approximately 0.7 mm thick, the maximum thickness of the preventive foot care hosiery was 2.7 mm around the toes, metatarsal phalangeal area, and the heel," Dr. Garrow's team explains.

"Although 2 mm may represent only a moderate increase in bulk inside the shoe, additional care in the fitting of shoes is nonetheless required when considering the use of such hosiery to avoid any localized increases in foot pressures," they add.
Altering the kind of socks patients wear is a simple, cost-effective way of protecting at-risk feet in the diabetic population. The team calls for further longitudinal studies "to determine whether the combination of padding and friction reduction offered by the preventive foot care socks would be useful in the primary or secondary prevention of diabetic foot ulcers."

Source: Diabetes In

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