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Comparative Clustering of Plantar Pressure Distributions in Diabetics with Polyneuropathy May Be Applied to Reveal Inappropriate Biomechanical Stress

Author

Listed:
  • Uli Niemann
  • Myra Spiliopoulou
  • Thorsten Szczepanski
  • Fred Samland
  • Jens Grützner
  • Dominik Senk
  • Antao Ming
  • Juliane Kellersmann
  • Jan Malanowski
  • Silke Klose
  • Peter R Mertens

Abstract

In diabetic patients, excessive peak plantar pressure has been identified as major risk factor for ulceration. Analyzing plantar pressure distributions potentially improves the identification of patients with a high risk for foot ulceration development. The goal of this study was to classify regional plantar pressure distributions. By means of a sensor-equipped insole, pressure recordings of healthy controls (n = 18) and diabetics with severe polyneuropathy (n = 25) were captured across eight foot regions. The study involved a controlled experimental protocol with multiple sessions, where a session contained several cycles of pressure exposure. Clustering was used to identify subgroups of study participants that are characterized by similar pressure distributions. For both analyzed groups, the number of clusters to best describe the pressure profiles was four. When both groups were combined, analysis again led to four distinct clusters. While three clusters did not separate between healthy and diabetic volunteers the fourth cluster was only represented by diabetics. Here the pressure distribution pattern is characterized by a focal point of pressure application on the forefoot and low pressure on the lateral region. Our data suggest that pressure clustering is a feasible means to identify inappropriate biomechanical plantar stress.

Suggested Citation

  • Uli Niemann & Myra Spiliopoulou & Thorsten Szczepanski & Fred Samland & Jens Grützner & Dominik Senk & Antao Ming & Juliane Kellersmann & Jan Malanowski & Silke Klose & Peter R Mertens, 2016. "Comparative Clustering of Plantar Pressure Distributions in Diabetics with Polyneuropathy May Be Applied to Reveal Inappropriate Biomechanical Stress," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-12, August.
    • Handle: RePEc:plo:pone00:0161326
    DOI: 10.1371/journal.pone.0161326
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    References listed on IDEAS

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    1. Ruth Barn & Roelof Waaijman & Frans Nollet & James Woodburn & Sicco A Bus, 2015. "Predictors of Barefoot Plantar Pressure during Walking in Patients with Diabetes, Peripheral Neuropathy and a History of Ulceration," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-12, February.
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    Cited by:

    1. Brian G Booth & Eva Hoefnagels & Toon Huysmans & Jan Sijbers & Noël L W Keijsers, 2020. "PAPPI: Personalized analysis of plantar pressure images using statistical modelling and parametric mapping," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-22, February.

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