Review of Foot Plantar Pressure—Focus on the Development of Foot Ulcerations

Abstract

There are many causes of plantar ulceration, which is a painful sore that occurs in the plantar tissue, common in cases of diabetes, peripheral arterial disease, obesity, and even high cholesterol. By way of perspective, approximately 15% of over 29.1 million diabetics in the U.S. will develop foot ulceration [1] and [2]. These causes could be diagnosed using multiple methods with reasonable accuracy; however, ulcers will still occur due to trauma to the plantar tissue. Measurement of the pressures within the plantar tissue has been suggested to be a suitable surrogate to the measurement of trauma; thus, many methods have been developed to measure the pressures and stresses in the plantar tissue. These methods – which include pressure mats, force platforms combined with fluoroscopy or footprint analysis as well as finite element modeling – describe the pressures and stresses that occur within the foot; however, they are limited in their analysis. The limitations include analysis of only the stance phase of gait, measurement of compression stress, and analysis of only healthy individuals. Further studies will be needed to meet the goal of measuring stress within plantar tissues from compression and shear forces during all phases of gait, and using the results to diagnose plantar ulcerations.