Temporal characteristics of plantar shear distribution: Relevance to diabetic patients

Metin Yavuz, Azita Tajaddini, Georgeanne Botek, Brian L. Davis

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

Diabetic foot ulcers are known to have a biomechanical etiology. Among the mechanical factors that cause foot lesions, shear stresses have been either neglected or underestimated. The purpose of this study was to determine various plantar pressure and shear variables in the diabetic and control groups and compare them. Fifteen diabetic patients with neuropathy and 20 non-diabetic subjects without foot symptoms were recruited. Subjects walked on a custom-built platform capable of measuring local normal and tangential forces simultaneously. Pressure-time integral quantities were increased by 54% (p=0.013) in the diabetic group. Peak AP and resultant shear magnitudes were found to be about 32% larger (p<0.05), even though diabetic subjects walked at a slower velocity. Lower AP and ML stress range (peak-to-peak) values were observed in the control subjects (p<0.05). Shear-time integral values were increased in the diabetic group by 61% and 132% for AP and resultant shear cases, respectively (p<0.05). Plantar shear is known to be a factor in callus formation and has previously been associated with higher ulcer incidence. During gait, shear stresses are induced with twice the frequency of pressure characteristically. Therefore, plantar shear should be investigated further from a broader perspective including the temporal specifications and fatigue failure characteristics of the affected plantar tissue.

Original languageEnglish
Pages (from-to)556-559
Number of pages4
JournalJournal of Biomechanics
Volume41
Issue number3
DOIs
StatePublished - 2008

Keywords

  • Diabetes
  • Diabetic foot lesions
  • Diabetic neuropathy
  • Diabetic ulcers
  • Foot biomechanics
  • Plantar shear
  • Plantar stresses

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