Screening of foot planter pressure distribution in diabetic foot patients

Abstract

Most skin injuries in neuropathy-type diabetic foot patients occur on the planter soft tissue at sites of abnormally high pressure values. If not detected and treated early enough, these localized sites are prone to develop skin breakdown and ulceration, which puts the patient at higher risks including the need for amputation. Current diagnostic techniques, such as CT and MRI, are primarily used for assessing later stage patients but are not used for screening. Other planter pressure measurement systems have been reported, but they are either too costly for routine clinical use or require extensive clinical training for successful utilization. This work reports a new system for the assessment of planter pressure distribution. The system is easy to use, is inexpensive, and may provide the needed accuracy to become a screening and ulceration risk assessment device. This system is designed for routine clinical use. The method used is based on the "blanching" effect of tissue that occurs when it is under pressure. Using a standard optical scanner, the footprint is acquired under body weight and the resulting blanching is mapped to different intensity levels using color codes to obtain pressure distribution maps. These maps can be used by the clinician to identify high risk sites to help prescribe the necessary intervention. The color coded maps generated by the system were in agreement with the physicians' expectations in all cases. The system proved to have a great potential not only for the purpose of screening but also as a clinical tool for treatment planning and follow up.