Publication
Plantar pressure thresholds as a strategy to prevent diabetic foot ulcers: A systematic review
| datacite.subject.fos | Engenharia e Tecnologia | |
| datacite.subject.sdg | 09:Indústria, Inovação e Infraestruturas | |
| dc.contributor.author | Castro-Martins, Pedro | |
| dc.contributor.author | Marques, Arcelina | |
| dc.contributor.author | Coelho, Luís | |
| dc.contributor.author | Vaz, Mário | |
| dc.contributor.author | Costa, José Torres | |
| dc.date.accessioned | 2025-02-13T18:35:59Z | |
| dc.date.available | 2025-02-13T18:35:59Z | |
| dc.date.issued | 2024 | |
| dc.description.abstract | Background The development of ulcers in the plantar region of the diabetic foot originates mainly from sites subjected to high pressure. The monitoring of these events using maximum allowable pressure thresholds is a fundamental procedure in the prevention of ulceration and its recurrence. Objective The aim of this review was to identify data in the literature that reveal an objective threshold of plantar pressure in the diabetic foot, where pressure is classified as promoting ulceration. The aim is not to determine the best and only pressure threshold for ulceration, but rather to clarify the threshold values most used in clinical practice and research, also considering the devices used and possible applications for offloading plantar pressure. Design A systematic review. Methods The search was performed in three electronic databases, by the PRISMA methodology, for studies that used a pressure threshold to minimize the risk of ulceration in the diabetic foot. The selected studies were subjected to eligibility criteria. Results Twenty-six studies were included in this review. Seven thresholds were identified, five of which are intended for the inside of the shoe: a threshold of average peak pressure of 200 kPa; 25 % and 40–80 % reduction from initial baseline pressure; 32–35 mm Hg for a capillary perfusion pressure; and a matrix of thresholds based on patient risk, shoe size and foot region. Two other thresholds are intended for the barefoot, 450 and 750 kPa. The threshold of 200 kPa of pressure inside the shoe is the most agreed upon among the studies. Regarding the prevention of ulceration and its recurrence, the efficacy of the proposed threshold matrix and the threshold of reducing baseline pressure by 40–80 % has not yet been evaluated, and the evidence for the remaining thresholds still needs further studies. Conclusions Some heterogeneity was found in the studies, especially regarding the measurement systems used, the number of regions of interest and the number of steps to be considered for the threshold. Even so, this review reveals the way forward to obtain a threshold indicative of an effective steppingstone in the prevention of diabetic foot ulcer. | eng |
| dc.description.sponsorship | This work was developed under a PhD grant (UI/BD/151285/2021) awarded to PCM and funded by the Portuguese Foundation for Science and Technology (FCT, Portugal). It also had the support of the “Smart-Health-4-All – Smart medical technologies for better health and care” project (POCI-01-0247-FEDER-046115; LISBOA-01-0247-FEDER-046115), which was co-financed by Portugal 2020, under the Operational Program for Competitiveness and Internationalization (COMPETE 2020) through the European Regional Development Fund (ERDF). | |
| dc.identifier.citation | Castro-Martins, P., Marques, A., Coelho, L., Vaz, M., & Costa, J. T. (2024). Plantar pressure thresholds as a strategy to prevent diabetic foot ulcers: A systematic review. Heliyon, 10(4). https://doi.org/10.1016/j.heliyon.2024.e26161 | |
| dc.identifier.doi | 10.1016/j.heliyon.2024.e26161 | |
| dc.identifier.issn | 2405-8440 | |
| dc.identifier.uri | http://hdl.handle.net/10400.22/29513 | |
| dc.language.iso | eng | |
| dc.peerreviewed | yes | |
| dc.publisher | Elsevier | |
| dc.relation | Conceção e desenvolvimento de um sapato inteligente. | |
| dc.relation.hasversion | https://www.sciencedirect.com/science/article/pii/S2405844024021923?via%3Dihub | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
| dc.subject | Diabetic foot | |
| dc.subject | Plantar pressure | |
| dc.subject | Plantar ulceration | |
| dc.subject | Pressure threshold | |
| dc.subject | Systematic review | |
| dc.title | Plantar pressure thresholds as a strategy to prevent diabetic foot ulcers: A systematic review | eng |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.awardTitle | Conceção e desenvolvimento de um sapato inteligente. | |
| oaire.awardURI | info:eu-repo/grantAgreement/FCT//UI%2FBD%2F151285%2F2021/PT | |
| oaire.citation.issue | 4 | |
| oaire.citation.title | Heliyon | |
| oaire.citation.volume | 10 | |
| oaire.version | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |
| project.funder.identifier | http://doi.org/10.13039/501100001871 | |
| project.funder.name | Fundação para a Ciência e a Tecnologia | |
| relation.isProjectOfPublication | 604dc6e8-648e-4ba8-b1fd-be9debf4d70c | |
| relation.isProjectOfPublication.latestForDiscovery | 604dc6e8-648e-4ba8-b1fd-be9debf4d70c |