Optical Pedobarography for Assessing Neuropathic Feet in Diabetic Patients—A Review

The use of optical pedobarography is presented in this article. The limitations of the analytical methods using peak pressures as a parameter for assessment of foot at risk of plantar ulcers are indicated. A new method, which takes into consideration the actual plantar pressure distribution using the power ratio PR (the ratio of high-frequency power to the total power in the walking foot pressure image distribution) and relates it to 3 levels of sensation loss is described. PR is able to detect early loss of foot sensation characterized by a loss of sensation level of 4.5 gm. The methods available in the literature for management of foot ulcers by proper footwear design, and their limitations, are discussed. A new method of individualized footwear based on matching the softness of the footwear insole with the softness of normal foot sole soft tissue (having durometer reading of 20° Shore) and optimum insole thickness (12 mm) is helpful in the prevention of plantar ulcers.