The association of plantar pressure measurements and perception of research grade monofilaments in the feet of human participants with Type 2 diabetes mellitus

Thomson, Mary Pamela (2006) The association of plantar pressure measurements and perception of research grade monofilaments in the feet of human participants with Type 2 diabetes mellitus. University of Southampton, Doctoral Thesis.

Abstract

The objective of the study was to investigate the association of plantar pressure measurement and perception of a range of research grade monofilaments at the same sites on the plantar aspect of the foot. The aim was to identify whether monofilament perception and any or all of the selected plantar pressure variables could be combined to produce a predictive model. Three groups of participants; persons with newly-diagnosed Type 2 diabetes mellitus of less than two years duration (NEW; n=80); those with established Type 2 diabetes mellitus of more than two years duration (EST; n=91), and a Comparison group without Type 2 diabetes mellitus (n=73), were recruited, a total of 244 participants.

The range of monofilaments (2, 4, 6, 8 and 10-grammes) tested sensory perception and other non-invasive investigations of vibration perception, temperature discrimination, pain awareness and a modified neuropathy symptom questionnaire, were employed. A Musgrave ^TMFootprint pressure measurement system was used to measure the three plantar pressure variables of mean pressure time integral, mean peak pressure and mean contact time of 90% or more of peak pressure.

A series of four pilot studies were conducted to identify and standardise the protocols for the methods used in the main study.

The findings showed that the 4-gramme monofilament may be used as the baseline for perception in normal feet. This study has identified a protocol for employing graded monofilaments, which will be of benefit to clinicians. Persons with newly-diagnosed Type 2 diabetes were shown in the study to have raised plantar pressures, confirming the need for prompt identification of other risk factors for foot ulceration through foot screening.

The results show that the association between variables of foot pressure measurements and graded monofilaments were not strong enough to create a predictive model.

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