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Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes, affecting up to 50% of individuals and their quality of life. DPN is characterised by the progressive loss of proprioception, somatosensory sensitivity and intrinsic distal muscle function. Musculoskeletal complications may cause bony deformities, such as clawing of digits and prominence of metatarsophalangeal joints and increase plantar pressures resulting in skin breakdown and ulceration. Since the repetitive action of mechanical stress during gait in the presence of DPN may lead to ulcer development, better understanding of the mechanism and biomechanical components of ulcer development is of vital importance. Literature shows that DFU are found on high plantar pressure areas, however, in the absence of neuropathy, high pressure areas alone do not lead to ulceration. This systematic review and meta-analysis aims to provide a comprehensive understanding of lower limb joint and muscle function and plantar pressures during gait in the presence of DPN. This, may provide evidence for the design of more efficient and specific treatment options of healing in order to prevent risk of amputation and reulceration. Reducing the mechanical loading on the ulcerated foot during gait may influence the healing of DFU and provide preventative mechanisms of ulceration., peer-reviewed

[Abstract] Objective: The presence of increased medial heel plantar pressure in plantar fasciitis has been debated, with clinicians often utilizing pressure-relieving devices, such as heel pads and cups, as a means of management.Method: Plantar pressures in a sample of 15 adult participants with chronic plantar fasciitis were compared to plantar pressures of the 15 adult participants forming the control group, who were matched for age, gender and weight.Results: There were no significant differences in peak heel plantar pressure (p = 0.244), lateral peakplantar pressure (p = 0.876), forefoot peak plantar pressure (p = 0.576) and the Forefoot to Rearfoot peak pressure ratio (p = 0.242) between the 2 groups. However, there was a significant difference (p = 0.015) in medial heel peak plantar pressure between the 2 groups, with the plantar fasciitis group having lower medial heel pressure than the control group.Conclusion: The findings in this study suggest that there is no relationship between peak medial heel plantar pressures and chronic medio-plantar heel pain in plantar fascitis. There is also no shift in pressure from the symptomatic medio-plantar heel region to the latero-plantar heel and forefoot regions. As a result, pressure may not play a part in the pathophysiology of plantar fascitis.[Resumen] Objetivos: La presencia de incremento de presión plantar en la zona medial del talón en la fascitis plantar ha sido estudiado, y los clínicos a menudo utilizan dispositivos de alivio de la presión, como almohadillas de talón y cazoletas, como medio de manejo.Método: Las presiones plantares en una muestra de 15 participantes adultos con fascitis plantar crónica se compararon con las presiones plantares de los 15 participantes adultos que formaron el grupo control, que fueron comparados por edad, sexo y peso.Resultados: No hubo diferencias significativas en la presión plantar en el pico pico (p = 0,244), en la presión pico lateral (p = 0,876), en la presión plantar pico en el antepié (p = 0,576) Los 2 grupos. Sin embargo, hubo una diferencia significativa (p = 0,015) en la presión plantar del talón medial entre los 2 grupos, con el grupo de fascitis plantar con menor presión en el talón medial que en el grupo control.Conclusión: Los hallazgos en este estudio sugieren que no hay relación entre el pico medial del talón de las presiones plantares y crónico medio-plantar talón dolor en la fascitis plantar. Tampoco hay cambio en la presión de la región sintomática del talón medio-plantar a las regiones del talón latero-plantar y del antepié. Como resultado, la presión puede no desempeñar un papel en la fisiopatología de la fascitis plantar