The Effectiveness of Felt in Reducing Peak Plantar Pressures at the 1st Metatarsophalangeal Joint: In a Healthy Population
Semi-compressed felt is frequently used in clinical podiatric practice to offload areas of high pressure, particularly in patients with chronic ulceration. The study aimed to assess the effectiveness of semi-compressed felt, on plantar pressures, in offloading the 1st metatarsophalangeal joint, whilst assessing pressure encountered at the peripheries. Elevated plantar pressures are a strong predictor of ulceration in patients with diabetic foot disease, where undetected mechanical trauma can
... idly become ulcerative. In this study, plantar pressure was assessed using the Foot Work Pro plate (AM CUBE, Inc., France, www.amcube.net), in three conditions: barefoot; 5mm thickness and 10mm thickness conditions. This study was of a cross sectional design, where participants were conveniently sampled within the Podiatric Medicine student population within the National University of Ireland, Galway. 33 participants (28 females; 5 males) with a mean age of 23 years (Interquartile Range, 18-44). Plantar pressures at the 1st metatarsophalangeal joint decreased (P<0.01; P<0.01), when semi-compressed felt was applied to offload the 1st metatarsophalangeal joint. Whereas, plantar pressures were found to be increased at both the 3rd metatarsophalangeal joint (P= 0.04; P= 0.01) and the 5th metatarsophalangeal joint (P=0.82; P=0.40), as a result of applying felt to the 1st metatarsophalangeal joint. Evidently, offloading one joint subjected other joints to greater mechanical load allowing insight into the mechanical redistribution associated with the use of felt in offloading, which must be accounted for in the high risk diabetic foot.