02698nas a2200421   4500000000100000008004100001260001300042653001000055653000900065653002200074653002500096653002800121653003200149653001100181653000900192653001500201653001100216653001200227653000900239653001600248653002100264653001300285653001900298653001000317653002300327653001200350653001900362100001200381700001100393700001700404700001300421700001300434245013600447300001100583490000700594520166100601022001402262       2013                            d  c2013 Mar10aAdult10aAged10aAged, 80 and over10aCase-Control Studies10aCross-Sectional Studies10aCumulative Trauma Disorders10aFemale10aFoot10aFoot Ulcer10aHumans10aleprosy10aMale10aMiddle Aged10aMononeuropathies10aPressure10aPressure Ulcer10aShoes10aStress, Mechanical10aWalking10aWeight-Bearing1 aSchie C1 aSlim F1 aKeukenkamp R1 aFaber WR1 aNollet F00aPlantar pressure and daily cumulative stress in persons affected by leprosy with current, previous and no previous foot ulceration.  a326-300 v373 a<p>Not only plantar pressure but also weight-bearing activity affects accumulated mechanical stress to the foot and may be related to foot ulceration. To date, activity has not been accounted for in leprosy. The purpose was to compare barefoot pressure, in-shoe pressure and daily cumulative stress between persons affected by leprosy with and without previous or current foot ulceration. Nine persons with current plantar ulceration were compared to 15 with previous and 15 without previous ulceration. Barefoot peak pressure (EMED-X), in-shoe peak pressure (Pedar-X) and daily cumulative stress (in-shoe forefoot pressure time integral×mean daily strides (Stepwatch™ Activity Monitor)) were measured. Barefoot peak pressure was increased in persons with current and previous compared to no previous foot ulceration (mean±SD=888±222 and 763±335 vs 465±262kPa, p<0.05). In-shoe peak pressure was only increased in persons with current compared to without previous ulceration (mean±SD=412±145 vs 269±70kPa, p<0.05). Daily cumulative stress was not different between groups, although persons with current and previous foot ulceration were less active. Although barefoot peak pressure was increased in people with current and previous plantar ulceration, it did not discriminate between these groups. While in-shoe peak pressure was increased in persons with current ulceration, they were less active, resulting in no difference in daily cumulative stress. Increased in-shoe peak pressure suggests insufficient pressure reducing footwear in persons with current ulceration, highlighting the importance of pressure reducing qualities of footwear.</p>  a1879-2219