{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:24:03Z","timestamp":1791908643006,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003092","name":"Diabetes Fonds","doi-asserted-by":"publisher","award":["2007.00.067"],"award-info":[{"award-number":["2007.00.067"]}],"id":[{"id":"10.13039\/501100003092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate people with Charcot midfoot deformity with regard to plantar pressure, footwear adherence and plantar foot ulcer recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty people with diabetes, Charcot midfoot deformity, plantar foot ulcer history and custom\u2010made footwear were assessed with regard to barefoot and in\u2010shoe plantar pressures during walking, footwear adherence (% of daily steps over 7\u2010day period) and plantar foot ulcer recurrence over 18 months. In a cohort design, they were compared to 118 people without Charcot foot (non\u2010Charcot foot group) with custom\u2010made footwear and similar ulcer risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median (interquartile range) barefoot midfoot peak pressures were significantly higher in the Charcot foot group than in the non\u2010Charcot foot group [756 (260\u20131267) vs 146 (100\u2013208) kPa;<jats:italic>P<\/jats:italic>&lt;0.001]. In\u2010shoe midfoot peak pressures were not significantly higher in the Charcot foot group [median (interquartile range) 152 (104\u2013201) vs 119 (94\u2013160) kPa] and significantly lower for all other foot regions. Participants in the Charcot foot group were significantly more adherent, especially at home, than participants in the non\u2010Charcot foot group [median (interquartile range) 94.4 (85.4\u201395.0)% vs. 64.3 (25.4\u201385.7)%;<jats:italic>P<\/jats:italic>=0.001]. Ulcers recurred in 40% of the Charcot foot group and in 47% of the non\u2010Charcot foot group (<jats:italic>P<\/jats:italic>=0.63); midfoot ulcers recurred significantly more in the Charcot foot group (4\/8) than in the non\u2010Charcot foot group (1\/55;<jats:italic>P=<\/jats:italic>0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Effective offloading and very high footwear adherence were found in people with diabetes and Charcot midfoot deformity. While this may help protect against plantar foot ulcer recurrence, a large proportion of such people still experience ulcer recurrence. Further improvements in adherence and custom\u2010made footwear design may be required to improve clinical outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14438","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T09:38:22Z","timestamp":1603273102000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Foot ulcer recurrence, plantar pressure and footwear adherence in people with diabetes and Charcot midfoot deformity: A cohort analysis"],"prefix":"10.1111","volume":"38","author":[{"given":"R.","family":"Keukenkamp","sequence":"first","affiliation":[{"name":"Amsterdam UMC University of Amsterdam, Rehabilitation Medicine Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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