{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:50:41Z","timestamp":1792083041399,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Diabetic foot ulceration (DFU) is a multifactorial process involving undetected, repetitive trauma resulting in inflammation and tissue breakdown. Shear stress forms a major part of plantar load, the aim of this review is to determine whether elevated shear stress results in ulceration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the Ovid Medline, EMBASE, CINAHL and Cochrane library databases was performed. Studies involving patients with diabetes who underwent plantar shear stress assessment were included. The primary outcome was plantar shear stress in patients with diabetes who had a current\/previous DFU compared with those with no prior ulceration. Meta\u2010analysis was performed comparing shear stress between those with a current or previous DFU and those without, and those with diabetes and healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search strategy identified 1461 potentially relevant articles, 16 studies met the inclusion criteria, involving a total of 597 patients. Comparing shear stress between the current\/previous DFU group and those without: Standardised mean difference (SMD) 0.62 (95% CI \u22120.01 to 1.25), in favour of greater shear stress within the DFU group,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.05. Comparing shear stress between people with diabetes and healthy controls: 0.36 (95% CI \u22120.31 to 1.03), in favour of greater shear stress within the diabetes group,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.29.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This review suggests that that patients with diabetes and a history of ulceration exhibit greater shear stress than their ulcer\u2010free counterparts. This strengthens the premise that development of systems to measure shear stress may be helpful in DFU prediction and prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14661","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T16:10:33Z","timestamp":1627575033000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Plantar shear stress in the diabetic foot: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0639-8115","authenticated-orcid":false,"given":"Alexander D.","family":"Jones","sequence":"first","affiliation":[{"name":"Leeds Vascular Institute Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"De Siqueira","sequence":"additional","affiliation":[{"name":"Leeds Vascular Institute Leeds Teaching Hospitals NHS Trust Leeds UK"},{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E.","family":"Nixon","sequence":"additional","affiliation":[{"name":"Leeds Institute of Clinical Trials Research University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi J.","family":"Siddle","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Culmer","sequence":"additional","affiliation":[{"name":"Leeds School of Mechanical Engineering University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Russell","sequence":"additional","affiliation":[{"name":"Leeds Vascular Institute Leeds Teaching Hospitals NHS Trust Leeds UK"},{"name":"Leeds Institute of Clinical Trials Research University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2019"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(11)60012-9"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00383-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13973"},{"issue":"1","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"e3269","DOI":"10.1002\/dmrr.3269","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)","volume":"36","author":"Bus SA","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(99)00076-5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0141-5425(83)90076-6"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2013.11.003"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2007.10.008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-1596"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-6362(01)00176-X"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2016.06.006"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2011.10.021"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/3157123"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1932296816648164"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1932296819849092"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2014.04.009"},{"key":"e_1_2_9_20_1","first-page":"CRD4202020","article-title":"The role of plantar shear assessment in the management of the diabetic foot: a systematic review","author":"Jones AD","year":"2020","journal-title":"PROSPERO Int Prospect Regist Syst Rev"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.7547\/17-131"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3268"},{"key":"e_1_2_9_23_1","unstructured":"WellsG SheaB O'ConnellD PetersonJ WelchV LososMTP.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses.http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. Published 2013."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2006.03.005"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2016.09.023"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2011.12.007"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(01)00015-8"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2007.10.005"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20080011"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2008.10.055"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2204"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.5.855"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113591"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2013.07.004"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00400259"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/s18051334"},{"key":"e_1_2_9_37_1","first-page":"83451D","article-title":"Pressure and shear sensing based on microstrip antennas","volume":"8345","author":"Mohammad I","year":"2012","journal-title":"Sensors Smart Struct Technol Civil, Mech Aerosp Syst"},{"key":"e_1_2_9_38_1","first-page":"2010","article-title":"Tri\u2010axial plantar pressure sensor: design, calibration and characterization","volume":"3","author":"Heywood E","year":"2004","journal-title":"Conf Proc IEEE Eng Med Biol Soc"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.2891241"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2011.11.004"},{"issue":"7","key":"e_1_2_9_41_1","first-page":"1989","article-title":"A review of wearable sensor systems to monitor plantar loading in the assessment of diabetic foot ulcers","volume":"67","author":"Wang L","year":"2020","journal-title":"IEEE Trans Biomed Eng"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.14661","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.14661","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.14661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T16:59:12Z","timestamp":1699289952000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.14661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/dme.14661"],"URL":"https:\/\/doi.org\/10.1111\/dme.14661","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,6]]},"assertion":[{"value":"2021-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14661"}}