{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:18:29Z","timestamp":1783531109304,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2012,11,14]],"date-time":"2012-11-14T00:00:00Z","timestamp":1352851200000},"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":[[2012,12]]},"abstract":"<jats:sec><jats:label\/><jats:p>Diabet. Med. 29, 1542\u20131549 (2012)<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2002<\/jats:bold> To assess the value of using in\u2010shoe plantar pressure analysis to improve and preserve the offloading properties of custom\u2010made footwear in patients with diabetes.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Dynamic in\u2010shoe plantar pressures were measured in new custom\u2010made footwear of 117 patients with diabetes, neuropathy, and a healed plantar foot ulcer. In 85 of these patients, high peak pressure locations (peak pressure &gt;\u2003200\u2003kPa) were targeted for pressure reduction (goal: &gt;\u200325% relief or below an absolute level of 200\u2003kPa) by modifying the footwear. After each of a maximum three rounds of modifications, pressures were measured. In a subgroup of 32 patients, pressures were measured and, if needed, footwear was modified at 3\u2010monthly visits for 1\u2003year. Pressures were compared with those measured in 32 control patients who had no footwear modifications based on pressure analysis.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> At the previous ulcer location and the highest and second highest pressure locations, peak pressures were significantly reduced by 23%, 21% and 15%, respectively, after modification of footwear. These lowered pressures were maintained or further reduced over time and were significantly lower, by 24\u201328%, compared with pressures in the control group.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> The offloading capacity of custom\u2010made footwear for high\u2010risk patients can be effectively improved and preserved using in\u2010shoe plantar pressure analysis as guidance tool for footwear modification. This provides a useful approach to obtain better offloading footwear that may reduce the risk for pressure\u2010related diabetic foot ulcers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1464-5491.2012.03700.x","type":"journal-article","created":{"date-parts":[[2012,4,30]],"date-time":"2012-04-30T05:34:27Z","timestamp":1335764067000},"page":"1542-1549","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Pressure\u2010reduction and preservation in custom\u2010made footwear of patients with diabetes and a history of plantar ulceration"],"prefix":"10.1111","volume":"29","author":[{"given":"R.","family":"Waaijman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. L. 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