{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T07:00:53Z","timestamp":1794294053434,"version":"4.9.0"},"reference-count":23,"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, 1534\u20131541 (2012)<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2002<\/jats:bold> Custom\u2010made therapeutic footwear is often prescribed to patients with diabetic neuropathy, foot deformity and a healed plantar foot ulcer. Offloading these feet is important to prevent ulcer recurrence. The aim was to evaluate the offloading effect of custom\u2010made footwear in these patients.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> In 171 patients with diabetic neuropathy (336 feet) with foot deformity and a recently healed plantar foot ulcer, plantar pressures walking barefoot and inside new custom\u2010made footwear were measured. At the previous ulcer location and at locations of highest barefoot pressure attributable to the deformity, in\u2010shoe pressures were compared with non\u2010deformed feet. The footwear was considered effective in offloading when in\u2010shoe peak pressure at these locations was &lt;\u2003200\u2003kPa.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Mean in\u2010shoe peak pressures ranged between 211 and 308\u2003kPa in feet with forefoot deformity (vs. 191\u2013222\u2003kPa in non\u2010deformed feet) and between 140 and 187\u2003kPa in feet with midfoot deformity (vs. 112\u2003kPa in non\u2010deformed feet). Offloading was effective in 61% of all feet with deformity, 81% of feet with midfoot deformity, 44% of feet with forefoot deformity and 62% of previous ulcer locations. Inter\u2010subject variability in measured in\u2010shoe plantar pressure was large.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Offloading in custom\u2010made footwear is often not sufficiently achieved in high\u2010risk diabetic feet with deformity. Highest offloading success rates were seen at known high\u2010risk locations such as previous ulcer locations and Charcot feet, the lowest success rates in forefoot deformities. Together with the large inter\u2010subject variability in pressure outcomes, this emphasizes the need for evidence\u2010based prescription and evaluation procedures to assure adequate offloading.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1464-5491.2012.03770.x","type":"journal-article","created":{"date-parts":[[2012,8,22]],"date-time":"2012-08-22T16:29:10Z","timestamp":1345652950000},"page":"1534-1541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Offloading effect of therapeutic footwear in patients with diabetic neuropathy at high risk for plantar foot ulceration"],"prefix":"10.1111","volume":"29","author":[{"given":"M. L. 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