{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T10:43:48Z","timestamp":1784976228071,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Elevated dynamic plantar pressures are a consistent finding in diabetic patients with peripheral neuropathy, with implications for plantar foot ulceration. This study aimed to investigate whether a first-ray amputation affects plantar pressures and plantar pressure distribution patterns in individuals living with diabetes and peripheral neuropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A nonexperimental matched-subject design was conducted. Twenty patients living with diabetes and peripheral neuropathy were recruited. Group 1 (n = 10) had a first-ray amputation and group 2 (n = 10) had an intact foot with no history of ulceration. Plantar foot pressures and pressure-time integrals were measured under the second to fourth metatarsophalangeal joints, fifth metatarsophalangeal joint, and heel using a pressure platform.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Peak plantar pressures under the second to fourth metatarsophalangeal joints were significantly higher in participants with a first-ray amputation (P = .008). However, differences under the fifth metatarsophalangeal joint (P = .734) and heel (P = .273) were nonsignificant. Pressure-time integrals were significantly higher under the second to fourth metatarsophalangeal joints in participants with a first-ray amputation (P = .016) and in the heel in the control group (P = .046).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Plantar pressures and pressure-time integrals seem to be significantly higher in patients with diabetic peripheral neuropathy and a first-ray amputation compared with those with diabetic neuropathy and an intact foot. Routine plantar pressure screening, orthotic prescription, and education should be recommended in patients with a first-ray amputation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/16-021","type":"journal-article","created":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T16:33:50Z","timestamp":1529685230000},"page":"225-230","source":"Crossref","is-referenced-by-count":10,"title":["Plantar Pressure Distribution in Patients with Diabetic Peripheral Neuropathy and a First-Ray Amputation"],"prefix":"10.3390","volume":"108","author":[{"given":"Iona","family":"Borg","sequence":"first","affiliation":[{"name":"Department of Health, Valletta, Malta."},{"name":"Faculty of Health Sciences, University of Malta, Msida, Malta."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Mizzi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Malta, Msida, Malta."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Formosa","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Malta, Msida, Malta."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"ref191","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/S0140-6736(05)67698-2","article-title":"The global burden of diabetic foot disease","volume":"366","author":"Boulton","year":"2005","journal-title":"Lancet"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.gaitpost.2013.01.028","article-title":"Reliability of plantar pressure platforms","volume":"38","author":"Hafer","year":"2013","journal-title":"Gait Posture"},{"key":"ref31","first-page":"854","article-title":"Anatomy and biomechanics of the first ray","volume":"79","author":"Glasoe","year":"1999","journal-title":"J Am Phys Ther 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