{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:04Z","timestamp":1783509304410,"version":"3.55.0"},"reference-count":10,"publisher":"MDPI AG","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"\n Background:<\/jats:bold>\n Foot ulcers and infections are a major and costly problem in patients with diabetes and a major cause of amputations. Plantar peak pressure plays an essential role in plantar ulceration. Off-loading is a common tool to reduce plantar peak pressure and risk of ulceration. The goal of this study was to determine whether reduction of plantar peak pressure can be achieved using a walking bike (a bike without pedals) compared with walking.\n <\/jats:p>\n \n Methods:<\/jats:bold>\n The study starts with a PubMed literature review. In a blinded prospective protocol, 14 healthy individuals (seven men, seven women; mean \u00b1 SD age, 39.5 \u00b1 11.3 years) are included. In-shoe pedobarography sensors were attached between the skin and the standardized shoes, then participants walked 10 m three times and then moved over the same distance using a walking bike without removal of the sensor (three times) in a gait laboratory (84 measurements).\n <\/jats:p>\n \n Results:<\/jats:bold>\n In this single-blinded prospective study, mean \u00b1 SD plantar peak pressure was significantly reduced from 49.4 \u00b1 12.9 N\/cm\n 2<\/jats:sup>\n with walking to 35.2 \u00b1 14.6 N\/cm\n 2<\/jats:sup>\n using a walking bike (\n P<\/jats:italic>\n = .003). Mean \u00b1 SD step length increased significantly from 0.68 \u00b1 0.13 m to 0.91 \u00b1 0.19 m (\n P<\/jats:italic>\n < .001) due to a significantly reduced number of steps (from 7.7 \u00b1 1.4 steps per 10 m of walking to 5.7 \u00b1 1.1 steps per 10 m of using a walking bike;\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n \n Conclusions:<\/jats:bold>\n Plantar peak pressure is a risk factor for ulceration in diabetes. Herein, a significant reduction of plantar peak pressure was seen using a walking bike compared with walking (\n P<\/jats:italic>\n = .003). Walking bikes may be a tool for off-loading for diabetic patients, especially if both feet are ulcerated. Additional studies to validate these findings in patient care are planned.\n <\/jats:p>","DOI":"10.7547\/22-127","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T11:20:33Z","timestamp":1725535233000},"source":"Crossref","is-referenced-by-count":2,"title":["Walking Bike as an Effective Tool to Reduce Plantar Peak Pressure in Diabetes Mellitus"],"prefix":"10.3390","volume":"114","author":[{"given":"Ulrich","family":"Illgner","sequence":"first","affiliation":[{"name":"Technical Orthopedic Surgery, Seintsch and Illgner Private Orthopedic Doctors Office, Koblenz, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Mehlhorn","sequence":"additional","affiliation":[{"name":"Center of Foot and Ankle Surgery, Sch\u00f6nklinik M\u00fcnchen Harlaching, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nani","family":"Osada","sequence":"additional","affiliation":[{"name":"Institut for Medical Informatics, University of Muenster, Muenster, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit","family":"Krenn","sequence":"additional","affiliation":[{"name":"Medical Center for Histology, Cytology, and Molecular Diagnostics, Trier, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"Landauer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","article-title":"Diabetes Atlas","unstructured":"International Diabetes Federation. 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J Diabet Foot Complications 9: 1, 2017."},{"key":"B6","series-title":"JAPMA","first-page":"437","article-title":"The Charcot foot in diabetes","volume":"101","author":"Rogers LC","year":"2011","unstructured":"Rogers LC, Frykberg RG, Armstrong DG, et al: The Charcot foot in diabetes. JAPMA 101: 437, 2011."},{"key":"B7","series-title":"Diabetes Care","first-page":"1595","article-title":"Evaluation and optimization of therapeutic footwear for neuropathic diabetic foot patients using in-shoe plantar pressure analysis","volume":"34","author":"Bus SA","year":"2011","unstructured":"Bus SA, Haspels R, Busch-Westenbroek TE: Evaluation and optimization of therapeutic footwear for neuropathic diabetic foot patients using in-shoe plantar pressure analysis. Diabetes Care 34: 1595, 2011."},{"key":"B8","series-title":"Foot Ankle Int","first-page":"80","article-title":"Impact of knee scooter flexion position on venous flow rate","volume":"40","author":"Ciufo DJ","year":"2019","unstructured":"Ciufo DJ, Anderson MR, Baumhauer JF: Impact of knee scooter flexion position on venous flow rate. Foot Ankle Int 40: 80, 2019."},{"key":"B9","series-title":"Sarcoidosis Vasc Diffuse Lung Dis","first-page":"192","article-title":"The effect of the walk-bike on quality of life and exercise capacity in patients with idiopathic pulmonary fibrosis: a feasibility study","volume":"37","author":"Wapenaar M","year":"2020","unstructured":"Wapenaar M, Bendstrup E, Molina-Molina M, et al: The effect of the walk-bike on quality of life and exercise capacity in patients with idiopathic pulmonary fibrosis: a feasibility study. Sarcoidosis Vasc Diffuse Lung Dis 37: 192, 2020."},{"key":"B10","series-title":"Chest","first-page":"1224","article-title":"The effects of a \u201cnew\u201d walking aid on exercise performance in patients with COPD: a randomized crossover trial","volume":"141","author":"Vaes AW","year":"2012","unstructured":"Vaes AW, Annegarn J, Meijer K, et al: The effects of a \u201cnew\u201d walking aid on exercise performance in patients with COPD: a randomized crossover trial. Chest 141: 1224, 2012."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/114\/4\/22-127.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/114\/4\/22-127.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/114\/4\/22-127.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:19:45Z","timestamp":1783505985000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/114\/4\/22127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":10,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.7547\/22-127","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2024,7]]}}}