Plantar Pressure Analysis in Diabetic Foot Health

Plantar pressure analysis has become a cornerstone in understanding, predicting and preventing foot complications in people with diabetes. Elevated loading under the sole of the foot, especially in regions of sensory loss due to peripheral neuropathy, is strongly associated with the development of plantar foot ulcers. By quantifying how and where forces are transmitted through the plantar surface during standing and gait, clinicians and engineers can identify areas at highest risk, design offloading interventions and monitor therapeutic effects. Traditional laboratory platforms measure vertical pressures in isolated trials, whereas recent advances in in-shoe sensors and wearable systems enable continuous monitoring during daily activities. Finite element modelling and personalised biomechanical simulations further enrich insight into tissue stress distribution and the impact of foot deformities. Together, these approaches inform custom footwear and insole design, real-time feedback devices and rehabilitation protocols, all aimed at reducing ulcer incidence and improving long-term foot health for a growing global diabetic population.

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Plantar Pressure Analysis in Diabetic Foot Health publication trend

The graph below shows the total number of articles in plantar pressure analysis in diabetic foot health across all publications each year (not limited to Nature Index journals).

Technical terms

Peak plantar pressure: The highest force per unit area recorded under the foot during a gait cycle or stance phase, used to identify points of excessive loading.

Pressure-time integral: The cumulative sum of pressure over time at a specific plantar region, reflecting both magnitude and duration of load.

Centre of pressure (COP): The weighted average location of all pressure points under the foot, indicating how load shifts during dynamic activities.

Offloading: A therapeutic strategy to redistribute plantar pressure away from high-risk areas, often by modifying footwear, insoles or using assistive devices.

Peripheral neuropathy: A diabetic complication characterised by loss of sensory and motor nerve function in the feet, leading to unperceived high pressure and increased ulcer risk.

References

1. The role of foot pressure measurement in the prediction and prevention of diabetic foot ulceration—A comprehensive review. Diabetes/Metabolism Research and Reviews (2019).
2. Innovative intelligent insole system reduces diabetic foot ulcer recurrence at plantar sites: a prospective, randomised, proof-of-concept study. The Lancet Digital Health (2019).
3. Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: a systematic literature review. Journal of Foot and Ankle Research (2020).
4. Subject-specific finite element modelling of the human foot complex during walking: sensitivity analysis of material properties, boundary and loading conditions. Biomechanics and Modeling in Mechanobiology (2017).