COMPARATIVE ANALYSIS OF THREE TYPES OF THERAPEUTIC OFFLOADING DIABETIC SHOES WITH CUSTOM MADE INSOLE ON PLANTAR PRESSURE DISTRIBUTION IN SEVERE DIABETIC CHARCOT FOOT
Bibliographic record
Abstract
BACKGROUND: Charcot foot deformity, a severe complication of diabetes, involves neuropathy and abnormal peak plantar pressure in the midfoot and forefoot. However, orthotic interventions and shoe modifications are used to address the sequelae of Charcot neuroarthropathy, offering different approaches to managing abnormal peak plantar pressure. OBJECTIVE: To compare the effects of three types of therapeutic offloading diabetic shoes; prefabricated, relasting, and double rocker-modified shoes on peak plantar pressure in the midfoot and forefoot of nonulcerated chronic Charcot foot during walking. METHODOLOGY: A repeated measure design involved 15 participants (40% males and 60% females) with a mean age of 60.73 years (SD=10.50), with Charcot neuropathy. Participants were provided with three types of shoes; prefabricated, relasting, and double rocker-modified shoes, each equipped with the same custom-made insole (CMI). Plantar pressure was recorded while walking on level ground, focusing on the forefoot, midfoot, and hindfoot. The study also investigated additional variables affecting plantar pressure distribution, including the pressure-time integral and contact area. FINDINGS: The type of shoe had distinct effects on the distribution of plantar pressure. The double rocker-modified shoe particularly impacted forefoot pressure during the terminal stance phase of the gait cycle. Peak plantar pressure at the forefoot increased by 5.37% with double rocker-modified shoes compared to relasting shoes. Both double rocker-modified and prefabricated shoes reduced midfoot peak plantar pressure by 8.73% and 11.97%, respectively. Similar trends were observed at the hindfoot, with reductions in peak plantar pressure. However, there were no significant differences in regional peak plantar pressure between the types of shoes except for the central forefoot (F (1.61, 22.5) = 5.69, p = 0.014). CONCLUSION: There were no significant differences in the effectiveness of prefabricated, relasting, and double rocker-modified shoes in reducing and redistributing peak plantar pressure in high-risk areas of chronic Charcot foot.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".