Implementing plantar pressure measurements in the clinic – New Zealand shows the way

In the latest guidelines from the International Working Group on the Diabetic Foot, it is strongly recommended to implement plantar pressure measurements in daily clinical practice. Patients with a previous foot ulcer should receive footwear with a demonstrated plantar pressure relieving effect during walking. Demonstrating this effect is only possible using pedobarography measurements, such as a force platform (for barefoot measurements) or in-shoe systems. These measurements are slowly finding their way to daily clinical practice, but are far from common practice in Australia.

New research from our trans-Tasman neighbours shows that implementing plantar pressure measurements is feasible in daily clinical practice. Researchers and clinicians from the University of Otago and various Northern Island clinics asked 48 patients to participate, and 39 of them agreed. The average plantar pressure measurements took less than half an hour, and patients were satisfied and happy with the measurements.

All patients reported to enjoy the measurements, no patient would refuse to have their pressure measured if asked again, and the vast majority found the information useful. This shows that plantar pressure measurements can be implemented in clinical practice to patients enjoyment and education, with only half an hour needed.

A shortcoming of the paper is the lack of clinical conclusions made from the measurements. While the authors outline important elements underreported in literature, especially the potential of education via plantar pressure measurements, the primary reason to implement these in practice is improving clinical outcomes. This is acknowledged in the study. The authors describe that this was a first step to learn more about the measurements and its implementation, with the next step involving the measurements in the clinical decision making process.

In conclusion, this is an easy to read and clinically very relevant paper. We hope this stimulates Australian clinicians to follow the New Zealanders and start implementing plantar pressure measurements in daily clinical practice.