A new publication on plantar tissue stress received wide acclaim at this year’s 8th International Diabetic Foot Symposium with many suggesting it may shape the future of diabetic foot offloading treatments.
The paper was authored by several leading offloading experts from the US (Crews & Najafi), Netherlands (van Netten & Bus Netherlands), UK (Chadwick) and Australia (Fernando & Lazzarini).
The authors defined plantar tissue stress as, “the accumulation of all mechanical (factor) stresses on an area of plantar foot tissue from all weight bearing activity over time … including factors such as plantar pressure, shear stress, ambulatory activity and offloading device adherence”.
After reviewing the literature they propose standards to estimate plantar tissue stress using existing measures of these factors that we already know influence diabetic foot ulcer outcomes. The authors go on to recommend researchers now use these standards to estimate plantar tissue stress and determine if certain levels lead to better or worse diabetic foot ulcer outcomes.
Finally, they suggest this new concept may lead to the development of a whole range of new personalised offloading treatment options, such as smart insoles, gait retraining and activity dosing. We say watch this space down under people ????.
But, if you want to know more, our very own Dr Pete Lazzarini will be presenting on this new concept and the new IWGDF offloading guideline recommendations at DFA 2019 here. The ‘not so standard’ rate ends midnight 31JUL to get in quick before they sell out!