Evaluation Of Pressure Distribution of kybun Shoes
- 1. Evaluation Of Pressure Distribution Of Kyboot Shoes In Comparison To Other Foot Wear In Diabetic Patients And In Healthy Subjects Dr. Simon Levy, Yael Dotan-Marom, Miri Rosenhouse, Dr. Sigal Portnoy, Dr. Itzhak Siev-Ner. Department of Orthopedic Rehabilitation, Sheba Medical Center, Tel Hashomer Department of Medical Professions, University of Tel Aviv Department of Physiotherapy, Sheba Medical Center, Tel Hashomer
- 2. Disclosure • The Orthopedic Rehabilitation Department, Tel Hashomer Hospital received funding for this study by the Kybun company • Our department initiated this study and we were solely responsible for the study design, choice of patients, conduct of the study and outcome without the influence of any third party.
- 3. Introduction • Every 30 seconds a limb is lost due to diabetes • The amputations are preceded by a foot ulcer in 84% of cases • Therefore a reduction of mechanical pressure is important • Ideal footwear for a diabetic patient decreases weight-bearing pressure and shear forces
- 4. Introduction • In this study we wanted to compare: – The pressure distribution – changes in the movement of the center of pressure – Several gait parameters of the KyBoot in comparison with normal shoes in healthy and diabetic subjects.
- 5. Methods • Location: Sheba Medical Center, Orthopedic Rehabilitation Department • 2 study groups – Healthy volunteers (10) – Diabetic patients (11)
- 6. Methods Inclusion criteria for group 1 (healthy subjects): – Signing of informed consent – Intact cognitive function – Healthy
- 7. Methods Inclusion criteria for group 2 (diabetic subjects): – Signing of informed consent – Diabetes mellitus Type 2 – Existence of sensory neuropathy – Intact cognitive function
- 8. Methods Exclusion criteria for group 2 (diabetic subjects): – An orthopedic or rheumatic disease that negatively influences range of motion, strength, gait or balance – Neurological diseases that influence proprioception , strength, balance, cognitive function / understanding, vision – Injury or disease that can influence normal gait – Need for assistive devices : crutches, cane, walker – Dialysis Treatment – Foot Ulcer – Major foot deformations necessitating fitting of specially fitted foot wear
- 9. Methods • In-sole Pressure Sensors (Tactilus Human Interface Stretch System) recorded the pressure distribution and changes in center of pressure inside the shoes. • With the help of the GaitRite System we determined walking speed, length of stride and step and several other gait parameters • We took measurements in stance and walk • The test subjects were asked to complete a questionnaire on comfort of wear, feeling of pressure and pain
- 10. Results The maximal average pressure was significantly reduced by an averaged 12.8% in gait with Kyboot shoes
- 11. Results The maximal contact area is significantly increased with KyBoot shoes
- 12. Results • Movement of the Center of Pressure The center of pressure moved significantly less in the medio-lateral axis (22% less) and in the anterio-posterior axis (19%) with Kyboot shoes
- 13. Results The maximal heel to forefoot pressure ratio decreased significantly by 58% Maximal heel pressure decreased by 26 kpa and max. forefoot pressure by 35 kpa
- 14. The same diabetic patient, during stance, same foot, each after 10 s of standing: Normal shoes Kyboot shoe Kyboot shoes
- 15. The step length increased significantly (3 cm) with Kyboot shoes
- 18. Discussion • KyBoot shoes reduce average pressure and distribute the pressure more effectively than other shoes in gait reduced risk of ulceration • The step length is significantly increased with KyBoot shoes (propulsion without increased pressure) • KyBoot shoes could be beneficial for diabetic patients and in some cases could offer an alternative to shoes provided by the Ministry of Health (Louis Institute) • We do not suggest Kyboot shoes for diabetic patients with significant deformities • KyBoot shoes reduce pain and improve comfort during stance and gait