A Review of the Plantar Pressure Distribution Effects from Insole Materials and at Different Walking Speeds

Abstract

Among people with diabetes mellitus (DM), the two common strategies for decreasing peak plantar pressure (PPP) to reduce diabetic foot ulcers (DFUs) risks are to modify walking speeds and to change insole materials. This study reviewed the PPP reduction based on various walking speeds and insole materials. The articles were retrieved from four major scientific databases and manual search. We identified 1585 articles, of which 27 articles were selected for full-text analysis. We found that in faster walking speeds, the forefoot PPP was higher (308 kPa) than midfoot (150 kPa) and rearfoot (251 kPa) PPP. The appropriate walking speed for reducing the forefoot PPP was about 6 km/h for non-DM and 4 km/h for DM people. The forefoot PPP in DM people was 185% higher than that of non-DM people. Ethylene–vinyl acetate (EVA) insole material was the most popular material used by experts (26%) in the forefoot and reduced 37% of PPP. In conclusion, the suitable walking speed for DM was slower than for non-DM people, and EVA was the most common insole material used to decrease the PPP under the forefoot. The clinicians might recommend DM people to walk at 4 km/h and wear EVA insole material to minimize the DFUs.