Association Between Plantar Temperatures and Triaxial Stresses in Individuals With Diabetes

Diabetic foot ulcers have a biomechanical etiology related to triaxial plantar stresses (3DS) (1). Bergtholdt and Brand (2) suggested that the foot would heat up before breaking down, indicating that elevated 3DS in the diabetic foot would result in inflammation that could be monitored by thermography. The purpose of this study was to explore the hypothesized relationship between 3DS and plantar temperatures. Twenty-eight individuals with diabetes, 14 with peripheral neuropathy (DN) and 14 without (DC), walked at self-selected speeds across a custom-built plate that quantified 3DS. After 10 min of acclimation, resting barefoot temperatures were recorded using a Fluke infrared thermal camera. Linear regressions were used to reveal associations between magnitudes of 3DS and resting temperatures. Associations between locations of peak 3DS and peak temperatures were also examined. As assessed by linear regression, temperature was a statistically significant predictor of peak shear stress (PS) and shear-time integral magnitudes at the hallux. No significant association was found …