Plantar Pressure Distribution and Asymmetry According to Preferred Walking Speed and Body Mass Index

Plantar pressure and asymmetry are crucial for foot health, especially in diabetic individuals at risk for diabetic foot ulcers (DFU). This study examined the effect of preferred walking speed (PWS) and body mass index (BMI) on regional plantar pressure and gait asymmetry in middle-aged diabetic men. Fifteen diabetic men (50–69 years) were grouped by PWS (slow, medium, fast) and BMI (normal = 18.5–22.9 kg/m2; pre-obesity = 23.0–24.9 kg/m2; obesity = ≥25.0 kg/m2). Participants average plantar pressure (APP), maximum plantar pressure (MPP) (total foot, forefoot, mid- foot, and rearfoot), asymmetry index, and plantar pressure difference were measured using a treadmill, while they walked at their PWS. Faster PWS was correlated with increased APP and MPP, primarily in the forefoot. The slower PWS groups showed greater overall APP asymmetry, whereas the faster PWS groups, despite better overall APP symmetry, exhibited increased MPP asymmetry in the midfoot and the highest in the rearfoot. Higher BMI was associated with increased plan- tar pressure asymmetry. Notably, the pre-obesity group, displayed the highest median MPP asymmetry across all foot regions. The rearfoot consistently demonstrated high pressure and MPP asymmetry. Both PWS and BMI significantly influenced plantar pressure and asymmetry in middle-aged men with diabetes, with distinct regional effects. These find- ings highlight that individualized gait assessment and customized footwear are required to redistribute pressure and man- age asymmetry based on PWS and BMI, which are crucial for DFU risk alleviation.