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Clinical Trial
. 2025 Mar 27;15(1):10603.
doi: 10.1038/s41598-025-94649-z.

Exploring air insole pressure and walking durations effects on microcirculation in healthy individuals to optimize diabetic foot ulcers prevention

Gilang Titah Ramadhan  1 , Fahni Haris  2 , Yih-Kuen Jan  3 , Ben-Yi Liau  4 , Wei-Cheng Shen  5 , Jian-Guo Bau  6 , Chun-Ming Lien  7 , Chien-Cheng Tai  8 , Chi-Wen Lung  9   10
Affiliations
Clinical Trial

Exploring air insole pressure and walking durations effects on microcirculation in healthy individuals to optimize diabetic foot ulcers prevention

Gilang Titah Ramadhan et al. Sci Rep. .

Abstract

To evaluate the impact of air insole on reducing the risk of diabetic foot ulcers (DFUs) in healthy individuals through microcirculation assessment, which considers blood flow as a critical factor due to the role of peripheral vascular disease in DFU development. The study analyzes the interaction between air insole pressure and walking duration. Repeated-measures design was used to assess the effects of two walking durations (10 and 20 min) and three air insole pressures (80, 160, and 240 mmHg), resulting in six walking conditions tested in 13 healthy participants. The average blood flow in the first metatarsal head (M1) was quantified using data from the last 3 min of the 10 min post-exercise period. The results of one-way ANOVA showed that the 80 mmHg air insole pressure was significantly lower microcirculation than 240 mmHg with 10 min walking duration (129.4 ± 9.1 vs 163.1 ± 12.6 PU, P = 0.035). The paired t-test showed three significant differences in the effects of the walking duration in all air insole pressures. (1) 10 min walking duration was significantly lower compared to 20 min with 80 mmHg air insole pressure (129.4 ± 9.1 vs 203.6 ± 10.1 PU, P = 0.001); (2) 10 min walking duration was significantly lower compared to 20 min with 160 mmHg air insole pressure (142.5 ± 10.6 vs 206.0 ± 12.5 PU, P = 0.001); (3) 10 min walking duration was significantly lower compared to 20 min with 240 mmHg (163.1 ± 12.6 vs 219.1 ± 11.8 PU, P = 0.008). This study highlights that walking with an air insole pressure of 80 mmHg for 20 minutes influences microcirculation at the first metatarsal head, potentially offering important benefits for individuals at risk of pressure-related injuries, such as DFUs.

Keywords: Blood flow; Diabetic foot ulcers; First metatarsal head; Peripheral vascular disease.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The studies involving humans were approved by Central Regional Research Ethics Committee China Medical University, Taichung, Taiwan (CRREC-111-017). The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Figures

Fig. 1
Fig. 1
Retrieval of microcirculation data from M1. (A) Shoes with air insole; (B) Participants walk on a treadmill; (C) Retrieval of microcirculation data on M1; (D) Preview Microcirculation Data with an average of last 3 min from 10 min, measured in PU, perfusion units.
Fig. 2
Fig. 2
Bar chart comparisons (A) Comparisons of the effect of the walking duration on the microcirculation at 3 air insole pressure of air insoles. (B) Comparisons of the effect of the air insole pressure on the microcirculation at 2 walking durations. Data are shown as mean ± standard errors. *A significant difference (P < 0.05) and **A significant difference (P < 0.01). PU perfusion units.
Fig. 3
Fig. 3
Illustration of the effect of air insole pressure and walking duration on the microcirculation (A) The effect of the air insole pressure showed 80 mmHg, which was lower microcirculation than 240 mmHg at 10 min. (B) The effect of walking durations on the microcirculation showed that 80, 160, and 240 mmHg with 10 min were lower than 20 min.
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References

    1. Gnanasundaram, S. et al. Gait changes in persons with diabetes: Early risk marker for diabetic foot ulcer. Foot Ankle Surg.26(2), 163–168 (2020). - PubMed
    1. Parker, E. D. et al. Economic costs of diabetes in the US in 2022. Diabetes Care47(1), 26–43 (2023). - PubMed
    1. Liao, F. et al. Effect of exercise on risk factors of diabetic foot ulcers: A systematic review and meta-analysis. Am. J. Phys. Med. Rehabil.98(2), 103–116 (2019). - PubMed
    1. Haris, F. et al. A review of the plantar pressure distribution effects from insole materials and at different walking speeds. Appl. Sci.11(24), 11851 (2021).
    1. Haris, F. et al. The effects of different inner pressures of air insoles and walking durations on peak plantar pressure. Medicine102(43), e35704 (2023). - PMC - PubMed

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