Article 2026-04-21 under-review v1

Dynamic changes in compressive and shear plantar tissue properties during gait and rest in people living with and without diabetes

C
Chaofan Lin University of Manchester
A
Athia Haron University of Manchester
D
Damian Crosby University of Manchester
G
Garry Massey University of Exeter
M
Maedeh Mansoubi University of Exeter
Z
Ziyuan Wang University of Manchester
Y
Yufeng Li University of Manchester
H
Helen Dawes University of Exeter
A
Andrew Weightman University of Manchester
G
Glen Cooper University of Manchester

Abstract

Plantar tissue adaptation during activity is thought to contribute to diabetic foot ulceration (DFU), yet most existing studies only measure compressive quasi-static properties. This pilot study developed an ultrasound-loadcell measurement tool, PlantarSense, and used an infrared thermometer to measure dynamic compressive and shear energy dissipation ratio (EDR) and temperature of plantar-tissue at the first metatarsal head (1stMTH) and calcaneus in people living with and without diabetes at baseline, post-walk, and post-recovery. People living with diabetes showed significantly greater post-walk temperature increases (11.0 % vs 6.9% in controls at calcaneus, p=0.03) and less complete thermal recovery than controls. Baseline compressive EDR at the 1stMTH was significantly higher in people living with diabetes (67.8% vs 56.0% in controls, p=0.04). EDR modulation was greater from shear loading (21.5%) than compression (5.4%) and post-walk induced reductions in EDR were present in all participants, but people living with diabetes showed a 20% lower recovery than controls. Impaired thermoregulation and tissue adaptation in people living with diabetes was demonstrated by plantar temperature and EDR differences in post-walk and post-recovery. Future work is needed to test more participants with a greater range of diabetes progression to quantify statistically significant plantar tissue differences to inform DFU risk management.

Citation Information

@article{chaofanlin2026,
  title={Dynamic changes in compressive and shear plantar tissue properties during gait and rest in people living with and without diabetes},
  author={Chaofan Lin and Athia Haron and Damian Crosby and Garry Massey and Maedeh Mansoubi and Ziyuan Wang and Yufeng Li and Helen Dawes and Andrew Weightman and Glen Cooper},
  journal={Scientific Reports},
  year={2026},
  doi={https://doi.org/10.21203/rs.3.rs-9160602/v1}
}
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