We compared the plantar pressures generated by walking in leather-soled
Oxford-style shoes and by walking in inexpensive running shoes with those
generated by walking in thin socks on a hard surface for thirty-nine
individuals (thirteen who had diabetes and neuropathy, and thirteen who had
diabetes without neuropathy, and thirteen who had neither diabetes nor
neuropathy [controls]). Except for two anatomical regions, the plantar
pressure associated with the Oxford-style shoes were not different from
those associated with walking without shoes. In comparison, the inexpensive
running shoes relieved plantar pressure in the forefoot and heel by a mean
(and standard deviation) of 31 +/- 9.1 per cent, with the most relief
occurring in the feet that had the highest pressures when they were unshod.
There were significant reductions in pressure in all regions of the foot
except for the midfoot (p < 0.01), and there were no significant
differences between the groups. Individuals who have insensate feet should
be discouraged from wearing leather-soled Oxford-style shoes because of the
risk of ulceration due to elevated plantar pressures. Inexpensive running
shoes should be viewed as the very minimally acceptable choice for footwear
for these individuals if the feet are free of deformity.