Changes in pedal plantar pressure variability and contact time following massage therapy: A case study of a client with diabetic neuropathy

Summary 

Objective

This study was conducted to examine changes in plantar foot pressure variability, and foot contact time in a client with diabetic neuropathy, following a single massage therapy treatment focused on the lower limbs.

Method

The research was a pre-test post-test case study, in which plantar foot pressure measurements were taken at baseline, and immediately following massage therapy treatment. The participant was purposefully selected from the client pool at Sutherland-Chan School of Massage Therapy, where the research was conducted.

Intervention

The intervention involved a single massage therapy treatment of 80min duration, focused on the lower limbs. The techniques applied followed principles as outlined in the standards of practice of the College of Massage Therapists of Ontario, and included Swedish and myofascial techniques, passive stretching, trigger point treatment and mobilization of the joints of the lower limb distal to the knee. Additionally, preparatory hydrotherapy was applied. All techniques were modified in relation to the client's clinical needs and presentation.

Outcome measures

Outcome measures were coefficients of variation for mean peak pressures (MPP) for the full foot, the first metatarsophalangeal joint and the hallux; coefficients of variation for the mean value pressure picture (MVP), also for the full foot, the first metatarsophalangeal joint and the hallux; and foot contact time.

Results

A significant increase in the variability of MPP and MVP (greater than 5%) below the hallux was noted. Additionally, there was a significant decrease in contact time (t(7)=58.207; p<0.001) following treatment. Other comparisons were not statistically significant.

Conclusion

The results suggest that the massage therapy intervention utilized increased the variability of pressure below the hallux of a participant with diabetic neuropathy, and also affected gait positively in terms of velocity and fluidity. Although this single case study is a preliminary investigation of the role, massage therapy may play in the management of clients with diabetic neuropathy, the results reflect a potential to improve mobility and reduce the incidence of neuropathic ulceration in the diabetic population.