# Analysis of Clinical Profiles, Deformities, and Plantar Pressure Patterns in Diabetic Foot Syndrome  
[PERSON]  
1 Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy 1  
[PERSON]  
2 UOC Medicina Riabilitativa e Neurorabilitazione, IRCCS Istituto Scizenze Neurologiche, 40139 Bologna, Italy; [EMAIL_ADDRESS] 2  
[PERSON]  
3 Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; [PERSON]DDRESS] (A.L. ); [EMAIL_ADDRESS] (P.C. ); [PERSON]M.O. ); [EMAIL_ADDRESS] (L.B.) [PERSON]  
3 Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; [PERSON]DDRESS] (A.L. ); [EMAIL_ADDRESS] (P.C. ); [EMAIL_ADDRESS] (M.O. ); [EMAIL_ADDRESS] (L.B.) [PERSON]  
3 Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; [PERSON]DDRESS] (A.L. ); [EMAIL_ADDRESS] (P.C. ); [EMAIL_ADDRESS] (M.O. ); [EMAIL_ADDRESS] (L.B.) 4 IRCCS-Azenda Oped  
and specificity to predict foot ulceration, but it was only validated for type 2 diabetes. [PERSON] et al. [5] proposed a diabetic foot prediction model based on regression analysis, with more than 150 variables. The model, which fitted a type 2 population well, mainly relied on diabetes-related clinical variables, a specific grading of neuropathy, anthropometrics but not body mass, foot structure and alignment, and foot and leg kinematics. [PERSON] et al. [6] reported gender, body mass, diabetes duration, glycated hemoglobin (HbA1c), vibration perception threshold (VPT), rotation axis of ankle joint motion, foot deformity, ankle range of motion, and callus as significant predictors of peak pressure among their population. [PERSON] et al. [7] reported a multivariate logistical regression analysis, performed over a pooled sample of 100 patients with type 1 (37%) and type 2 (63%) diabetes, where risk of ulceration was found to be associated with duration of diabetes, smoking, severity of neuropathy, glycemic control, and high peak pressure values and gradients. The study did not account for foot motion. [PERSON] et al. [8] modelled risk factors for diabetic foot complications on the wide cohort (62,681 patients with diabetes) of the Saudi National Register and showed significant odds ratio for Charcot joints, peripheral vascular disease, neuropathy, diabetes duration >10 years, insulin use, retinopathy, nephropathy, age >45 years, cerebral vascular disease, poor glycemic control, coronary artery disease, male gender, smoking, and hypertension. This study analyzed clinical and biological variables, demographics, and lifestyle, while no data were available with respect to foot structure and biomechanics. With respect to ulcer recurrence, [PERSON] et al. [9] recently developed a multivariate prediction model addressing all types of recurrent plantar foot ulcers and including the following risk factors: the presence of a minor lesion, living alone, increased barefoot peak plantar pressure, longer duration of having a previous foot ulcer, and less variation in daily stride count. The study included 171 patients with type 1 (~30%) and type 2 (~70%) diabetes and history of recurrent ulcers, and the model area under the receiver operator curve was 68%. With special attention to model diabetic foot plantar pressures by exploiting radiological assessment, [PERSON] et al. [10] implemented a linear regression model based on variables extracted from barefoot plantar pressure measurements, radiographic evaluation, and peripheral neurological, orthopedic, and vascular assessment. The latter consisted of weight-bearing anterior-posterior and lateral radiographs, which delivered 18 (5 angular and 13 linear) and 15 (9 angular and 6 linear) measurements, respectively. The model could only explain about 34% of the variance in the local peak pressure. However, the inclusion of foot architecture in the model may be of interest, especially now that innovative foot architecture measurements can be extracted from the weight-bearing CT (WBCT) [11].