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

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.