The proprioceptive insole: A therapeutic aid for the diabetic patient in prevention?


  • Innocenzo Secolo University of Palermo, Italy
  • Federica Catanzaro Podiatry Clinic “Catanzaro”, Italy
  • Valentina Catanzaro Podiatry Clinic “Catanzaro”, Italy
  • Erika Rizzo I.O.M.I. Group "Franco Scalabrino", Italy
  • Giuseppe Secolo University of Palermo, Italy



Biomechanics, Diabetes, Proprioception, Diabetic foot, Insole, Posturology


The diabetic foot represents one of the most common complications among patients with type 2 diabetes mellitus. Prevention of the diabetic foot is therefore essential both to ensure the patient a better quality of life and to reduce the costs borne by the NHS and this requires a multidisciplinary approach. It is important to underline that the major complications of the diabetic foot are due to biomechanical, vascular and neuropathic alterations. Diabetic patients are less likely to perform physical exercises and tend to walk less, adopting compensatory strategies based on the type of terrain they find. They walk slower, tend to take shorter steps with a wider base of support, have limited knee and ankle mobility. It is very important to study the biomechanics and hyperload points in order to assess the risk of ulceration. In this study we decided to treat the postural alterations of diabetic patients not suffering from neuropathy with the use of proprioceptive insoles by analysing the degrees of perturbation of postural balance using a stabilometric platform. This work intends to evaluate the objective possibility of considering posturology in diabetology as an instrument discipline, to guarantee the patient less risk of ulceration through a correct postural structure and a possible postural reprogramming.


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Ahmmed, A. U., & Mackenzie, I. J. (2003). Posture changes in diabetes mellitus. The Journal of Laryngology and Otology, 117(5), 358-364.

Bansal, V., Kalita, J., & Misra, U. K. (2006). Diabetic neuropathy. Postgraduate Medical Journal, 82(964), 95-100.

Battaglia, G., Giustino, V., Messina, G., Faraone, M., Brusa, J., Bordonali, A., Barbagallo, M., Palma, A., & Dominguez, L.-J. (2020). Walking in Natural Environments as Geriatrician's Recommendation for Fall Prevention: Preliminary Outcomes from the "Passiata Day" Model. Sustainability, 12(7), 2684.

Cesanelli, L., Ylaitė, B., Messina, G., Zangla, D., Cataldi, S., Palma, A., & Iovane, A. (2021). The Impact of Fluid Loss and Carbohydrate Consumption during Exercise, on Young Cyclists' Fatigue Perception in Relation to Training Load Level. International Journal of Environmental Research and Public Health, 18(6), 3282.

Francavilla, V. C., Braschi, A., Cascio, A., Di Pietro, V., Bongiovanni, T., & Francavilla, G. (2016). A new prevention strategy for amateur athletes: spatial QT dispersion. Medicina dello Sport, 69(2), 249-53.

Francavilla, V. C., Genovesi, F., Asmundo, A., Di Nunno, N. R., Ambrosi, A., Tartaglia, N., ... & Ruberto, M. (2020). Fascia and movement: the primary link in the prevention of accidents in soccer. Revision and models of intervention. Med Sport 2020;73:291-301.

Francia, P., Gulisano, M., Anichini, R., & Seghieri, G. (2014). Diabetic Foot and Exercise Therapy: Step by Step The Role of Rigid Posture and Biomechanics Treatment. Current Diabetes Reviews, 10(2), 86-99.

Hazari, A., Maiya, A. G., Shivashankara, K. N., Agouris, I., Monteiro, A., Jadhav, R., Kumar, S., Shashi Kumar, C. G., & Mayya, S. S. (2016). Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: A systematic review and meta-analysis. SpringerPlus, 5(1), 1819.

Hopkins, W. G., Marshall, S. W., Batterham, A. M., & Hanin, J. (2009). Progressive statistics for studies in sports medicine and exercise science. Medicine and Science in Sports and Exercise, 41(1), 3-13.

Ivanenko, Y., & Gurfinkel, V. S. (2018). Human Postural Control. Frontiers in Neuroscience, 12.

Kharroubi, A. T., & Darwish, H. M. (2015). Diabetes mellitus: The epidemic of the century. World Journal of Diabetes, 6(6), 850-867.

Kwon, O.-Y., Minor, S. D., Maluf, K. S., & Mueller, M. J. (2003). Comparison of muscle activity during walking in subjects with and without diabetic neuropathy. Gait & Posture, 18(1), 105-113.

Mehdikhani, M., Khalaj, N., Chung, T. Y., & Mazlan, M. (2014). The effect of feet position on standing balance in patients with diabetes. Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine, 228(8), 819-823.

Molines-Barroso, R. J., Lázaro-Martínez, J. L., Aragón-Sánchez, F. J., Álvaro-Afonso, F. J., García-Morales, E., & García-Álvarez, Y. (2016). Forefoot ulcer risk is associated with foot type in patients with diabetes and neuropathy. Diabetes Research and Clinical Practice, 114, 93-98.

Patti, A., Bianco, A., Karsten, B., Montalto, M. A., Battaglia, G., Bellafiore, M., Cassata, D., Scoppa, F., Paoli, A., Iovane, A., Messina, G., & Palma, A. (2017). The effects of physical training without equipment on pain perception and balance in the elderly: A randomized controlled trial. Work (Reading, Mass.), 57(1), 23-30.

Patti, A., Bianco, A., Şahin, N., Sekulic, D., Paoli, A., Iovane, A., Messina, G., Gagey, P. M., & Palma, A. (2018). Postural control and balance in a cohort of healthy people living in Europe: An observational study. Medicine, 97(52), e13835.

Scoppa, F., Gallamini, M., Belloni, G., & Messina, G. (2017). Clinical stabilometry standardization: Feet position in the static stabilometric assessment of postural stability. Acta Med. Mediterr, 33, 707-713.

Wrobel, J. S., & Najafi, B. (2010). Diabetic foot biomechanics and gait dysfunction. Journal of Diabetes Science and Technology, 4(4), 833-845.


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How to Cite

Secolo, I., Catanzaro, F., Catanzaro, V., Rizzo, E., & Secolo, G. (2021). The proprioceptive insole: A therapeutic aid for the diabetic patient in prevention?. Journal of Human Sport and Exercise, 16(4proc), S1659-S1665.