Pressure-sensing devices for assessment of soft tissue loading under bony prominences: technological concepts and clinical utilization.

Pressure-related chronic wounds, such as diabetic neuropathic foot ulcers and pressure ulcers, are an important health concern that affect millions of patients and accumulate billions in annual costs. Pressure-related chronic wounds may occur when soft tissues are mechanically compressed between bony prominences and a supporting surface. Interface pressure measurements allow the determination of the spatial and temporal mechanical loads that are transferred to soft tissues. These measurements are a basic engineering tool for evaluating the susceptibility of an individual to suffer a pressure-related wound. The purpose of this review is to: 1) describe the current techniques for body-support interface pressure measurements, 2) list the pressure value ranges measured under the foot in standing and walking, and under the buttocks in sitting (with particular emphasis on abnormal alterations in foot pressures as a result of diabetic neuropathy and alterations in sitting pressures in paralyzed patients), and 3) discuss clinical utilization of interface pressure measurements in the fitting of diabetic footwear and wheelchair cushions.