Diabetic Study at the Istituto Superiore di Sanita
Based on my research and preliminary clinical cases, which suggest that proprioceptive stimulation will effectively reduce the risk of plantar ulcerations in the diabetic patients, a three-year diabetic study was planned at the Istituto Superiore di Sanita (Department of Biomedical Engineering) and submitted by Drs Rothbart, Giocomozzi and Macellari (Director, Rehabilitation Technologies, ISS) for funding to the National Institute of Health in October 2004. This project was personally commended and supported by the President of ISS, Dr Enrico Garaci, in a letter sent to the National Institute of Health.
I suggest that entrapment of the medial plantar artery and nerve is the result of abnormal foot twist (pronation) (See Animation directly below). This entrapment of the vascular network decreases the blood flow and innervation to the foot. This places the diabetic patient, who is already suffering form microangiopathy (decrease of the small blood vessels) at a higher risk to developing foot ulcerations.
Entrapment of the medial vascular network resulting from excessive foot twist
It interesting to note that most of the ulcers that develop in the diabetic patient lie in dermatones feed by the medial plantar artery (See Photo below).
Diabetic ulcers. Three of the four above diabetic ulcers are located in the area served by the medial plantar calcaneal artery
Prof/Dr Brian A Rothbart Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain