Diabetic peripheral neuropathy (DPN) is a prominent issue for the diabetes population and may lead to ulceration and lower-extremity amputation. Individuals with DPN have diminished plantar sensation and exhibit abnormal peak foot pressure while walking, however, a direct connection between plantar pressure and extent of plantar sensation loss has not been entirely explored. Further, research has shown that environmental factors such as stair gait and insoles affect dynamic balance of healthy aging individuals, therefore individuals with DPN may be even more risk. The objective of this dissertation was to examine the effects on balance, plantar pressure and foot sensitivity of individuals with DPN, while considering both intrinsic (health) and extrinsic (stairs and insole) factors.

The three studies that make up this dissertation provide another perspective of the contributions of various health characteristics have in relation to DPN, as well as provide insight into the role of stair gait and insoles on balance and plantar pressure.

Specifically, the first study investigated the severity of sensation loss and plantar pressure during stair gait, while taking into account relevant health factors. The study also attempted to better understand factors that may best predict pressure using a hierarchical multiple regression model. This model was utilized to observe the contribution of diabetes related factors, above and beyond factors of age, body mass, and walking characteristics. The second study compared balance and plantar pressure between individuals with diabetes and pronounced sensation loss and a healthy age-matched group. The third study provided much needed understanding to how insoles may offload pressure and affect dynamic balance of individuals with diabetes during star gait.

These studies provide insight into the role of health factors on plantar pressure and sensation, as well as provide a dataset of balance and pressure during the task of stair gait. The balance and pressure results suggest that individuals with diabetes may have exhibited a cautious walking pattern, compared to the control group. Further, commercial pressure offloading insoles worn by individuals with diabetes were no better in reducing foot pressure than normal insoles, during the specific task of stair gait.