Full project title:
Trial for effective plantar pressure reduction

Project coordination
The Leprosy Mission International (Bangladesh)

Partners
American Leprosy Missions (Nepal)

Aim: This study sought to quantify the differences or similarities between MCR commonly sourced in Bangladesh and footwear available in the Bangladesh market. 

Final project summary
Although Micro-cellular rubber (MCR) is not available in commercially produced footwear, other comfort-enhancing products have been developed and are readily available in many markets. As MCR has a long and successful history of reducing foot ulcers, it would be ill-advised to recommend replacement materials without evidence of their efficacy. 

This project compared the pressure applied on various parts of the sole of the foot while wearing different types of commercially available footwear with the pressure while wearing traditional MCR footwear. Footwear that was performing comparable to (or better than) MCR footwear was subsequently field-tested by leprosy affected persons who could not feel a 10mg monofilament and by leprosy affected persons with a history of plantar ulcers. Two commercially available models that had similar peak pressure and pressure time interval effect as MCR were identified for men and two models were identified for women. The cross over study was completed in January 2017 and the results indicate that the market footwear that was selected produced similar protection against ulcers. 

Impact

Presentation at International Leprosy Congress, Beijing, 20 September 2016. Comparison of in Shoe Plantar Pressure Using MCR and Market Footwear. Bowers, B., Hossain, D., Singh, S., & Cross, H.